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‘Communication, that is the key’: a qualitative investigation of how essential workers with COVID-19 responded to public health information

2022-07-07, Roe, Mark, Buggy, Conor J., Ingram, Carolyn, Codd, Mary, Buckley, Claire, Archibald, Mary, Rachwal, Natalia, Downey, Vicky, Chen, Yanbing, Sripaiboonkij, Penpatra, Drummond, Anne, Alvarez, Elizabeth, Perrotta, Carla

Objectives: To understand how essential workers with confirmed infections responded to information on COVID-19. Design: Qualitative analysis of semistructured interviews conducted in collaboration with the national contact tracing management programme in Ireland. Setting: Semistructured interviews conducted via telephone and Zoom Meetings. Participants: 18 people in Ireland with laboratory confirmed SARS-CoV-2 infections using real-time PCR testing of oropharyngeal and nasopharyngeal swabs. All individuals were identified as part of workplace outbreaks defined as ≥2 individuals with epidemiologically linked infections. Results: A total of four high-order themes were identified: (1) accessing essential information early, (2) responses to emerging ‘infodemic’, (3) barriers to ongoing engagement and (4) communication strategies. Thirteen lower order or subthemes were identified and agreed on by the researchers. Conclusions: Our findings provide insights into how people infected with COVID-19 sought and processed related health information throughout the pandemic. We describe strategies used to navigate excessive and incomplete information and how perceptions of information providers evolve overtime. These results can inform future communication strategies on COVID-19.

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COVID-19 and its impact on Irish workplaces – OSH professionals experience and observations of preparation and adaptation

2022-01, Buggy, Conor J., Chen, Yanbing, Roe, Mark, Sripaiboonkij, Penpatra, Drummond, Anne, Perrotta, Carla

Introduction: An investigation of Irish workplace adaptation to COVID-19 was conducted to assess impact to workers, their organisations and to develop new OSH adaptation mechanisms for future health emergencies. Materials and Methods: As part of the study, OSH professionals (n=60), each representing their workplace, took part in a series of semi-structured online focus groups. Each focus group incorporated twenty quantitative questions (covering four themes: organisational preparedness; organisational impacts; worker impacts; and the future of OSH) that were answered anonymously via a poll function. Results: 59 participants completed the questions. 58% of workplaces began pandemic preparations prior to COVID-19 emerging in Ireland. 66% of workplaces remained open while 27% were partially closed. 34% of workplaces had more than half their workforce working from home (5% pre-pandemic). 37% of workplaces had a working from home policy with 54% of workplaces having risk assessments for infectious diseases in place prior to the pandemic. 41% of workplaces had identified a viral pandemic scenario as part of its emergency planning prior to COVID-19. OSH professionals indicated that the majority (63%) of their colleagues understood the control measures instigated as a response to COVID-19 with a greater majority (90%) more willing to accept future workplace changes if they know it is to keep them safe and healthy. Conclusion: Irish workplaces adapted well to the changing OSH landscape that emerged in response to COVID-19. Irish workplaces are now more likely to be able to adapt and respond well to future public health emergencies.

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Teaching design thinking as a tool to address complex public health challenges in public health students: a case study

2022-04-12, Ingram, Carolyn, Langhans, Tessa, Perrotta, Carla

Background: Developing a public health workforce that can understand problems from a population perspective is essential in the design of impactful user-centred responses to current population health challenges. Design Thinking, a user-driven process for problem-defining and solution-finding, not only has utility in the field of public health but stands as a potential mechanism for developing critical skills -such as empathy, creativity and innovation- amongst future professionals. Though the literature reflects the use of DT across many health sciences disciplines, less research has been published on how students apply learned concepts using real-world challenges of their choice and what difficulties they face during the process. Methods: This case study evaluates achieved learning outcomes after the introduction of a design thinking block into post-graduate public health curriculum at the University College Dublin. Two independent assessors evaluated student learning outcomes and observed difficulties during the process by assessing group presentations to identify and understand any learning difficulties using an ad-hoc designed tool. The tool consisted of twelve items scored using a 5-point Likert scale. Student feedback, in the form of an online survey, was also analysed to determine their level of enjoyment, perceived learning outcomes and opinions on the course content. Results: The assessors evaluated thirteen DT group presentations and reports from 50 students. The groups chose a range of topics from socialization of college students during Covid-19 to mental health challenges in a low-income country. Independent assessment of assignments revealed that the highest scores were reached by groups who explored a challenge relevant to their own lives (more than 80% of total possible points versus 60% class average). The groups that explored challenges more distant to themselves struggled with problem finding with a mean score of 2.05 (SD ± 1.2) out of 5 in that domain. The greatest difficulties were observed in problem finding and ideation. Though most students found the design thinking block enjoyable and relevant to their education, they recommended that the DT block be a stand-alone module. Students recognized that groups who chose a familiar topic experienced fewer difficulties throughout the process. Conclusion: The study showed that DT learning outcomes were best achieved when students focused on challenges, they had either personally experienced or were familiar with. These findings provide insight for future iterations of DT workshops and support the teaching of user-centred approaches to future public health practitioners.

