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Objectives: Recruitment through Facebook is gaining favor as an approach for research, including clinical trials, because of the platform's ability to reach broad and diverse populations. As older adults increase their social media use, recruitment through Facebook has become a viable option. The purposes of this paper are to report the methodological process and lessons learned from recruiting custodial grandmothers (CGMs) for a cross‐sectional study examining parenting self‐efficacy and psychological well‐being. Participants: A total of 113 people consented and accessed the survey online, with 40 (35.4%) completing surveys. The final sample comprised 68 grandmothers, with 59% recruited via Facebook. Methods: Facebook recruitment for the online survey included creating a dedicated Facebook study page, accessing existing Facebook pages for custodial grandparents, and using paid advertising. Face‐to‐face recruitment strategies also were used with paper surveys. Results: We compared the characteristics of those completing online surveys versus paper surveys. CGMs completing the survey online were significantly younger and more likely to be Caucasian than those completing the paper survey. Conclusions: Findings indicated online recruitment via Facebook is an advantageous method to reach CGMs. However, additional research is needed to determine if other online and social media platforms would be useful in recruiting this population. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. Sample: This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Measurement: Random blood glucose was assessed for each participant using a finger prick test. Results: The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. Conclusion: The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden. [ABSTRACT FROM AUTHOR]

Objective: Two percent of the Japanese population is comprised of foreign residents with further increase expected due to immigration policy revisions. The purpose of this paper is to examine the healthcare needs and difficulties experienced by foreign residents in Japan by level of their Japanese language fluency. Design: A quantitative, descriptive design was used. Sample: We surveyed foreign residents in the greater Tokyo area (N = 209). Measurements: The research team created the survey questions and the contents of the survey include foreign residents' experiences during their visits or stays at medical and public health facilities in Japan. Results: More than 90% of the participants or their families visited medical facilities in Japan regardless of Japanese language fluency; however, those with less Japanese language fluency experienced statistically significant uneasiness or inconvenience concerning communication compared to those with native Japanese language fluency (p =.000). Conclusions: Nurses in Japan may benefit from additional training related to use of interpreters as well as education about diversity and cultural humility. Through better understanding of the specific communication barriers of foreign residents, nurses will be able to better anticipate difficulties and address them. [ABSTRACT FROM AUTHOR]

Objectives: To better understand the knowledge, practice, importance, awareness, usefulness, and confidence of non‐Hispanic Black and English‐ and Spanish‐speaking Hispanic/Latino adults with diabetes. Design: A descriptive cross‐sectional survey study design was used and descriptive statistics was conducted. Sample: Non‐Hispanic Black and Hispanic/Latino adults with diabetes were recruited from three New York City public hospitals. Measurements: A one‐time survey was delivered via email, text message or over the phone. Results: Of the 96 participants, 47.9% were Hispanic/Latino and 52.1% were non‐Hispanic Black individuals; 43.8% of the surveys were completed in Spanish and 56.3% in English; 41.7% were female and 58.3% male; 77.1% preferred to complete the survey via the telephone, 14.6% through email, and 8.3% via text message. Chi‐square findings showed, 90.6% knew mask wearing prevented COVID‐19; 96.9% knew that covering the nose and mouth during mask wearing is needed, 93.8% wore a mask, and 92.8% felt it important or very important to wear a mask to prevent the spread of COVID‐19. For social distancing, 88.5% knew it prevented the spread of COVID‐19, 93.8% practiced it, and 95.8% felt it important or very important. Conclusion: In having a better understanding of the knowledge and practices of COVID‐19 among non‐Hispanic Black and Hispanic populations with diabetes, the development of culturally and linguistically tailored community‐based mitigation strategies can be developed that are aimed at improving the preparedness of these groups for the next emerging infectious disease, such as COVID‐19. [ABSTRACT FROM AUTHOR]

