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An individual's perception of risk plays an influential role in the behaviors they engage in, which could reduce or increase exposure or transmission of a certain disease. Since risk perceptions vary by social identities (e.g., gender, race/ethnicity, age) they are believed to influence the interpretation and likelihood of following guidance from risk-communication efforts. This study aims to understand how COVID-19 risk perceptions vary by social identity (with an emphasis upon socioeconomic factors), how such identities influence behavior adoption through risk-communication pathways, and how findings can be practically applied in messaging. Previous studies have investigated the role of social factors on risk perceptions, but SES has not been modeled as the main factor. Guided by the Health Belief Model and Social Determinant of Health Frameworks, findings from our 326 participants suggest those with high-risk COVID-19 perceptions identified as higher income and held more advanced educational degrees, suggesting a positive relationship between risk perceptions and SES. Individuals with high-risk perceptions more frequently reported practicing protective behaviors against COVID-19 and reported greater severity, susceptibility, barriers, benefits, trust, confidence, and health literacy in adopting behavior changes against the virus. When applying such findings to create a local risk-communication plan (logic model), it was found that messaging should be culturally relevant, in-plain language, and consistent to improve health literacy. In addition to using the most trusted and frequently used communication sources self-identified by residents, we recommend uniting trusted formal and informal community leaders to provide information in diverse pathways and formats.

Basic needs insecurities affect university students disproportionately and may impact health and academic performance. This study examined associations between food insecurity (FI), housing insecurity (HI) and a novel basic needs insecurity score, and mental and physical health among university students. Eight-thousand undergraduate and postgraduate students at a large university in the southwestern U.S. were selected via stratified random sampling to complete an online cross-sectional survey in April 2021. The survey included the USDA 10-item food security module, a 9-item housing insecurity measure, the Generalized Anxiety Disorder-2 screener (GAD-2), the Patient Health Questionnaire-2 (PHQ-2) assessing depression, and self-rated health. Sociodemographics were self-reported and integrated from the university’s enterprise system. Multiple logistic regression was utilized to examine odds of depression, anxiety, and fair/poor health by food and housing security status. Multiple linear regression was utilized to examine predictors of food insecurity score (range = 0–10), housing insecurity score (range = 0–9), and an overall basic needs insecurity score (range = 0–19). Eight-hundred thirty-three students participated (response rate = 10.4%; mean age = 28.3 years, 66% female, 40% Hispanic, 60% undergraduates). Nearly 26% were food insecure in the past month and 44% were housing insecure in the past year. Basic needs insecurities significantly increased odds of anxiety (FI aOR = 4.35, HI aOR = 3.43), depression (FI aOR = 3.18, HI aOR = 3.16), and fair/poor health (FI aOR = 2.84, HI aOR = 2.81). GAD-2 score explained the most variance in food (r-squared = 0.14), housing (r-squared = 0.12), and basic needs insecurity scores (r-squared = 0.16). Basic needs insecurities remain concerns among university students due to associations with mental and physical health, prompting a critical need for multifaceted interventions.

The coronavirus disease (COVID-19) pandemic has required health services to rapidly respond to the needs of people diagnosed with the virus. Over 80% of people diagnosed with COVID-19 experience a mild illness and there is a need for community management to support these people in their home. In this paper we present, a telephone based COVID-19 community monitoring service developed in an Australian public health network, and we describe the rapid implementation of the service and the demographic and clinical characteristics of those enrolled. A retrospective mixed methods evaluation of the COVID-19 community monitoring service using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Eight hundred and fifty COVID-19 positive patients were enrolled, 54% female, 45% male, mean age 34 years SD 17. Four hundred and nine (48%) patients were born outside Australia. Among the 850 patients, 305 (36%) were classified as having a high risk of serious illness from COVID-19. The most prevalent risk factors were cardiovascular disease (37%), lung disease (30%) and age over 60 years (26%). The most common reported ongoing symptoms were fatigue (55%), breathing issues (26%) and mental health issues such as low mood (19%). There were no deaths in patients that participated in the service. The process of risk stratification undertaken with telephone triage was effective in determining risk of prolonged illness from COVID-19. Telephone monitoring by trained health professionals has a strong potential in the effective management of patients with a mild COVID-19 illness.

It is important to distinguish between apprehensions that lead to vaccine rejection and those that do not. In this study, we (1) identifed latent classes of individuals by vaccination attitudes, and (2) compared classes of individuals by sociodemographic characteristics COVID-19 vaccination, and risk reduction behaviors. The COVID-19 Coping Study is a longitudinal cohort of US adults aged ≥ 55 years (n = 2358). We categorized individuals into three classes based on the adult Vaccine Hesitancy Scale using latent class analysis (LCA). The associations between class membership and sociodemographic characteristics, COVID-19 vaccination, and other behaviors were assessed using chi-square tests. In total, 88.9% were Vaccine Acceptors, 8.6% were Vaccine Ambivalent, and 2.5% Vaccine Rejectors. At the end, 90.7% of Acceptors, 62.4% of the Ambivalent, and 30.7% of the Rejectors had been vaccinated. The Ambivalent were more likely to be Black or Hispanic, and adopted social distancing and mask wearing behaviors intermediate to that of the Acceptors and Rejectors. Targeting the Vaccine Ambivalent may be an efficient way of increasing vaccination coverage. Controlling the spread of disease during a pandemic requires tailoring vaccine messaging to their concerns, e.g., through working with trusted community leaders, while promoting other risk reduction behaviors. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-022-01064-w.

