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1.
BMJ ; 378: o1803, 2022 07 19.
Article in English | MEDLINE | ID: covidwho-1950097

Subject(s)
COVID-19 , Freedom , Humans , SARS-CoV-2
2.
Adv Ther ; 39(6): 3019-3030, 2022 06.
Article in English | MEDLINE | ID: covidwho-1859126

ABSTRACT

INTRODUCTION: Obesity significantly increases the risk of developing (or worsening) more than 200 chronic diseases, and it is also a risk factor for severe COVID-19. With the rising prevalence of obesity in the UK, there is a need to develop obesity care competencies that apply to healthcare professionals (HCPs) at all levels of the health service, to increase the capacity for contemporary, evidence-based treatment that is effective, compassionate, and avoids stigmatising patients. METHODS: A UK Obesity Care Competencies Working Group consisting of experts by profession and experts by experience was created to provide a framework of obesity care competencies for HCPs involved in specialist obesity care (tiers 2-4 in the UK). The framework was adapted from a set of competencies recently published by the USA-based Obesity Medicine Education Collaborative (OMEC) and was intended to be adaptable to nurses and allied health professionals, as well as physicians, owing to the multidisciplinary team approach used in healthcare in the UK. RESULTS: The UK Obesity Care Competencies Working Group developed a set of 29 competencies, divided into five focal areas, namely obesity knowledge, patient care and procedural skills, practice-based learning and improvement, professionalism and interpersonal communication skills, and systems-based practice. The working group recommends that the obesity care competencies are targeted at HCPs training as specialists. The competencies could be imported into existing training programmes to help standardise obesity-related medical education and could also be used to direct a new General Practitioner with Extended Role (GPwER) qualification. CONCLUSION: This list of obesity care competencies aims to provide an initial framework to improve education for HCPs and therefore to improve patient care in obesity. The acceptance and integration of these competencies into the healthcare system should provide a stepping stone toward addressing trends in health inequality.


Subject(s)
COVID-19 , Clinical Competence , Delivery of Health Care , Health Status Disparities , Humans , Obesity/therapy , United Kingdom
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335539

ABSTRACT

Background. The COVID-19 pandemic has shone further light on some of the challenges facing social care in Wales, as in many countries, and looks to have exacerbated a crisis that was already extant. This has led to the intensification of longer-standing arguments that social reform is necessary and that the pandemic presents an added impetus and opportunity for reform. Methods. An online survey was completed by 2569 respondents between February 11th and March 11th, 2022. Additionally, online focus groups were conducted with a sample of 14 participants. The inclusion criteria were adults aged 18 years and over living in Wales. Results. Four-in-ten of those who felt that they or someone in their household or close family needed social care during the past two years did not receive or make use of it. The pandemic was cited as a major reason why many of those who may have needed social care didn’t access it Satisfaction with social care was variable, with approximately one-third either very or quite dissatisfied, and a little over half either very or quite satisfied with social care services for themselves or a household or close family member. Discussion. Social care policymakers and providers should seek to understand and address what people feel are the main barriers to accessing or using social care, including increasing provision for those who need it, encouraging and enabling those who feel they need social care to apply, consider broadening the eligibility criteria where appropriate, and simplifying the application process.

4.
Obes Facts ; 15(3): 428-441, 2022.
Article in English | MEDLINE | ID: covidwho-1700303

ABSTRACT

INTRODUCTION: Overweight and obesity is a global problem incurring substantial health and economic implications. This has also been highlighted by the ongoing COVID-19 pandemic which has disproportionately affected overweight and obese individuals. Most of the interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. The purpose of this study was to explore the relationship between bodyweight and how individuals state they would trade-off immediate income for higher amounts in the future (time preference). METHODS: An online survey was conducted targeting adults aged >16 years in the UK (England, Northern Ireland, Scotland, and Wales) from January 1, 2016 to July 31, 2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height, and weight and to complete a time preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents' characteristics and time preference using Spearman rank-order correlation and χ2 tests as appropriate. We adopted STROBE guidelines for the reporting of the study. RESULTS: A total of 561 responses were analysed (female = 293, males = 268). The relationship between time preference and overweight/obesity, using BMI as the measure is highly significant (χ2 = 95.92: p < 0.001). Individuals of normal weight have low time preferences and are more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (χ2 = 37.03; p < 0.001), physical activities (p < 0.0001), income levels (χ2 = 6.68; p < 0.035), family orientation, i.e., with or without children (χ2 = 12.88; p < 0.012), and ethnicity (χ2 = 18.31; p < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time preferences compared to people from white backgrounds. DISCUSSIONS/CONCLUSIONS: People's preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population's uptake and maintenance of overweight and obesity prevention actions. People who have low time preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation. Public health programmes should therefore use the knowledge of the association between time preference and overweight/obesity to inform designs of intervention programmes.


