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      How to improve adherence with quarantine: rapid review of the evidence

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          Abstract

          Objectives

          The December 2019 outbreak of coronavirus has once again thrown the vexed issue of quarantine into the spotlight, with many countries asking their citizens to ‘self-isolate’ if they have potentially come into contact with the infection. However, adhering to quarantine is difficult. Decisions on how to apply quarantine should be based on the best available evidence to increase the likelihood of people adhering to protocols. We conducted a rapid review to identify factors associated with adherence to quarantine during infectious disease outbreaks.

          Study design

          The study design is a rapid evidence review.

          Methods

          We searched Medline, PsycINFO and Web of Science for published literature on the reasons for and factors associated with adherence to quarantine during an infectious disease outbreak.

          Results

          We found 3163 articles and included 14 in the review. Adherence to quarantine ranged from as little as 0 up to 92.8%. The main factors which influenced or were associated with adherence decisions were the knowledge people had about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, as well as practical issues such as running out of supplies or the financial consequences of being out of work.

          Conclusions

          People vary in their adherence to quarantine during infectious disease outbreaks. To improve this, public health officials should provide a timely, clear rationale for quarantine and information about protocols; emphasise social norms to encourage this altruistic behaviour; increase the perceived benefit that engaging in quarantine will have on public health; and ensure that sufficient supplies of food, medication and other essentials are provided.

          Highlights

          • •

            Adherence to quarantine can be difficult, and adherence rates are variable.

          • •

            Adherence can be affected by perceived risks and social norms.

          • •

            Knowledge about quarantine protocol is essential.

          • •

            Public health benefits of quarantine must be made clear.

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          Most cited references10

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          Is Open Access

          Understanding the school community’s response to school closures during the H1N1 2009 influenza pandemic

          Annette Braunack-Mayer, Rebecca Tooher, Joanne E Collins … (2013)
          Background During the 2009 H1N1 influenza pandemic, Australian public health officials closed schools as a strategy to mitigate the spread of the infection. This article examines school communities’ understanding of, and participation in, school closures and the beliefs and values which underpinned school responses to the closures. Methods We interviewed four school principals, 25 staff, 14 parents and 13 students in five schools in one Australian city which were either fully or partially closed during the 2009 H1N1 pandemic. Results Drawing on Thompson et al’s ethical framework for pandemic planning, we show that considerable variation existed between and within schools in their attention to ethical processes and values. In all schools, health officials and school leaders were strongly committed to providing high quality care for members of the school community. There was variation in the extent to which information was shared openly and transparently, the degree to which school community members considered themselves participants in decision-making, and the responsiveness of decision-makers to the changing situation. Reservations were expressed about the need for closures and quarantine and there was a lack of understanding of the rationale for the closures. All schools displayed a strong duty of care toward those in need, although school communities had a broader view of care than that of the public health officials. Similarly, there was a clear understanding of and commitment to protect the public from harm and to demonstrate responsible stewardship. Conclusions We conclude that school closures during an influenza pandemic represent both a challenge for public health officials and a litmus test for the level of trust in public officials, government and the school as institution. In our study, trust was the foundation upon which effective responses to the school closure were built. Trust relations within the school were the basis on which different values and beliefs were used to develop and justify the practices and strategies in response to the pandemic.
          Article 0 comments Cited 68 times – based on 0 reviews     Review now
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            Risk Perception and Compliance With Quarantine During the SARS Outbreak

            Maureen A Cava, Krissa E Fay, Heather J Beanlands … (2005)
            Article 0 comments Cited 45 times – based on 0 reviews     Review now
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              Attitudes toward the use of quarantine in a public health emergency in four countries.

              Robert J Blendon, Catherine M DesRoches, Martin S. Cetron … (2006)
              Countries worldwide face the threat of emerging infectious diseases. To understand the public's reaction to the use of widespread quarantine should such an outbreak occur, the Harvard School of Public Health, with the U.S. Centers for Disease Control and Prevention, undertook a survey of residents of Hong Kong, Taiwan, Singapore, and the United States. A sizable proportion of the public in each country opposed compulsory quarantine. Respondents were concerned about overcrowding, infection, and inability to communicate with family members while in quarantine. Officials will need specific plans to deal with the public's concerns about compulsory quarantine policies.
              Article 0 comments Cited 42 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                R.K. Webster
                Journal
                Journal ID (nlm-ta): Public Health
                Journal ID (iso-abbrev): Public Health
                Title: Public Health
                Publisher: The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
                ISSN (Print): 0033-3506
                ISSN (Electronic): 1476-5616
                Publication date PMC-release: 30 March 2020
                Publication date (Print): May 2020
                Publication date (Electronic): 30 March 2020
                Volume: 182
                Pages: 163-169
                Affiliations
                [a ]Department of Psychology, University of Sheffield, United Kingdom
                [b ]King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
                Author notes
                [∗ ]Corresponding author. University of Sheffield, Department of Psychology, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, United Kingdom. Tel.: +44 20 7848 5686. r.k.webster@ 123456sheffield.ac.uk
                Article
                Publisher ID: S0033-3506(20)30071-8
                DOI: 10.1016/j.puhe.2020.03.007
                PMC ID: 7194967
                PubMed ID: 32334182
                SO-VID: 35755fa0-3f0e-409e-a075-3ac8c437b227
                Copyright © © 2020 The Author(s)
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 26 February 2020
                Date revision received : 11 March 2020
                Date accepted : 13 March 2020
                Categories
                Subject: Article

                ScienceOpen disciplines: Public health
                Keywords: adherence,compliance,infectious disease outbreak,quarantine
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: adherence, compliance, infectious disease outbreak, quarantine

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