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      Codesigning an intervention to strengthen COVID-19 vaccine uptake in Congolese migrants in the UK (LISOLO MALAMU): a participatory qualitative study protocol

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          Abstract

          Introduction

          Migrants positively contribute to host societies yet experience barriers to health and vaccination services and systems and are considered to be an underimmunised group in many European countries. The COVID-19 pandemic has highlighted stark inequities in vaccine uptake, with migrants facing access and informational barriers and lower vaccine confidence. A key challenge, therefore, is developing tailored vaccination interventions, services and systems which account for and respond to the unique drivers of vaccine uptake in different migrant populations. Participatory research approaches, which meaningfully involve communities in co-constructing knowledge and solutions, have generated considerable interest in recent years for those tasked with designing and delivering public health interventions. How such approaches can be used to strengthen initiatives for COVID-19 and routine vaccination merits greater consideration.

          Methods and analysis

          LISOLO MALAMU (‘Good Talk’) is a community-based participatory research study which uses qualitative and coproduction methodologies to involve adult Congolese migrants in developing a tailored intervention to increase COVID-19 vaccine uptake. Led by a community–academic coalition, the study will involve (1) semistructured in-depth interviews with adult Congolese migrants (born in Democratic Republic of Congo, >18 years), (2) interviews with professional stakeholders and (3) codesign workshops with adult Congolese migrants. Qualitative data will be analysed collaboratively using reflexive thematic analysis, and behaviour change theory will be used in parallel to support the coproduction of interventions and make recommendations across socioecological levels. The study will run from approximately November 2021 to November 2022.

          Ethics and dissemination

          Ethics approval was granted by the St George’s University Research Ethics Committee (REC reference: 2021.0128). Study findings will be disseminated to a range of local, national and international audiences, and a community celebration event will be held to show impact and recognise contributions. Recommendations for implementation and evaluation of prototyped interventions will be made.

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          Using thematic analysis in psychology

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            The behaviour change wheel: A new method for characterising and designing behaviour change interventions

            Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.
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              Reflecting on reflexive thematic analysis

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2023
                13 January 2023
                13 January 2023
                : 13
                : 1
                : e063462
                Affiliations
                [1 ]departmentMigrant Health Research Group, Institute for Infection and Immunity , St George's, University of London , London, UK
                [2 ]departmentHackney Refugee and Migrant Forum , Hackney Council for Voluntary Service , London, UK
                [3 ]Hackney Congolese Women Support Group , London, UK
                [4 ]Doctors of the World UK , London, UK
                [5 ]departmentInstitute for Infection and Immunity and Population Health Research Institute , St George's, University of London , London, UK
                [6 ]departmentFaculty of Health, Science, Social Care and Education, Centre for Applied Health and Social Care Research , Kingston University , Kingston, UK
                [7 ]Our Future Health , Manchester, UK
                Author notes
                [Correspondence to ] Dr Sally Hargreaves; s.hargreaves@ 123456sgul.ac.uk
                Author information
                http://orcid.org/0000-0003-0450-7258
                http://orcid.org/0000-0002-6934-1925
                http://orcid.org/0000-0003-2974-4348
                Article
                bmjopen-2022-063462
                10.1136/bmjopen-2022-063462
                9842599
                36639215
                86a333f2-08c8-40da-959c-9fc11decc204
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 01 April 2022
                : 15 December 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000272, National Institute for Health Research;
                Award ID: 300072
                Funded by: FundRef http://dx.doi.org/10.13039/100004423, World Health Organization;
                Award ID: N/A
                Funded by: FundRef http://dx.doi.org/10.13039/501100000691, Academy of Medical Sciences;
                Award ID: SBF005\1111
                Funded by: La Caixa Foundation;
                Award ID: N/A
                Funded by: FundRef http://dx.doi.org/10.13039/501100009708, Novo Nordisk Fonden;
                Award ID: N/A
                Categories
                Research Methods
                1506
                2474
                1730
                Protocol
                Custom metadata
                unlocked
                free

                Medicine
                public health,qualitative research,primary care,covid-19
                Medicine
                public health, qualitative research, primary care, covid-19

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