Lucy Yardley

Lucy Yardley
University of Bristol and University of Southampton · Psychology

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684
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Introduction

Publications

Publications (684)
Article
Background Antibiotic prescription is common for respiratory tract infections (RTIs) in primary care, despite evidence to suggest little clinical benefit as many RTIs are viral or self-limiting, with prescribing often attributed to clinical uncertainty regarding microbiological diagnosis. Rapid microbiological point-of-care tests (POCTRM) have the...
Article
Background Antibiotics are prescribed for over 50% of RTIs in primary care, despite good evidence most patients do not benefit. Rapid multiplex microbiological point-of-care-tests (POCTRM) determine the presence/ absence of respiratory pathogens in 15 min. Whether POCTRM reduce antibiotic prescribing without worsening patient outcomes is not known....
Article
Full-text available
Background The person-based approach (PBA) has emerged as a prominent methodology guiding the development of digital and hybrid health behaviour change interventions over the last decade, and there is a salient need to understand its utilization. Objective This study aims to describe which elements of the PBA have been utilised in intervention dev...
Preprint
The objective of this systematic review was to (1) identify existing digital interventions for adolescent depression and anxiety, (2) assess the promise of those interventions, and (3) identify characteristics of promising interventions. Six databases (PubMed, PsycINFO, Web of Science, EMBASE, MEDLINE, and Google Scholar) were used to conduct searc...
Article
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Background: Rapid microbiological point-of-care tests (POCTRM) present an opportunity to reduce antibiotic exposure and antimicrobial resistance. So far, there is limited understanding of how POCTRM may support clinicians in primary care in the UK and how POCTs might be integrated into practice. Aim: To investigate clinicians’ views on how POCTRM c...
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Background Blood pressure (BP) control following stroke is important but currently sub-optimal. This trial aimed to determine whether self-monitoring of hypertension with telemonitoring and a treatment escalation protocol, results in lower BP than usual care in people with previous stroke or transient ischaemic attack (TIA). Methods Unblinded rand...
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Background In the United Kingdom, psychology departments are responding to growing calls for curriculum decolonization. However, there remains limited dialogue and sharing of best practice. Objective We aimed to catalyze discussion among key faculty members involved in curriculum decolonization, learn from their experiences, and collaboratively de...
Article
Background Throughout the coronavirus pandemic, references to scientific findings have permeated public-facing communications. Understanding how members of the public view science, scientists and scientific uncertainty should enhance approaches to communication and individuals’ decisions to engage with public health measures, including restrictions...
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Objective Liver disease is a growing cause of premature death in the UK. The National Health Service in England (NHS England) has funded regional early detection programmes through Community Liver Health Check pilots. ‘Alright My Liver?’ is Bristol and Severn’s pilot service offering early detection of liver disease through screening events serving...
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Background Excessive use of antibiotics is a widespread problem. We aim to evaluate the efficacy of a multifaceted intervention for reducing antibiotic use in patients with respiratory tract infections (RTIs). Methods In this two-arm cluster randomized controlled trial, we enrolled patients aged 18+ with symptomatic RTIs at 40 township health cent...
Article
Background Poor sleep is a common problem in adolescents aged 14 to 18 years. Difficulties with sleep have been found to have a bidirectional link to mental health problems. Objective This new research sought to involve young people in the co-creation of a new app, particularly those from underserved communities. The Sleep Solved app uses science-...
Article
Objectives Self-medication with antibiotics is common practice in many low- and middle-income countries (LMIC). This review synthesizes the qualitative evidence on influences on perceptions and practices in relation to self-medication by the public with antibiotics in LMIC. Methods A systematic search was conducted of relevant medical, internation...
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Background In the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those identified as ‘at risk’ may help reduce malnutrition risk and associated healthcare use, and improve quality of life. The aim of this study is to explore how primary car...
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Full-text available
Background: Poor sleep is a common problem in adolescents age 14-18. Difficulties with sleep have been found to have a bidirectional link to mental health problems. Objective: This new research sought to involve young people in the co-creation of a new app, particularly those from under-served communities. The Sleep Solved app uses science-based...
Conference Paper
Background and Aims In 2022, NHS England funded the Bristol and Severn hepatitis C operational delivery network to deliver a community-based proactive screening pilot to identify chronic liver disease in high-risk groups. Liver health screening events were co-located with existing services that serve vulnerable and high risk groups, for instance at...
