Evidence map›Paper›PMID 36418978›Full record

ArticleBMC public health2022

Exploring the impact of shielding advice on the wellbeing of individuals identified as clinically extremely vulnerable amid the COVID-19 pandemic: a mixed-methods evaluation.

Gemma Lasseter, Polly Compston, Charlotte Robin, Helen Lambert, Matthew Hickman, Sarah Denford, Rosy Reynolds, Juan Zhang, Shenghan Cai, Tingting Zhang and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Gemma Lasseter *NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK. gemma.lasseter@bristol.ac.uk.
Polly Compston *Field Epidemiology Service, UK Health Security Agency, Cambridge, UK.
Charlotte RobinNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Helen LambertNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Matthew HickmanNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Sarah DenfordNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Rosy ReynoldsNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Juan ZhangPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Shenghan CaiPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Tingting ZhangPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Louise E SmithNIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.
G James RubinNIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.
Lucy YardleyNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Richard AmlôtNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.
Isabel OliverNIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN, UK.

Funding

Department of Health
6 · The paper itself

Abstract

backgroundThe national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of "shielding" on the health and wellbeing of CEV individuals in Southwest England during the first COVID-19 lockdown.

methodsA two-stage mixed methods study, including a structured survey (7 August-23 October 2020) and semi-structured telephone interviews (26 August-30 September 2020) with a sample of individuals who had been identified as CEV and advised to "shield" by Bristol, North Somerset & South Gloucestershire (BNSSG) Clinical Commissioning Group (CCG).

resultsThe survey was completed by 203 people (57% female, 54% > 69 years, 94% White British, 64% retired) in Southwest England identified as CEV by BNSSG CCG. Thirteen survey respondents participated in follow-up interviews (53% female, 40% > 69 years, 100% White British, 61% retired). Receipt of 'official' communication from NHS England or General Practitioner (GP) was considered by participants as the legitimate start of shielding. 80% of survey responders felt they received all relevant advice needed to shield, yet interviewees criticised the timing of advice and often sought supplementary information. Shielding behaviours were nuanced, adapted to suit personal circumstances, and waned over time. Few interviewees received community support, although food boxes and informal social support were obtained by some. Worrying about COVID-19 was common for survey responders (90%). Since shielding had begun, physical and mental health reportedly worsened for 35% and 42% of survey responders respectively. 21% of survey responders scored ≥ 10 on the PHQ-9 questionnaire indicating possible depression and 15% scored ≥ 10 on the GAD-7 questionnaire indicating possible anxiety.

conclusionsThis research highlights the difficulties in providing generic messaging that is applicable and appropriate given the diversity of individuals identified as CEV and the importance of sharing tailored and timely advice to inform shielding decisions. Providing messages that reinforce self-determined action and assistance from support services could reduce the negative impact of shielding on mental health and feelings of social isolation.

Indexed as

COVID-19General PractitionersCommunicable Disease ControlFemaleHumansMaleMental HealthPandemicsCOVID-19Health policyInfection controlPublic healthShielding

Identifiers

PMID36418978
PMCPMC9685010

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.