Background: Dating apps for men who have sex with men (MSM) have favored unprotected sexual encounters; other unsafe practices, including drug use, are widespread. No evidence is available from the perspective of the structure of their relationships, a personal aspect included in all nursing meta‐paradigms. Aim: To study the structure of MSM networks through dating and contact applications and this relationship to risky sexual activities such as condom use, chemsex (sex while using drug), and group sex. Design: Descriptive cross‐sectional study. Sample: A total of 32 MSM participants from Madrid (Spain). Measurements: Socio‐demographic and structural variables with Social Network Analysis (SNA) metrics. Data on condom use, drug use during encounters, and group sex were included. Results: Twenty‐five percent of respondents practiced chemsex, and 75% of these used poppers. MSM with higher socioeconomic status participated in group sex sessions more frequently than those with lower socioeconomics. Within the network analysis, the relationships strong showed greater ease in having unprotected anal intercourse. Conclusion: SNA can be effective in the study of MSM sexual networks and their risk behaviors for community nurses to improve their interventions in sexual health promotion. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effects of occupational stress, anxiety, depression, and sleep disturbance on the level of fatigue among public health nurses (PHNs). Design: The study had a cross‐sectional, correlational survey design. Measures: A total of 198 PHNs were enrolled from 30 public healthcare centers/offices. Data were collected between May and July 2021 using a structured questionnaire to investigate the general characteristics, occupational stress, anxiety, depression, sleep disturbance, and fatigue of the participants. Descriptive statistics and multiple regressions were used to determine fatigue and its influencing factors among PHNs. Results: The participants showed high fatigue and occupational stress levels due to a lack of rewards. The percentage of participants with mild‐to‐severe anxiety and mild‐to‐severe depression, and those who identified themselves as poor sleepers were 44.9%, 50.5%, and 70.2%, respectively. High levels of sleep disturbance (β =.23, p <.001), occupational stress (β =.21, p <.001), anxiety (β =.20, p =.016), depression (β =.17, p =.043), being younger (β = –.15, p =.004), and being a regular worker (β =.13, p =.017) were influencing factors of fatigue. Conclusions: Individual efforts and organizational interventions to enhance sleep quality are needed to relieve fatigue among PHNs. Further, organizational support can be considerate of young nurses and regular workers, and alleviate their occupational stress. Moreover, anxiety and depression should be managed efficiently to reduce fatigue. [ABSTRACT FROM AUTHOR]

To describe experiences of student nurses and faculty who participated in COVID‐19 vaccine delivery through a multischool collaboration. Cross‐sectional survey. Student nurses and faculty members from five university schools and colleges of nursing who participated in one or more COVID‐19 vaccination or education events in 2021. Surveys were designed for students and faculty to document process and outcome experiences associated with project participation. Surveys were administered through an online survey platform. Overall, 648 students and 68 faculty members participated in the project. The evaluation survey was completed by 115 students (18%) and 58 faculty members (85%). Students valued increasing their clinical skills and reported the experience influenced their perspectives on nursing, fueling their passion and informing future career choices. Students reported that it was personally important to contribute to the vaccination effort. Few students reported challenges in participating in the project. Faculty reported positive experiences including gaining knowledge about public health and their communities, fueling their passion for nursing education, feeling a deeper connection with students, and experiencing personal satisfaction from contributing to the pandemic response. This project resulted in meaningful student learning opportunities, enhanced capacity for the public health emergency response, and strengthened partnerships among nursing programs and between academia and public health community partners. [ABSTRACT FROM AUTHOR]

Objective: To compare nurse and non‐nurse lead executives' relationship with organizational characteristics supporting performance and health equity in local health departments (LHD). Design: This was a cross‐sectional quantitative study. Sample: The final national sample consisted of 1447 LHDs using the 2019 Profile of Local Health Departments survey. Measurements: We used multivariable logistic and negative binomial regression analyses to explore the relationship between nurse versus non‐nurse LHD lead executives and involvement in ten organizational characteristics including community health assessment (CHA) and community health improvement plan (CHIP) completion and policy activities related to the social determinants of health (SDOH). Results: Multivariable logistic regression models showed that, for nurse lead executives, the odds of having completed a CHA is 1.49 times, and the odds of having completed a CHIP is 1.56 times, that of non‐nurse lead executives. Negative binomial regression models predicted nurse lead executives, compared to non‐nurses, to perform 1.18 times more SDOH‐related policy activities. Conclusion: Results suggest that nurse lead executives are more likely than non‐nurses to emphasize assessment in their work and engage in upstream‐focused policy activities. As such, they are important partners in work to facilitate health equity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore the association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID‐19 pandemic. Design: A cross‐sectional study via SurveyMonkey was conducted in Australia between August 2020 and October 2020. Descriptive and inferential statistics were used to analyze the data. Results: A total of 1211 individuals responded to the survey. Income loss was significantly associated with those from low socioeconomic status (OR = 1.65; 95% CI 1.01–2.68). Access of superannuation was significantly associated with those in outer regional (OR = 3.61; 95% CI 0.81–16.03) and low socioeconomic status (OR = 2.72; 95% CI 1.34–5.53). Financial inability to pay for services was significantly associated with living in remote areas (OR = 2.26; 95% CI 0.88–5.80). Conclusions: The economic wellbeing of people who identify as Aboriginal and Torres Strait Islander, live in regional or remote areas, and reside in low socioeconomic areas have been substantially impacted during the pandemic. Findings call for policies to address the underlying social determinants of health. [ABSTRACT FROM AUTHOR]

