Co-producing public health advice for people working on premises infected with highly pathogenic avian influenza

Objectives: Uptake of protective measures to prevent bird-to-human transmission of avian influenza (AI) (correct use of personal protective equipment [PPE], taking antivirals if recommended) and to increase the timely detection of AI in humans (prompt reporting of symptoms after exposure) is imperfect. The aim of this project was to co-produce public health advice for AI with people who work on infected premises. Study design: Co-production following the Agile Co-production and Evaluation (ACE) framework for developing messaging and guidance. Methods: We co-produced five factsheets in simple English (1. avian influenza, 2. PPE, 3. Tamiflu® (oseltamivir), 4a. Reporting symptoms and active follow-up, 4b. Reporting symptoms and passive follow-up), with accompanying infographics based on theory, previous literature, behavioural science principles, and stakeholder input. Seventeen people who worked on infected premises including two people who did not speak English gave feedback on sheets and shared their lived experience of working on infected premises. Results: Co-producers generally preferred infographics to factsheets and suggested how sheets could be displayed on farms and disseminated within the poultry farming community. Suggested changes included that phrases should be shortened, amendments made to language and images to align with terms and items used on site, and that images in infographics were sometimes ambiguous if accompanying text was not understood. Co-producers also suggested creating videos to accompany the sheets. Conclusions: The co-production process helped to develop good working relationships with people who work on infected premises and gave practical insight into their experiences.