Kesten Joanna May, Audrey Suzanne, Holding Maya, Coope Caroline, Young Nick, Brown Colin S, Harries Jenny, Hickman Matthew, Oliver Isabel
NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK.
The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
BMJ Glob Health. 2018 Jun 27;3(3):e000788. doi: 10.1136/bmjgh-2018-000788. eCollection 2018.
In response to the 2013-2016 West African outbreak of the Ebola virus disease (EVD), Public Health England introduced enhanced screening at major UK ports of entry. Our aim was to explore screeners' and screened travellers' perceptions of screening as part of an evaluation of the screening programme.
We undertook qualitative focus groups and semistructured interviews with screeners and travellers who had returned from affected countries before and after the introduction of screening in England. The study was conducted in two airports: one international rail terminal and one military airport. Research topic guides explored perceptions of the purpose and implementation of the process, potential improvements and reactions to screening. The data were analysed using the framework method.
Twenty-four screeners participated in 4 focus groups (one for each port of entry) and 23 travellers participated in interviews. Three themes are presented: 'Context', 'Screeners' experience of the programme' and 'Screening purpose and experiences'. The programme was implemented rapidly, refined over time and adapted to individual ports. Screeners reported diverse experiences of screening including negative impacts on their normal roles, difficult interactions with passengers and pressure to identify positive EVD cases. Screening was considered unlikely to identify individuals with symptoms of EVD, and some participants suggested it was driven by political concerns rather than empirical evidence. The screening process was valued for its provision of information and reassurance.
This qualitative study found that the UK EVD screening process was perceived to be acceptable to assess individual risk and provide information and advice to travellers. Future programmes should have clear objectives and streamlined processes to minimise disruption, tailored to the nature of the threat and developed with the needs of humanitarian workers as well as general travellers in mind.
为应对2013 - 2016年西非埃博拉病毒病（EVD）疫情，英国公共卫生部门在英国主要入境口岸加强了筛查。我们的目的是探讨筛查人员和接受筛查的旅行者对筛查的看法，作为筛查计划评估的一部分。
我们对在英国引入筛查前后从受影响国家返回的筛查人员和旅行者进行了定性焦点小组讨论和半结构化访谈。研究在两个机场进行：一个国际铁路终点站和一个军事机场。研究主题指南探讨了对筛查过程目的和实施、潜在改进以及对筛查反应的看法。数据采用框架法进行分析。
24名筛查人员参加了4个焦点小组（每个入境口岸一个），23名旅行者参加了访谈。呈现了三个主题：“背景”、“筛查人员对该计划的体验”和“筛查目的与体验”。该计划实施迅速，随着时间推移不断完善，并根据各个口岸进行了调整。筛查人员报告了筛查的不同体验，包括对其正常工作的负面影响、与乘客的艰难互动以及识别埃博拉病毒病阳性病例的压力。筛查被认为不太可能识别出有埃博拉病毒病症状的个体，一些参与者认为这是出于政治担忧而非实证依据。筛查过程因其提供信息和安慰而受到重视。
这项定性研究发现，英国的埃博拉病毒病筛查过程被认为在评估个人风险以及向旅行者提供信息和建议方面是可以接受的。未来的计划应该有明确的目标和简化的流程，以尽量减少干扰，根据威胁的性质进行调整，并在考虑人道主义工作者以及普通旅行者需求的情况下制定。
