Covid-19 Post-Shielding Research: October 2023

Appendix B: Interview Discussion Guide

Covid-19 Post-Shielding Research - Discussion Guide, v.Aug 2023

Advance Preparation

Researcher to familiarise with survey responses in advance, noting here:

• whether they had been asked to shield at the start of the pandemic,
• whether they were on the HRL when it ended,
• which type of letter that they received from the Chief Medical Officer (CMO) when the list ended (i.e. general or higher risk),
• whether they are immunosuppressed, taking into account guidance from Scottish Government based on previous research,
• whether they are eligible for treatments,
• the health condition of the participant

Set up

Introduce Diffley Partnership Team member

Thank you for completing the survey through ScotPulse on this topic and subsequently agreeing to take part in this interview.

Welcome to the interview–

- Explain the discussion will last up to 30 minutes

• Fully anonymous and confidential; The Diffley Partnership abide by the Market Research Society Code of Practice and the SRA Ethical Guidelines.
• Request permission to record discussion – with your permission I will record the discussion; this is just so we can go back and listen again after the discussion

^[1] Coronavirus (COVID-19): communications to the high risk group - gov.scot (www.gov.scot)

Do you have any questions before we start?

During COVID and HRR

Let’s start, if you are comfortable, by hearing a bit more about you.

Please give me an overview of your health condition/s during the COVID-19 pandemic.

What was your experience of shielding during the pandemic?

Highest Risk List/ Shielding List

What was your experience of being on the Highest Risk List/ Shielding List?

Follow ups-

• How did that come about?
• How did it make you feel?
• What were the positive and negative impacts of being on the list?

The Highest Risk List/ Shielding List ended on 31 May 2022. Did you have any concerns over the ending of the HRL?

How comfortable do you feel now with the decision to end this list?

Follow up:

• What might make you feel more comfortable since the end of the HRL?

Since the HRL ended, did you adapt to living with Covid?

Follow ups-

• How so/ how not?

How has the end of the HRL affected the following?

- your confidence when leaving home

- your physical health

- your mental health

- relationships

- employment/education

Guidance and advice

Do you know what current SG guidance in relation to Covid-19 is?

If yes Follow up- Can you summarise this for me please?

Do you look to Scottish Government for any information or advice?

Follow ups-

• Is this helpful?
• Is anything unclear?
• Do you find it reassuring?
• Is anything missing from their communications?
• Do you have any suggestions for improvement?

Have your feelings regarding SG Guidance changed at all from when the ‘highest risk groups’ were first identified to now?

Follow up:

• Have your feelings in relation to SG guidance changed at all since the end of the HRL?

What are any other sources you look to for information or advice in relation to Covid-19?

Prompts- NHS/ GPs, charities, online forum or groups, friends and family

If yes Follow up- Can you summarise this for me please?

Follow ups for each source they mention-

• Is this helpful?
• Is this clear?
• Do you find this reassuring?

Ongoing shielding behaviours- themselves

Are you shielding now?

Follow ups-

• Why/ why not?
• Please give us some examples of what you are doing or not doing

Are you taking steps to protect yourself and others at the moment?

Follow ups-

• Why/ why not?
• Please give us some examples of what you are doing or not doing

Probe on certain circumstances-

• In their own home
• In public places
• Working
• Leisure
• Transport

Probe on certain factors they raise-

• Ventilation
• Masks
• Hand sanitisation
• Social distancing – in the home, with visitors, or in public spaces, or elsewhere?
• Taking Lateral Flow Device tests
• Follow up: in what circumstances would you take an LFD test? For example, if you felt unwell, if you were visiting someone, if you were presenting at a healthcare setting?
• Asking others to Lateral Flow Device tests
• Follow up: in what circumstances would you ask someone else to take an LFD test? For example, if they had recently been unwell, if they were visiting you, if they had recently been in a healthcare setting?

How are you deciding what steps to take?

Follow ups- Are you basing this on any of the following?

• advice of your own GP/clinician
• former SG guidance from when the high risk register was live
• making your own risk assessments and deciding what to do – if so, what factors lead into your own risk assessments?

[If participant is making their own risk assessments and deciding what to do based on anxiety driver behaviours, rather than clinical advice] What might help you to build confidence to reduce shielding behaviours – where clinically appropriate for your circumstances?

Follow ups: would any of the following be useful?

• Increased understanding from your GP/clinician about health anxiety (for example, understanding that anxiety-driven behaviours can increase anxiety and ultimately reinforce what can be irrational thoughts)
• Increased understanding from others about health anxiety
• Increased understanding from your GP/Clinical about your current health condition and what protective behaviours would be proportionate/appropriate?
• More widespread information about what behaviours are safe now, versus at previous stages during the pandemic
• More clearly defined or unambiguous guidance around reducing shielding behaviours to avoid any uncertainty
• Support for anxiety – specifically related to the pandemic or more broadly
• Other?

Have you heard of the Distance Aware scheme?

If yes follow ups-

• Do you find this helpful?- how so/ not so?
• Has this made you change your behaviour in any way?

Have you heard of the Covid Sense Signage Pilot or the Stay Well This Winter Signage Scheme?

If yes follow ups-

• Do you find this helpful?- how so/ not so?
• Has this made you change your behaviour in any way?

Ongoing shielding behaviours- contacts

Are any other household members shielding or taking steps to protect you?

Follow ups-

• Why do you think they are/ aren’t?
• Please give us some examples of what you are doing or not doing

Are any other close contact you have taking steps to protect you?

Follow ups-

• Why do you think they are/ aren’t?

Please give us some examples of what you are doing or not doing

Health and quality of life

How would you currently describe your health?

How would you currently describe your quality of life?

Can you think of anything which would improve your quality of life?

Do you think COVID currently has an impact on your health or quality of life?

Follow ups:

• How so/ how not so?

Hypothetical future scenarios

What measures should be in place if there is another variant/surge of Covid-19?

Follow ups:

• What would be acceptable to you as a minimum?
• What would you desire to be put in place?
• Who should need to comply?

How do you feel about the future generally, and your future quality of life?

Conclusions and wrap-up

Thank you very much for the discussion, is there anything not already covered that you would like to mention?

Confirmation of incentive payment procedure for £20

Thank and close