Journal article 422 views 70 downloads
Rationale for the shielding policy for clinically vulnerable people in the UK during the COVID-19 pandemic: a qualitative study
,
Ashley Akbari ,
Andrew Carson-Stevens,
Jeremy Dale ,
Lucy Dixon,
Adrian Edwards ,
Bridie Evans,
Lesley Griffiths,
Ann John ,
Stephen Jolles,
Mark Kingston ,
Ronan Lyons ,
Jennifer Morgan,
Berni Sewell ,
Anthony Whiffen,
Victoria Williams,
Helen Snooks
BMJ Open, Volume: 13, Issue: 8, Start page: e073464
Swansea University Authors:
Alison Porter , Ashley Akbari , Bridie Evans, Ann John , Mark Kingston , Ronan Lyons , Berni Sewell , Victoria Williams, Helen Snooks
-
PDF | Version of Record
© Author(s) 2023. Distributed under the terms of a Creative Commons Attribution Non Commercial 4.0 License (CC BY-NC 4.0).
Download (750.01KB)
DOI (Published version): 10.1136/bmjopen-2023-073464
Abstract
Introduction: Shielding aimed to protect those predicted to be at highest risk from COVID-19 and was uniquely implemented in the UK during the first year of the pandemic from March 2020. As the first stage in the EVITE Immunity evaluation (Effects of shielding for vulnerable people during COVID-19 p...
| Published in: | BMJ Open |
|---|---|
| ISSN: | 2044-6055 2044-6055 |
| Published: |
BMJ
2023
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa64039 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract: |
Introduction: Shielding aimed to protect those predicted to be at highest risk from COVID-19 and was uniquely implemented in the UK during the first year of the pandemic from March 2020. As the first stage in the EVITE Immunity evaluation (Effects of shielding for vulnerable people during COVID-19 pandemic on health outcomes, costs and immunity, including those with cancer:quasi-experimental evaluation), we generated a logic model to describe the programme theory underlying the shielding intervention. Design and participants: We reviewed published documentation on shielding to develop an initial draft of the logic model. We then discussed this draft during interviews with 13 key stakeholders involved in putting shielding into effect in Wales and England. Interviews were recorded, transcribed and analysed thematically to inform a final draft of the logic model. Results: The shielding intervention was a complex one, introduced at pace by multiple agencies working together. We identified three core components: agreement on clinical criteria; development of the list of people appropriate for shielding; and communication of shielding advice. In addition, there was a support programme, available as required to shielding people, including food parcels, financial support and social support. The predicted mechanism of change was that people would isolate themselves and so avoid infection, with the primary intended outcome being reduction in mortality in the shielding group. Unintended impacts included negative impact on mental and physical health and well-being. Details of the intervention varied slightly across the home nations of the UK and were subject to minor revisions during the time the intervention was in place. Conclusions: Shielding was a largely untested strategy, aiming to mitigate risk by placing a responsibility on individuals to protect themselves. The model of its rationale, components and outcomes (intended and unintended) will inform evaluation of the impact of shielding and help us to understand its effect and limitations. |
|---|---|
| Keywords: |
COVID-19, pandemic, shielding policy, EVITE Immunity evaluation, UK |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work is supported by the National Core Studies Immunity Programme (NCSi4P). |
| Issue: |
8 |
| Start Page: |
e073464 |