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Background Inclusion in public health research of young people from low-income households and those from minority ethnic groups remains low. It is recognised that there is a need to change the way in which research is conducted so that it becomes more inclusive. The aim of this work was to identify novel and innovative ways to maximise recruitment...
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Aims Eating disorders (ED) have significant physical and psychosocial impacts, and the highest mortality rates of any psychiatric illness. About a third of patients with Anorexia Nervosa or Bulimia Nervosa do not recover and develop persistent ED. Development of novel treatments is a priority to prevent adverse effects on young people's physical, r...
Preprint
BACKGROUND Physical activity (PA) in older adults can prevent, treat, or offset symptoms and deterioration from various health conditions and help maintain independence. However, most older adults are insufficiently active. Digital interventions have the potential for high reach at low cost. OBJECTIVE This paper reports on the implementation of ‘A...
Article
Full-text available
Background Antibiotics are prescribed for over 50% of respiratory tract infections in primary care, despite good evidence of there being no benefit to the patient, and evidence of over prescribing driving microbial resistance. The high treatment rates are attributed to uncertainty regarding microbiological cause and clinical prognosis. Point-of-car...
Preprint
Psychology departments are responding to the growing calls for curriculum decolonisation. Despite numerous initiatives, there remains limited dialogue and sharing of best practices among them. This co-production study aimed to catalyse discussion among key people involved in curriculum decolonisation, learn from their experiences of undertaking dec...
Article
Full-text available
Background Two online behavioural interventions (one website for parents/carers of children with eczema; and one for young people with eczema) have been shown in randomised controlled trials to facilitate a sustained improvement in eczema severity. Aim To describe intervention use and examine potential mediators of intervention outcomes and contex...
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Objective To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective. Methods Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder...
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Background Many cancer survivors following primary treatment have prolonged poor quality of life. Aim To determine the effectiveness of a bespoke digital intervention to support cancer survivors. Design and setting This was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224). Method People having finished primary...
Article
Full-text available
Background Germ Defence ( www.germdefence.org ) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19, the intervention needed to be implemented at scale rapidly. Methods With NHS England approval, we co...
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Background Vestibular rehabilitation is a safe and effective exercise-based treatment for patients with chronic vestibular symptoms. However, it is underused in general practice. Internet-based vestibular rehabilitation (Vertigo Training), which has proven to be effective as well, was developed to increase uptake. We now aim to improve the quality...
Article
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Background The 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to con...
Preprint
Full-text available
Backgrounds: New interventions need to fit with existing ways of working in primary care. The Person-Based Approach (PBA) is a way to tailor interventions to context and stakeholder engagement can be a more or lesser part of this approach. Using co-participatory stakeholder engagement, as part of the PBA, provides a novel way to involve clinicians...
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Introduction Machine-assisted topic analysis (MATA) uses artificial intelligence methods to help qualitative researchers analyze large datasets. This is useful for researchers to rapidly update healthcare interventions during changing healthcare contexts, such as a pandemic. We examined the potential to support healthcare interventions by comparing...
Article
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Background During the early “containment” phase of the COVID-19 response in England (January-March 2020), contact tracing was managed by Public Health England (PHE). Adherence to self-isolation during this phase and how people were making those decisions has not previously been determined. The aim of this study was to gain a better understanding of...
Article
Background There have been successful applications of AI to answering health-related questions, which suggests a potential role for AI in assisting with development of intervention text. This paper explores how ChatGPT might be used to support the rapid development of intervention text. Methods Three case studies are presented. In the first case st...
Article
Full-text available
Objectives To investigate rates of mpox beliefs, knowledge and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. Design Cross-sectional online surve...
Article
Full-text available
Background and Aims Heavy alcohol use and depression commonly co‐occur. However, health and social care services rarely provide coordinated support for these conditions. Using relational autonomy, which recognizes how social and economic contexts and relational support alter people's capacity for agency, this study aimed to (1) explore how people e...
Conference Paper
Background and Aims 75% of people with cirrhosis are diagnosed during an emergency admission to hospital, at which point mortality is 1 in 6. Cirrhosis prevalence is <1% in the general population, making a targeted approach to case finding desirable. In 2022, NHS England funded the Bristol and Severn hepatitis C operational delivery network to broa...
Article
Full-text available
Introduction Digital delivery of pre‐operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre‐ and post‐operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks. Objective To develop a pre‐operativ...
