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  1. Article ; Online: Predictors of uncertainty and unwillingness to receive the COVID-19 booster vaccine

    Elise Paul / Daisy Fancourt

    The Lancet Regional Health. Europe, Vol 14, Iss , Pp 100317- (2022)

    An observational study of 22,139 fully vaccinated adults in the UK

    2022  

    Abstract: Summary: Background: The continued success of the COVID-19 vaccination programme in the UK will depend on widespread uptake of booster vaccines. However, there is evidence of hesitancy and unwillingness to receive the booster vaccine, even in fully ... ...

    Abstract Summary: Background: The continued success of the COVID-19 vaccination programme in the UK will depend on widespread uptake of booster vaccines. However, there is evidence of hesitancy and unwillingness to receive the booster vaccine, even in fully vaccinated adults. Identifying factors associated with COVID-19 booster vaccine intentions specifically in this population is therefore critical. Methods: We used data from 22,139 fully vaccinated adults who took part in the UCL COVID-19 Social Study. Multinomial logistic regression examined predictors of uncertainty and unwillingness (versus willingness) to receive a COVID-19 booster vaccine (measured 22 November 2021 to 6 December 2021), including (i) socio-demographic factors, (ii) COVID-19 related factors (e.g., having been infected with COVID-19), and (iii) initial intent to receive a COVID-19 vaccine in the four months following the announcement in the UK that the vaccines had been approved (2 December 2020 to 31 March 2021). Findings: 4% of the sample reported that they were uncertain about receiving a COVID-19 booster vaccine, and a further 4% unwilling. Initial uncertainty and unwillingness to accept the first COVID-19 vaccine in 2020-21 were each associated with over five times the risk of being uncertain about and unwilling to accept a booster vaccine. Healthy adults (those without a pre-existing physical health condition) were also more likely to be uncertain or unwilling to receive a booster vaccine. In addition, low levels of current stress about catching or becoming seriously ill from COVID-19, consistently low compliance with COVID-19 government guidelines during periods of strict restrictions (e.g., lockdowns), lower levels of educational qualification, lower socio-economic position, and age below 45 years were all associated with uncertainty and unwillingness. Interpretation: Our findings highlight that there are a range of factors that predict booster intentions, with the strongest predictor being previous uncertainty and unwillingness. Two other ...
    Keywords COVID-19 ; Booster vaccine ; Vaccine refusal ; Vaccine hesitancy ; Public aspects of medicine ; RA1-1270
    Subject code 300
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England

    Feifei Bu / Andrew Steptoe / Daisy Fancourt

    PLoS Medicine, Vol 20, Iss 4, p e

    A panel data analysis over 2 years.

    2023  Volume 1004144

    Abstract: Background There has been much research into the mental health impact of the Coronavirus Disease 2019 (COVID-19) pandemic and how it is related to time-invariant individual characteristics. However, there is still a lack of research showing long-term ... ...

    Abstract Background There has been much research into the mental health impact of the Coronavirus Disease 2019 (COVID-19) pandemic and how it is related to time-invariant individual characteristics. However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying factors with mental health outcomes. This study aimed to provide a longitudinal profile of how mental health in adults changed across different stages of the COVID-19 pandemic and to examine their longitudinal associations with time-varying contextual (e.g., COVID-19 policy response and pandemic intensity) and individual level factors. Methods and findings This study used data from a large panel study of over 57,000 adults living in England, who were followed up regularly for 2 years between March 2020 and April 2022. Mental health outcomes were depressive and anxiety symptoms. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and anxiety symptoms by the Generalized Anxiety Disorder assessment (GAD-7). Entropy balancing weights were applied to restore sample representativeness. After weighting, approximately 50% of participants were female, 14% from ethnic minority backgrounds, with a mean age of 48 years. Descriptive analyses showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects (FE) models, which controlled for all time-invariant confounders (observed or not). FE models were fitted separately across 3 stages of the COVID-19 pandemic, including the first national lockdown (21/03/2020-23/08/2020), second and third national lockdowns (21/09/2020-11/04/2021), and "freedom" period (12/04/2021-14/11/2021). We found that more stringent policy response (measured by stringency index) was associated with increased depressive symptoms, in particular, during lockdown periods (β = 0.23, 95% ...
    Keywords Medicine ; R
    Subject code 150
    Language English
    Publishing date 2023-04-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Financial adversity and subsequent health and wellbeing during the COVID-19 pandemic in the UK

    Tom May / Henry Aughterson / Daisy Fancourt / Alexandra Burton

    SSM: Qualitative Research in Health, Vol 3, Iss , Pp 100224- (2023)

    A qualitative interview study

    2023  

    Abstract: Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how ... ...