Subject(s)
COVID-19 , Overweight , Adult , Body Mass Index , COVID-19/epidemiology , Child , Female , Humans , Male , Obesity/epidemiology , Overweight/epidemiology , Pandemics , Surveys and Questionnaires , United Kingdom/epidemiology
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307360

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) had an unparalleled impact and in particular for people with pre-existing health conditions who in some instances were left unsupported due to reduced provision of routine healthcare services. People living with obesity (PLWO) are identified as at higher risk of severe illness from COVID-19 infection. Currently, there is a paucity of evidence about the COVID-19 lockdown on PLWO, including those accessing weight management and bariatric surgery services.Methods: Using an online survey, 543 UK PLWO were recruited. People were invited through social media advertisements, UK charities, obesity advocacy groups, obesity organisations and weight management services.Findings: PLWO reported that health-related behaviours such as diet, physical activity and sleep were adversely impacted during the first COVID-19 lockdown. Depression, wellbeing and self-reported mental health played a significant role in predicting changes in health-related behaviours. Most PLWO attending weight management services reported reduced access with insufficient communication from their clinical service providers. Perceived stigma remained unchanged during the first COVID-19 lockdown, with the majority of people reporting not experiencing stigma as compared to before COVID-19.Interpretation: This study shows the detrimental impact of COVID-19 on PLWO in relation to health-related behaviours, mental health and access to healthcare services and support. Our findings highlight the need for greater mental health support for PLWO during future lockdowns.Funding: This research was funded through University College London and National Institute for Health Research (NIHR) Biomedical Research funding.Declaration of Interests: AB has received funding for investigator-initiated research through an educational grant and travel grants from Cambridge Weight Plan Ltd, received support to attend an obesity conference from Novo Nordisk and is on the scientific advisory board and share holder of Reset Health Clinics Ltd. RLB consultancy with Boehringer Ingelheim, GSK, Novo Nordisk, and Pfizer. MOK has received honorium and support to attend an obesity conference from Novo Nordisk. SW has received international flights, accommodation and subsistence from Novo Nordisk to attend obesity-related meetings. There are no other declarations of interest. Ethics Approval Statement: The study was granted ethical approval by the UCL Research Ethics Committee (REC number 16191/004).

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324008

ABSTRACT

Objectives This study explored public attitudes to COVID-19 ‘booster’ vaccines and influenza vaccines, including participants intentions to have them or not, and their preferences on how and when they should be administered. Study design. Qualitative study using online focus groups and interviews.Methods Group and individual online interviews were conducted with a diverse sample of 21 adults in the United Kingdom to explore their views on the issue of COVID-19 booster and influenza vaccination. Data were analysed using a framework approach.Results Three themes emerged to unpack participants views on COVID-19 booster and flu vaccinations: (1) Booster intentions correspond with decisions around initial vaccination (2) Mixed views on booster and flu vaccines (3) Mixed views on whether to get COVID-19 booster and flu vaccines together or separately. Those who had been more willing to accept their initial COVID-19 vaccine were more willing to accept a booster and a flu vaccine, whereas those who had been more hesitant about their initial COVID-19 vaccine were more hesitant about getting a booster and a flu vaccine – including the idea of getting them together.Conclusions Public health messaging related to COVID-19 boosters might emphasise that they can be seen as: an extension of their initial decision to get vaccination;a way to maintain population immunity over the longer term;a collective act (to protect others);a way to maintain freedoms or ‘normality’. Messaging around boosters and influenza vaccines needs to emphasise they are safe and convenient to be taken together and that both are important, especially for those clinically vulnerable