Article
Full-text available
Background Most adults in the UK experience at least one viral respiratory tract infection (RTI) per year. Individuals with comorbidities and those with recurrent RTIs are at higher risk of infections. This can lead to more severe illness, worse quality of life and more days off work. There is promising evidence that using common nasal sprays or im...
Article
Full-text available
Background Increasing healthy behaviours (e.g. physical activity) can improve cancer survivors’ quality of life. Renewed is a digital intervention developed to provide behaviour change advice with brief healthcare practitioner support. A three-arm randomised controlled trial (Renewed, Renewed with support or a control condition) suggested that pros...
Article
Full-text available
A lesson identified from the COVID-19 pandemic is that we need to extend existing best practice for intervention development. In particular, we need to integrate (a) state-of-the-art methods of rapidly coproducing public health interventions and messaging to support all population groups to protect themselves and their communities with (b) methods...
Preprint
Full-text available
Background: Germ Defence (www.germdefence.org) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19 the intervention needed to be implemented at scale rapidly. Methods: With the approval of NHS England,...
Preprint
Full-text available
Background: The 2022-23 Mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to co...
Article
Full-text available
Introduction: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection. Methods: We conducted an online questionnaire study recruiting memb...
Article
Full-text available
Introduction Ear pain is the most prominent symptom of childhood acute otitis media (AOM). To control the pain and reduce reliance on antibiotics, evidence of effectiveness for alternative interventions is urgently needed. This trial aims to investigate whether analgesic ear drops added to usual care provide superior ear pain relief over usual care...
Article
Full-text available
Objective We urgently need to develop and evaluate more psychological interventions to support people with Motor Neurone Disease (MND) and caregivers. We used the person-based approach to develop a digital mental health intervention and conducted two studies to explore people’s experiences of using it. Methods In Study 1, we conducted think-aloud...
Article
Full-text available
Background Antimicrobial resistance is a leading global public health threat, with inappropriate use of antimicrobials in healthcare contributing to its development. Given this urgent need, we developed a complex ePrescribing-based Anti-Microbial Stewardship intervention (ePAMS+). Methods ePAMS+ includes educational and organisational behavioural...
Preprint
Full-text available
Objectives: To investigate rates of mpox beliefs, knowledge, and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. Design: Cross-sectional online sur...
Article
Full-text available
Objective To determine the effectiveness of two online behavioural interventions, one for parents and carers and one for young people, to support eczema self-management. Design Two independent, pragmatic, parallel group, unmasked, randomised controlled trials. Setting 98 general practices in England. Participants Parents and carers of children (...
Article
Full-text available
Background There is a lack of well-conducted randomised controlled trials evaluating the effectiveness of theory-based online interventions for eczema. To address these deficiencies, we previously developed and demonstrated the effectiveness of two online behavioural interventions: Eczema Care Online for parents/carers of children with eczema, and...
Article
Full-text available
Background Digital interventions offer a potentially cost-effective means to support patient self-management in primary care, but evidence for the feasibility, acceptability and cost-effectiveness of digital interventions remains mixed. This programme focused on the potential for self-management digital interventions to improve outcomes in two comm...
Article
Full-text available
Background The national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of “shielding” on the health...
Article
(Abstracted from JAMA 2022;327:1656–1665 It is estimated that approximately 10% of pregnancies worldwide in 2019 were affected by elevated blood pressure (BP). The United Kingdom has previously reported inadequate monitoring of elevated BP as a significant contributing factor to maternal death.
Preprint
A lesson identified from the COVID-19 pandemic is that we need to extend existing best practice for intervention development by establishing better methods of rapidly coproducing public health interventions and messaging to support all population groups to protect themselves and their communities, together with better methods of rapidly evaluating...
Article
Full-text available
Background: In the UK, during the study period (April to July, 2021), all contacts of people with COVID-19 were required to self-isolate for 10 days, which had adverse impacts on individuals and society. Avoiding the need to self-isolate for those who remain uninfected would be beneficial. We investigated whether daily use of lateral flow devices...
Article
Full-text available
Background Strategies to reduce antibiotic overuse in hospitals depend on prescribers taking decisions to stop unnecessary antibiotic use. There is scarce evidence for how to support these decisions. We evaluated a multifaceted behaviour change intervention (ie, the antibiotic review kit) designed to reduce antibiotic use among adult acute general...