Nationally, the 18–49 years old age group are less likely to be vaccinated compared to those 50 years and older. Data describing the risk of COVID-19 severe illness that requires hospitalization among younger healthy adults is limited. In an effort to underscore the importance of vaccination and provide data that may influence COVID-19 risk perception, COVID-19 data of a sample of hospitalized non-elderly age group who clinically may not be considered as high risk for severe COVID-19 illness are presented. Specifically, this retrospective chart review (spanning the period of March 2020 to September 2021) provides a descriptive analysis examining the characteristics, vaccination status and outcomes of adults who were hospitalized at Memorial Healthcare System with laboratory-confirmed COVID-19. The study’s data focuses on non-pregnant adults, aged 18–49 years old, without underlying conditions and with no reported history of smoking. As a sub-analysis, data on young and otherwise healthy pregnant females who were hospitalized with COVID-19, as well as data stratified by the pre-Delta and Delta variant dominant period are also presented. There was a total of 482 young and otherwise healthy non-pregnant adults who were hospitalized with COVID-19. Overall, more than 13% of our study population had severe COVID-19 disease. Further, a higher proportion of unvaccinated patients had severe COVID-19 compared to those who received at least one dose of the vaccine. All ventilator or ECMO placements, 30-day readmissions and deaths occurred among unvaccinated patients. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-022-01062-y.

To describe effects of the COVID-19 pandemic on older adults living in non-institutionalized settings in New York City (NYC) we used random digit dial sampling of landlines phones to sample then interview residents 70 years and older in NYC from December 2020–March 2021. Socio-demographic, health characteristics and effects of the COVID-19 pandemic were solicited. Of 676 respondents, the average age was 78, 60% were female, and 63% had ever been tested for SARS-CoV-2, with 12% testing positive. Sixty-three percent of respondents knew someone who had been diagnosed with COVID-19 and 51% reported knowing at least one person who had died from COVID-19. Eight percent of respondents reported sometimes or often not having enough to eat, with 31% receiving food from a food pantry program. Significantly more Latinx respondents (24%) reported a positive SARS-CoV-2 test, whereas 17% of those of another race, 8% of white, and 7% of Black respondents had a positive COVID-19 test (p

In the U.S., overdoses have become a health crisis in both public and private places. We describe the impact of the overdose crisis in public libraries across five U.S. states, and the front-line response of public library workers. We conducted a cross-sectional survey, inviting one worker to respond at each public library in five randomly selected states (CO, CT, FL, MI, and VA), querying participants regarding substance use and overdose in their communities and institutions, and their preparedness to respond. We describe substance use and overdose patterns, as well as correlates of naloxone uptake, in public libraries. Participating library staff (N = 356) reported witnessing alcohol use (45%) and injection drug use (14%) in their libraries in the previous month. Across states surveyed, 12% of respondents reported at least one on-site overdose in the prior year, ranging from a low of 10% in MI to a high of 17% in FL. There was wide variation across states in naloxone uptake at libraries, ranging from 0% of represented libraries in FL to 33% in CO. Prior on-site overdose was associated with higher odds of naloxone uptake by the library (OR 2.5, 95% CI 1.1-5.7). Although 24% of respondents had attended a training regarding substance use in the prior year, over 90% of respondents wanted to receive additional training on the topic. Public health professionals should partner with public libraries to expand and strengthen substance use outreach and overdose prevention efforts.

A number of the people who have recovered from the acute effects of COVID-19 are facing long term sequelae from the infection. As the COVID-19 pandemic is still evolving, so is knowledge of the long-term effects of the virus on patients who still experience symptoms. Clearly, news media play a crucial role in distributing information and this distribution of information can, in turn, influence the actions of the public. The purpose of this study was to describe the content of news coverage of COVID-19 long haul symptoms currently posted on the internet. This study utilized Google News, a news aggregator service, and included the first 100 English language pieces of news. Video content and news article content were coded in depth for information on COVID-19 long haul symptoms. A total of 41% of news reports mentioned the length of time that the COVID-19 related symptoms persist. The length of time was reported to range from 1 month to more than 1 year. The symptom most commonly mentioned was tiredness or fatigue (74%), followed by difficulty breathing or shortness of breath (62 cases; 62%), and difficulty thinking or concentrating (50 cases; 50%). Other symptoms were mentioned less frequently. There were no statistically significant differences in any of the content including having video, written news reports, or both video and written news reports by source of the news reports based on consumer, professional, or television or internet-based news (p = .14). More complete coverage by online news media of the long-term effects of COVID-19 enhances public awareness of the post-acute syndromes, augments health providers' awareness of the range of chronic COVID-19 effects and the possibility of a second infection, increases the probability of patients' seeking and obtaining the proper care for their symptoms, and contributes to preventive actions for enhancing public health.

