Learning about COVID-19 across borders: public health information and adherence among international travellers to the UK
Learning about COVID-19 across borders: public health information and adherence among international travellers to the UK
Objective: public health control measures at borders have long been central to national strategies for the prevention and containment of infectious diseases. Travel was inevitably associated with the rapid global transmission of COVID-19. In the UK, public health authorities tried to reduce the risks of travel-associated spread by providing public health information at ports of entry. This study investigates risk assessment processes, decision-making and adherence to official advice among international travellers, to provide evidence for future policy on the provision of public health information to facilitate safer international travel.
Study design: this study is a qualitative study evaluation.
Method: international air passengers arriving at the London Heathrow Airport on scheduled flights from China and Singapore were approached for interview after consenting to contact in completed surveys. Semi-structured interviews were conducted by telephone, using two topic guides to explore views of official public health information and self-isolation. Interview transcripts were coded and analysed thematically.
Results: participants regarded official advice from Public Health England as adequate at the time, despite observing differences with intervention measures implemented in their countries of departure. Most participants also described adopting precautionary measures, including self-isolation and the use of face coverings that went beyond official advice, but reported adherence to guidance on contacting health authorities was more variable. Adherence to the official guidance was informed by the perceived salience of specific transmission possibilities and containment measures assessed in relation to participants’ local social and institutional environments.
Conclusion: analysis of study findings demonstrates that international air travellers' responses to public health advice constitute a proactive process of risk assessment and rationalised decision-making to guide preventive action. This process incorporates consideration of the current living situation, trust in information sources, correspondence with cultural logics and willingness to accept potential risk to self and significant others. Our findings concerning international passengers’ understanding of, and compliance with, official advice and mitigation measures provide valuable evidence to inform future policy and generate recommendations on the presentation of public health information to facilitate safer international travel. Access to a central source of regularly updated official information would help minimise confusion between different national guidelines. Greater attention to the differentiated information needs of diverse groups in creating future public-facing guidance would help to minimise the uncertainties generated by the receipt of generic information.
Adherence, Behaviour, COVID-19, International travel, Public health advice, airport, precautionary measures, Airport, Precautionary measures
9-14
Cai, S.
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Zhang, T.
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Robin, C.
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Sawyer, C.
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Rice, W.
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Smith, L. E.
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Amlot, R.
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Rubin, G.J.
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Yardley, L.
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Hickman, M.
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Oliver, I.
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Lambert, H.
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February 2022
Cai, S.
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Zhang, T.
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Robin, C.
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Sawyer, C.
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Rice, W.
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Smith, L. E.
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Amlot, R.
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Rubin, G.J.
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Yardley, L.
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Hickman, M.
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Oliver, I.
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Lambert, H.
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Cai, S., Zhang, T., Robin, C., Sawyer, C., Rice, W., Smith, L. E., Amlot, R., Rubin, G.J., Yardley, L., Hickman, M., Oliver, I. and Lambert, H.
(2022)
Learning about COVID-19 across borders: public health information and adherence among international travellers to the UK.
Public Health, 203, .
(doi:10.1016/j.puhe.2021.11.015).
Abstract
Objective: public health control measures at borders have long been central to national strategies for the prevention and containment of infectious diseases. Travel was inevitably associated with the rapid global transmission of COVID-19. In the UK, public health authorities tried to reduce the risks of travel-associated spread by providing public health information at ports of entry. This study investigates risk assessment processes, decision-making and adherence to official advice among international travellers, to provide evidence for future policy on the provision of public health information to facilitate safer international travel.
Study design: this study is a qualitative study evaluation.
Method: international air passengers arriving at the London Heathrow Airport on scheduled flights from China and Singapore were approached for interview after consenting to contact in completed surveys. Semi-structured interviews were conducted by telephone, using two topic guides to explore views of official public health information and self-isolation. Interview transcripts were coded and analysed thematically.
