Background Self-isolation is challenging and adherence is dependent on a range of psychological, social and economic factors. We aimed to identify the challenges experienced by contacts of coronavirus disease 2019 (COVID-19) cases to better target support and minimize the harms of self-isolation. Methods The Contact Adherence Behavioural Insights Study (CABINS) was a 15-minute telephone survey conducted with confirmed contacts of COVID-19 (N = 2027), identified through the NHS Wales Test Trace Protect (TTP) database. Results Younger people (aged 18–29 years) were three times more likely to report mental health concerns (adjusted odds ratio [aOR]: 3.16, 95% confidence interval [CI]: 2.05–4.86) and two times more likely to report loneliness (aOR: 1.96, CI: 1.37–2.81) compared to people aged over 60 years. Women were 1.5 times more likely to experience mental health concerns (aOR: 1.51, 95% CI: 1.20–1.92) compared to men. People with high levels of income precarity were eight times more likely to report financial challenges (aOR: 7.73, CI: 5.10–11.74) and three times more likely to report mental health concerns than their more financially secure counterparts (aOR: 3.08, CI: 2.22–4.28). Conclusion Self-isolation is particularly challenging for younger people, women and those with precarious incomes. Providing enhanced support is required to minimize the harms of self-isolation.

ObjectivesAn evaluation of a short animated film on adverse childhood experiences (ACEs) to explore attitudes and sentiment towards the film including, for a subsample of professionals, associations between attitudes and personal experience of ACEs.DesignMixed-method exploratory design.SettingProfessionals and the general public.ParticipantsA short online survey with 239 professionals. Interaction and user sentiment towards with the film on social media (Twitter, YouTube).Primary and secondary outcome measuresSurvey: participants’ attitudes towards the film including feelings invoked, learning gained and ACE count prevalence. Twitter user and YouTube viewer sentiment (positive, negative or neutral) and interaction (likes, retweets or comments) with the film.ResultsAttitudes to the film were positive: 94.1% and 93.7%, respectively, agreed that it provided a helpful explanation of ACEs and trusted that the film was credible. Of those who reported ACE exposure, 88.9% agreed that those with ACEs would benefit from watching the film. Despite 50.6% reporting that the film had made them feel sad or upset, the majority (66.4%) reported they found the film hopeful or encouraging. Across 358 publicly available tweets from 313 users, 39.1% of tweets expressed positive sentiment, with only 1.4% negative (59.5% neutral). However, there was no association between tweet sentiment and interaction. Thirteen YouTube versions of the film received 171 812 views, 97.3% (n=889/914) ratings were positive (ie, ‘thumbs up’).ConclusionsDespite being emotionally arousing, many professionals reflected positive impacts of the film including a perceived increased ability to discuss ACEs. Public sentiment demonstrated a positive reaction to and acceptability of the film. Understanding the professional and public response to materials developed to increase ACE awareness, such as the film explored here, is important given the growing number of international movements which seek to increase ACE awareness, prevent ACEs and mitigate their lifelong negative effects.

Objectives: To identify the specific challenges of self-isolation experienced by population sub-groups to better target and tailor support. Design: The Contact Adherence Behavioural Insights Study (CABINS) was a 15-minute telephone survey of confirmed contacts of cases of COVID-19 identified through the national NHS Wales Test Trace Protect (TTP) database. Methods: Confirmed contacts of cases of COVID-19 reached by TTP completed a 15-minute telephone survey (N = 2,027). Binary logistic regression models adjusted for age, gender, living alone, survey round, deprivation quintile (defined by the Welsh Index of Multiple Deprivation) and income precarity (financial security) determined which population sub-groups were more likely to experience challenges during self-isolation. Results: Younger people (aged 18-29 years) were 3 times more likely to report mental health concerns (Adjusted Odds Ratio [aOR]: 3.16, 95% Confidence Interval [CI]: 2.05-4.86) and 2 times more likely to report loneliness (aOR: 1.96, CI: 1.37-2.81) compared to people aged over 60 years. Women were 1.5 times more likely to experience mental health concerns (aOR: 1.51, 95% CI: 1.20-1.92) compared to men. People with high/very high levels of income precarity were 8 times more likely to report financial challenges (aOR: 7.73, CI: 5.10-11.74) and 3 times more likely to report mental health concerns than their more financially secure counterparts (aOR: 3.08, CI: 2.22-4.28). Conclusions: Self-isolation is particularly challenging for those with younger people, women and precarious incomes. Providing enhanced emotional, financial and social support and signposting to these groups is required to minimise the harms of self-isolation.