COVID-19 is responsible for over 750,000 Americans deaths. Despite efforts to vaccinate, many college students are hesitant. Hesitancy has hindered efforts to achieve high COVID-19 vaccination rates. Students at a Midwest university completed an online survey. Questions included COVID-19 vaccination intent and behavior. Over 1600 students participated. Half reported being vaccinated. Of those not vaccinated, 49% did not intend to get vaccinated, and 22% were undecided. Reasons for hesitancy included not trusting the vaccine was fully tested (85%), fear of potential side effects (78%), not trusting the vaccine is safe (72%), not trusting the US government (61%), and having read negative reports from the media about the vaccine (60%). Additionally, students were concerned the vaccine was not safe (B = − 0.902; 95% Χ2 = 11.68; p = 0.001) and that it could not protect them from COVID-19 (B = − 0.834; Χ2 = 12.43; p

Medical schools are developing global health programmes, and medical students are requesting global health training and creating opportunities when these are not provided by medical schools. This article described the Wolisso Project (WP), a medical experience on clinical electives in Sub-Saharan Africa, driven by a collaboration between a student organisation and a Nongovernmental Organization (NGO). Preclinical medical students spent 4 weeks as part of a multidisciplinary medical team in Africa. Post-elective questionnaires were administered to all subjects who participated in the project. Of all, 141 students responded to the questionnaire. The participants came from 30 Italian universities. The main difficulties reported are due to the lack of resources for the exercise of the medical activity, and difficulties related to language and communication. The African experience had a positive impact on the progress of the studies upon return, with an increase in determination and motivation. The experience had also positive influences on the future professional choices and carriers. The experience seems to contribute not only to the professional growth, but also to the personal development. A key factor in the positive outcomes of this experience is it being implemented by an NGO with long-term working relationships with the African populations. Another is that the project is carried out in health facilities where NGO staff have been working for a long time. These factors reduce the potential risks connected with this type of experience. They ensure a satisfactory level of supervision, the lack of which has been a serious problem in many similar experiences. A well-structured, mentored experience in international health can have a positive impact on preclinical students’ attitudes, including their compassion, volunteerism, and interest in serving underserved populations. Only a small number of Italian universities facilitate pre-graduate medical elective experiences in LMICs. The WP seems to be attempting to compensate for the lack of international experience in LMICs offered by universities. Italian medical schools should incorporate changes in their curricula to train socially responsible physicians. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-021-01045-5.

Vaccination is a critical means for mitigating the worst effects of the COVID-19 pandemic in the United States (US). However, the initial high demand for COVID-19 vaccines has not persisted, and the rate of vaccination slowed significantly in the summer of 2021. This study seeks to understand the motivations to receive the COVID-19 vaccine among hesitant adopters. Hesitant adopters are individuals who express some level of hesitancy about the vaccine but have also received at least one dose of the vaccine. Using a qualitative descriptive design, three loci for motivation emerged during analysis: extrinsic motivators, intrinsic motivators, and structural motivators. Extrinsic motivations, such as protecting one’s community, family, and friends, were reported as driving vaccination behavior. Among intrinsic motivators, the desire to protect themselves from COVID-19 was the most frequently reported. Structural motivators were also identified, indicating that vaccine mandates also serve to motivate hesitant adopters of the COVID-19 vaccine. These findings have important implications in ongoing efforts to increase COVID-19 vaccine uptake in the US and highlight the multi-dimensional motivations for vaccination among hesitant adopters. Additionally, we provide recommendations for practice based on our findings.

Vaccination behavior is an informative metric for assessing flu seasons and is especially important to understand for the 2020–2021 flu season, which coincided with the COVID-19 pandemic. This study aimed to estimate flu vaccine behavior and assess vaccine perceptions during the pandemic season. Using a cross-sectional descriptive study design, we conducted an online survey to assess vaccination behavior and perceptions of both COVID-19 and the flu. Patients were identified as recently seen by providers in an academic internal medicine practice (n = 827) and surveys were distributed as messages in the Epic electronic medical record system. We found that 88.3% of respondents (188/206) had received their flu vaccination for the season at the time of their survey response in December 2020–February 2021. Of those that had not yet received the flu vaccine, only 13.6% indicated they planned on getting one. 12.5% of respondents said they had changed their flu vaccine plans due to the COVID-19 pandemic. Looking at differences from past season’s behavior, more individuals switched to getting the flu vaccine than those that switched to not getting the vaccine this season. The most frequently cited reasons for not receiving the flu vaccination were concerns about side effects and not being in a priority group. Changes in flu vaccination behavior from previous seasons represent a net positive in the direction of vaccine acceptance. Barriers to vaccination were identified and results from this study provide more information on vaccine perceptions, beliefs, and behavior, which can benefit future vaccination programs.