Results: participants regarded official advice from Public Health England as adequate at the time, despite observing differences with intervention measures implemented in their countries of departure. Most participants also described adopting precautionary measures, including self-isolation and the use of face coverings that went beyond official advice, but reported adherence to guidance on contacting health authorities was more variable. Adherence to the official guidance was informed by the perceived salience of specific transmission possibilities and containment measures assessed in relation to participants’ local social and institutional environments.
Conclusion: analysis of study findings demonstrates that international air travellers' responses to public health advice constitute a proactive process of risk assessment and rationalised decision-making to guide preventive action. This process incorporates consideration of the current living situation, trust in information sources, correspondence with cultural logics and willingness to accept potential risk to self and significant others. Our findings concerning international passengers’ understanding of, and compliance with, official advice and mitigation measures provide valuable evidence to inform future policy and generate recommendations on the presentation of public health information to facilitate safer international travel. Access to a central source of regularly updated official information would help minimise confusion between different national guidelines. Greater attention to the differentiated information needs of diverse groups in creating future public-facing guidance would help to minimise the uncertainties generated by the receipt of generic information.
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Accepted/In Press date: 22 November 2021
e-pub ahead of print date: 27 November 2021
Published date: February 2022
Additional Information:
Funding Information:
We wish to thank all participants who contributed to this study and all staff in the London Heathrow Airport for their kind support. The authors acknowledge support from the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol , in partnership with Public Health England (PHE). L.Y. is an NIHR Senior Investigator and partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation and the NIHR Southampton Biomedical Research Centre (BRC). M.H., I.O. and H.L. are supported by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol in partnership with Public Health England. L.S. and J.R. are supported by the NIHR HPRU in Emergency Preparedness and Response at King's College London in partnership with Public Health England. C.R. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with Public Health England (PHE), in collaboration with the Liverpool School of Tropical Medicine and the University of Oxford, the NIHR HPRU in Gastrointestinal Infections at the University of Liverpool in partnership with PHE, in collaboration with the University of Warwick and the NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol, in partnership with PHE.
Funding Information:
This study was funded by NIHR on behalf of the Department of Health and Social Care. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England.
Funding Information:
We wish to thank all participants who contributed to this study and all staff in the London Heathrow Airport for their kind support. The authors acknowledge support from the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, in partnership with Public Health England (PHE). L.Y. is an NIHR Senior Investigator and partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation and the NIHR Southampton Biomedical Research Centre (BRC). M.H., I.O. and H.L. are supported by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol in partnership with Public Health England. L.S. and J.R. are supported by the NIHR HPRU in Emergency Preparedness and Response at King's College London in partnership with Public Health England. C.R. is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with Public Health England (PHE), in collaboration with the Liverpool School of Tropical Medicine and the University of Oxford, the NIHR HPRU in Gastrointestinal Infections at the University of Liverpool in partnership with PHE, in collaboration with the University of Warwick and the NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol, in partnership with PHE.This study was funded by NIHR on behalf of the Department of Health and Social Care. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or Public Health England.
Publisher Copyright:
© 2021 The Authors
Keywords:
Adherence, Behaviour, COVID-19, International travel, Public health advice, airport, precautionary measures, Airport, Precautionary measures
Identifiers
Local EPrints ID: 453332
URI: http://eprints.soton.ac.uk/id/eprint/453332
ISSN: 0033-3506
PURE UUID: 511c586d-1a56-46f8-99d3-b8ba39299d41
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Date deposited: 13 Jan 2022 17:33
Last modified: 17 Mar 2024 02:47
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Contributors
Author:
S. Cai
Author:
T. Zhang
Author:
C. Robin
Author:
C. Sawyer
Author:
W. Rice
Author:
L. E. Smith
Author:
R. Amlot
Author:
G.J. Rubin
Author:
M. Hickman
Author:
I. Oliver
Author:
H. Lambert
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