Public Health Institute Journal (LJMU)
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An online study assessing the impact of dog ownership on mental health during the COVID-19 pandemic
No full textThe COVID-19 pandemic left many people unemployed, furloughed or working from home as well as enduring periods of mandated lockdown. Since the start of the pandemic, 3.2 million households in the UK have acquired a pet and there are now currently around 12 million dogs as pets. The purpose of the research is to understand and identify the impact owning a dog has had on dog owners during the recent pandemic as well as understanding the impact the pandemic has had on dogs. The method for this study was an online questionnaire, collecting qualitative and qualitative data with participants recruited via Facebook Dog Groups. In particular this study explored the relationship between the number of dogs owned per household compared with the owner’s quality of life, and how the pandemic impacted upon dog owners and dogs. This study found that the lockdown did not impact on dogs in the most part although some participants noted an increase in behavioural issues during this time. For dog owners, they felt their dog contributed positively towards their mental health due to comfort and companionship owning a pet can bring. Further research is needed to see whether this is maintained long term and similarly to understand impacts on both dogs and dog owners following the lifting of lockdown. The research is one of the first of its type, there is little data on the subject due to the pandemic being so recent. Therefore, future studies can use this as a baseline on how dog ownership affects mental health during the pandemic. 
A survey study on eating habits during the COVID-19 lockdowns in the UK
No full textThe current global coronavirus pandemic (COVID-19) has forced many countries to enforce national lockdowns and periods of self-isolation in an attempt to stem the virus from being transmitted between humans, aiming for fewer deaths from the highly-infectious disease. The United Kingdom has undergone three of these national lockdown periods, during which individuals will have found themselves spending extended periods of time in their own homes, ultimately sacrificing many freedoms and potentially even their health. Participants (n=365) of this study were recruited, using social media advertisements, to self-report changes in their eating habits from the beginning of the pandemic as a result of the lockdowns and periods of self-isolation. An anonymous online questionnaire, targeting the UK adult population was completed. The results identified several positive changes made by individuals but the pandemic had mostly a detrimental impact on the population’s eating habits. Over a quarter of participants reported that the pandemic had a positive effect on their diet overall; 23% reported an increase in homemade meals, 22% reported fewer takeaways consumed and 27% said they gave more nutritional consideration to their diet. Thirty-two percent reported an improvement in their own cooking ability and 16% felt they succumbed to emotional eating less often. Negative health trends appeared to be more abundant in this survey. Findings highlighted that more than a third of participants were consuming more takeaways while at home as well as more than half agreeing that it was easier to have a takeaway delivered. The study also found that 22% of participants were cooking fewer homemade meals than they did beforehand and almost a third struggled to get hold of the groceries they needed during this time. The study also found that 44% of people changed their spending habits when it came to buying groceries although there was no significant correlation between personal finances and eating habits. These findings suggest that eating habits have been affected greatly by the COVID-19 pandemic and the government-enforced lockdowns, and more often in a negative way. It may be that individuals were not aware of the effect the pandemic is having on their nutritional health and therefore more should be done from major bodies to ensure that awareness is raised and that the lockdowns have proven to be beneficial to some individual’s health and the reasons for this should be broadcast nationwide. 
The Views and Experiences of Drug and Alcohol Treatment Professionals and People Seeking Recovery from Substance Dependency, that Influence Referral To, and Attendance at Twelve Step Groups in the UK: A Systematic Review of Qualitative Studies
No full textBackground: There is a high level of drug related mortality and morbidity in the UK. Although treatment is effective in reducing harm, funding cuts combined with unmet demand present significant public health challenges. Twelve-step groups (TSGs) are an approach to treatment that can improve recovery outcomes and reduce healthcare costs. This review examined the factors that influence referral to and attendance at TSGs in the UK, through the views and experiences of drug and alcohol treatment professionals (DATPs) and people seeking recovery from substance dependency (PSRFSD).
Methods: A qualitative systematic review was undertaken. A literature search was conducted on Medline, PsycInfo, Web of Science and CINAHL matching relevant eligibility criteria from inception to February 2021. The search strategy was developed using a PICo framework. Inclusion criteria were primary studies of qualitative data undertaken in the UK. Quality of the included studies was appraised using the CASP (2018) Qualitative Checklist. Analysis of the studies was conducted by utilising Thematic Synthesis (Thomas and Harden, 2008).
