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BackgroundIn July 2022 it was estimated 2 million people in the UK have self-reported Long Covid (LC).1 Many people have reported not receiving adequate healthcare support. There is a lack of research which provides an in-depth exploration of the barriers faced by people with LC in accessing healthcare support. It is important to understand these barriers to provide better support, care and advice for those experiencing LC. ObjectiveTo understand the barriers faced in accessing primary, secondary and specialist healthcare support for people with LC. Design and participation40 interviews were conducted with people with LC alongside 12 interviews with healthcare professionals (HCPs) providing LC support in Bradford, as part of a UK wide qualitative longitudinal study. ResultsPeople living with LC had a large degree of difficulty in accessing healthcare services for LC support. We categorised the healthcare access experiences of participants into five main types: 1) being unable to access primary care 2) accessing primary care but receiving (perceived) inadequate support 3) extreme persistence 4) alternatives to mainstream healthcare 5) positive experiences. There was a severe lack of access to specialist LC services. Ethnic minority participants faced a further barrier of mistrust and fear of services deterring them from accessing support. HCPs discussed systemic barriers to delivering services. Experiences were embedded in macro structural issues further exacerbated by the pandemic. ConclusionTo better support people with LC the barriers faced in accessing healthcare support must be addressed. Of significance, improvements to GP access are required; especially as GPs are the first line of support for people living with LC. Patient and public involvementA PPI group is engaged at regular intervals in the project. O_TEXTBOXBox 1Patient and Public Contribution Designing an interview schedule for people with LC: The wider CONVALSCENCE research project has a PPI group involved in various work packages. The PPI group is hosted by researchers at University of West of England who have expertise in patient and public involvement. Members of the PPI group all have or had LC. After an extensive literature review4, a draft of the interview schedule was presented to the group via a workshop. It was then revised after incorporating their feedback and piloted by the research team for further refinement. Data interpretation workshop: Following advice of the UWE researchers, the PPI group were presented ahead of time with 4 interview transcripts from the dataset and provided their interpretation of the interviews via a workshop. The theme of barriers to accessing healthcare was also highlighted by attendees, for example they discussed patients being disbelieved (particularly young people) and fragmented services as some points of interest within the transcripts. C_TEXTBOX
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BackgroundCOVID-19 vaccines have been the central pillar of the public health response to the pandemic, intended to enable us to live with Covid. It is important to understand COVID-19 vaccines attitudes and decisions in order to maximise uptake through an empathetic lens. ObjectiveTo explore the factors that influenced peoples COVID-19 vaccines decisions and how attitudes towards the vaccines had changed in an eventful year. Design and participantsThis is a follow up study that took place in Bradford, UK one year after the original study, between October 2021 and January 2022. In-depth phone interviews were conducted with 12 (of the 20 originally interviewed) people from different ethnic groups and areas of Bradford. Reflexive thematic analysis was conducted. Results11 of the 12 participants interviewed had received both doses of the COVID-19 vaccine and most intended to have a booster dose. Participants described a variety of reasons why they had decided to have the vaccines, including: feeling at increased risk at work; protecting family and others in their communities, unrestricted travel and being influenced by the vaccine decisions of family, friends and colleagues. All participants discussed ongoing interaction with COVID-19 misinformation and for some this meant they were uneasy about their decision to have the vaccine. They described feeling overloaded by and disengaged from COVID-19 information, which they often found contradictory and some felt mistrustful of the UK governments motives and decisions during the pandemic. ConclusionsThe majority of participants had managed to navigate an overwhelming amount of circulating COVID-19 misinformation and chosen to have two or more COVID-19 vaccines, even if they had been previously said they were unsure. However, these decisions were complicated, and demonstrate the continuum of vaccine hesitancy and acceptance. This follow up study underlines that vaccine attitudes are changeable and contextual. Patient or Public ContributionThe original study was developed through a rapid community and stakeholder engagement process in 2020. Discussion with the Bradford Council Public Health team and the public through the Bradford COVID-19 Community Insights Group was undertaken in 2021 to identify important priorities for this follow up study.
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BackgroundCovid-19 vaccines can offer a route out of the pandemic, yet initial research suggests that many are unwilling to be vaccinated. A rise in the spread of misinformation is thought to have played a significant role in this vaccine hesitancy. In order to maximise vaccine uptake it is important to understand why misinformation has been able to take hold at this time and why it may pose a more significant problem within certain populations and places. ObjectiveTo understand peoples Covid-19 beliefs, their interactions with health (mis)information during Covid-19 and attitudes towards a Covid-19 vaccine. Design and participantsIn-depth phone interviews were carried out with 20 people from different ethnic groups and areas of Bradford during Autumn 2020. Reflexive thematic analysis was conducted. ResultsParticipants spoke about a wide range of emotive misinformation they had encountered regarding Covid-19, resulting in confusion, distress and mistrust. Vaccine hesitancy could be attributed to three prominent factors: safety concerns, negative stories and personal knowledge. The more confused, distressed and mistrusting participants felt about their social worlds during the pandemic, the less positive they were about a vaccine. ConclusionsCovid-19 vaccine hesitancy needs to be understood in the context of the relationship between the spread of misinformation and associated emotional reactions. Vaccine programmes should provide a focused, localised and empathetic response to counter misinformation. Patient or public contributionA rapid community and stakeholder engagement process was undertaken to identify Covid-19 related priority topics important to both Bradford citizens and local decision makers.