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ObjectivesTo explore attitudes and intentions towards COVID-19 vaccination, and influences and sources of information about COVID-19 across diverse ethnic groups (EGs) in the UK. DesignRemote qualitative interviews and focus groups (FGs) conducted June-October 2020 before UK COVID-19 vaccine approval. Data were transcribed and analysed through inductive thematic analysis. SettingGeneral public in the community across England and Wales. Participants100 participants from 19 self-identified EGs with spoken English or Punjabi. ResultsMistrust and doubt were common themes across all EGs including white British and minority EGs, but more pronounced amongst Bangladeshi, Pakistani, Black ethnicities and Travellers. Many participants shared concerns about perceived lack of information about COVID-19 vaccine safety, efficacy and potential unknown adverse effects. Across EGs participants stated occupations with public contact, older adults and vulnerable groups should be prioritised for vaccination. Perceived risk, social influences, occupation, age, co-morbidities and engagement with healthcare influenced participants intentions to accept vaccination once available; all Jewish FG participants intended to accept, while all Traveller FG participants indicated they probably would not. Facilitators to COVID-19 vaccine uptake across all EGs included: desire to return to normality and protect health and wellbeing; perceived higher risk of infection; evidence of vaccine safety and efficacy; vaccine availability and accessibility. COVID-19 information sources were influenced by social factors, culture and religion and included: friends, family; media and news outlets; and research literature. Participants across most different EGs were concerned about misinformation or had negative attitudes towards the media. ConclusionsDuring vaccination programme roll-out, including boosters, commissioners and vaccine providers should provide accurate information, authentic community outreach, and use appropriate channels to disseminate information and counter misinformation. Adopting a context-specific approach to vaccine resources, interventions and policies and empowering communities has potential to increase trust in the programme. Article summary: strengths and limitationsO_LIThis is amongst the largest qualitative studies on attitudes to the COVID-19 pandemic in the UK general public across ethnic groups (EGs), ages and religions, adding insights from a broader range of participants. C_LIO_LIQualitative methodology enabled discussion of participants responses around COVID-19 vaccination, probing to collect rich data to inform recommendations across EGs. C_LIO_LIMost data collection was undertaken in English, possibly excluding sectors of the population who may access COVID-19 information through different sources due to language. C_LIO_LIData collection was June-October 2020 before COVID-19 vaccines were licensed. Attitudes are highly responsive to current information around a COVID-19 vaccine, as well as the state of the pandemic and perceived risk. Data were collected prior to much of the intervention work, putting the attitudes and intentions expressed in this study in a context of minimal community engagement and support. This provides a baseline snapshot of attitudes, providing the option to explore and assess the impact of such interventions. C_LIO_LISocioeconomic data and index of multiple deprivation were not collected, limiting the ability to determine a possible accumulative effect of factors such as socioeconomic status, ethnicity and age. C_LI
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ObjectivesTo explore public reactions to the COVID-19 pandemic across diverse ethnic groups. DesignRemote qualitative interviews and focus groups in English or Punjabi. Data were transcribed and analysed through inductive thematic analysis. SettingEngland and Wales June-October 2020. Participants100 participants from 19 diverse self-identified ethnic groups. ResultsDismay, frustration and altruism were reported across all ethnic groups during the first six to nine months of the COVID-19 pandemic. Dismay was caused by participants reported individual, family and community risks, and loss of support networks. Frustration was caused by reported lack of recognition of the efforts of minority ethnic groups (MEGs), inaction by government to address COVID-19 and inequalities, rule breaking by government advisors, changing government rules around: border controls, personal protective equipment, social distancing, eating out, and perceived poor communication around COVID-19 and the Public Health England (PHE) COVID-19 disparities report (leading to reported increased racism and social isolation). Altruism was felt by all, in the resilience of NHS staff and their communities and families pulling together. Data, participants suggested actions, and the Behaviour Change Wheel informed suggested interventions and policies to help control COVID-19. ConclusionTo maintain public trust, it is imperative that governmental bodies consider vulnerable groups, producing clear COVID-19 control guidance with contingency, fiscal, service provision and communication policies for the next rise in COVID-19 cases. This needs to be combined with public interventions including information, education, modelling and enablement of infection prevention through local community involvement and persuasion techniques or incentivisation. Government policy needs to review and include town and social planning leading to environmental restructuring that facilitates infection prevention control. This includes easy access to hand-washing facilities in homes, work, all food providers and shopping centres; toilet facilities as our Travellers mentioned, and adequate living accommodation and work environment facilitating IPC for all. Strengths and limitationsO_LIThis is amongst the