Objective(s): To explore the perceived threats of COVID-19 and how it changed the personal hygienic precautionary behaviors across multiple countries in the Middle East and North Africa (MENA) region. Design: A cross-sectional descriptive design was used to survey the four targeted MENA countries: Jordan, Palestinian territories, Saudi Arabia, and Egypt. Sample: A nonprobability convenience sampling design was utilized. The link to the survey questionnaire was distributed through social media groups within Facebook® and Twitter®. The groups are known and accessible by known across the general population at the targeted countries. Measurement: Data was collected using The Brief Illness Perception Questionnaire and an adapted instrument that examine the hygienic precautionary behaviors during COVID-19 pandemic. Results: Answers of participants (n = 2604) were valid and included in the study. The results show that a minimal perception of threat among the participants on most of the BIP-Q5 items (M = 12.9, SD = 7.2). Moreover, the highest compliance rates to recommended hygienic precautionary behaviors were found among populations above the age of 50 years (F = 2.89, p = .04), females (t = 5.18, p = .003), being married (F = 3.09, p = .029), and being a health care professional (t = -2.20, p = .028). Conclusion: The perceived threat of COVID-19 and compliance rates with the recommended hygienic precautionary behaviors among Arab societies were found to below and need critically urgent attention. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore healthcare providers’ (HCP) stigmatization from patients during the COVID-19 outbreak in Jordan. Method: A cross-sectional design was used. Data collection was conducted between May and July 2021. The research questionnaire included demographic information about participants and multiple statements that reflect stigma of participants toward HCPs. Regression analysis was conducted to assess the association between stigma and explanatory variables. Results: A total of 777 surveys were included in the study. Many people show high stigma toward HCPs during COVID-19 pandemic. Various factors including hearing news all time (p<.001), having children (p<.024), and smoking (p<.001) were significant in prediction stigma toward HCPs. Conclusion: This one of few studies conducted in Jordan regarding the stigma toward HCP from other people with chronic diseases. Our study found that many people showed some stigma toward HCP during COVID-19. Stigmatization of HCP related to a pandemic is a lesson most people have not learned. It is not enough to cheer HCPs. A clear, sensible public education campaign about the public’s risks by interacting with HCP is necessary. [ABSTRACT FROM AUTHOR]

The coronavirus outbreak threatens global well‐being, costing thousands of lives and an unstable economy. Traditional hand‐washing (HaWa) with clean water and hand‐washing sanitizers (HaWaSas) are among WHO recommended practices against the outbreaks. HaWaSa and HaWa lacked proper quality monitoring evaluation that may pose health risks. The current study investigates the potential of traditional hygienic practices adopted to mitigate the 2019–2020 Pandemic. It involved assessing the effectiveness of 15 HaWaSa collected from the Dodoma market. Thirty volunteered participants were subjected to different hygienic practices involving HaWa and HaWaSa. The obtained hand‐swabbed samples were subjected to the streak plate technique for inoculation, followed by counting colonies. The results revealed that, among the collected HaWaSa brands, only 33.3% were certified by the Tanzania Bureau of Standards (TBS). In the setting under no hand‐wash, each client had a different number of colony counts. HaWa did not eliminate all colonies since water acted as a secondary source while only one sanitizer proved effective. The p‐values obtained in either setting were greater than 0.05, indicating that each variable was independent. Despite global awareness and fighting against the Coronavirus Disease 2019 (Covid‐19) outbreak, quality monitoring of all diagnostic tools, preventive HaWaSa, and related drugs should be prioritized for human safeguard. [ABSTRACT FROM AUTHOR]