    Abstract Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how financial adversity contributes to poor health outcomes in this context. This study aimed to explore forms of financial adversity experienced during the pandemic and their subsequent impacts for health and wellbeing. Methods: Qualitative semi-structured interviews with 20 people who experienced a form of financial adversity during the pandemic and six service providers employed in social welfare support services. Data were analysed using reflexive thematic analysis. Results: Two main sources of financial adversity were identified: reductions in household incomes and increased living costs which engendered emotional and physical burdens. Coping strategies included increased financial borrowing, support from informal and formal networks and cutting back on energy use, food and non-essential items. Conclusion: Our study highlighted exposure to multiple financial adversities because of the pandemic and how these experiences led to poor mental and physical health. The findings underline the importance of measures attending to the immediate needs of individuals, including accessible, co-located financial and psychological services, as well as broader measures that seek to reduce social and economic inequalities.
    Keywords Financial adversity ; Mental health ; Wellbeing ; COVID-19 ; Qualitative ; Social determinants ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

    Feifei Bu / Daisy Fancourt

    BMC Health Services Research, Vol 21, Iss 1, Pp 1-

    2021  Volume 7

    Abstract: Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of ... ...

    Abstract Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions This study has provided strong empirical evidence from England linking patient activation ...
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Perspective Commentary

    Sophie Wickham / Daisy Fancourt

    Frontiers in Public Health, Vol

    The Implementation of Welfare Policies Are Not Held to the Same Ethical Standards as Research: Raising Intergenerational Health Inequality Concerns

    2021  Volume 9

    Abstract: Over the last 12 years the United Kingdom (UK) has seen the introduction of an austerity programme—a fiscal policy—with the primary goal to reduce the government's budget deficit and the role of the welfare system. Between 2010 and 2015 there was an ... ...

    Abstract Over the last 12 years the United Kingdom (UK) has seen the introduction of an austerity programme—a fiscal policy—with the primary goal to reduce the government's budget deficit and the role of the welfare system. Between 2010 and 2015 there was an estimated reduction of £14.5 billion in spending, attributable to decreasing the value of benefits and restricting entitlement to benefit claimants. By 2020, there had been an estimated unprecedented £27 billion less spent on welfare compared with spending in 2010. Whilst fiscally-successful at reducing spending, some implemented welfare policies have had direct consequences for people's health, increasing inequalities which have been heavily criticized. Moreover, there is growing concern that this has an intergenerational effect. In this paper, we describe the ethical principles in human research, how these have been considered in public health policy, and the existing evidence of the direct and intergenerational health and welfare consequences of some recent, nationally-implemented welfare policies. We argue that ethical principles, specifically the ethical principle of safety that is applied in all research, should be applied to all public welfare policies to stop the rising inequalities in health we are seeing across generations. We highlight that initial changes implemented to welfare policies as a response to COVID-19 demonstrate that there can be a political and societal perceived value in going further to support individuals and their families during times of adversity, and consider the ethical implications of this.
    Keywords welfare policies ; ethics ; intergenerational ; health inequalities ; safety ; COVID-19 ; Public aspects of medicine ; RA1-1270
    Subject code 170
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Do socio-demographic factors predict children's engagement in arts and culture? Comparisons of in-school and out-of-school participation in the Taking Part Survey.

    Hei Wan Mak / Daisy Fancourt

    PLoS ONE, Vol 16, Iss 2, p e

    2021  Volume 0246936

    Abstract: There is evidence on the health, social and developmental benefits of arts and cultural participation for young people. While there is a known social gradient across adult arts participation where socially advantaged individuals are more likely to engage ...

    Abstract There is evidence on the health, social and developmental benefits of arts and cultural participation for young people. While there is a known social gradient across adult arts participation where socially advantaged individuals are more likely to engage in the arts, it remains unclear whether socio-economic factors also affect child participation either in school or out of school. This study analysed cross-sectional data from 1,986 children aged 11-15 in the Taking Part Survey interviewed from 2015-2018. It focused on three aspects of children's participation: (i) performing arts activities, (i) arts, crafts and design activities, and (iii) cultural and heritage engagement. Results show a social gradient across all three activities for out-of-school engagement, but not for in-school engagement. Arts and cultural activities provided by schools are therefore important to ensuring universal access to the arts amongst young people.
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: The Impact of the COVID-19 Pandemic and Associated Societal Restrictions on People Experiencing Homelessness (PEH)

    Jo Dawes / Tom May / Daisy Fancourt / Alexandra Burton

    International Journal of Environmental Research and Public Health, Vol 19, Iss 15526, p

    A Qualitative Interview Study with PEH and Service Providers in the UK

    2022  Volume 15526

    Abstract: People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. ...

