Introduction
respiratory tract infection, infection, infections
RESPIRATORY TRACT INFECTIONS, RECRUITMENT, INFECTIONS, INFECTION, RESPIRATORY TRACT INFECTION
The COVID-19 pandemic has highlighted the importance of behavioural strategies for controlling infection transmission. Effective implementation of good hygiene practices as public health measures (including social distancing, self-isolation, handwashing, mask wearing and ventilation) was vital to control the spread until a vaccine was developed [Supporting behaviour change is a complex process that requires an in-depth understanding of why people do/do not engage in target behaviours [Reducing within-household transmission pathways is important in contexts where inter-household contact is reduced (i.e. during lockdowns and self-isolation [In a previous trial of Germ Defence, 20,066 adults from UK primary care practices were randomised to be given access to Germ Defence reported fewer respiratory tract infections (mean 0.84 vs 1.09 in control group), fewer family member infections and less severe infections [Could be disseminated to patients via general practitioner (GP) practicesDecreased the number of respiratory tract infection diagnoses in GP practicesDecreased other transmissible infections (COVID-19, gastrointestinal)Decreased associated healthcare utilisation (consultations, hospital admissions, antibiotic usage)Historically, NHS (National Health Service) electronic health record data has been accessed by researchers via a process of pseudonymisation (replacing explicit identifiers such as name and address with a pseudonymous identifier) followed by dissemination of a subset of patients’ records for local analysis. Recently, published UK (United Kingdom) Department of Health and Social Care policy [We used a novel efficient trial design to evaluate the effectiveness of implementing Germ Defence through all GP practices in England being asked to send the intervention to their adult patients. The efficient trial design meant that no GP practice or patient recruitment was required, and GP practices were not required to send the research team any data, with all outcomes assessed using anonymous patient record data in situ via the OpenSAFELY platform trusted research environment and website analytics.