largest qualitative studies on attitudes to the COVID-19 pandemic in the UK general public across ethnic groups, ages and religions, adding insights to previous smaller qualitative studies, from a broader range of participants. C_LIO_LIThe qualitative methodology allowed us to discuss participants responses around the COVID-19 pandemic, probing their answers to obtain detailed data to inform needs across ethnic groups. C_LIO_LIMost data collection was undertaken in English and therefore excludes non-English speaking sectors of the population who may have experienced the COVID-19 pandemic differently. C_LIO_LIWe did not obtain the views of older members of the population over 70 years, who were most at risk. C_LIO_LIThe data reflect public perceptions six to nine months into the pandemic when some of the social distancing rules had been relaxed in England; as the pandemic progresses attitudes and needs may well change. C_LI
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ObjectivesWe examined whether providing different types of information about Long COVID would affect expectations about the illness. DesignA 2 (Illness description: Long COVID vs ongoing COVID-19 recovery) x 2 (Illness uncertainty: uncertainty emphasised vs uncertainty not emphasised) x 2 (Efficacy of support: enhanced support vs basic support) between-subjects randomised online experimental study. SettingThe online platform Prolific, collected in October 2021. ParticipantsA representative sample of 1110 members of the public in the UK. InterventionsParticipants were presented with a scenario describing a positive COVID-19 test result and then presented with one of eight scenarios describing a Long COVID diagnosis. Primary and Secondary Outcome MeasuresVarious outcome measures relating to illness expectations were captured including: symptom severity, symptom duration, quality of life, personal control, treatment control and illness coherence. ResultsWe ran a series of 2 x 2 x 2 ANOVAs on the outcome variables. We found a main effect of illness description: individuals reported longer symptom duration and less illness coherence when the illness was described as Long COVID (compared to ongoing COVID-19 recovery). There was a main effect of illness uncertainty: when uncertainty was emphasised, participants reported longer expected symptom duration, less treatment control, and less illness coherence than when uncertainty was not emphasised. There was also a main effect of efficacy of support: participants reported higher personal control and higher treatment control when support was enhanced (compared to basic support). We also found an interaction between illness description and efficacy of support: when support was enhanced, participants reported less illness coherence for Long COVID (compared to ongoing COVID-19 recovery). ConclusionsCommunications around Long COVID should not emphasise symptom uncertainty and should provide people with information on how they can facilitate their recovery and where they can access additional support. The findings also suggest that use of the term ongoing COVID-19 recovery, where possible, may reduce negative expectations associated with the illness. Strengths and Limitations of this studyO_LIThis is one of the first experimental designed studies to assess the impact of different types of communication about Long COVID. C_LIO_LIParticipants were a UK representative sample, although these findings are not necessarily applicable to all population groups (i.e., ethnic minorities). C_LIO_LIThis study is one of the first applications of the IPQ-R in a hypothetical, online experiment, with high reliability. C_LIO_LIThis was an online experiment, with hypothetical scenarios and participants with no experience of COVID-19 or Long COVID, therefore outcomes may be different in a real-world context. C_LI
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ObjectivesIndividuals who receive a negative lateral flow coronavirus (Covid-19) test result may misunderstand it as meaning no risk of infectiousness, giving false reassurance. This experiment tested the impact of adding information to negative test result messages about (a) residual risk and (b) need to continue protective behaviours. Design4 (residual risk) x 2 (post-test result behaviours) between-subjects design. SettingOnline. Participants1200 adults from a representative UK sample recruited via Prolific (12-15 March 2021). InterventionsParticipants were randomly allocated to one of eight messages. Residual risk messages were: 1) Your coronavirus test result is negative (control); 2) Message 1 plus Its likely you were not infectious when the test was done (Current NHS Test & Trace); 3) Message 2 plus But there is still a chance you may be infectious (Elaborated NHS T&T); 4) Message 3 plus infographic depicting residual risk (Elaborated NHS T&T + infographic). Each message contained either no additional information or information about behaviour, i.e. the need to continue following guidelines and protective behaviours. Outcome measures(i) proportion understanding residual risk of infectiousness and (ii) likelihood of engaging in protective behaviours (score range 0-7). ResultsThe control message decreased understanding relative to the current NHS T&T message: 54% vs 71% (AOR=0.37 95% CI [0.22, 0.61], p<.001). Understanding increased with the elaborated NHS T&T (89%; AOR=3.27 95% CI [1.78, 6.02], p<.001) and elaborated NHS T&T + infographic (91%; AOR=4.03 95% CI [2.14, 7.58], p<.001) compared to current NHS T&T message. Likelihood of engaging in protective behaviours was unaffected by information (F(1,1192)=0.43, p=.513), being high (M=6.4, SD=0.9) across the sample. ConclusionsThe addition of a single sentence ( But there is still a chance you may be infectious) to current NHS Test & Trace wording increased understanding of the residual risk of infection. Trial registrationOpen Science Framework: https://osf.io/byfz3/