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COVID-19 workplace impacts - Irish OSH professionals experience and observations

2021-10-20, Buggy, Conor J., Chen, Yanbing, Roe, Mark, Ingram, Carolyn, Büttner, Fionn Cléirigh, Perrotta, Carla

COVID-19 has had a significant impact on workers, arising from adaptations to control measures and consequent behaviour changes that minimise disease spread in the workplace. From an occupational safety & health (OSH) perspective, understanding how adaptations and behaviour changes have impacted workers is relevant to how organisations can preserve the health of their workers when adapting to future health emergencies.

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Employee Mental Health During COVID-19 Adaptation: Observations of Occupational Safety and Health/Human Resource Professionals in Ireland

2022-08-09, Chen, Yanbing, Ingram, Carolyn, Downey, Vicky, Roe, Mark, Drummond, Anne, Sripaiboonkij, Penpatra, Buckley, Claire, Alvarez, Elizabeth, Perrotta, Carla, Buggy, Conor J.

Objectives: This study aims to understand mental health issues among Irish employees arising from COVID-19 adaptation from the perspective of Occupational Safety and Health (OSH) and/or Human Resource (HR) professionals. Methods: Fifteen focus groups including 60 OSH/HR professionals from various sectors were conducted covering four predetermined themes. The data were transcribed verbatim, with transcripts entered into Nvivo for thematic analysis incorporating intercoder reliability testing. Results: The mental health impacts among employees are identified from three stages: pre-adaptation, during adaptation, and post-adaptation. Most issues were reported during the second stage when working conditions dramatically changed to follow emerging COVID-19 policies. The identified mental health support from participating organizations included providing timely and reliable information, Employee Assistance Programme (EAP), informal communication channels, hybrid work schedules and reinforcement of control measures. Conclusion: This study explores the challenges facing employees during the different stages of COVID-19 adaptation and the associated mental health impacts. Gender’s influence on mental health consultations should be considered when planning for public health emergencies, and further research conducted in male dominated industries.

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Worker adaptation behaviours and mental health impacts in Irish workplaces arising from COVID-19 – observations of OSH professionals

2022-01, Chen, Yanbing, Buggy, Conor J., Roe, Mark, Sripaiboonkij, Penpatra, Drummond, Anne, Perrotta, Carla

Introduction: Workers quickly adapted during the COVID-19 pandemic to comply with updated work arrangements, control measures and policies. Understanding adaptation difficulties/fatigue and mental health issues among workers is crucial for OSH professionals to plan for future emergencies. Materials and Methods: As part of a larger COVID-19 workplace study, 16 two-hour focus groups (4-6 participants each) were conducted with OSH professionals (n=60) in Ireland, covering four predetermined themes (organisational preparedness; organisational impacts; worker adaptation behaviour; and the future of OSH post-pandemic). Thematic analysis was conducted using Nvivo. Results: OSH professionals observed many workers rapidly adapted and became involved in organisational COVID-19 outbreak prevention and long-term adaptation, in contrast to some workers that exhibited mental health problems as they struggled to adapt. Adaptation fatigue was observed when staff were sent home to work due to a range of factors: 1) isolation at home 2) no boundary between work and life; and 3) inability to disconnect from negative media coverage. The situation can be alleviated by 1) increasing informal communication to cope with isolation; 2) Employee Assistance Programmes; and 3) additional consultation regarding their COVID-19 concerns. Conclusion: Most Irish workplaces focused more on employees’ physical safety rather than their mental wellbeing. The experiences shared by OSH professionals in this study illustrate their agility and ability to apply their risk management and control skills to any unanticipated public/occupational health crisis that arises.

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COVID-19 prevention and control measures in workplace settings: a rapid review and meta-analysis

2021-10-20, Ingram, Carolyn, Downey, Vicky, Roe, Mark, Chen, Yanbing, Büttner, Fionn Cléirigh, Buggy, Conor J., Perrotta, Carla

Workplaces are high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities.

