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Governments around the world are seeking to slow the spread of Covid-19 by implementing measures that encourage, or mandate, changes in people's behaviour. These changes include the wearing of face masks, social distancing, and testing and self-isolating when unwell. The success of these measures depends on the commitment of individuals to change their behaviour accordingly. Understanding and predicting the motivation of individuals to change their behaviour is therefore critical in assessing the likely effectiveness of these measures in slowing the spread of the virus. In this paper we draw on a novel framework, the I3 Compliance Response Framework, to understand and predict the motivation of residents in Auckland, New Zealand, to comply with measures to prevent the spread of Covid-19. The Framework is based on two concepts. The first uses the involvement construct to predict the motivation of individuals to comply. The second separates the influence of the policy measure from the influence of the policy outcome on the motivation of individuals to comply. In short, the Framework differentiates between the strength of individuals' motivation and their beliefs about the advantages and disadvantages of policy outcomes and policy measures. We found this differentiation was useful in predicting an individual's possible behavioural responses to a measure and discuss how it could assist government agencies to develop strategies to enhance compliance. [ABSTRACT FROM AUTHOR]

Lung cancer screening can significantly reduce mortality from lung cancer. Further evidence about how to optimize lung cancer screening for specific populations, including Aotearoa New Zealand (NZ)'s Indigenous Māori (who experience disproportionately higher rates of lung cancer), is needed to ensure it is equitable. This community-based, pragmatic cluster randomized trial aims to determine whether a lung cancer screening invitation from a patient's primary care physician, compared to from a centralized screening service, will optimize screening uptake for Māori. Participating primary care practices (clinics) in Auckland, Aotearoa NZ will be randomized to either the primary care-led or centralized service for delivery of the screening invitation. Clinic patients who meet the following criteria will be eligible: Māori; aged 55–74 years; enrolled in participating clinics in the region; ever-smokers; and have at least a 2% risk of developing lung cancer within six years (determined using the PLCOM2012 risk prediction model). Eligible patients who respond positively to the invitation will undertake shared decision-making with a nurse about undergoing a low dose CT scan (LDCT) and an assessment for Chronic Obstructive Pulmonary Disease (COPD). The primary outcomes are: 1) the proportion of eligible population who complete a risk assessment and 2) the proportion of people eligible for a CT scan who complete the CT scan. Secondary outcomes include evaluating the contextual factors needed to inform the screening process, such as including assessment for Chronic Obstructive Pulmonary Disease (COPD). We will also use the RE-AIM framework to evaluate specific implementation factors. This study is a world-first, Indigenous-led lung cancer screening trial for Māori participants. The study will provide policy-relevant information on a key policy parameter, invitation method. In addition, the trial includes a nested analysis of COPD in the screened Indigenous population, and it provides baseline (T0 screen round) data using RE-AIM implementation outcomes. [ABSTRACT FROM AUTHOR]