Healthcare students play an important role in volunteering activity, often addressing staff shortages. However, during the COVID-19 pandemic, the willingness of students to volunteer in contribution to the pandemic response, especially in Vietnam, has not been thoroughly investigated. This study aimed to determine the prevalence of and factors associated with the willingness of healthcare students to volunteer during the COVID-19 pandemic in Vietnam. For this, an online cross-sectional survey was conducted, between June 7th and July 6th, 2021, among healthcare students from 10 fields of study at the largest public university of medicine and pharmacy in the Mekong Delta, Vietnam. Of 2032 respondents, 1473 (72.5%) reported that they would be willing to volunteer during the COVID-19 pandemic. More than half of the students reported having a desire to volunteer in non-patient contact activities such as data entry (65.9%) and logistics (57.7%). Whereas less than 50% of the participants were willing to volunteer with activities involving patients. Year of education, study field, educational format, living arrangements, health status self-perception, chronic illness possession, COVID-19 fear level, past volunteering experience in non-healthcare sectors, and COVID-19 prevention and control training course attendance were all associated with a willingness to volunteer. The strongest barriers preventing volunteering included fear for the health of their family and lack of training/knowledge. Conclusively, healthcare students reported a high level of willingness, indicating a positive attitude toward responding to the COVID-19 pandemic. Adequate training should be employed to increase the willingness among healthcare students in Vietnam.

Background Meningococcal disease is a life-threatening illness that can cause sequelae such as neurological impairment, hearing loss, seizures, limb amputations, and scarring. Adolescents and young adults are at highest risk for contracting this disease which comes with a case-fatality ratio of 10–15%. Common serogroups in the United States are B, C, W, and Y, which are covered by two separate vaccines administered in a two-dose series. While MenACWY is routinely administered, the booster dose is often missed. Only 21.8% of teens reported receiving the MenB vaccine. While it is not currently part of routine care, recent outbreaks have been caused by serogroup B, prompting the need for increased vaccination rates. Methods MenACWY and MenB vaccination rates and demographic information were collected for 16–19-year-old patients in a pediatric clinic. Interventions including staff education, call logs, EMR communications to parents/guardians, and careful chart review were employed. Results At the time of baseline MenACWY data collection, there were N = 333 subjects between 16 and 19 years of age and N = 335 subjects between 16 and 19 years of age provided for MenB data. Upon completion, there were N = 319 subjects. Comparison of pre- and post-intervention data demonstrated a statistically significant increase in MenACWY series completion from 67.3 to 76.2% (p = 0.035) and a non-statistically significant increase in MenB completion from 6.9 to 10.3% (p = 0.197). Conclusions There was a statistically significant improvement in MenACWY but not MenB vaccination rates, indicating a need for more effective measures in addressing low MenB coverage.

Childhood vaccine hesitancy has been studied extensively before the COVID-19 pandemic. The pandemic presented new barriers to pediatric vaccinations. Furthermore, the development of COVID-19 vaccines has complicated factors underlying vaccine hesitancy. We performed a cross-sectional mobile phone-based survey at Children’s Hospital Los Angeles querying parents regarding perspectives on vaccines before and during the pandemic. Our primary aim was to understand the impact of the pandemic on routine childhood vaccine hesitancy. Secondarily, we examined intent to vaccinate, COVID-19 vaccine hesitancy, and key contributing demographic factors. Among 252 participants, we found overall increased childhood vaccine hesitancy (p = 0.006), increased risk perception (p = 0.006), and unchanged vaccine confidence during the COVID-19 pandemic. Increased hesitancy did not translate into decreased intent to vaccinate with routine childhood vaccines or influenza vaccines. During the pandemic, households with higher income (50–99 K, > 100 K) correlated with decreased routine childhood vaccine hesitancy, while Hispanic ethnicity and African American race had increased risk perception. For COVID-19 vaccine hesitancy, households with higher income (> 100 K) correlated with decreased hesitancy, while non-White ethnicity and race had increased risk perception. We found that routine childhood vaccine hesitancy increased during the COVID-19 pandemic, mainly due to increased risk perception. Key contributing demographic factors behind both childhood vaccine hesitancy and COVID-19 vaccine hesitancy included household income and race. Understanding factors behind routine childhood vaccine hesitancy is crucial to maintaining pediatric vaccination rates and promoting vaccine confidence during and after the COVID-19 pandemic.

The coronavirus (COVID-19) pandemic continues to be a global concern, with over 150 million cases worldwide. Arizona, which was recently a hotspot for COVID-19, has over 860 thousand cases. Reviewing the COVID-19 trends over time is crucial in understanding the pandemic and evaluating the impact of mitigation techniques. This current study analyzes the trends in COVID-19 testing and positivity rates from a mobile testing program in the Phoenix metropolitan area between December 2020 and April 2021. Of the 32,234 tests performed there was a total of 3654 COVID positive cases, yielding an overall positivity rate of 11.3%. COVID-19 positivity rates were significantly higher in December (12.9%) and January (12.7%), compared to February (7.5%), March (4.9%), and April (6.7%), p

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the U.S. Over a 7-week period in late 2020, with funding from the NC Office of Minority Health and Health Disparities, the West Greenville Health Council (WGHC), a community-academic, non-profit partnership, engaged and activated a 27-member organizational partnership network for COVID-19 health communication and personal protective equipment (PPE) distribution in African American communities in Eastern North Carolina. Outreach included: local production and dissemination of 10 culturally relevant safety videos, 10 risk, prevention, and safety postcard messages, 3 virtual forums, and PPE kit distribution via the network and their distribution venues. Communication mediums included social media posts (i.e., Facebook and YouTube), network email distribution lists, and postcards distributed along with PPE kits. Outreach activities were evaluated via an online survey, reach of social media posts, and PPE distribution. Working through the organizational network, the WGHC reached a combined total of 30,310 community members with educational materials. Forty-four outreach events were held during this period and over 8000 PPE kits were distributed. The online survey, distributed through the network, yielded more than 400 completed questionnaires. This tool was used to gain insights on community perceptions of COVID-19 safety barriers and media messages. The activation of the network as an approach for rapid response to an emerging public health crisis greatly expanded the reach of the WGHC. The WGHC is working to institutionalize the network to address future emerging health threats, as well as the dissemination of health information more generally.

