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The COVID-19 vaccine was initially offered to frontline health care workers (HCWs), due to the high risk of contracting COVID-19 through occupational exposure to patients. Low HCW vaccine uptake can impact overall community-level vaccine uptake. This study used the Diffusion of Innovation (DOI) Theory to understand factors related to COVID-19 vaccine uptake in HCWs. We surveyed Pennsylvanian HCWs (excluding Philadelphia) from August 2022 to February 2023. Survey questions inquired about demographics, COVID-19 vaccination status, reasons for receiving/declining the COVID-19 vaccine, and sources of information about the vaccine. Participants (n = 3,490) were 85% female, 89% White, and 93% (n = 3,255) reported receiving at least one dose of a COVID-19 vaccine. HCWs were categorized into adopter categories of the DOI Theory: innovators (56%), early adopters (9%), early majority (11%), late majority (7%), and laggards (17%). The major reason that prompted participants to get the vaccine was to protect them against COVID-19 infection (78%), while the major reason for declining the vaccine was due to concern about possible side effects from the vaccine (78%). We applied the DOI Theory to characterize adopters and identify factors related to COVID-19 vaccine uptake in HCWs. As updated COVID-19 vaccines are approved for the United States market, our findings may be used to improve vaccine education and communication among HCWs to support vaccine uptake. • The Diffusion of Innovation Theory was used to characterize COVID-19 vaccine uptake. • Most health care workers were categorized as innovators and early adopters. • Factors related to COVID-19 vaccine uptake vary by category of adoption. [ABSTRACT FROM AUTHOR]

This cross-sectional study examines differences in the prevalence of suicidal thoughts and behaviors across intersectional combinations of gender, sexual orientation, race and ethnicity, and rurality among US adults. Key Points: Question: Does the prevalence of suicide ideation, plan, and attempt vary across intersectional combinations of gender, sexual orientation, race and ethnicity, and rurality? Findings: In this cross-sectional study of 189 800 adults based on 5 years of data from an annual population-based US survey, prevalence of suicide ideation, plan, and attempt were highest among Hispanic and non-Hispanic Black bisexual women living in nonmetropolitan counties. Meaning: The findings suggest that Hispanic and non-Hispanic Black bisexual women living in nonmetropolitan counties may experience high prevalence of suicide ideation, plan, and attempt, possibly due to experiencing compounding forms of structural discrimination. Importance: Suicidal thoughts and behaviors (STBs) are major public health problems, and some social groups experience disproportionate STB burden. Studies assessing STB inequities for single identities (eg, gender or sexual orientation) cannot evaluate intersectional differences and do not reflect that the causes of inequities are due to structural-level (vs individual-level) processes. Objective: To examine differences in STB prevalence at the intersection of gender, sexual orientation, race and ethnicity, and rurality. Design, Setting, and Participants: This cross-sectional study used adult data from the 2015-2019 National Survey on Drug Use and Health (NSDUH), a population-based sample of noninstitutionalized US civilians. Data were analyzed from July 2022 to March 2023. Main Outcomes and Measures: Outcomes included past-year suicide ideation, plan, and attempt, each assessed with a single question developed for the NSDUH. Intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) models were estimated, in which participants were nested within social strata defined by all combinations of gender, sexual orientation, race and ethnicity, and rurality; outcome prevalence estimates were obtained for each social stratum. Social strata were conceptualized as proxies for exposure to structural forms of discrimination that contribute to health advantages or disadvantages (eg, sexism, racism). Results: The analytic sample included 189 800 adults, of whom 46.5% were men; 53.5%, women; 4.8%, bisexual; 93.0%, heterosexual; 2.2%, lesbian or gay; 18.8%, Hispanic; 13.9%, non-Hispanic Black; and 67.2%, non-Hispanic White. A total of 44.6% were from large metropolitan counties; 35.5%, small metropolitan counties; and 19.9%, nonmetropolitan counties. There was a complex social patterning of STB prevalence that varied across social strata and was indicative of a disproportionate STB burden among multiply marginalized participants. Specifically, the highest estimated STB prevalence was observed among Hispanic (suicide ideation: 18.1%; 95% credible interval [CrI], 13.5%-24.3%) and non-Hispanic Black (suicide plan: 7.9% [95% CrI, 4.5%-12.1%]; suicide attempt: 3.3% [95% CrI, 1.4%-6.2%]) bisexual women in nonmetropolitan counties. Conclusions and Relevance: In this cross-sectional study, intersectional exploratory analyses revealed that STB prevalence was highest among social strata including multiply marginalized individuals (eg, Hispanic and non-Hispanic Black bisexual women) residing in more rural counties. The findings suggest that considering and intervening in both individual-level (eg, psychiatric disorders) and structural-level (eg, structural discrimination) processes may enhance suicide prevention and equity efforts. [ABSTRACT FROM AUTHOR]

There is limited research regarding interpretation services training and its benefit in contact tracing programs. This study seeks to assess the impact of optional formal interpretation services training on contact tracers and identify specific barriers tracers face when contacting patients with limited English proficiency, who have been disproportionately impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

• Health professional students can effectively implement a contact tracing initiative • A replicable workflow and onboarding system aids in efficient contact tracing • Testing capacity, community buy-in, and sparse resources can impact contact tracing The Centers for Disease Control and Prevention recommends aggressive contact tracing to control the COVID-19 pandemic. In this work, we (1) describe the development of a COVID-19 contact tracing initiative that includes medical, nursing, and public health students, and is led by clinicians and infectious disease epidemiologists within our health system, and, (2) articulate process steps for contact tracing including workflows and telephone scripts, and, (3) highlight the key challenges and strategies to overcome these challenges. A single academic institution-based contact tracing initiative was rapidly scaled to 110 health professional students, four physicians, two epidemiologists, and a research team. Following training, students called patients who were COVID-19 positive and the individuals they were in contact with to ensure proper isolation and quarantine measures. Students also assisted those who faced barriers to quarantine. In total, between March 24 and May 28 – this initiative completed contact tracing for 536 confirmed cases, which resulted in the identification of 953 contacts. We aim to disseminate this process, including telephone scripts and workflow, to other health systems for use in their initiatives to respond to the COVID-19 pandemic and future public health emergencies. [ABSTRACT FROM AUTHOR]

• A 2017 mumps outbreak on a college campus triggered a test, trace, and isolate response. • Response teams documented average contacts per case and compliance with quarantine and isolation protocols. • We identify strategies to increase compliance with contact tracing efforts and quarantine and isolation protocols to reduce pathogen transmission on campus. • Lessons learned from the outbreak can applied to future outbreak management on college campuses, including SARS-CoV-2. In 2017, Penn State University's campus experienced a mumps outbreak that coincided with unrelated restrictions on social gatherings. University Health Services implemented testing, contact tracing, and quarantine and isolation protocols. Approximately half of the supplied contact tracing information was usable, ∼70% of identified contacts were reached, and <50% of those contacted complied with quarantine protocol. Students with confirmed mumps reported ∼7.4 (1-35) contacts on average. Findings from this outbreak can inform future outbreak management on college campuses, including COVID-19, by estimating average contacts per case, planning capacity for testing and quarantine/isolation, and strategically increasing compliance with suggested interventions. [ABSTRACT FROM AUTHOR]