Table 4 Barriers and facilitators to participation in and delivery of RB-TPP, mapped to the COM-B Framework

Capability: physical and psychological capacity to engage in the behaviour

Facilitator (physical)

“The saliva test was really, it’s really easy to do and it’s not like uncomfortable like the swab tests so, yeah, I much prefer doing them.” [FG2, S4]

“It just seemed really well organised, easy to find and easy to do. “[FG1, S5]

Test ease and preferences

“I think making it easy for them reduces the barriers and makes it more likely that they’ll get involved with us.” [I, S4]

“We like to say that our testing protocol is a lot easier and less invasive than the one you stick up your nose, it takes longer to get the results, but they are more accurate. But that’s not seen a good enough reason to test” [I, S1]

Facilitator (psychological)

“Because that’s [socialising] the whole point of coming to university” [S

“I would just say it felt a little more normal, like there was one bubble, our hall within uni that we could live almost as if Covid wasn’t really a thing, obviously there was the testing, mask wearing in communal areas and the dining hall, but other than that it was as [S1] said like, as close to university experience as we could get.” [FG1, S4]

“I’ve really enjoyed being in Halls, obviously meeting people, making friends and in general the Hall living experience has been as I hope it would be normally” [FG4, S1]

“It gave a sense of normality because being in university halls and not allowed to socialise is not a good experience.” [S]

Perceived normality of university life

“I think it was the pilot, they did see the kind of freedom of it, so I would guess their kind of normal student experience kind of came back into play a little bit and they did see that kind of happen.” [I, S7]

Facilitator (psychological)

“I think it was a big positive impact on wellbeing. I know a few people that were really anxious about socialising anyway before the pilot and they were much more comfortable while it was happening. They seemed to be much more relaxed and happier in themselves.” [FG7, S1]

“I mean other than being happier, it was a relief that we could actually communicate with other people...I was very happy that you know, it occurred.” [FG1, S1]

“I went to dinner alone for 5 months straight, until this pilot study came in. It was definitely less isolating”. [S]

“Felt nice for normality and to speak to people I’d seen around but never been able to speak to, definitely improved my mental health” [S]

“more is risked by allowing students to feel isolated in their tiny rooms with only 5 in their household and letting their mental health plummet” [S]

Student wellbeing

“I haven’t spoken to students about it but I think that it would have helped their mental welfare in terms of being able to socialise more freely” [I, S12)

“It didn’t really make a difference, I don’t think, because they’ve been partying all year so, you know, there have been quite a few incidents round the campus but they have been partying all year. So I don’t think it made that much of a difference to them.” [I, S9]

Facilitator (psychological)

“[before the pilot] They didn’t really want to go out of their way to get tested, especially as they’d been through the really severe isolation, they weren’t allowed to leave at all, and they don’t kind of want to go through that again.” [FG1, S5]

“[before the pilot] I think it was a very real fear of it’s just not going to be a good time if you quarantine” [FG4, S2]

“[with surge testing in place]...they don’t want to be the reason that the rest of their household has to stay indoors for 10 days and not see anyone or do the things that they’ve got planned. So I think the surge testing was actually quite a good idea to kind of test to see how the spread would happen.” [FG7, S2]

Reducing fear of self-isolation

“I suspect beforehand there would have been a bit of taboo almost about going and testing at the risk of them becoming positive and then locking down households. If you think in a house of six, one of you goes, gets tested and then the rest of them have to isolate, the other five might be a little bit miffed at that.” [I, S4]

“And then we’ve got the process in place now, if we do have a positive we don’t have to isolate the whole household, you know, that person then just gets moved to the [alternative accommodation], taken out the equation, and then everybody just has to test for one week and then negatives are coming back in 24 hours, so really they don’t have to isolate for very long, it’s only a 24 hour period where at the beginning of the academic year we had 97 and 92 households in isolation for ten days.” [I, S3]

Barrier (psychological)

“They [other students] said, ‘well I don’t see the point in testing because there’s no cases on campus anyway so why should we test?’” [FG3, S1]