This study aimed to assess the coronavirus disease (COVID-19) school-related information New York City residents sought through the 311 Call Center. July to November inquiries were downloaded from the NYC Open Data website for 2018-2020. Calls were categorized as related to "Schools", "Access", "Food", "Hospitals", "Transportation", and "Unemployment". Overall call types, and among school-related calls, detailed call types, were compared over the years, using chi-squared tests. School-related inquiries increased by 71% from 2018 to 2020. During 2020, the most common (49%, n = 22,471) call description was "Coronavirus and Schools", encompassing calls about learning options, safety, and resources. Spikes in these calls corresponded to official announcements, including those about Fall reopening plans (August 31: n = 678; September 1: n = 624) and schedules and staffing (September 16th: n = 1043; September 17th: n = 713), and after the start of in-person learning (September 21: n = 680). This study demonstrates that as government officials updated NYC schooling plans for Fall 2020, there were increased concerns among NYC residents. Future COVID-19 schooling changes need to be conveyed clearly and disseminated effectively in order to avoid confusion about NYC's pandemic learning strategy and to address health and safety concerns.

Decreasing COVID-19 vaccine hesitancy is an urgent challenge in the US. This study aimed to examine COVID-19 vaccine hesitancy among U.S. adults with a history of using tobacco products or marijuana. Data were collected online in 2020–2021 including respondents’ willingness to accept a COVID-19 vaccine, factors that may promote vaccine acceptance, and prior history of influenza vaccination. Logistic regression models were conducted to estimate the associations between vaccine hesitancy and demographic characteristics, substance use, the impact of the COVID-19 pandemic, and prior influenza vaccination. Among 387 respondents, 49.1% were willing to receive a COVID-19 vaccine, 26.0% were unwilling, and 24.9% were “not sure.” Blacks, suburban or rural residents, those who lived by themselves or with a family with five members or above, those who were not stressed because of the COVID-19 pandemic were more likely to say “no” to a COVID-19 vaccine. Respondents who never, only once, or during some years received an influenza vaccine were 7.0, 6.2, and 5.2 times more likely to say “no” to a COVID-19 vaccine than respondents who received an influenza vaccination every year or almost every year. The use of cigarettes, e-cigarettes, and marijuana, as well as heavy drinking of alcohol, were not associated with COVID-19 hesitancy. The associations between demographic factors and vaccine hesitancy were roughly similar for COVID-19 and influenza vaccines. Although various demographic groups have different levels of vaccine hesitancy and also have different factors to increase their acceptance, addressing misinformation related to COVID-19 vaccines, particularly concern about the safety of the vaccines is crucial in general.

While data have shown that Black populations are disproportionately affected by COVID-19, few studies have evaluated birth outcomes in these understudied populations. This study hypothesized that SARS-CoV-2 infection would confer worse maternal and neonatal outcomes in a predominantly Black and underserved population in Brooklyn, New York City. In particular, SARS-CoV-2 is associated with higher rates of preterm birth, cesarean delivery, postpartum hemorrhage, lower APGAR scores, and neonatal resuscitation. Demographic factors and comorbidities were compared between the SARS-CoV-2 positive and negative groups. A retrospective cohort study was conducted in hospitalized patients who gave birth at Kings County Hospital from April 10 through June 10, 2020. Demographic and clinical data were obtained from the electronic medical record. Patients were categorized based on SARS-CoV-2 infection status and peripartum outcomes were analyzed. We used the Fisher exact test for categorical variables and the Wilcoxon rank-sum test for continuous variables. P

African Americans and people of color have been disproportionately affected by the coronavirus (COVID-19) pandemic. As the second wave of the virus raged across the nation, there was a renewed effort to increase adherence to social distancing and mask-wearing guidelines. A community-based study led by members of the local National Black Nurses Association (NBNA) was conducted in a Midwest metropolitan city to identify barriers to mask-wearing experienced by business owners and employees in predominantly African American neighborhoods. Neighborhood business owners and their employees are essential to the life of a community as they provide needed goods and services from convenient neighborhood locations. Thus, attitudes and behaviors exhibited by business owners, supervisors, and other employees are important to combat COVID-19 in underserved communities. Semi-structured interviews were conducted with 39 business owners or supervising employees. Simple content analysis was used to identify codes and themes from the narrative data. Responses to the question ‘What can make mask-wearing easier for your business and businesses in the neighborhood?’ yielded three themes. Themes included ‘a sense of community’, the ‘need for external support’, and ‘internal leadership’. These themes can be used to develop interventions to improve mask-wearing behaviors, support business owners and their customers, and lower the spread of COVID-19 in high-risk communities.