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Study Protocol: Prospective, observational, cohort study of COVID-19 in General Practice (North Dublin COVID-19 Cohort [‘ANTICIPATE’] Study)

2020-09-17, Cullen, Walter, Avramovic, Gordana, Broughan, John, Burke, Mary Carmel, Cotter, Aoife, Crowley, Des, Downey, Joanne, Duggan, Paul, Fawsitt, Ronan, Guerandel, Allys, Hennessy, Eilis, Kelleher, Cecily, Mills, Gerald, McCombe, Geoff, McHugh, Tina, O’Connor, Eileen, Perrotta, Carla, Lambert, John

Background: It is accepted that COVID-19 will have considerable long-term consequences, especially on people’s mental and physical health and wellbeing. Although the impacts on local communities have been immense, there remains little data on long term outcomes among patients with COVID-19 who were managed in general practice and primary care. This study seeks to address this knowledge gap by examining how the COVID-19 pandemic has impacted the medium and long-term health and wellbeing of patients attending general practice, especially their mental health and wellbeing. Methods: The study will be conducted at 12 general practices in the catchment area of the Mater Misericordiae University Hospital, i.e. the North Dublin area, an area which has experienced an especially high COVID-19 incidence. Practices will be recruited from the professional networks of the research team. A member of the general practice team will be asked to identify patients of the practice who attended the practice after 16/3/20 with a confirmed or presumptive diagnosis of COVID-19 infection. Potential participants will be provided with information on the study by the clinical team. Data will be collected on those patients who consent to participate by means of an interviewer-administered questionnaire and review of clinical records. Data will be collected on health (especially mental health) and wellbeing, quality of life, health behaviours, health service utilisation, and wider impacts of COVID-19 at recruitment and at two follow up time points (6, 12 months). Deliverables: The project involves collaboration with Ireland’s Health Service Executive, Ireland East Hospital Group, and the Mater Misericordiae University Hospital, Dublin. The study is funded by the Health Research Board. Findings will inform health policies that attenuate the adverse impacts of COVID-19 on population mental health and health generally.

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COVID-19 prevention and control measures in workplace settings: a rapid review and meta-analysis

2021-07-24, Ingram, Carolyn, Downey, Vicky, Roe, Mark, Chen, Yanbing, Archibald, Mary, Kallas, Kadri-Ann, Kumar, Jaspal, Naughton, Peter, Uteh, Cyril Onwuelaza, Rojas-Chaves, Alejandro, Shrestha, Shibu, Syed, Shiraz, Büttner, Fionn Cléirigh, Buggy, Conor J., Perrotta, Carla

Workplaces can be high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. The included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, environmental adjustments, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-one studies from healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ~280,000 employees based in Europe, Asia, and North America. Meta-analyses showed that combined IPC measures resulted in lower employee COVID-19 positivity rates (0.2% positivity; 95% CI 0–0.4%) than single measures such as asymptomatic PCR testing (1.7%; 95% CI 0.9–2.9%) and universal masking (24%; 95% CI 3.4–55.5%). Modelling studies showed that combinations of (i) timely and widespread contact tracing and case isolation, (ii) facilitating smaller worker cohorts, and (iii) effective use of PPE can reduce workplace transmission. Comprehensive COVID-19 IPC measures incorporating swift contact tracing and case isolation, PPE, and facility zoning can effectively prevent workplace outbreaks. Masking alone should not be considered sufficient protection from SARS-CoV-2 outbreaks in the workplace.

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Development and validation of a multi-lingual online questionnaire for surveying the COVID-19 prevention and control measures used in global workplaces

2022-01, Ingram, Carolyn, Chen, Yanbing, Downey, Vicky, Archibald, Mary, Rachwal, Natalia, Roe, Mark, Buggy, Conor J., Perrotta, Carla

Introduction: There is an ongoing need for targeted disease prevention and control efforts in high-risk occupational settings. This study aimed to develop, pilot, and validate an instrument for surveying occupational COVID-19 infection prevention and control (IPC) measures available to the global workforce. Material and Methods: A 44-item QualtricsXM survey was developed, translated, and validated for face, content, and cross-cultural validity according to literature review, expert consultation, and pre-testing. The survey was piloted with 890 workers from diverse industries and countries. Exploratory factor analysis (EFA) was conducted, and internal consistency reliability verified with Cronbach’s alpha. Hypothesis testing and Pearson correlation coefficients verified construct validity (i.e., known-groups technique, discriminant validity), and criterion validity. Results: EFA revealed nine key IPC domains relating to: environmental adjustments, testing and surveillance, education, costs incurred, restricted movements, physical distancing, masking, isolation strategies, and areas for improvement. Each domain showed sufficient internal consistency reliability (Cronbach’s alpha ≥ 0.60). Hypothesis testing confirmed construct validity (p < 0.001), criterion validity (p ≤ 0.03), and discriminant validity (r = -0.45). Conclusions: The occupational IPC measures survey showed strong validity and reliability. It can be used by decision makers in the distribution of IPC resources, and to guide occupational health and safety (OSH) recommendations for preventing COVID-19 and future infectious disease outbreaks.