“It felt basically the same from my point of view. I think other people did mix more but, yeah, they hadn’t really been enforcing the household only mixing beforehand anyway, everyone had just been sitting in the dining room next to each other for a while before, so it didn’t feel like it changed that much” [FG2, S4]

“It needs to be a bit more forceful in ‘look, you’re either doing this or you’re not’, because otherwise I think that kind of – what’s the word – just that indifference will set in and people stop doing it.” [FG2, S5]

Complacency and indifference

“...there was some feedback that some students really didn’t quite get the point of why we were doing it, why they were doing the testing” [I, S12]

“The students weren’t aware of the bigger picture here what was going on really, because they’re obviously in their own household, they’re on campus, they’re in their little bubble and really it’s a much bigger thing that we’re trying to protect.” [I, S3]

Opportunity: external factors that make the behaviour possible

Facilitator (testing service)

“now since it’s [test site] literally just inside the Hall, so it’s a lot more convenient.” [FG3, S6]

“It just seemed really well organised, easy to find and easy to do. “[FG1, S5]

“test results were always given out quickly” [S]

Convenience and efficiency of testing

“The very fact that we were in the Halls of Residence in a location where the footfall was really good, people were going past all of the time, I was surprised how important that was and make it easier for people to drop samples off, yeah, I was surprised about that.” [I, S2]

“Well I think the testing team are brilliant. So I think anything relating to the process of the testing was always done brilliantly and they would adapt to whatever”. [I, S12]

“the testing team were really good on site as well, you know, they’d just turn up and say ‘we’re here for the kit’ and off they go, they were really good, showed us how to use all the laptops, how to record the samples.” [I, S3]

Facilitator (testing service)

“I also appreciated how transparent the university was with testing figures” [S]

“It was pretty clear and we got regular updates on the progress of the participation” [S]

Transparency

“.. keeping the comms a bit more bitesized and even if there had have been, if we’d had the time to do infographics and things” [I, S7]

Facilitator (testing service)

“I thought it was pretty straight forward actually, the information everything, um … the emails were pretty frequent everything like that, so I think we had all the information that we needed.” [FG1, S1]

“I definitely want to know what’ll happen if someone tested positive in the Hall, what that means for me.” [FG2, S5]

“I feel everything was well communicated, if any changes occurred, we would be notified about these very quickly, we would always be reminded to collect and hand in our test samples. So overall, information was very well communicated”. [S]

Clear and regular information

“I think the university’s messages are really good, it’s just that they’re having to respond to changes that have come from government.” [I, S11]

“The communication team did well communicating what they had to communicate but for ever changing times, needing to clarify behaviours and everything just led to excess communications being sent out and I imagine that didn’t go down too well with students.” [I, S6]

Facilitator (peers)

“It seemed as far as I was aware, as I was aware, everyone who was in halls was testing” [FG1, S4]

“during the pilot the adherence was pretty good … I think overall we did pretty well with everyone testing and everything like that.” [FG1, S1]

Testing as a social norm

“...going into the new academic year when you’ve got a new Halls intake, pushing normalisation of testing I think is really beneficial potentially.” [I, S4]

“The positive of the pilot was that we had far greater, a far greater amount of testing within them two halls than we’ve seen across accommodation at any point. I think we got 60, 70% within the halls which just wouldn’t have happened without the pilot so that was the positive.” [I, S6]

Facilitator (peers)

“it was a great opportunity to be able to actually meet other people in, um, in a more secure environment and without having to breach Covid restrictions, um or kind of standing outside in the rain talking to people” [FG1, S5]

“I’ve really enjoyed being in Halls, obviously meeting people, making friends and in general the Hall living experience has been as I hope it would be normally” [FG4, S1]

Creating social opportunities

“There was positive impact because we definitely seen them socialising more, we opened up more of our areas so they could socialise, we opened the bar up at [site 2] for use so they could use the bar as a bar service throughout the period, so they gained more facilities for starters, more socialising facilities and they can socialise with more people.” [I, S3]

Barrier (testing service)