Although Vietnam has been successful in the fight against the first wave of COVID-19, domestic outbreaks have continued to occur. Given university students constitute a significant proportion of the population in Vietnam, to improve the prevention and control of COVID-19 in Vietnam and comparable countries, we examined their knowledge, attitude, and practice (KAP) towards face mask use which is an important preventive measure and the association between the levels of COVID-19 knowledge and KAP towards face mask use. A cross-sectional survey was conducted on all students studying at Phenikaa University, Hanoi, using a self-developed questionnaire consisted of 42 questions regarding KAP towards face mask use as well as reuse of cloth mask, and COVID-19 knowledge. Among 728 participants, 40.9% (298/728) were male, 63.2% (460/728) were from health-related faculties, 46% (335/728) lived in urban areas, and 51.9% (378) had good levels of COVID-19 knowledge. Regarding face mask, most (89.7%, 653/728) participants had good knowledge scores, 72.8% (530/728) had positive attitudes, and 76.5% (557/728) had good practice scores. The most common types of masks used were surgical mask (57.6%, 419/728), followed by non-antibacterial cloth mask (23.1%, 168/728). Among 168 participants using non-antibacterial cloth mask, 43.5% reused masks (73/168), of whom 6.8% (5/73) did not wash their masks at least daily. Face mask use knowledge was statistically associated with COVID-19 knowledge (P

We examined factors associated with and reasons for perceived susceptibility to COVID-19 among urban and rural adults in Alabama. We surveyed 575 eligible participants’ engagement in preventive behaviors, concern about COVID-19 in their communities, perceived susceptibility to the virus, and reasons for susceptibility across three response options (Yes, No, and Don’t Know/Not Sure). Bivariate analyses compared characteristics by level of perceived susceptibility to COVID-19. A multinomial logistic regression model evaluated the association of demographics, health insurance coverage, and chronic illness status with perceived susceptibility. Participants’ race, gender, and educational attainment were significantly associated with perceived susceptibility to COVID-19. African Americans and males had higher odds of responding ‘No’, compared to ‘Yes’ and ‘Don’t Know/Not Sure’ than Whites and females. Participants with a high school education and lower had higher odds of responding ‘Don’t Know/Not Sure’ versus ‘Yes’ compared to those with college or higher education. Those unconcerned about COVID-19 in their community had higher odds of responding ‘No’ (OR = 2.51, CI 1.35–4.68) and ‘Don’t Know/Not Sure’ (OR = 2.51, CI 1.26–4.99) versus ‘Yes’, as compared to those who were concerned. Possibility of exposure at work was the most frequent reasons for perceiving themselves susceptible to COVID-19, engagement in recommended preventive measures was the most frequent reason among respondents who indicated ‘No’, and uncertainty/perception that everyone is at risk was the most frequent reason among the ones who indicated ‘Don’t Know/Not Sure’. Results indicate that tailored efforts to heighten perceived susceptibility to COVID-19 among specific demographics are needed.

The COVID-19 pandemic first became evident at the end of 2019, and because of the many unknown aspects of this emerging infectious disease, the internet quickly became a source of information for consumers. It is important for any vital information to be written unambiguously, and at a level that can be understood by all people regardless of education levels. The purpose of this study was to assess the readability of 50 sources of COVID19 testing information online. Only 6 websites out of 50 received an appropriate readability score on more than one assessment. One-sample, one-tailed t-tests (α = 0.05, df = 49) were used to see if the websites with information on COVID-19 testing are being written at appropriate reading levels. The resulting p-values indicate that each p-value recorded is substantially below 0.05, it is very unlikely that websites on this topic are being written at the recommended levels. Even the optimal messages on COVID-19 reflect a confusing and rapidly changing public health crisis, however if messages are kept simple and clear, individuals will have the best possible chance of optimizing behavioral mitigation strategies. These are compelling reasons for informational hosts to take necessary steps to ensure that messages are written in as simple terms as possible. To this end, it is suggested that internet sites dispersing COVID-19 testing information build in text analysis methods for all published messages, particularly those meant to inform best health practices in the time of a pandemic.

Early in the COVID-19 pandemic, Canadians faced much ambiguity in the public health messages around face mask use. As public health messaging plays a pivotal role in the provision of directives during a health crisis, this study examines Canadians' opinions on the early messaging they received regarding personal protection, especially around mask use, with the goal of identifying potential improvements to strengthen future health messaging. Nine online focus group interviews with 47 Canadians were conducted. These natural conversations focused on personal protective equipment (PPE) choices, mask-relevant public health information sources, and advice to Canadian authorities to improve public health messaging on mask use. Responses were imported into NVivo for thematic analysis. Four meta-themes of relevance were identified. Despite demonstrating trust in scientific evidence and public health authorities, the inconsistencies in public health messaging fostered confusion, and induced mistrust toward health professionals. Further, several information deficits were identified pertaining to the scientific efficacy, safe use, and disposal of masks. Rooted in loyalty to healthcare workers, these Canadians eschewed using medical grade masks during PPE shortages to ensure a sufficient supply for medical workers. The findings stress that consistency in public health messages should be prioritized, with necessary changes clearly justified and explained. More information should reach the public on the scientific benefits and proper use of masks. Public health recommendations should be evidence-based, simple, transparent, and realistic in the current circumstances to guide Canadians to make more informed personal protection choices in the rapidly evolving pandemic.