8.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-296318

ABSTRACT

Background COVID-19 vaccinations in children remains controversial. In the UK, as of August 2021, they have not been approved, except in a few limited circumstances. To date, little qualitative research exists to explain the reasons and nuances behind public attitudes on this issue. Methods Qualitative group and one-to-one online interviews were conducted with a diverse sample of 24 adults to explore their views on the issue of COVID-19 vaccination in children. Results COVID-19 vaccination in children was framed as a complex problem (a “minefield”). Six themes emerged to explain participants views: (1) Uncertainty over whether children can catch, transmit or be severely harmed by COVID-19;(2) Lower risk tolerance for unknown longer-term effects of the vaccine in children;(3) Association of the vaccine program with government’s handling of the pandemic ;(4) Local social norms as a driver of hesitancy;(5) Vaccinating children as a way to protect vulnerable adults;(6) Children’s vaccination as parental choice. Conclusions Public attitudes to COVID-19 vaccination in children are likely to be met with more hesitancy compared to adult vaccinations. Public health communications will need to combat this hesitancy if vaccine uptake for children is to be pursued as a public health policy.

10.
PLoS One ; 16(10): e0258781, 2021.
Article in English | MEDLINE | ID: covidwho-1496514

ABSTRACT

BACKGROUND: Novel viral pandemics present significant challenges to global public health. Non-pharmaceutical interventions (e.g. social distancing) are an important means through which to control the transmission of such viruses. One of the key factors determining the effectiveness of such measures is the level of public adherence to them. Research to date has focused on quantitative exploration of adherence and non-adherence, with a relative lack of qualitative exploration of the reasons for non-adherence. OBJECTIVE: To explore participants' perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence. METHODS: Qualitative study comprising 12 focus groups conducted via video-conferencing between 25th September and 13th November 2020. Participants were 51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities. Data were analysed using a thematic approach. RESULTS: Participants reported seeing an increase in non-adherence in others over the course of the pandemic. Reports of non-adherence in self were lower than reports of non-adherence in others. Analysis revealed six main themes related to participants' reported reasons for non-adherence in self and others: (1) 'Alert fatigue' (where people find it difficult to follow, or switch off from, information about frequently changing rules or advice) (2) Inconsistent rules (3) Lack of trust in government (4) Learned Helplessness (5) Resistance and rebelliousness (6)The impact of vaccines on risk perception. Participants perceived a number of systemic failures (e.g. unclear policy, untrustworthy policymakers) to strongly contribute to two forms non-adherence-violations and errors. CONCLUSION: Findings suggest that latent and systemic failures-in the form of policy decisions that are commonly experienced as too changeable, inconsistent and confusing, and policy makers that are commonly perceived as untrustworthy-may play a significant role in creating the conditions that enable or encourage non-adherence.


Subject(s)
COVID-19/psychology , Patient Compliance/psychology , Public Health/trends , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , Female , Focus Groups , Humans , Male , Middle Aged , Pandemics/prevention & control , Physical Distancing , Public Health/methods , Public Opinion , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , United Kingdom
12.
BMJ ; 373: n1373, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1251736
14.
EClinicalMedicine ; 34: 100796, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1141722

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has led to unprecedented changes in the way we live, particularly for people at higher risk of severe illness from COVID-19. People with pre-existing health conditions have been markedly impacted and, in some instances, left unsupported due to reduced provision of routine healthcare services. People living with obesity (PLWO) are identified as at higher risk of severe illness from COVID-19 infection. Currently, there is a paucity of evidence about the impact of the first COVID-19 lockdown on PLWO, including those accessing weight management and bariatric surgery services (WMS). METHODS: 543 adults (16-80 years) with obesity (BMI ≥ 30 kg/m2) were recruited between 14th May and 9th July 2020 through social media advertisements, professional and patient obesity organisations and WMS. Participants completed an online survey regarding the impact of the first COVID-19 lockdown upon, mental health, well-being, health-related behaviours, risk mitigating behaviours, access to WMS and weight stigma. FINDINGS: During the first COVID-19 lockdown, the majority of PLWO reported deterioration of their mental health and health-related behaviours such as diet, physical activity (PA) and sleep. With 55% reporting an unhealthier diet, 61% reduced PA and 80% worsening of their sleep. Higher depression and lower wellbeing scores were found to associate with the greatest adverse impact upon health-related behaviours. PLWO who were attending WMS prior to the first lockdown reported a greater deterioration of their diet, with nearly 50% reporting worsening of their diet and PA worsening compared to PLWO who were not attending WMS. Most participants took two or more risk mitigating actions (73%). PLWO attending WMS reported reduced access (44%) with insufficient information (49%) from their clinical service providers. The majority of participants reported no change in perceived weight stigma. INTERPRETATION: This study shows the detrimental impact of the first COVID-19 lockdown on PLWO in relation to health-related behaviours, mental health and access to WMS. Our findings show that PLWO with poor mental health and those attending WMS were most adversely impacted and highlights the need for greater mental health support and continued provision of support from WMS for PLWO during future lockdowns. FUNDING: This research was funded through National Institute for Health Research University College London Hospitals Biomedical Research Centre funding.