Results: Five studies were included in the review. The heterogeneity of study aims within the review provided a diverse range of evidence, illustrating similarities and differences within the themes across both review populations. There were no significant concerns about the quality of included studies. Three analytical themes emerged: ‘benefits’, ‘concerns’, and ‘knowledge’. There were many reported ‘benefits’ of TSGs. Many of the ‘concerns’ and gaps in ‘knowledge’ about TSGs were shared between DATPs and PSRFSD, with the main exception of risk, which was limited to DATPs. Some contributing factors to ‘concerns’ related to gaps in ‘knowledge’.
Conclusions: This review provided the first synthesis of the views and experiences of both review populations on this topic in the UK. It emerged that there are both positive and negative influencing factors shared across both populations and some key differences. Varying levels of knowledge and understanding about twelve-step recovery were apparent. This lack of clarity may disable both review populations from making informed decisions as to whether TSG attendance might be helpful. Improved knowledge, through training, could assist DATPs to provide consistent advice, guidance and twelve-step facilitation (TSF). Recommendations are made for training content, revised practitioner guidance, and improved TSF, where appropriate
A Scoping Review on Understanding Stigmas and Their Prevalence in Relation to Vegans and Exploring & Initiating a Change in Perception
No full textBackground: The interest in adopting a vegan diet is increasing across the globe, gaining more media coverage and is expected to grow even further within the next 20 years. Taking this into consideration, there is a risk of an increased level of stigmatization towards current vegans as well as individuals considering making this transition. In order to tackle potential stigmatization, the prevalence of stigma in today’s society is crucial to recognise in order to identify new modernised approaches and strategies that can help to challenge current stigmas as well as tackle potential new stigmatization over the coming years in order to break down and eliminate stereotypical views.
Methods: A scoping review was carried out in order to define and identify stigmas in relation to vegan diets and also to identify current and potential new approaches and strategies in order to help eliminate and challenge identified stigmas. A search strategy was developed through various databases using specified search terms and an inclusion and exclusion criteria. The scoping review applied and used a suitable framework PCC (Population, Concept & Context).
Results: Overall, 20 studies were selected to be included within the review, all of which were sourced from peer reviewed journals. From the studies selected, five related to definitions and frameworks of stigma in order to provide contextual background regarding stigma and help to define and identify vegan stigma. Six studies focused on defining vegan stigma the and the different forms in which it exists and is currently prevalent A further six studies focused on gaining an insight of how vegans experienced stigmatization and potential routes in which vegan stigma may originate. The remaining three studies focused on current approaches and strategies which can initiate change and challenge current stigma as well as potentially identifying new modernized methods.
Conclusions: It was determined that stigma was a complex term to define universally, however it was identified that early methodologies and frameworks helped to define and identify different forms of vegan stigma and their prevalence in today’s society. It was found that stigmatization, from the experience of vegans, predominantly originated from carnivores, however other groups such as vegetarians also create a level of stigmatization towards vegans. Gender was also an issue identified and lightly touched upon however further research is needed within this area in order to produce reliable evidence in which conclusions may be drawn. From this, it was identified that traditional methods, approaches and strategies such as education, contact and protest were of use. However, due to the growing interest surrounding vegan diets, more modernized techniques such as social media and the labelling of vegan food products would be useful in order to initiate a change in thinking and breaking down stereotypical views and stigmatization towards vegans
To investigate adult women’s perceptions and experiences of Health and Safety in the workplace during pregnancy
No full textPrevious research has shown issues relating to experiences of health and safety at work during pregnancy not only in the United Kingdom but internationally as well. In previous studies, women felt that their physical and mental health was negatively affected and one in four sustained an injury at work. Additionally, women felt they were not supported by their employer and department. This research study aims to understand women’s experiences and perceptions of health and safety whilst at work during pregnancy. At present there is limited research exploring the impact of different work environments, which led the researcher to ask participants to specify their occupation in the study. The aims of this study were to look at women’s experiences with health and safety during pregnancy at work and the problems that occurred, changes to working practices, and the support and care they received. Women aged 18 years and over who live and work in the UK were chosen as the target population. The study used a quantitative approach using an online anonymous questionnaire which was posted on Facebook and Mumsnet. Convenience sampling was used with 89 participants recruited. The questionnaire data was analysed using Excel and SPSS, and responses to the questions were also compared with participants demographics to see if experiences differ by age groups, using a Chi-squared statistical test. The results are presented in tables, pie charts and bar graphs. The results found show that the participants have mixed feelings relating to their experiences at work during pregnancy. Half had experienced health problems while at work, which were caused by work stress and physical demands of their job. Just over one in five (22%) felt they were unfairly treated throughout their pregnancy, e.g., through unpleasant comments from their employer, with a small proportion of the younger women stating their employer was unsupportive. The recommendations centre around giving employers further education and awareness on the matter, liaising with Environmental Health practitioners who have the powers to advise.  