“... the submitting part is the hardest part because the timing isn’t really suitable for people who’ve got live sessions” [FG3, S6]

“I saw a lot of people handing in tests but then not being given another one to do” [FG7, S1]

“People would go home without telling the uni and they would be counted as not having a test despite them not being able to” [FG1, S3]

Logistical challenges

“we learned as we went through the timings that we were there – with the greatest of respect there wasn’t a lot of point in us being there at 10 am in the morning! There was a lot of benefit from us being there at five o’clock in the evening when it was the first opening of the doors for dinner. And that was an ideal time. And we learned that and perhaps we should have thought of that right at the very start.” [I, S2]

Barrier (testing service)

“information about the timing and place for picking up and dropping off tests kept changing” (S)

“I didn’t feel like it was very clear, like, the extra things we were allowed to do, we were just sort of, it felt like we were told, like, vaguely what we were allowed to do but it wasn’t very clear” [FG2, S4]

“Personally in [site 1] we had a couple of incidents where testing times weren’t clearly communicated between the testing team and the students.” [FG1, S5]

“The second day of pilot we were in a room with eight people who were all in [site 1] and we got kicked out by a security guard. When I asked him why because we were doing a pilot scheme he said ‘I don’t know, I’ve not been told about it’.” [FG5, S2]

“Felt like there was a lot of miscommunication between security and the organisers as security kept trying to enforce normal social distancing rules”. [S]

Changing processes and mixed messages

“If you’re changing the goalposts every week, that gives my team a really tough job because you’re having to make people understand something new every week and they’re just going to eventually switch off because you’ve only got a few opportunities.” [I, S6]

“I think if it was to be in halls again, it’s just making things much more black-and-white so that the students know exactly what their rules are and what the expectations are and not setting the expectation crazy high.” [I, S7]

“You need to have a consistent message throughout for that to get through to people and for people to really understand it” [I, S6].

“There was a bit of confusion over what they were allowed to do, what they weren’t allowed to do, and you’ve got two security people, you’ve got university security, you’ve got [company name] and I’m not sure they were always on the same page and I’m not sure security was comfortable with going in and dealing with stuff.” [I, S4]

Motivation: brain processes that direct behaviour, such as decision-making, habitual processes and emotional responses

Facilitator (peers)

“The reason why I wanted to do it was to be able to mix with more people in my Hall, get to know people better, so yeah, it was largely sociable reasons” [FG2, S1]

“I wanted to be able to socialise more freely within Halls like with friends and stuff” [FG4, S4]

Social motivation

“So it’s about telling them why they should be tested every day so they can socialise and have a more normal university life.” [I, S9]

Facilitator (peers)

“That was probably the main benefit of it was just, you know, just easily being able to text and answer a question.” [FG7, S3]

“I think it definitely had its place as a tool to remind people” [FG7, S1]

Peer-to-peer support (student ambassadors)

“We had champions recruited to help and I think they were great because ... it’s very important to know what’s the view on the ground from their perspective and having those testing champions was a fantastic link to be able to understand what was going on from the students’ point of view.” [I, S8]

“it’s showing that the staff and students are working together and it shows student voice and also where the authority or the boundaries are. Involving people, I think is the key.” [I, S11]

Facilitator (staff)

[punitive] “My reason for taking part is because I had a guy, there was just some guy that was coming round knocking on everyone’s doors saying that we’d be relocated from the Hall if we didn’t participate, so that sort of scared me into doing it.” [FG4, S4]

[punitive] “communications about the Pilot were partisan; there was immense pressure to participate”. [S]

Practical motivation

Anything from staff to suggest they thought students felt under pressure to take part, or weren’t?

