Crossroads of well-being and compliance: a qualitative cohort study of visitor restriction policy during the COVID-19 pandemic, the Netherlands, May 2020-December 2021.

BACKGROUND: In this qualitative study we observed in-depth the impact of the visiting restriction policy (VRP, i.e. number of visitors allowed at home) on well-being and compliance during the COVID-19 pandemic to regulate infection rates. METHODS: A cohort of 15 interviewees was followed throughout the COVID-19 pandemic in the Netherlands in 12 interview rounds (May 2020-December 2021). Every round semi-structured telephone interviews were conducted by a team of 8 researchers. In total 176 interviews were conducted. RESULTS: This study showed that four categories can be identified when observing the impact of the VRP on well-being and compliance. For Resilient-Followers reasons for compliance were risk perception, following government rules, and for some having a small social circle. Because they accepted the situation, well-being was hardly affected. Resilient-Rulebreakers made their own risk assessment of people they met. Their well-being was hardly affected, because they experienced social rest and interpreted the measure in their own way. Suffering-Followers complied, because of risk perception, following government rules, and working in healthcare. However, the VRP had substantial impact on well-being, because social structures were disrupted. Suffering-Rulebreakers gave their own interpretation to the VRP, trying to find a balance between compliance and well-being. We observed that the categories were quite stable over time. CONCLUSIONS: The VRP appeared to be a measure with substantial impact on well-being for some, mostly because social structures were disrupted. The measure showed fluctuating compliance, in which feasibility and frequent changes in the VRP played a role. Well-being seemed related to the number of visitors that was allowed; a restriction of four visitors was feasible, while one visitor resulted in a negative breaking-point in resilience, which had an impact on compliance, even among the most compliant. Taken together, this study provides valuable insights into the implications of and compliance to a VRP during different phases of the COVID-19 pandemic, which may contribute to policymaking during future pandemics.

Cohort profile: The Corona Behavioral Unit cohort, a longitudinal mixed-methods study on COVID-19-related behavior, well-being and policy support in the Netherlands.

This 'cohort profile' aims to provide a description of the study design, methodology, and baseline characteristics of the participants in the Corona Behavioral Unit cohort. This cohort was established in response to the COVID-19 pandemic by the Dutch National Institute for Public Health and the Environment (RIVM) and the regional public health services. The aim was to investigate adherence of and support for COVID-19 prevention measures, psychosocial determinants of COVID-19 behaviors, well-being, COVID-19 vaccination, and media use. The cohort also examined specific motivations and beliefs, such as for vaccination, which were collected through either closed-ended items or open text responses. In April 2020, 89,943 participants aged 16 years and older were recruited from existing nation-wide panels. Between May 2020 and September 2022, 99,676 additional participants were recruited through online social media platforms and mailing lists of higher education organizations. Participants who consented were initially invited every three weeks (5 rounds), then every six weeks (13 rounds), and since the summer of 2022 every 12 weeks (3 rounds). To date, 66% of participants were female, 30% were 39 years and younger, and 54% completed two or more questionnaires, with an average of 9.2 (SD = 5.7) questionnaires. The Corona Behavioral Unit COVID-19 cohort has published detailed insights into longitudinal patterns of COVID-19 related behaviors, support of COVID-19 preventive measures, as well as peoples' mental wellbeing in relation to the stringency of these measures. The results have informed COVID-19 policy making and pandemic communication in the Netherlands throughout the COVID-19 pandemic. The cohort data will continuously be used to examine COVID-19 related outcomes for scientific analyses, as well as to inform future pandemic preparedness plans.

Understanding a national increase in COVID-19 vaccination intention, the Netherlands, November 2020-March 2021.

The intention to get the COVID-19 vaccine increased from 48% (November 2020) to 75% (March 2021) as national campaigning in the Netherlands commenced. Using a mixed method approach we identified six vaccination beliefs and two contextual factors informing this increase. Analysis of a national survey confirmed that shifting intentions were a function of shifting beliefs: people with stronger intention to vaccinate were most motivated by protecting others and reopening society; those reluctant were most concerned about side effects.

Expert Views on Their Role as Policy Advisor: Pilot Study for the Cases of Electromagnetic Fields, Particulate Matter, and Antimicrobial Resistance.

This perspective presents empirical data to demonstrate the existence of different expert views on scientific policy advice on complex environmental health issues. These views are partly research-field specific. According to scientific literature, experts differ in the way they provide policy advice on complex issues such as electromagnetic fields (EMF), particulate matter (PM), and antimicrobial resistance (AMR). Where some experts feel their primary task is to carry out fundamental research, others actively engage in the policy dialogue. Although the literature provides ideas about expert roles, there exists little empirical underpinning. Our aim is to gather empirical evidence about expert roles. The results of an international study indicated that experts on EMF, PM, and AMR differ in the way they view their role in the policy dialogue. For example, experts differed in their views on the need for precaution and their motivation to initiate stakeholder cooperation. Besides, most experts thought that their views on the risks of EMF/PM/AMR did not differ from those of colleagues. Great dissensus was found in views on the best ways of managing risks and uncertainties. In conclusion, the theoretical ideal-typical roles from the literature can be identified to a certain extent.

Different roles of electromagnetic field experts when giving policy advice: an expert consultation.

BACKGROUND: The overall evidence for adverse health effects of electromagnetic fields (EMF) at levels of exposure normally experienced by the public is generally considered weak. However, whether long-term health effects arise remains uncertain and scientific policy advice is therefore given against a background of uncertainty. Several theories exist about different roles that experts may take when they provide advice on complex issues such as EMF. To provide empirical evidence for these theories, we conducted an expert consultation with as main research question: What are the different roles of EMF experts when they provide policy advice? METHODS: Q methodology was used to empirically test theoretical notions on the existence and determinants of different expert roles and to analyze which roles actually play out in the domain of EMF. Experts were selected based on a structured nominee process. In total 32 international EMF experts participated. Responses were analyzed using Principal Component Analysis and for the open questions we used Atlas.ti. RESULTS: Four expert roles were found. Most striking differences between the four roles are whether experts consider current EMF policies adequate or not, whether additional -precautionary- measures are needed, and how experts view their position vis-à-vis policymakers and/or other stakeholders. CONCLUSION: This empirical study provides support for the so far mainly theoretical debate about the existence of different roles of experts when they give policy advice. The experts' assessment of the degree of uncertainty of the issue turned out to be highly associated with their role. We argue that part of the controversy that exists in the debate regarding scientific policy advice on EMF is about different values and roles.

Different roles and viewpoints of scientific experts in advising on environmental health risks.

Environmental health risks are often complex, largescale, and uncertain. The uncertainties inherent in these problems permit differences among experts in the appraisal of risks. This raises the question of whether different expert roles exist and, if so, how this affects the policy advice that is given. Here, we present a pilot study of the different roles and viewpoints that can be discerned among scientific experts in the Netherlands. Q methodology was used to empirically explore existing theoretical treatises on different expert roles. In total, 26 electromagnetic field (EMF) experts and 21 particulate matter (PM) experts participated. The responses were analyzed separately for EMF and PM respondents using Q factor analysis. In both the EMF and PM domain, three different expert roles were identified. This suggests that particular expert roles depend on the specific environmental health risk. The results indicate that different expert roles exist among scientists who provide policy advice on environmental health risks. This empirical study adds new data and insights to the literature on expert roles. The results of this study are relevant for the selection and composition of expert committees and the interpretation of expert advice.