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COVID-19 represents a serious challenge to governments and healthcare systems. On the island of Ireland there are two public health and governmental jurisdictions, the Republic of Ireland and Northern Ireland, which has resulted in two different approaches to dealing with COVID-19. An expert interdisciplinary research team are working in tandem with leaders in public health to explore the implications of the different measures and messaging around COVID-19 across these two jurisdictions on two similar populations.

Catherine Darker, Associate Professor of Health Services Research at Trinity College Dublin, Ireland, and a team from Trinity College Dublin are leading this project, which is part of the Rapid Response Research and Innovation funding programme. We interviewed Catherine to tell us more about their plans, as set out in their Study Protocol, published on HRB Open Research, and why creating an evidence-based toolbox for public health messaging can help guide decision makers in their approach to further waves of COVID-19 or for future epidemics.

What is your field of research?

I have trained as a Health Psychologist, interested in population level health and healthcare, in particular how peoples’ behaviours effect their health and wellbeing. I particularly enjoy designing, implementing and evaluating health behaviour change interventions to reduce the risk of people developing common chronic conditions. I also routinely do both process and outcome evaluations of healthcare services.

Have the measures and messaging for COVID varied between the Republic of Ireland and Northern Ireland?

Yes and no. Largely speaking the types of messages have been the same. For example, both jurisdictions have included messaging relating to hand washing, social/physical distancing, good cough/sneeze hygiene or older persons or those with medical vulnerabilities to shield or to cocoon. Both jurisdictions implemented school closures, encouraged ‘working from home’, and also encouraged people to reduce the number of social contacts that they made.

There were some differences in the timings of these measures and recommendations. What does add a degree of complexity, especially for those people living in border counties, is that there are three entities that are providing advice – the Government of the Republic of Ireland, the Northern Ireland Executive and the Government of the United Kingdom. The border between Northern Ireland and the Republic is porous and many citizens live, work, socialise, and are educated on either side of the border, making travel across the border a routine part of normal everyday life.

What is the CONTAIN study?

Having two jurisdictions and two public health services on the same small island is a fascinating natural experiment. During a pandemic it presents a unique opportunity to investigate how a virus like COVID-19 can spread and the implications of differing measures and messaging across these two jurisdictions on two very similar populations.

What areas will you be investigating?

This project has four nested studies – looking at psychological and behavioural aspects of COVID-19: (social) media messaging in both jurisdictions and looking at the spread of (mis)information; trying to link these two areas with case and mortality data;  and finally looking at the politics and health policy of the situation as well. We believe that all of these factors are important to explaining how the two areas of the island of Ireland cope with the pandemic.

Why is it important to develop an evidence-based COVID-19 toolbox?

Data is crucial as it provides factual information like numbers, percentages and statistics, but evidence is when we take that data and we make sense of it to inform decision making. Data relating to COVID-19 is a very fast moving space. What is needed is analyses and consideration of what the data is actually telling us.

In applied research, we are always trying to take data and make sense of it so as that we can form opinions that are evidence based and provide guidance to people like the Department of Health and health services providers, so as that they in turn can make decisions that are sound.

What impact do you hope this will have on public health policies in future?  

In future, we would hope that both Governments on the island of Ireland, will be able to respond quickly and effectively when the next pandemic comes to Ireland. Having a strong foundation of knowledge from our experiences of COVID-19 can help with this.

You are part of an interdisciplinary research team working on this – why is this beneficial for this study?  

I knew when I conceived the study that I wanted to have aspects of it that spanned across health psychology, social psychology, public health, epidemiology, and political science. I contacted colleagues in universities, and asked them to be a part of the CONTAIN study. The team comprises ourselves in the Discipline of Public Health & Primary Care in Trinity College Dublin, University College Dublin, Queens University, Belfast and also University of Bristol, UK. We formed a team quickly, secured our funding from the Health Research Board and Irish Research Council and were in the field collecting data within a matter of weeks. Conducting research rapidly in a pandemic is not for the faint hearted!

Data collection and analysis plays a vital role in this study. What type of data will you be collecting and how do you intend to maximise the availability of the research data produced?

We want to find out the views and opinions of ordinary people across the whole of the island. To do this we will conduct a telephone survey with approximately 3000 people from both Northern Ireland the Republic of Ireland on a weekly basis. We will try and figure out common motivations of people who adhere or do not adhere to containment behaviours like social distancing and handwashing.

This will be with a view to developing profiles of these groups to inform targeted public health campaigns, Alongside this we will also run a series of focus groups with sub-groups of the population to do a ‘deep dive’ on their views of COVID-19, how they are responding to the pandemic and how its effecting them. For instance, to explore the effects of COVID-19 on younger people or people over the age of 70 years of age.

“The all-Ireland data collection, the wide-range of leading experts on the study team and the diversity and integration of the data sources are particular strengths of this programme of work,” wrote Gerry Molloy, National University of Ireland Galway, Ireland in his review of the article.

Read the Study Protocol and the review reports via HRB Open Research, ‘Study protocol for the COvid-19 Toolbox for All IslaNd (CONTAIN) project: A cross-border analysis in Ireland to disentangle psychological, behavioural, media and governmental responses to COVID-19’