    Abstract People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. This in-depth qualitative research aims to add to the existing, but limited research exploring how the pandemic affected PEH. 33 semi-structured qualitative interviews (22 with PEH during the pandemic and 11 with homelessness sector service providers) were undertaken in the United Kingdom between April 2021 and January 2022. Interviews were audio-recorded, transcribed and analysed using reflexive thematic analysis. To ensure consistency of coding, 10% of interviews were coded by two researchers. The PEH sample was 50% female, aged 24–59 years, 59% white British, and included people who had lived in hostels/hotels, with friends/family, and on the streets during the COVID-19 pandemic. Providers came from varied services, including support charities, housing, and addiction services. Five key themes were identified: (i) the understanding of and adherence to public health guidance and restrictions; (ii) the experience of people accommodated by the ‘Everyone In’ initiative; (iii) the impact of social distancing guidelines on PEH experiences in public spaces; (iv) the importance of social support and connections to others; and (v) how homelessness services adapted their provision. Policy makers and public health communicators must learn from PEH to maximize the effectiveness of future public health strategies. Housing providers and support services should recognize the implications of imposing a lack of choice on people who need accommodation during a public health emergency. The loss of usual support for PEH triggered a loss of ability to rely on usual ‘survival strategies’, which negatively influenced their health. This research highlights successes and difficulties in supporting PEH during the COVID-19 pandemic and informs planning for similar public health events.
    Keywords homelessness ; COVID-19 ; health ; housing ; support services ; coping ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Relationships between Volunteering, Neighbourhood Deprivation and Mental Wellbeing across Four British Birth Cohorts

    Hei Wan Mak / Rory Coulter / Daisy Fancourt

    International Journal of Environmental Research and Public Health, Vol 19, Iss 1531, p

    Evidence from 10 Years of the UK Household Longitudinal Study

    2022  Volume 1531

    Abstract: Volunteering is associated with greater mental, physical and social wellbeing. However, less is known about whether the health benefits of volunteering vary with two sets of factors known to shape population health and health-related behaviours: (1) age ... ...

    Abstract Volunteering is associated with greater mental, physical and social wellbeing. However, less is known about whether the health benefits of volunteering vary with two sets of factors known to shape population health and health-related behaviours: (1) age and birth cohort, and (2) place of residence. This study examined how these factors influence the relationship between volunteering and self-reported mental health using five waves of data from Understanding Society: The UK Household Longitudinal Study (UKHLS) enriched with information on neighbourhood deprivation (Index of Multiple Deprivation 2015). Two self-reported mental health and wellbeing outcomes were examined: mental distress (GHQ-12) and health-related quality of life (SF-12). The sample was stratified by cohort: pre-1945 (born before 1945), Baby Boomers (born 1945–1964), Gen X (born 1965–1979), and Millennials (born from 1980). Fixed-effects regressions revealed that volunteering was associated with reduced levels of mental distress and greater levels of health-related quality of life in older generations, but not amongst younger generations. No moderating effect of area deprivation was found. This study suggests that generational social attitudes and changes in how volunteering is portrayed and delivered could influence not only whether people volunteer, but also whether doing so bolsters health.
    Keywords volunteering ; deprivation ; cohorts ; panel data analysis ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Facilitators and barriers to compliance with COVID-19 guidelines

    Liam Wright / Elise Paul / Andrew Steptoe / Daisy Fancourt

    BMC Public Health, Vol 22, Iss 1, Pp 1-

    a structural topic modelling analysis of free-text data from 17,500 UK adults

    2022  Volume 22

    Abstract: Abstract Background During the COVID-19 pandemic, the UK government implemented a series of guidelines, rules, and restrictions to change citizens’ behaviour to tackle the spread of the virus, such as the promotion of face masks and the imposition of ... ...

    Abstract Abstract Background During the COVID-19 pandemic, the UK government implemented a series of guidelines, rules, and restrictions to change citizens’ behaviour to tackle the spread of the virus, such as the promotion of face masks and the imposition of lockdown stay-at-home orders. The success of such measures requires active co-operation on the part of citizens, but compliance was not complete. Detailed research is required on the factors that aided or hindered compliance with these measures. Methods To understand the facilitators and barriers to compliance with COVID-19 guidelines, we used structural topic modelling, a text mining technique, to extract themes from over 26,000 free-text survey responses from 17,500 UK adults, collected between 17 November and 23 December 2020. Results The main factors facilitating compliance were desires to reduce risk to oneself and one’s family and friends and to, a lesser extent, the general public. Also of importance were a desire to return to normality, the availability of activities and technological means to contact family and friends, and the ability to work from home. Identified barriers were difficulties maintaining social distancing in public (due to the actions of other people or environmental constraints), the need to provide or receive support from family and friends, social isolation, missing loved ones, and mental health impacts, perceiving the risks as low, social pressure to not comply, and difficulties understanding and keep abreast of changing rules. Several of the barriers and facilitators raised were related to participant characteristics. Notably, women were more likely to discuss needing to provide or receive mental health support from friends and family. Conclusion The results demonstrated an array of factors contributed to compliance with guidelines. Of particular policy importance, the results suggest that government communication that emphasizes the potential risks of the virus and provides simple, consistent guidance on how to reduce the spread of the ...
    Keywords COVID-19 ; Compliance ; Adherence ; Non-pharmaceutical interventions ; Free-text data ; Structural topic modelling ; Public aspects of medicine ; RA1-1270
    Subject code 320
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Correction to

    Liam Wright / Elise Paul / Andrew Steptoe / Daisy Fancourt

    BMC Public Health, Vol 22, Iss 1, Pp 1-

    Guidelines: a structural topic modelling analysis of free-text data from 17,500 UK adults

    2022  Volume 5

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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