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A systematic approach to public health - Novel application of the human factors analysis and classification system to public health and COVID-19.

ABSTRACT: In this article, we argue for a novel adaptation of the Human Factors Analysis and Classification System (HFACS) to proactive incidence prevention in the public health and in particular, during and in response to COVID-19. HFACS is a framework of causal categories of human errors typically applied for systematic retrospective incident analysis in high-risk domains. By leveraging this approach proactively, appropriate, and targeted measures can be quickly identified and established to mitigate potential errors at different levels within the public health system (from tertiary and secondary healthcare workers to primary public health officials, regulators, and policymakers).

SUBMITTER: Bickley SJ

PROVIDER: S-EPMC8053242 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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A systematic approach to public health - Novel application of the human factors analysis and classification system to public health and COVID-19.

Bickley Steve J SJ Torgler Benno B

Safety science 20210418

In this article, we argue for a novel adaptation of the Human Factors Analysis and Classification System (HFACS) to <i>proactive</i> incidence prevention in the public health and in particular, during and in response to COVID-19. HFACS is a framework of causal categories of human errors typically applied for systematic retrospective incident analysis in high-risk domains. By leveraging this approach proactively, appropriate, and targeted measures can be quickly identified and established to miti ...[more]

PMID: 33897105

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Project description:IntroductionDigital exposure notification (EN) approaches may offer considerable advantages over traditional contact tracing in speed, scale, efficacy, and confidentiality in pandemic control. We applied the science of learning health systems to test the effect of framing and digital means, email vs Short Message Service (SMS), on EN adoption among patients of an academic health center.MethodsWe tested three communication approaches of the Apple and Google EN system in a rapid learning cycle involving 15 000 patients pseudorandomly assigned to three groups. The patients in the first group received a 284-word email that presented EN as a tool that can help slow the spread. The patients in the second group received a 32-word SMS that described EN as a new tool to help slow the spread (SlowTheSpreadSMS). Patients in the third group received a 47-word SMS that depicted the system as a new digital tool that can empower them to protect their family and friends (EmpowerSMS). A brief four-question anonymous survey of adoption was included in a reminder message sent 2 days after the initial outreach.ResultsOne hundred and sixty people responded to the survey within 1 week: 2.33% from EmpowerSMS, 0.97% from SlowTheSpreadSMS, and 0.53% from emails; 29 (41.43%), 24 (41.38%), and 11 (34.38%) reported having adopted EN from each group, respectively. Patient reported barriers to adoption included iOS version incompatibility, privacy concerns, and low trust of government agencies or companies like Apple and Google. Patients recommended that healthcare systems play an active role in disseminating information about this tool. Patients also recommended advertising on social media and providing reassurance about privacy.ConclusionsThe EmpowerSMS resulted in relatively more survey responses. Both SMS groups had slightly higher, but not statistically significant EN adoption rates compared to email. Findings from the pilot not only informed operational decision-making in our health system but also contributed to EN rollout planning in our State.

Project description:ObjectivesThe COVID-19 pandemic has led to a change in people's volunteering behaviours; participation has increased in informal volunteering (giving unpaid help to those who are not a relative) while decreasing in formal volunteering (unpaid help to groups or clubs). There is an interest from stakeholders who have experienced increased participation in maintaining the positive patterns of volunteering, aligning with National Health Service (NHS) objectives and realising benefits in a wider public health context. This research uses a local COVID-19 public health volunteering programme case study to explore the volunteer's journey and perspective using volunteers' reported experiences to consider the potential for volunteer retention and role expansion into other public health issues beyond the COVID-19 pandemic.MethodsRecruitment was undertaken by Birmingham City Council Public Health Team via the COVID-19 Community Champions programme mailing list. Semi-structured focus group discussions, one-to-one interviews and email interviews were conducted with volunteers. Data were analysed through directed thematic analysis using an iteratively developed coding frame.ResultsData were collected from three focus group discussions, four interviews, and one email interview involving a total of 16 participants. Six themes were identified: volunteer motivations and expectations; volunteer management; programme organisation; feeling valued; continued need for role, and interest in new responsibilities.ConclusionOur findings indicate that the factors which are conducive to volunteer recruitment, retention and re-purposing were: maintaining the original terms of engaging with the volunteering opportunity (including retaining the original brief and remit), adjusting these through consultative processes with an emphasis on seeking permission from the volunteers already involved and ensuring a reliable and consistent management and support structure. While some of the learning is specific to the local volunteer programme in question and the context of the COVID-19 pandemic, there are lessons that can be generalised to other scenarios and settings.

Project description:BackgroundPublic health education plays a crucial role in effectively addressing infectious diseases such as COVID-19. However, existing educational materials often provide only foundational information, and traditional group education faces challenges due to social distancing policies.ObjectiveAddressing these gaps, our study introduces a serious game called "Flattening the Curve." This interactive experience immerses learners in the role of quarantine policy managers, offering unique insights into the effects and challenges of social distancing policies.MethodsThe development of the game adhered to the SERES framework, ensuring a scientifically designed foundation. To achieve its learning objectives, the game incorporated learning and game mechanics including an agent-based infection model, a social distancing policy model, and an economic model, which were developed based on previous literature. After defining a broad concept of scientific and design foundations, we used a participatory design process. This study included 16 undergraduates and took place over one semester. Participants played the game, gave feedback, and answered surveys. The game was improved based on participants' feedback throughout the process. Participants' feedback was analyzed based on the Design, Play, and Experience framework. Surveys were conducted before and after the activity and analyzed to assess participants' evaluation of and satisfaction with the game.ResultsThe game successfully achieved its learning objectives, encompassing a comprehensive understanding of infectious disease characteristics; the disease transmission process; the necessity and efficacy of quarantine policies and their delicate balance with economic factors; and the concept of flattening the curve. To achieve this, the game includes the following: (1) an agent-based infection model based on the modified Susceptible-Exposed-Infectious-Hospitalized-Recovered (SEIHR) model with five infectious disease scenarios; (2) a quarantine policy model with social distancing, travel control, and intensive care unit management; and (3) an economic model that allows users to consider the impact of quarantine policies on a community's economy. In response to participatory design feedback, the game underwent meticulous modifications, including refining game systems, parameters, design elements, the user interface, and interactions. Key feedback included requests for more scenarios and engaging yet simple game elements, as well as suggestions for improving the scoring system and design features. Notably, concerns about the fairness of the outcome evaluation system (star rating system), which could incentivize prioritizing economic activity over minimizing casualties, were raised and addressed by replacing the star rating system with a progress-based vaccine development system. Quantitative evaluation results reflect participants' positive assessments of the game through the learner-centric approach.ConclusionsThe serious game "Flattening the Curve," developed through a participatory design approach, emerges as a valuable tool for public health education, particularly concerning social distancing policies. The game and its source code are openly accessible online, enabling widespread use for research and educational purposes.

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A systematic approach to public health - Novel application of the human factors analysis and classification system to public health and COVID-19.

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A systematic approach to public health - Novel application of the human factors analysis and classification system to public health and COVID-19.

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