Background The use of face masks remains contentious, with international variation in practice. Their prevalence in the UK, is likely to increase due to new legislation. Clear information regarding the appropriate use of masks is needed, to ensure compliance with policies to reduce transmission of COVID-19. We aimed to assess the impact of visual representations of guidance, or infographics, upon the knowledge of appropriate face mask usage in a representative UK cohort. Methods Adult patients were recruited to this randomised internet-based questionnaire study during the 12–14 May 2020 from across the UK. Respondents viewed one of five public health stimuli regarding the use of face masks, or no stimulus. The groups accessed aids by the European Centre for Disease Control (EUCDC), World Health Organisation (WHO), Singaporean Ministry of Health (SMOH), text from the UK government (UK Gov), or an infographic designed by the Behavioural Insights Team (BIT). The primary outcome was to evaluate the effect of each infographic upon participants’ recall of face mask technique, sentiments and willingness to wear a face covering. Secondary outcomes included the effect of symptomology and socio-demographic factors. Results 4099 respondents were randomised (1009 control, 628 EUCDC, 526 WHO, 639 SMOH, 661 UKGOV and 606 BIT). Stimuli from the WHO, SMOH and BIT demonstrated significantly higher average recall scores compared to the controls (7.40 v. 7.38 v. 7.34 v. 6.97, P < 0.001). BIT’s stimulus led to the highest confidence about mask-wearing (87%). Only 48.2% of the cohort felt stimuli reduced anxiety about COVID-19. However, willingness to use a mask was high, (range 84 to 88%). Conclusions To ensure the appropriate use of masks, as mandated by UK law, guidance must provide sufficient information, yet remain understandable. Infographics can aid the recall of correct mask techniques by highlighting salient steps and reducing cognitive burden. They have also demonstrated greater trustworthiness than text-only guidance. The effect of infographics upon COVID-19-related anxiety was poor, and they should be further developed to address this sentiment. A willingness to wear face masks has, however, been demonstrated.

Background: Little attention has been paid to understanding the impact of values, attributes and characteristics of drugs workers on therapeutic relationships and treatment outcomes. Interaction of values with other variables is considered to be of importance since values play a role in determining attitudes and behaviours. This exploratory study investigates the impact of drug workers' personal values on client outcomes within a drug treatment service. Methods: 8 drug workers and 58 clients were recruited at a UK charity working with problematic drug users who are also socially excluded. Drug workers completed a validated questionnaire (Schwartz, 1992) to elicit their personal values. Client outcomes were assessed using the Christo Inventory for Substance Misuse Services (Christo et al., 2000). The relationship between client outcomes and worker values were analysed using Spearman's rank test of association. Results: Drug workers prioritising stimulation, self-direction and hedonism value types experienced more positive client outcomes compared with those prioritising security, conformity, benevolence, tradition and universalism types. The value types associated with positive outcomes fall within Schwartz's 'openness to change' superordinate dimension, whereas those related to more negative outcomes fall within the 'conservation' dimension. Conclusion:The study suggests that drug workers' personal values may have a significant impact upon client outcomes in the treatment of substance misuse. Reasons for this finding are explored, as are limitations of this study and suggestions for future research.Despite the substantial proportion of drugs agencies' funding allocated to human resources, little attention has been paid to the important contribution that drug workers bring to the treatment of those experiencing problematic drug use. The focus of research thus far has tended toward examining models or styles of treatment. Yet, given the complex issues usually associated with problem drug users, drug worker attributes including skills, values, beliefs and adaptability are likely to have some effect in the outcome of treatments.One area where attention has been paid to the contribution of the worker is in the impact of the 'therapeutic alliance' (e.g. Luborsky et al., 1995;Belding et al., 1997;Connors et al., 2000;Joe et al., 2001), conceptualised as the degree to which the therapist and client develop a positive, collaborative relationship (Bordin, 1979;Horvarth, 2001). Within drug treatment settings it is generally accepted that establishing a therapeutic alliance is important, not least because of the difficulties of engaging and retaining clients in treatment (Simpson et al., 1997;Gossop et al., 1999). This view is supported by research that finds that establishing the alliance early on is a "consistent predictor of engagement and retention in drug treatment" (Meier et al., 2005: 313).Despite the importance of retention as a prerequisite for positive treatment outcomes, few studies follow the course of t...