Background Self-isolation is known to be challenging and adherence is dependent on a range of psychological, social, and economic factors. We aimed to identify the specific challenges experienced by contacts of COVID-19 cases to better target support and minimise the harms of self-isolation. MethodsThe Contact Adherence Behavioural Insights Study (CABINS) was a 15 min telephone survey of contacts of COVID-19 cases, identified through NHS Wales Test Trace Protect (TTP). Quota sampling by age, gender (interlocked), and Welsh Index of Multiple Deprivation (WIMD) was used to ensure a representative sample of those in the TTP database. Logistic regression models adjusted for age, gender, living alone, time period, WIMD, and income precarity (financial insecurity) established which subgroups were more likely to experience challenges. Ethical approval was gained from the NHS Research Ethics Committee and the Public Health Wales Research and Development Office. Informed consent was gained from participants at the beginning of the telephone call. Findings We identified 47 072 eligible contacts (24 825 female, 23 090 male, and 10 542 did not say) who were informed to self-isolate over two periods (period 1 [regional lockdowns in place; no financial support available]: Sept 13, 2020, to Oct 23, 2020 [n=18 568]; period 2 [during a national lockdown; self-isolation support payments available]: Dec 13, 2020, to Jan 16, 2021 [n=28 504]). 10 801 were invited to participate (5092 from period 1, 5709 from period 2); 2027 (18•8%) completed the survey. People with high income precarity were almost eight times more likely to report financial challenges (adjusted odds ratio 7•73; 95% CI 5•10-11•74) and three times more likely to report mental health concerns (3•08; 2•22-4•28) than their more financially secure counterparts. Younger people (18-29 years) were twice as likely to report loneliness (1•96; 1•37-2•81) and three times more likely to report mental health concerns (3•16; 2•05-4•86) than individuals aged 60 years and older. Women were nearly twice as likely to experience mental health difficulties as men (1•51; 1•20-1•92). No effects of WIMD were found. Findings were similar between the two periods.Interpretation Financial challenges of self-isolation were particularly acute among those individuals with high income precarity, and younger people and women had considerable mental health challenges. During the pandemic, Welsh Government and local TTP teams used this insight to target financial and mental health support to those with greatest need. Despite easing of self-isolation requirements for contacts of COVID-19 cases, identifying these groups remains important for future pandemics and the provision of financial and social support.

Background The COVID-19 pandemic had an early impact on employment, with the United States (US) and the United Kingdom (UK) experiencing more severe immediate labour market impacts than other Western countries. Emerging evidence from the initial phase of the pandemic highlighted that job losses were experienced more by those holding atypical contracts. Furthermore, it is predicted that this associated unemployment will increase precarious employment arrangements during the COVID-19 pandemic. In this paper we seek to answer the following research questions: I. What is the prevalence of precarious employment in Wales and are there differences in employment precariousness by socio-demographic characteristics and self-reported health status? II. Which domains are the main contributing factors of precarious employment in Wales? III. Which domains of precarious employment are associated with poorer health? IV. Haves there been changes in job quality (as reflected by precarious employment domains) during the COVID pandemic (between February 2020 and Winter 2020/2021)? Methods Data was collected from a national household survey carried out in May/June 2020, with a sample of 1,032 residents in Wales and follow-up responses from 429 individuals collected between November 2020 and January 2021. To examine the associations between experiencing precarious employment or the separate domains of employment precariousness and socio-demographics and health, chi-squared analyses and logistic regression models (multinomial and binary) were used. To determine longitudinal changes in precarious employment experienced by socio-demographic groups and furlough status, McNemars test was used. The data is presented as proportion of respondents or adjusted odds ratios (aOR) and 95% confidence intervals following logistic regression. Results Overall, pre-pandemic, one in four respondents were determined to be in precarious employment (26.5%). A higher proportion of females (28.3%) and those aged 18-29 years (41.0%) were in precarious employment in February 2020. In addition, a greater percentage of individuals who reported poorer health across all self-reported measures were in precarious employment compared to those reporting better health. Worse perceived treatment at work was twice as likely in those who reported a pre-existing condition (aOR 2.45 95% CI [1.33-4.49]), poorer general health (aOR 2.33 95% CI [1.22-4.47]) or low mental wellbeing (aOR 2.81 95% CI [1.34-5.88]) when compared to their healthier counterparts. Those calculated to have high wage precariousness were three times more likely to report low mental wellbeing (aOR 3.12 95% CI [1.54-6.32]). In the subsample, there was an observed increase in the prevalence of precarious employment, with this being attributable to lower affordability of wages and a perceived increase in vulnerability at work. The subgroups that were most impacted by this decrease in job quality were females and the 30-39 years age group. Implications Improving the vulnerability and wages domains, through the creation and provision of secure, adequately paid job opportunities has the potential to reduce the prevalence of precarious employment in Wales. In turn, these changes would improve the health and wellbeing of the working age population, some of which are already adversely impacted by the COVID-19 pandemic.