Electronic cigarette (E-cig) use has increased substantially among the young population, who adopt using E-cig for various reasons. Our present study aimed to explore vaping preferences and reasons for using E-cig among current users in the United Arab Emirates (UAE) and to assess physical and psychological symptoms experienced while using E-cig during intermittent fasting. A cross-sectional study was conducted from April 23 to May 22, 2020, to solicit responses from current E-cig users in the UAE. Data were collected about sociodemographic profile, tobacco cigarette smoking, vaping preferences, reasons for use, and withdrawal symptoms during fasting in Ramadan. A convenience sample of 591 adult E-cig users were initially recruited, of whom 392 participants with complete responses were included in our analysis. The majority of participants were males (n = 275, 70.2%) and around 28.6% (n = 112) were dual users. Vape tank/Box-mod was the most used type of E-cig (50.3%). Most of the participants (n = 317; 80.9%) believed that E-cigs are less harmful than tobacco cigarettes. During fasting time, around 46.2% (n = 181) of E-cig users have experienced various physical symptoms, while 51.0% (n = 200) of users have experienced various psychological symptoms. E-cig use is gaining popularity within the UAE after the recent legalization as these devices are commonly advertised and claimed by manufacturers to aid smoking cessation. The effectiveness of E-cig in aiding smoking cessation should be investigated with a higher level of evidence, especially in a new context of usage as the UAE, considering various types of devices, hundreds of E-liquid brands, and the influence of concurrent poly-tobacco use.

The novel coronavirus disease 2019 (COVID-19) continues to be a major public health concern. The aim of this study was to describe the presenting characteristics, epidemiology and predictors of outcomes among confirmed COVID-19 cases seen at a large community healthcare system which serves the epicenter and diverse region of Florida. We conducted a retrospective analysis of individuals with lab-confirmed SARS-CoV-2 infection who were seen, from March 2, 2020 to May 31, 2020, at Memorial Healthcare System in South Florida. Data was extracted from a COVID-19 registry of patients with lab-confirmed SARS-CoV-2 infection. Univariate and backward stepwise multivariate logistic regression models were used to determine predictors of key study outcomes. There were a total of 1692 confirmed COVID-19 patients included in this study. Increasing age was found to be a significant predictor of hospitalization, 30-day readmission and death. Having a temperature of 38 °C or more and increasing comorbidity score were also associated with an increased risk of hospitalization. Significant predictors of ICU admission included having a saturated oxygen level less than 90%, hypertension, dementia, rheumatologic disease, having a respiratory rate greater than 24 breaths per minute. Being of Hispanic ethnicity and immunosuppressant utilization greatly increased the risk of 30-day readmission. Having an oxygen saturation less than 90% and an underlying neurological disorder were associated with an increased likelihood of death. Results show that a patient’s demographic, underlying condition and vitals at triage may increase or reduce their risk of hospitalization, ICU admission, 30-day readmission or death. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-020-00957-y.

This paper examines the epidemiology of nonfatal firearm violence (NFFV) on the Westside of Chicago over three finite time periods: 2005–2008, 2009–2012, and 2013–2016. The trend analysis will look at any significant changes over the time periods and describe the demographic characteristics of NFFV. A descriptive analysis of Mount Sinai Hospital (MSH) Emergency Department (ED) data was conducted. NFFV patients were identified by specific firearm ICD-9 primary eCode injury categories: accident, assault, legal intervention, undetermined intent, suicide or self-inflicted injury, and legal intervention. The Pearson Chi-square test was conducted to statistically compare the categorical frequencies of the Chicago metropolitan region of injury, cause of firearm related injury, and place of injury by time period. There were a total of 3962 nonfatal hospitalizations at MSH between the three time periods due to gun violence related injuries. Overall, nonfatal hospitalizations were most frequent for those between age groups 16–24 (52.5%). The number of nonfatal hospitalizations decreased with increasing age for the age groups 35–44 (9.7%), 45–54 (3.2%), and > 54 (1.2%). There were significantly more nonfatal hospitalizations in males (n = 3649) than females (n = 312) across the three time periods. However, there was a 74.7% increase in female nonfatal hospitalizations from 2009–2012 to 2013–2016. There were significant racial differences in nonfatal hospitalizations between the three time periods. NFFV continues to be problem on the Westside of Chicago, particularly for young, Black men. The incidence of gun violence however has not changed significantly between 2005 and 2016.

Care-delays can further exacerbate racial and ethnic health disparities in novel coronavirus disease 2019 (COVID-19) related complications. The purpose of our study was to describe and evaluate a Patient Engagement Messaging campaign (PEM campaign) promoting health care seeking behaviors among community and rural clinic patients in North Carolina. Text and voice messages were delivered over 3-weeks. Messages encouraged patients to call a regional operation call center (ROC) line for information related to health care appointments and testing. A cross-sectional evaluation was conducted on the total population (n = 48,063) and a sample without recent health care contact (n = 29,214). Among the sample, logistic regression was used to model determinants of calls to the ROC-line and associations between calling the ROC-line and health care seeking behaviors (scheduling any health care appointment or receiving a COVID-19 test). 69.9% of text messages and 89% of voice messages were delivered. Overall, 95.4% of the total population received at least 1 message. Successful delivery was lower among Black patients and higher among patients with moderate health-risk comorbidities. Among the sample, 7.4% called the ROC-line, with higher odds of calling among minority patients (vs. White) and among Medicaid and uninsured (vs. private insurance). Calling the ROC-line was associated with higher odds of scheduling any health care appointment (OR: 4.14; 95% CI 2.93–5.80) and receiving a COVID-19 test (OR: 2.39; 95% CI 1.64–3.39). Messaging campaigns may help disconnected patients access health care resources and reduce disparities, but are likely still limited by existing barriers. Electronic supplementary material The online version of this article (10.1007/s10900-020-00939-0) contains supplementary material, which is available to authorized users.

