Dale Weston’s research while affiliated with Symetrica Security (United Kingdom) and other places

As many individuals with Long Covid are left without formal support, they have turned to online support groups for help. Previous research has shown that online support groups may improve group members’ wellbeing, but there is limited evidence on the role of group moderators in influencing such outcomes. Applying the social identity approach to leadership, this pre-registered study explored the applicability of the four dimensions of identity leadership in online support groups for Long Covid. Interviews were conducted with 10 members and seven moderators, to explore whether moderators displayed dimensions of identity leadership and whether this related to the health and wellbeing of both group members and moderators. Participants explained how the moderators of their groups had, or had recovered from, Long Covid (prototypicality), developed and maintained the ethos of the group (entrepreneurship), hosted activities for group members (impresarioship), and carried out advocacy work for the broader Long Covid community by engaging with policymakers, the media, and healthcare professionals (advancement). Group members reported improvements in symptom management, adjustment, and social wellbeing by engaging with online support groups, but members mostly attributed this to the support from other group members. Moderators reported finding purpose through moderating the groups, but sometimes this was to the detriment of their physical health. When considering the leadership role of moderators, group members reflected on the importance of characteristics associated with identity entrepreneurship, whereas group moderators were more likely to consider identity advancement activities. Seven recommendations are provided, to enhance the experiences of online support groups for both group moderators and members.

Online support groups provide support to people with Long Covid in the absence of formal treatment, but their effects on health outcomes are unclear. In this longitudinal study, we examined the role of shared social identity with an online support group, external psychological resources (support and connection), internal psychological resources (meaning and control), and negative posting norms on the mental and physical health outcomes of individuals with Long Covid. Participants completed an online survey at three timepoints: June-July 2024 (n = 102), August–October 2024 (n = 95), and October–December 2024 (n = 95). Results showed that shared social identity consistently predicted external resources, but external resources did not predict health outcomes. Shared social identity did not predict internal resources, but internal resources predicted greater physical functioning, and lower depression and anxiety; but this effect was diminished when controlling for previous health outcomes. Interestingly, negative posting norms moderated the relationship in the longitudinal analyses, whereby at lower levels of negative norms external resources predicted greater internal resources. Overall, whilst online support groups may offer support and connection, there may be limitations to the benefits afforded by such groups for improving mental and physical health for people with Long Covid.

Here we report the results of two nationwide randomized controlled trials. By refining behavioural-science-informed text messages notifying patients of their vaccine eligibility, we observed improvements in vaccination rates. The randomized controlled trials involved adults aged 40–44 years (n = 1,825,937) and 24–29 years (n = 2,174,064) in England. Messages emphasizing ‘Top of queue’ status led to small, but policy-relevant, increases in vaccination rates in both the 40–44 age group (odds ratio 1.02, 95% confidence interval 1.01–1.03) and the 24–29 age group (odds ratio 1.02, 95% confidence interval 1.01–1.04). Consequently, the ‘Top of queue’ message was nationally rolled out to other age groups. These findings demonstrate the potential of ‘queue’ framing in relevant contexts and the value of rigorous testing of public health messaging.

This pre-registered systematic review aimed to examine whether online support groups affect the health and wellbeing of individuals with a chronic condition, and what mechanisms may influence such effects. In September 2024, literature searches were conducted across electronic databases (Medline, Embase, PsycInfo, Web of Science and Google Scholar), pre-publication websites (MedRxiv and PsyArXiv) and grey literature websites. Qualitative and quantitative studies were included if they explored the impact of online support groups on the health and wellbeing outcomes of individuals with a chronic condition. The Mixed Methods Appraisal Tool was used to appraise the quality of the included studies. In total 100 papers met the inclusion criteria with their findings presented in a thematic synthesis. Health and wellbeing outcomes were categorised as: physical health, mental health, quality of life, social wellbeing, behaviour and decision-making, and adjustment. Mechanisms reported in these studies related to exchanging support, sharing experiences, content expression, and social comparison. User and group characteristics were also explored. The included studies suggest that online support groups can have a positive impact on social wellbeing, behaviour, and adjustment, with inconclusive findings for physical health and quality of life. However, there is also the possibility of a negative effect on anxiety and distress, particularly when exposed to other group members’ difficult experiences. Research comparing different online group features, such as platforms, size, and duration is needed. In particular, future research should be experimental to overcome the limitations of some of the cross-sectional designs of the included studies. The review was funded by the National Institute for Health and Care Research Health Protection Research in Emergency Preparedness and Response. Pre-registration ID: CRD42023399258