Objective: To understand communities' perceptions, beliefs, and health‐related behavior choices related to COVID‐19 in order to guide public health nursing communication and interaction with patients and the community. Design: A qualitative study, guided by the Health Belief Model (HBM), strove to comprehend the perceptions and reactions to COVID‐19 among Wisconsinites. Sample: Twenty‐five diverse Wisconsin residents aged 18 or older. Measurements: Semi‐structured interviews provided information about individuals' attitudes, perceptions, and reactions to COVID‐19. Interviews were audio‐recorded, transcribed, and thematic analysis was conducted to identify themes. Results: We identified three major themes: (1) "health care starts way before you ever enter the doors of a healthcare facility"; (2) "to live in a society is to help each other"; and (3) mental health as impacted by COVID‐19. Conclusions: This study demonstrated the need for greater public health support, as well as the role of Social Determinants of Health. Understanding perceptions and reactions to COVID‐19 can help public health nurses understand and better respond to future pandemics. [ABSTRACT FROM AUTHOR]

Objective: To analyze the impact of the foot health and health behavior and the characteristics of outdoor footwear among minority ethnic groups. Design and measures: A cross‐sectional study design using the Foot Health Status Questionnaire: foot pain, foot function, shoe, general foot health, general health, physical activity, social capacity, and vigor. Outcomes included the self‐reported type of outdoor footwear and clinical characteristics by sex were collected in 2019–2020. Sample: A total of 78 Roma participants self‐identified as members of this ethnic minority and 72 participants non‐Roma were assessed (n = 150). Results: The lower score values was recorded in the footwear and general foot health domains in Roma population. General population obtained higher scores in general health domains. The most common outdoor footwear types were running shoes and walking shoes in non‐Roma population, versus flip flops and slippers in Roma population. Clinical characteristics did not show any statistically significant differences (p <.05). Conclusion: Roma people wear flip flops and slippers and non‐Roma people running shoes and walking shoes. These findings reveal cultural differences that make it easier for the Roma population to experience a greater burden of foot health problems. General foot health and foot pain dimensions show statistically significant differences among ethnicity. [ABSTRACT FROM AUTHOR]

Design: A cross‐sectional study was conducted in December 2020/January 2021 in the five significant cities of Germany. Sample: 135 of 244 identified service institutions took part in the evaluation. Measurements: This evaluation included changes in institutions' operating hours as well as capacity for homeless people. Service institutions described changes in guests' characteristics, moods, and mental burden. Finally, equipment including face masks, coveralls, and gloves was investigated. In addition, the study examined how the cooperation with the health authorities works. Results: Institutions reduced their operating hours and capacity for guests (62.4%). Increased costs, which they had to cover themselves, were reported by 70.9% of institutions. Institutions reported, that guests showed more symptoms of aggression (15%), anxiety (25%), and desperation (32%) and fewer signs of being relaxed (75%). The institutions reported room for improvement in PPE supplies and collaboration with health authorities. Conclusions: Services are limited for a vulnerable population, which shows changes in moods and mental health. Health authorities are not sufficiently engaged to take over the role of institutions in caring for homeless people. In the future, in‐depth investigation to improve this is necessary. [ABSTRACT FROM AUTHOR]

States across the country have been experiencing a steady decline in public health nursing workforce, including North Carolina (NC). Objectives: To better understand retention in the NC Public Health Nurses (PHNs) workforce through an assessment of perceptions of the working environment, stress, intent to stay, and job satisfaction. Design: A cross‐sectional online survey using closed and open‐ended questions. Sample: The study population comprised of non‐supervisory PHNs (n = 672) working at NC local health departments (LHD). Measurements: Retention problem, working environment, and job satisfaction measures were adapted from the revised Casey‐Fink Registered Nurse Retention Survey© (2009) to fit public health settings. Results: Despite high levels of job satisfaction (79.76%, n = 473), 53% of respondents (n = 323) acknowledged a retention problem within their LHD; 35.32% (n = 203) planned to/considered leaving their position in the next 3 years for reasons other than retirement. ANOVAs and Kruskal Wallis Test results showed that those planning to leave had statistically lower scores on perceived working environment and job satisfaction and demonstrated higher negative stress levels. Conclusion: Like other states, NC is experiencing a PHN shortages predicted to worsen in coming years. To retain the current workforce, LHDs need to work to improve PHNs working environment, increase PHNs' pay, and alleviate stressors. [ABSTRACT FROM AUTHOR]