Article
Full-text available
Background: The e-coachER trial aimed to determine whether adding web-based behavioural support to exercise referral schemes (ERS) increased long-term device-measured physical activity (PA) for patients with chronic conditions, compared to ERS alone, within a randomised controlled trial. This study explores the mechanisms of action of the e-coachE...
Article
Full-text available
Introduction Multidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the “Active Brains” digital behavior change intervention and its trial procedures. Materials and methods Active Brains aims to reduce cognitive decline...
Article
Full-text available
Background The efforts to contain SARS-CoV-2 and reduce the impact of the COVID-19 pandemic have been supported by Test, Trace and Isolate (TTI) systems in many settings, including the United Kingdom. Mathematical models of transmission and TTI interventions, used to inform design and policy choices, make assumptions about the public’s behaviour in...
Article
Full-text available
Introduction. Evidence suggests that although people modify their behaviours, full adherence to self-isolation guidance in England may be suboptimal, which may have a detrimental impact on COVID-19 transmission rates. Hypothesis. Testing asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmissio...
Article
Introduction: evidence suggests that although people modify their behaviours, full adherence to self-isolation guidance in England may be suboptimal, which may have a detrimental impact on COVID-19 transmission rates. Hypothesis: testing asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmissi...
Article
Full-text available
Objectives: To describe a transparent approach to planning a digital intervention for adolescents to self-manage their asthma using breathing retraining (BRT), based on an existing, effective adult intervention (BREATHE). Methods: A theory-, evidence and Person-Based Approach was used to maximise the effectiveness and persuasiveness of the inter...
Article
Full-text available
Background In July 2021, a randomised controlled trial was conducted to compare the effect on SARS-CoV-2 transmission of seven days of Daily Contact Testing (DCT) using Lateral Flow Test (LFT) and two Polymerase Chain Reaction (PCR) tests as an alternative to 10 days of standard self-isolation with one PCR, following close contact with a SARS-CoV-2...
Article
Background: In the UK, during the study period all COVID-19 contacts were required to self-isolate for 10 days, which had adverse impacts. Avoiding the need to self-isolate for those who remain uninfected would be beneficial to society. We investigated whether using daily lateral flow devices (LFDs) to test for COVID-19 with removal of self-isolati...
Preprint
Background Strategies to reduce antibiotic overuse in hospitals depend on clinicians taking decisions to stop unnecessary antibiotics. There is a lack of evidence on how support clinicians do this effectively. We evaluated a multifaceted behaviour change intervention (ARK) which aims to reduce antibiotic consumption in hospitals by increasing decis...
Article
Full-text available
Objectives Nasal sprays could be a promising approach to preventing respiratory tract infections (RTIs). This study explored lay people’s perceptions and experiences of using nasal sprays to prevent RTIs to identify barriers and facilitators to their adoption and continued use. Design Qualitative research. Study 1 thematically analysed online cons...
Article
Full-text available
Background: machine-assisted topic analysis (MATA) uses artificial intelligence methods to assist qualitative researchers to analyse large amounts of textual data. This could allow qualitative researchers to inform and update public health interventions ‘in real-time’, to ensure they remain acceptable and effective during rapidly changing contexts...
Article
Full-text available
The rapid transmission of COVID-19 in school communities has been a major concern. To ensure that mitigation systems were in place and support was available, a digital intervention to encourage and facilitate infection-control behaviours was rapidly adapted and optimised for implementation as a whole-school intervention. Using the person-based appr...
Preprint
Full-text available
Background Machine-assisted topic analysis (MATA) uses artificial intelligence methods to assist qualitative researchers to analyse large amounts of textual data. This could allow qualitative researchers to inform and update public health interventions ‘in real-time’, to ensure they remain acceptable and effective during rapidly changing contexts (...
Article
Full-text available
Background: Psychological interventions for managing emotional distress in neurodegenerative diseases are needed, but progressive worsening of symptoms and increasing disability might pose difficulties with engagement. We aimed to synthesise the experiences of engaging with and using psychological interventions in neurodegenerative diseases and ide...
Preprint
Full-text available
Introduction: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection. Methods: We conducted an online questionnaire study recruiting members...
Article
Full-text available
Importance: Inadequate management of elevated blood pressure is a significant contributing factor to maternal deaths. The role of blood pressure self-monitoring in pregnancy in improving clinical outcomes for the pregnant individual and infant is unclear. Objective: To evaluate the effect of blood pressure self-monitoring, compared with usual ca...