Staff didn’t mention the feeling of being under pressure to participate

Facilitator (self)

“I really felt the relaxed restrictions during the testing pilot helped um, where mixing between households was inevitable, I felt it was probably a lot safer during the pilot” [FG1, S2]

“I felt safe knowing that everyone had been tested.” [FG6, S2]

“Felt safe interacting knowing there were no cases in the hall” [S]

“I feel safest on campus than anywhere else” [S]

“it did feel a bit unsafe as it’s quite a big hall and knowing anyone could mingle and get ill was concerning” [S]

Safety perception

“Yeah, I think it’s a good idea (testing). Like I say, it made the staff feel safe, it made us feel safe, and I’m hoping it made the students feel safe as well. There are a lot of students who are sensible and behaved, so I’m hoping that it made them feel safe as well.” [Staff member

Facilitator (community)

“... by testing twice a week, if then I’m then at less risk as well if I’m negative of passing it on to other people, so yeah, that was it for me.” [FG2, S1]

“And then with the testing twice a week I suppose if there was a case it would be caught more quickly and then if there was an outbreak it could be contained quicker as well.” [FG2, S2]

Societal responsibility

“I think it’s very important to controlling the virus within universities. It keeps us ahead of the virus. In terms of knowing when an outbreak has occurred, it gives us more time to get it under control so I think it’s an important part of getting universities back to you know some kind of normal.” [I, S6]

Facilitator (university)

“quite liked the incentives they gave us, like, with the stats and also the little goody bags they gave us, that was pretty good.” [FG4, S5]

“It was only until it was known that there was food bags when students started to get tested.” [S]

Incentivisation

“At the end of the day I think it’s wrong to incentivise it, because I think that people should be doing it as a norm, and I don’t see a problem in doing it, as normality is once a week you do a test. To me that doesn’t seem like we’re asking anything really hard of anyone to do, but it’s a shame that we have to incentivise things in that way.” [I, S10]

Barrier (university)

“the food bags weren’t enough. It wasn’t like enough but it didn’t encourage them to get out of bed to drop off their samples and stuff.” [FG6, S2]

Lack of incentivisation

“And the incentive wasn’t there for them because they’d already been mixing all year, you know, we’re always fighting the fight, you know, ‘no you’ve got to split up, no you’ve got to stay together in your household’, so from the start it’s been difficult for us that way and there was no massive incentive for them” [I, S3]

“I don’t think the students felt that it [food bag incentive] was impactful enough for them. They didn’t feel like they were getting a lot from it... They wanted something extra to other students that weren’t doing it, so other halls that weren’t doing it. I think they wanted to feel like they were getting some more benefit than they actually did get.” [I, S10]

Barrier (testing service)

“I think at first when they first sort of advertised the pilot scheme, it was very like glorified that it was like there’s literally no social distancing, no masks, like, it was all sort of focused on that, but then in reality when the actual sort of more detailed information came out once we’d all signed up to it, it was kind of not as it was advertised in a way” [FG2, S1]

“I thought that with the relaxation there might be some activities put on for the whole Hall but that didn’t seem to happen at all” [FG4, S3]

“I think that was why our participation got really low because all the students were like ‘we can’t be bothered, it’s not lived up to what it was supposed to be’” [FG5, S2]

False expectations

“It’s a shame that there wasn’t one positive case – it seems a really strange thing to say – but I think that that would have actually shown to people the way that we could then contain it, the fact that we would have been able to put in extra testing for that group of people, they wouldn’t have all had to self-isolate, the person who tested positive would have got the ability to isolate in the [alternative accommodation] and all things like that.” [I, S2]

Barrier (peers)

“I think just as a generalisation of Halls I don’t think the social distancing mask thing within Halls, within bedrooms, that sort of thing in student only spaces, I don’t think it happens all that much, but it’s been the same the entire year, it’s not changed really with the pilot.” [FG4, S2]

“So, when we went out into town for example, we’d stay as a group, instead of distancing, because of the pilot study” [FG1, S4]

“it encouraged parties which would get out of hand, granted they were dealt with accordingly, but I do think it was seen by some as a reason to be reckless” [S]

Non-compliance with the rules (within and outside residence)

“I also think for the Hall staff that were involved in it, during those two weeks, I imagine it was really stressful for them because of the behaviour that they saw I guess they didn’t quite know what was going to come next, what was going to be round the corner and I imagine that can be quite daunting for them”. [I, S2]