Background Whilst healthcare workers (HCWs) are at high risk of contracting infectious viral diseases, such as COVID-19, measures can be put in place to reduce the spread of diseases in healthcare settings. These currently include the use of different types of masks: fluid-resistant surgical masks (FRSM) and filtering facepiece (FFP3) respirators. However, for mask policies to be effective, compliance with their use must be high. Aim To understand any barriers to face mask use, and to promote compliance with face mask policy. Methods Twelve HCWs from a variety of backgrounds were interviewed during the COVID-19 pandemic in England in 2022 to understand their experiences of mask use. We explored factors associated with compliance with mask use and potential impacts on HCW wellbeing. Findings Overall, participants reported good understanding of the benefits of masks and high compliance levels with policy. However, factors that reduced their compliance with mask policy and impacted their ability to carry out their role were highlighted. These included wearing masks for longer durations, policy being perceived as out of proportion with risk, communication challenges, and discomfort. Conclusion This study highlights the importance of clear communication of guidance, particularly when it has changed, ensuring staff are familiar with up-to-date research on efficacy of masks, and ensuring guidance aligns with risk. Furthermore, this study highlights the importance of masks being required for an appropriate duration (based on risk).

Background SIREN is a healthcare worker cohort study aiming to determine COVID-19 incidence, duration of immunity and vaccine effectiveness across 135 NHS organisations in four UK nations. Conducting an intensive prospective cohort study during a pandemic was challenging. We designed an evolving retention programme, informed by emerging evidence on best practice. This included applying a multifactorial approach, and considering strategies for barrier reduction, community building, follow-up, and tracing. We utilised participant engagement tools underpinned by our Participant Involvement Panel (PIP) and here we evaluate cohort retention over time and identify learnings. Methods A mixed method evaluation of cohort retention in 12 and 24-month follow-up (June 2020 – March 2023). We described cohort retention by demographics and site, using odds ratios from logistic regression. Withdrawal reasons during this time were collected by survey. We collected participant feedback via cross-sectional online survey conducted October – November 2022, utilising a behavioural science approach. We conducted two focus groups with research teams in February 2023 and conducted thematic analysis exploring cohort retention challenges and facilitators. Results 37,275 (84.7%) participants completed 12-months of follow-up. Of 14,772 participants extending their follow-up to 24 months, 12,635 (85.5%) completed this. Retention increased with age in the 12 (55–64 years vs < 25 years OR = 2.50; 95% CI: 2.19–2.85; p < 0.001) and 24-month (> 65 years vs < 25 years OR = 2.92; 95% CI: 1.78–4.88; p < 0.001) cohorts. Retention was highest in the Asian and Black ethnic groups compared to White in the 12 (OR = 1.38; 95% CI: 1.23–1.56; p < 0.001, and OR = 1.64; 95% CI: 1.30–2.08; p < 0.001) and 24-month (OR = 1.78; 95% CI: 1.42–2.25; p < 0.001, and OR = 2.12; 95% CI: 1.41–3.35; p < 0.001) cohort. Among participants withdrawing, the median time in follow-up at withdrawal was 7 months (IQR: 4–10 months) within the 12-month cohort and 19 months within the 24-month cohort (IQR: 16–22 months). The top three reasons for participant withdrawal were workload, leaving site employment and medical reasons. Themes identified from focus-groups included: the need to monitor and understand participant motivation over time, the necessity of inclusive and comprehensive communication, the importance of acknowledging participant contributions, building collaboration with local research teams, and investing in the research team skillset. Conclusion Participant retention in the SIREN study remained high over 24-months of intensive follow-up, demonstrating that large cohort studies are feasible as a pandemic research tool. Our evaluation suggests it is possible to maintain an engaged cohort of healthcare workers (HCWs) during an acute pandemic response phase. The insights gained from this population group are important, as a highly exposed group fulfilling an essential pandemic response and patient care function. The success of the cohort study overall, as well as the specific population group retained, offer useful insight for pandemic preparedness planning and healthcare worker studies.