A quantitative study exploring the experiences of food labelling in restaurants and food packaging among adults who have food allergies
No full textA food allergy is when the body’s immune system reacts unusually to certain foods. This can result in a person’s throat becoming itchy or swelling (NHS, 2019) and, in more serious cases, it can result in anaphylaxis. Food allergies can dictate how people live their lives because they have to avoid certain food premises if appropriate food labelling is not in place. In recent years, there have been increasing numbers of deaths in the UK due to food premises not having to list all ingredients on labelling in order to comply with UK law. Usually, food allergies that develop during adulthood are expected to be lifelong allergies (NHS, 2019). However, there is limited literature looking at adults’ experience of food allergies. The aim of this research was to explore the experiences among adults (aged 18 years and over) who have allergies with food labelling and how food labelling affects their daily life. The quantitative study used an online survey which was sent out to four food allergy support groups via Facebook. In total, 69 adults with food allergies completed the survey. The data from the questionnaire was analysed using Microsoft Excel to compare the participants different experience of food labelling in different food premises. The data collected were presented throughout the study in form of bar charts and pie charts. The main findings from the study show that there is not enough adequate information on food labels and that the font type and size affected participants’ ability to read the required information. The majority of participants (90%) reported they sometimes look the food labelling and a large proportion (70%) reported having had an allergic reaction (either in a restaurant or after buying food) when the food they are allergic to was not on the food label or ingredient list. As a consequence, 67% of participants reported they have avoided eating food from a take away due to concerns the food would contain the ingredient they were allergic to. Overall, the findings suggest that all the contained ingredients should be on food labels and not just the 14 food allergens currently required by UK law
Incidence and Comparison of the Factors associated with Treatment Delay of Tuberculosis in the UK and India - A Systematic Review
No full textBackground: Tuberculosis (TB) remains a significant public health issue globally. A significant number of TB patients have been seen to have over 4 months delay in their diagnosis and treatment. Late initiation of treatment of TB increases the risk of its severity and transmission of the disease further in communities. A delay, both pulmonary and extra-pulmonary, is a major set-back in TB control worldwide. Reducing delay to access care is important to reduce the TB burden in countries like India with a high incidence of TB. The review aims to observe the treatment delay in India and the UK, identify and compare the associated risk factors and also, assess their effect on the treatment outcomes. It is also important to classify the delays, risk factors associated with them and their effect on the treatment outcome.
Methods: CINHAL, Medline, and Google Scholar were searched for studies that assessed factors associated with delays in diagnosis and treatment in populations suffering from TB in India and UK. Studies done between 2017-2021, satisfying the exclusion criteria were selected, followed by data extraction and analysis of the evidence through a narrative synthesis. Quality appraisal was an important step in the systematic review to maintain internal validity.
Results: The findings suggest the existence of treatment initiation delays in both the UK and India. Both countries have individual factors as well as common reasons for the delays. The factors include socio-demographic characteristics, TB-related symptoms, and conditions of seeking medical care. The median delay in initial care seeking and diagnosis was calculated as 10 days each, and 2 days for treatment initiation. The various domains identified for delay were negligence, facility-related issues, and social reasons. Such factors led to health-seeking delays and further delay in treatment initiation.
Conclusions: Future studies must use stronger evidence through cohort and case-control studies to establish further clarity on the factors associated with the delays. Interventions for reducing the knowledge gap and stigma, increasing the accessibility of services, active case finding; capacity building of providers, quality assured sputum microscopy, and communication skills will help reduce these delays
Empirical exploration into perceptions towards a Covid-19 vaccination and how attitudes and belief systems may influence vaccination uptake among Students in Higher Education in England
No full textBackground: Vaccine hesitancy is a threat to vaccine uptake and can reduce the collective benefit vaccination programmes offer through herd immunity. Although vaccine uptake is generally high in the UK, at the time of this study the vaccination programme had moved through a tiered system, starting with those most at risk from Covid-19 related health harms, and then continue down through the population age brackets. Currently the vaccination programme is covering the mean age (28.12) of students sampled in this study. Therefore, it may be critical to understand the reasons behind vaccine hesitancy within this group of the population to help inform targeted public health intervention. The aim of this study is to explore perceptions towards a Covid-19 vaccination and how attitudes and beliefs may influence vaccination uptake among students in Higher Education in England
Methods: A cross-sectional online survey with convenience sampling was undertaken with Higher Education students in the UK. Participants must have been currently studying and live in the UK to participate. A total of 154 individuals were recruited, (18 participants were excluded) with a final sample size of 136. Vaccine beliefs were measured across 4 domains; Barriers; Safety; Seriousness in my age; and Cue to action.
