Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study
Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic,...
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| Veröffentlicht in: | PloS one 2024-05, Vol.19 (5), p.e0299823 |
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| creator | Meyer, Carly Crayton, Elise Wright, Abigail Spyer, Moira Vora, Nina Houlihan, Catherine Walker, Naomi F Nastouli, Eleni Michie, Susan Lorencatto, Fabiana |
| description | Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing.
An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants).
Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing.
It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks. |
| doi_str_mv | 10.1371/journal.pone.0299823 |
| format | Article |
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An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants).
Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing.
It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0299823</identifier><identifier>PMID: 38722954</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Behavior ; Biology and Life Sciences ; Control ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; COVID-19 - psychology ; Cross-Sectional Studies ; Disease control ; Disease transmission ; Engineering and Technology ; England - epidemiology ; Epidemics ; Feasibility ; Female ; Health aspects ; Health care ; Health care reform ; Health Personnel - psychology ; Hospitals ; Humans ; Infection ; Infection Control - methods ; Infections ; Infectious diseases ; Male ; Medical personnel ; Medical supplies ; Medicine and Health Sciences ; Methods ; Middle Aged ; Mixed methods research ; Motivation ; Pandemics ; Pandemics - prevention & control ; Patients ; People and Places ; Personal Protective Equipment ; Physical Distancing ; Practice ; Protective equipment ; Public health ; Safety equipment ; SARS-CoV-2 ; Social distancing ; Social Sciences ; Surveys ; Surveys and Questionnaires ; United Kingdom ; Viral diseases ; Workers</subject><ispartof>PloS one, 2024-05, Vol.19 (5), p.e0299823</ispartof><rights>Copyright: © 2024 Meyer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Meyer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Meyer et al 2024 Meyer et al</rights><rights>2024 Meyer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-a23e2d94173be95d0c67db17a323c127ee553c8616b45259601031b96801619e3</cites><orcidid>0000-0002-2444-2407 ; 0000-0002-2268-3055 ; 0000-0002-9266-1302</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081271/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081271/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38722954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gesser-Edelsburg, Anat</contributor><creatorcontrib>Meyer, Carly</creatorcontrib><creatorcontrib>Crayton, Elise</creatorcontrib><creatorcontrib>Wright, Abigail</creatorcontrib><creatorcontrib>Spyer, Moira</creatorcontrib><creatorcontrib>Vora, Nina</creatorcontrib><creatorcontrib>Houlihan, Catherine</creatorcontrib><creatorcontrib>Walker, Naomi F</creatorcontrib><creatorcontrib>Nastouli, Eleni</creatorcontrib><creatorcontrib>Michie, Susan</creatorcontrib><creatorcontrib>Lorencatto, Fabiana</creatorcontrib><creatorcontrib>SAFER investigators</creatorcontrib><creatorcontrib>on behalf of the SAFER investigators</creatorcontrib><title>Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing.
An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants).
Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing.
It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.</description><subject>Adult</subject><subject>Behavior</subject><subject>Biology and Life Sciences</subject><subject>Control</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 - psychology</subject><subject>Cross-Sectional Studies</subject><subject>Disease control</subject><subject>Disease transmission</subject><subject>Engineering and Technology</subject><subject>England - epidemiology</subject><subject>Epidemics</subject><subject>Feasibility</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care reform</subject><subject>Health Personnel - psychology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infection</subject><subject>Infection Control - 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Fabiana</au><au>Gesser-Edelsburg, Anat</au><aucorp>SAFER investigators</aucorp><aucorp>on behalf of the SAFER investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-05-09</date><risdate>2024</risdate><volume>19</volume><issue>5</issue><spage>e0299823</spage><pages>e0299823-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing.
An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants).
Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing.
It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38722954</pmid><doi>10.1371/journal.pone.0299823</doi><tpages>e0299823</tpages><orcidid>https://orcid.org/0000-0002-2444-2407</orcidid><orcidid>https://orcid.org/0000-0002-2268-3055</orcidid><orcidid>https://orcid.org/0000-0002-9266-1302</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-05, Vol.19 (5), p.e0299823 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3069285430 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Behavior Biology and Life Sciences Control COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 - psychology Cross-Sectional Studies Disease control Disease transmission Engineering and Technology England - epidemiology Epidemics Feasibility Female Health aspects Health care Health care reform Health Personnel - psychology Hospitals Humans Infection Infection Control - methods Infections Infectious diseases Male Medical personnel Medical supplies Medicine and Health Sciences Methods Middle Aged Mixed methods research Motivation Pandemics Pandemics - prevention & control Patients People and Places Personal Protective Equipment Physical Distancing Practice Protective equipment Public health Safety equipment SARS-CoV-2 Social distancing Social Sciences Surveys Surveys and Questionnaires United Kingdom Viral diseases Workers |
| title | Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study |
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