Introduction The experiences of UK Government response-focused employees, who were considered frontline workers during the coronavirus response, are missing from current literature. Meeting the demands of being on the frontline, whilst also adjusting from a normal and practiced way of working to having to work from within one’s home, may bring a plethora of new barriers and facilitators associated with providing an effective pandemic response. Method This interview study collected and analysed data from 30 UK Civil servants who worked on the COVID-19 pandemic response from their own homes. Interviews aimed to: (1) explore UK Government employee’s experiences of working from home whilst contributing to the pandemic response; and, (2) establish what support and guidance employees were offered, and what they would recommend for future public health emergencies requiring homeworking. Results Seven themes were extracted from the data: overall experience of working from home; preparedness for working from home; experience of contributing to the response effort; work life balance; relationships with colleagues; space and equipment; and, inclusivity. Findings suggested that during the pandemic, participants reported feeling a strong sense of purpose and achievement for contributing to the response. But, the work was demanding, particularly for those who had to rapidly, and unexpectedly, transition from office or lab work to home working. More generally, the nature of their homeworking experience depended on a range of practical (e.g., space in the home), organisational (e.g., relationships with managers) and personal factors (e.g., caring responsibilities). Many participants were underprepared to work from home, but participants provided a plethora of information relating to what support offers they would find useful during future work on the frontline from their own homes. Conclusion The results of this study demonstrate that frontline UK Civil servants may need more tailored and flexible multilevel support (i.e., from peers, managers, organisations) during future public health emergencies when they are required to work from home. A series of data-informed recommendations are created and discussed.

Objective This study investigates perceptions of homeworking in UK Government response-focused employees that contributed to the COVID-19 pandemic response. Method A cross-sectional online survey with open-ended questions was conducted. Free-text responses detailing participants perceptions of barriers, facilitators, advantages, and disadvantages were analysed using content analysis. Results A total of 1,943 free-text responses (from 150 participants) were analysed. There were many conflicting advantages and disadvantages provided by participants, but crudely more positive statements were provided than negative. Flexibility associated with working from home was the most common positive factor, and the isolation and impact on working relationships was the most reported negative factor of working from home. Conclusion We suggest a ‘one size fits all’ approach to supporting staff working from home is not fit for purpose due to individual circumstances and contextual factors.

As many individuals with Long Covid are left without formal support, they have turned to online support groups for help. In a pre‐registered study, interviews were carried out with 21 adults with Long Covid to explore experiences of using online support groups, to understand whether participants felt these experiences influenced their health and wellbeing, and to identify whether group members developed a shared social identity. The reported benefits varied by the nature and size of the online support group: participants reported that smaller groups enabled a sense of community; occupation groups provided work‐specific support; and larger groups helped with symptom management. Interviewees reported that support groups validated members' experiences, made them feel less alone, and enhanced self‐efficacy by providing and offering support and enabling participants to learn new skills. However, negative outcomes were also reported, such as increased fear and reduced wellbeing. Shared identities developed based on mutual Long Covid experiences, shared values towards illness management, and pre‐existing identities. Reported experiences also varied between online support group size (large vs small); type (e.g., advocacy‐focused, yoga‐based, local or international); and platform (video‐ vs text‐based) and throughout the illness. Whilst this study recognises the necessity of medical treatment for Long Covid, we also recommended that individuals with Long Covid explore different support groups to find the most suitable group for them in terms of preferred group features, values towards illness management and enablement of social identities.