Objectives: Healthcare workers (HCWs) are considered an important target group for the COVID‐19 vaccines. The current study assesses the knowledge and attitudes of Israeli HCWs regarding COVID‐19 immunization, and how various occupational and demographic factors may underlie COVID‐related knowledge and attitudes differences. Methods: Following a pre‐test to validate measures, a cross‐sectional online anonymous survey was distributed to HCWs using a snowball sampling method. Results: The survey was completed by 714 participants (mean age 39.9; range 18–74; 447 female), 52% doctors, 32% nurses, and the remainder by paramedical staff. Of the respondents, 553 (77.4%) answered the question are you in favor of getting the COVID‐19 vaccine, 105 (14.7%) were not sure, and 56 (7.8%) were not in favor. Doctors had higher odds of agreement as compared to both nurses (p <.025) and paramedical staff (p <.001). Multivariate logistic regression analysis revealed that increased age (OR: 1.075; 95% CI: 1.04–1.11, p <.001), profession (physician vs. nurse; OR: 2.73; 95% CI: 1.32–5.65; p <.007), and getting the current influenza vaccine (OR: 4.96; 95% CI: 2.47–9.95) were significant predictors of agreement. Conclusions: A high level of HCWs knowledge and in favor attitudes were observed. Yet negative attitudes were also noted, particularly among nurses, paramedical staff, and young employees. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to (1) determine the number of persons evicted from the Durham Housing Authority (DHA) over a 5‐year period, (2) explore changes in the number of persons with various medical diagnoses and health care utilization patterns before and after eviction, and (3) examine how many persons evicted from DHA became literally homeless. Design: This was a pre/post cross‐sectional quantitative study. Sample: Heads of households evicted from DHA properties from January 1, 2013 through December 31, 2017 were included in the study. Measurements: We matched people evicted by the DHA in a university health system electronic health record system to determine changes in diagnoses and health care utilization before and after eviction. We also matched the cohort in the homeless management information system to determine how many persons evicted became literally homeless. Results: Findings indicate statistically significant increases in persons with medical diagnoses in five of ten categories, total hospital admissions, and emergency department visits after eviction. Of the 152 people included in the study, 34 (22%) became literally homeless. Conclusions: Health and health care utilization patterns were different before and after eviction. Implications for clinicians are explored. [ABSTRACT FROM AUTHOR]

Objectives: To translate, cross‐cultural adapt and psychometrically validate the Children's Environmental Health Knowledge Questionnaire (ChEHK‐Q) and the Children's Environmental Health Skills Questionnaire (ChEHS‐Q) for community nurses in China. Design: This was an observational, cross‐sectional study undertaken in two phases: (1) translation and cultural adaptation process; (2) psychometric evaluation. Sample: A total of 294 nurses from 23 community health service centers in cities of Henan province participated in the study. Methods: These two questionnaires were analysed psychometrically based on IRT. ChEHK‐Q was analyzed based on basic Rasch Model, and ChEHS‐Q based on Rating Scale Model (RSM). EFA, expert validity, threshold analysis, retest reliability, item and individual reliability were used to evaluate the psychometric attributes of these two questionnaires. Results: The Infit and Outfit values for most items are within reasonable limits. The person reliability of ChEHK‐Q was 0.85 and the item reliability was 0.97. The person reliability of ChEHS‐Q was 0.94 and the item reliability was 0.93. The test‐retest reliability of the ChEHK‐Q was 0.85 and the ChEHS‐Q was 0.87. Conclusions: ChEHK‐Q and ChEHS‐Q are reliable and valid instruments with satisfactory psychometric properties for nurses in China. Future studies should recruit a more representative sample to verify the applicability of these two questionnaires. [ABSTRACT FROM AUTHOR]

Objective: To explore the current practice and perceptions of health visitors in supporting multiple birth families. Design and sample: Practicing health visitors across the United Kingdom were invited to complete a cross‐sectional, descriptive, online survey. The questionnaire covered multiple birth caseload, education received about multiples and the experience of working with families. Two‐hundred and ninety health visitors completed the questionnaire. Descriptive and inferential statistics were used for analysis of the quantitative components and thematic analysis for the qualitative data. Results: Most health visitors had twins on their current workload. Most health visitors had not received any specific training or continuing professional development regarding the needs of multiple birth families. Supporting the families within the confines of reduced time and increased workload was challenging. Daily tasks of caring for multiples were the main areas that health visitors and parents wanted more information about. Conclusions: In the United Kingdom, health visitors are uniquely positioned to support multiple birth families, in particular during the more challenging early years. However, the findings of this study suggest that many health visitors are aware that the care and support that they are able to provide multiple birth families falls short of meeting their needs [ABSTRACT FROM AUTHOR]

