Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study

Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic,...

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Bibliographic Details
Published in:PloS one Vol. 19; no. 5; p. e0299823
Main Authors: Meyer, Carly, Crayton, Elise, Wright, Abigail, Spyer, Moira, Vora, Nina, Houlihan, Catherine, Walker, Naomi F., Nastouli, Eleni, Michie, Susan, Lorencatto, Fabiana
Format: Journal Article
Language:English
Published: United States Public Library of Science 09.05.2024
Public Library of Science (PLoS)
Subjects:
Adult
Behavior
Biology and Life Sciences
Control
COVID-19
COVID-19 - epidemiology
COVID-19 - prevention & control
COVID-19 - psychology
Cross-Sectional Studies
Disease control
Disease transmission
Engineering and Technology
England - epidemiology
Epidemics
Feasibility
Female
Health aspects
Health care
Health care reform
Health Personnel - psychology
Hospitals
Humans
Infection
Infection Control - methods
Infections
Infectious diseases
Male
Medical personnel
Medical supplies
Medicine and Health Sciences
Methods
Middle Aged
Mixed methods research
Motivation
Pandemics
Pandemics - prevention & control
Patients
People and Places
Personal Protective Equipment
Physical Distancing
Practice
Protective equipment
Public health
Safety equipment
SARS-CoV-2
Social distancing
Social Sciences
Surveys
Surveys and Questionnaires
United Kingdom
Viral diseases
Workers
England
United Kingdom
United Kingdom > UK
United States > US
ISSN:1932-6203, 1932-6203
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Summary:Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing. An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants). Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing. It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.
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Competing Interests: The authors have declared that no competing interests exist.
Membership of the SAFER research team is provided in the Acknowledgelements.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0299823