Results: Vaccine beliefs and attitudes were predicted by White ethnicity (b= -23, t= -2.95 p < .004), higher perceived safety of vaccine (b= -45, t= -5.04 p <.001), higher cue to action score (b=.49, t= 6.15 p <.001), higher perceived seriousness of Covid-19 to people of participants’ own age (b= .18, t=2.28, p < .025).
Conclusions: Vaccine hesitancy was explored, and associations discovered between predicted variable outcomes and vaccine hesitancy. Recommended future research into vaccine hesitancy may wish to further explore the association between perceived seriousness of Covid-19 by age as vaccination continues in younger age brackets. It would be beneficial to understand if fears concerning the safety of the Covid-19 vaccine is greater than the fear of the perceived health risks from catching Covid-19
Exploring the determinants of human behaviours in Social Distancing and COVID-19 Testing decisions: A Scoping Review
No full textBackground: The World Health Organization declared COVID-19 a pandemic in March 2020 and has continued to be a public health disaster worldwide ever since. Several public health and social measures are recommended and have been taken up by governments to prevent the spread of infection. These measures include social distancing, hand washing, avoiding touching face and nose, not going outside, getting tested for the virus and self-isolation if infected or in contact with the disease. These measures are known as ‘behavioural vaccines’ and are viewed as critical in mitigating the spread of infection, however, in order for them to work it requires consistent behaviour among the population. The aim of the scoping review was to explore the behavioural determinants of social distancing and testing among the population of United Kingdom (UK), to assess adherence to these behaviours and factors affecting adherence.
Methods: A scoping review of all types of articles published from April 2020 to April 2021 was done utilising different database searches. Articles were scanned by relevance from titles and abstract and then full text was reviewed on the final included articles (n=14). A five-stage methodological framework was followed for reviewing, charting and narrative synthesis of the data.
Results: Fourteen articles were included in this study for review. Factors affecting the adherence to behaviour for social distancing and testing was further reviewed. The scoping review highlighted that as the severity of the disease increased, adherence to behaviour increased. The older population was seen to follow adherence more than the younger generation. Due to various circumstantial issues such as staying alone, it was not possible for many people to adhere to the social distancing and testing policy.
Conclusions: These findings throw light on the important part played by behavioural responses of the community. There are certain barriers and facilitators allied to social distancing measures and test and trace. Recommendations are made to convey clear messages that are timely and context specific
A mixed methods exploration of parents’ experiences of free school meals in Wirral
No full textBackground: The United Kingdom is thought of as one the richest countries in the world and the idea that many of its citizens face hunger every day seems contradictory. Years of austerity and welfare cuts have increasingly widened the gap between the richest and poorest members of society, allowing inequalities to manifest, of which childhood food poverty has fallen victim to. This study aims to explore the views and lived experiences of parents from schools in Wirral who currently receive Free School Meals (FSM) for their children. In particular, the research will seek to examine the demographic characteristics of participants, their perceptions of stigmatisation and challenges to accessing FSM, along with the extent to which the recent media campaign led by Marcus Rashford has affected these experiences and perceptions. This research was conducted with the hope of adding to the existing literature surrounding FSM in the UK, and in particular, adding to the currently limited literature on the effects of COVID-19, and the Marcus Rashford campaign on recipients of FSM.
Methods: Data was collected via an online JISC survey. The survey was sent to parents who met the inclusion criteria through parent emails and announcements, achieved via gatekeeper contact with both primary and secondary schools in Wirral. Questions within the survey followed logically from the research objectives, with a range of both closed and open questions, inviting both quantitative and qualitative analysis.
Results: Results found that participants’ experiences with FSM were varied, with a mixture of positive and negative experiences, regarding their respective school’s FSM policy and experiences of stigmatisation and embarrassment. A key problem participants highlighted as access to FSM in the school holidays, with the nature of FSM provided during COVID-19 being a common topic of debate. Knowledge around the Marcus Rashford campaign on FSM was varied, with a small majority of participants claiming to be aware of it.
Conclusions: The key takeaway messages from this study, is that more research particularly needs to be conducted on FSM and school holidays, along with the effects of the Marcus Rashford campaign
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