15.
Health Expect ; 24(2): 377-385, 2021 04.
Article in English | MEDLINE | ID: covidwho-1024191

ABSTRACT

BACKGROUND: During the 2020 COVID-19 pandemic, one of the key components of many countries' strategies to reduce the spread of the virus is contact tracing. OBJECTIVE: To explore public attitudes to a COVID-19 contact tracing app in the United Kingdom. SETTING: Online video-conferencing. PARTICIPANTS: 27 participants, UK residents aged 18 years and older. METHODS: Qualitative study consisting of six focus groups carried out between 1st-12th May, 2020 (39-50 days into the UK 'lockdown'). RESULTS: Participants were divided as to whether or not they felt they would use the app. Analysis revealed five themes: (1) lack of information and misconceptions surrounding COVID-19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4)concerns over uptake; and (5) contact tracing as the 'greater good'. Concerns over privacy, uptake and stigma were particularly significant amongst those stated they will not be using the app, and the view that the app is for the 'greater good' was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID-19 cases amongst their contacts and in their vicinity. CONCLUSIONS: Our participants were torn over whether digital contact tracing is a good idea or not, and views were heavily influenced by moral reasoning. PATIENT OR PUBLIC CONTRIBUTION: No patients were involved in this study. The public were not involved in the development of the research questions, research design or outcome measures. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Summary results were disseminated via email to participants prior to publication for feedback and comment.


Subject(s)
COVID-19/prevention & control , Contact Tracing , Mobile Applications , Pandemics/prevention & control , Smartphone , Adolescent , Adult , Attitude , COVID-19/epidemiology , COVID-19/psychology , Communicable Disease Control , Female , Focus Groups , Humans , Male , Middle Aged , Privacy , Qualitative Research , SARS-CoV-2 , Surveys and Questionnaires , United Kingdom , Videoconferencing
16.
BMJ Open ; 10(7): e039334, 2020 07 20.
Article in English | MEDLINE | ID: covidwho-665965

ABSTRACT

OBJECTIVE: This study explored UK public perceptions and experiences of social distancing and social isolation related to the COVID-19 pandemic. DESIGN: This qualitative study comprised five focus groups, carried out online during the early stages of the UK's stay at home order ('lockdown'), and analysed using a thematic approach. SETTING: Focus groups took place via online videoconferencing. PARTICIPANTS: Participants (n=27) were all UK residents aged 18 years and older, representing a range of gender, ethnic, age and occupational backgrounds. RESULTS: Qualitative analysis revealed four main themes: (1) loss-participants' loss of (in-person) social interaction, loss of income and loss of structure and routine led to psychological and emotional 'losses' such as loss of motivation, loss of meaning and loss of self-worth; (2) criticisms of government communication-participants reported a lack of trust in government and a lack of clarity in the guidelines around social distancing and isolation; (3) adherence-participants reported high self-adherence to social distancing guidelines but reported seeing or hearing of non-adherence in others; (4) uncertainty around social reintegration and the future-some participants felt they would have lingering concerns over social contact while others were eager to return to high levels of social activity.Most participants, and particularly those in low-paid or precarious employment, reported feeling that the social distancing and isolation associated with COVID-19 policy has had negative impacts on their mental health and well-being during the early stages of the UK's 'lockdown'. CONCLUSIONS: A rapid response is necessary in terms of public health programming to mitigate the mental health impacts of COVID-19 social distancing and isolation. Social distancing and isolation 'exit strategies' must account for the fact that, although some individuals will voluntarily or habitually continue to socially distance, others will seek high levels of social engagement as soon as possible.


Subject(s)
Attitude , Communicable Disease Control , Coronavirus Infections , Government , Pandemics , Pneumonia, Viral , Public Policy , Social Isolation , Adolescent , Adult , Betacoronavirus , COVID-19 , Communication , Employment , Female , Focus Groups , Humans , Income , Interpersonal Relations , Male , Middle Aged , Motivation , Qualitative Research , SARS-CoV-2 , Trust , United Kingdom , Videoconferencing , Young Adult
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