Objective: To conduct a community health needs assessment among the Hispanic faith community population to develop a community‐partnered research agenda. Design: A cross‐sectional design was used to conduct a community needs assessment using a community‐based participatory research approach Sample: Hispanic faith community members in Central Arkansas. Measurement: Data collection was led by Hispanic faith leaders using an audience response system at places of worship. An 88‐item Community Health Needs Assessment survey was used that included demographic questions and questions related to five domains including community concerns, community resources, healthcare access, health concerns, and hunger and nutrition. Results: There were a total of 100 participants in the community needs assessment. Hunger and nutrition was the highest ranking community concern followed by healthcare access. Conclusion: Based upon the results of the study, the university researchers and Hispanic faith community members have begun the initial steps to developing a research agenda to address the major concerns of the community. [ABSTRACT FROM AUTHOR]

Almost half of all pregnancies (45%) in the United States (US) are unintended, with the highest concentration in women with low incomes. Targeted research is warranted to identify risk and protective factors that influence pregnancy intention to improve maternal/child health. Purpose: To identify individual and interpersonal level associations to pregnancy intention to use as leverage points to build resilience. Method: A cross‐sectional, secondary analysis of Medicaid eligible pregnant women in Kentucky (n = 309). Results: Sixty‐two percent reported their current pregnancy was unintended. Older age, partnered, negative drug screen, and increased social support were associated with decreased odds of unintended pregnancy. For every 1 unit increase of belonging and tangible social support, women were 13% and 14% (respectively) less likely to have an unintended pregnancy (OR = 0.87, 95% CI = 0.78–0.97, p =.011, OR = 0.86, 95% CI = 0.77–0.95, p =.005). A positive drug screen was associated with an almost three‐fold increase in the odds of unintended pregnancy (OR = 2.88, 95% CI = 1.49–5.58, p =.002). Conclusion: Public health nurses can play a critical role in reducing unintended pregnancy rates by promoting social support, inclusion, and acceptance. There remains a critical need to identify barriers and facilitators to pregnancy planning for persons who use illicit drugs. [ABSTRACT FROM AUTHOR]

Objective: The study examined the impact that the Medicaid expansion in Illinois had upon insurance rates, access to medical care, dental care, pharmaceuticals, and mental‐health counseling between rural and urban counties. Design and Sample: A serial cross‐sectional design was used to assess the health perceptions of adults living in Illinois. Measures: Survey data were collected in 2012 (n = 6,149) before the Medicaid expansion in Illinois and in 2015 (n = 3,532) after the expansion from rural (n = 4) and urban counties (n = 4). Intervention: Medicaid expansion reduced the uninsured rate in both rural (16.39%–4.87%) and urban counties (17.05%–5.2%) and improved self‐reported health. It also increased access to all types of healthcare, with the biggest increase in dental coverage. Results: Path analysis indicated that the Medicaid expansion β = −1.03 (p <.01) and poor versus not poor β = −1.50 (p <.01) were a significant predictor to no healthcare access. Rural verses urban location was not significant (β = 0.04); however, race/ethnicity was significantly different (p <.01). Conclusion: Findings suggest that although the expansion has increased access to care overall, those who are the most vulnerable are still not benefiting equally from the expansion. Therefore, strategies to assist high‐risk adults in enrolling and using their Medicaid coverage need to developed and implemented. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to develop and evaluate a theoretical model to explain the relationships among participation in individual and social activities, compliance with prevention guidelines, and the perception of fatalism and fear of COVID‐19. Methods: Cross‐sectional survey of 1,067 participants who were >18 years of age living in different provinces of Turkey recruited between August 15, 2020 and October 15, 2020. We used covariant structural analysis to assess the relationships of the constructs of the theoretical model. Results: Significant fits were detected for Model 1 (χ2 = 924,389, p <.001, comparative fit index or CFI = 0.944), and for Model 2 (χ2 = 2,253,751, p <.001, CFI = 0.926). The predetermination and luck subdimensions reduce the fear of COVID‐19, while the pessimism subdimension and compliance with preventive measures increase the fear. Conclusion: In public health crises such as COVID‐19, it is important to plan scientific knowledge‐based public education; take initiatives in accordance with the cultural, social, economic, religious, and local characteristics of the societies; and conduct public health studies covering the whole society. [ABSTRACT FROM AUTHOR]