To understand the role public health students play in response to COVID-19 despite cuts in funding for graduate student emergency response programs (GSERPs), we reviewed the websites of the Association of Schools and Programs of Public Health, Council on Education in Public Health, and individual schools and programs to identify student participation in COVID-19 response activities. Thirty schools and programs of public health are supporting public health agencies in response to COVID-19, primarily through the provision of surge capacity (n = 20, 66.7%), contact tracing (n = 19, 63.3%), and training (n = 11, 36.7%). The opportunity to participate in formal and informal applied public health experiences like practica, service-learning, and field placements can benefit both public health students and agency partners. Although recent publications have identified gaps in academic public health response to COVID-19, in part due to the cessation of funding for workforce development and other university-based programs in public health preparedness, schools and programs of public health continue to support public health agencies. Future funding should explicitly link public health students to applied public health activities in ways that can be measured to document impacts on public health emergency response and the future public health workforce.

Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19’s devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers’ health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits

Little is known about Community Health Workers (CHWs) who work in non-clinical settings to provide sexual health support around HIV, viral hepatitis, and other sexually transmitted infections (STIs) to men who have sex with men (MSM) in Europe and neighbouring countries. This article describes for the first time, who CHWs are, and how they contribute to the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM. The first European Community Health Worker Online Survey (ECHOES) developed in the framework of the EU-funded ESTICOM project ( www.esticom.eu ), was available in 16 languages (October 2017-January 2018). Amongst the 1035 persons aged 18 and older reporting CHW activities in the previous 12 months, 28.2% were women, 30.7% were volunteers, 59.2% were men self-defining as gay/homosexual, bisexual or queer (‘peer CHWs’), and most CHWs worked/volunteered in private not-for-profit organisations (86.4%). CHWs involvement in the continuum of services for HIV, viral hepatitis and other STIs was as follows: primary prevention (88.6%), consultation and counselling (58.0%), testing provision (50.6%), linkage to care (49.8%), and treatment and support activities (51.3%). CHWs were also involved in cross-cutting activities such as developing interventions, advocacy, and engaging in research (46.3%). CHWs as a public health workforce contribute to all steps of the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM in Europe. National governments should recognise and support CHWs better in order to make their activities more visible and sustainable, and increase their impact on the continuum of services.

Exceptional precautionary measures have been adopted to stop the transmission and control of COVID-19 through the world and Pakistan is facing lockdown in this scenario. Public loyalty to precautionary measures is affected by their knowledge, attitude, risk factors and practices (KAP) towards COVID-19. The present study was conducted among the Pakistani residents to observe the knowledge, attitude, practices and risk factors towards COVID-19 outbreak in Pakistan. A questionnaire was designed, and a cross-sectional survey was conducted among participants of the study area. Participants were asked the questions regarding knowledge, attitude, practices and risk factors towards COVID-19. Data were analyzed by SPSS and t/F test and correlation was applied among the knowledge, attitude, risk factors and practices. A total of 1060 questionnaires were received. 1004 were included while 56 were excluded. The highest representation was from Punjab province (65.6%), female (63%) and age group of 21–30 years (62.1%). Most participants were single (85%), Muslim (99.4%), Urdu speaking (45.6%) and were graduates (51.5%). Most of the participants were students (52.9%) and were from economically middle-class families (40.8%). The knowledge was positively correlated with attitude and practices whereas negatively correlated with risk factors (P

HIV rapid testing algorithms (RTAs) using any two orthogonal rapid tests (RTs) allow for on-site confirmation of infection. RTs vary in performance characteristics therefore the selection of RTs in an algorithm may affect identification of infection, particularly if acute. National HIV Behavioral Surveillance (NHBS) assessed RTAs among men who have sex with men recruited using anonymous venue-based sampling. Different algorithms were evaluated among participants who self-reported never having received a positive HIV test result prior to the interview. NHBS project areas performed sequential or parallel RTs using whole blood. Participants with at least one reactive RT were offered anonymous linkage to care and provided a dried blood spot (DBS) for testing at CDC. Discordant results (RT-1 reactive/RT-2 non-reactive) were tested at CDC with lab protocols modified for DBS. DBS were also tested for HIV-1 RNA (VL) and antiretroviral (ARV) drug levels. Of 6500 RTAs, 238 were RT-1 reactive; of those, 97.1% (231/238) had concordant results (RT-1/RT-2 reactive) and 2.9% (7/238) had discordant results. Five DBS associated with discordant results were available for confirmation at CDC. Four had non-reactive confirmatory test results that implied RT-1 false reactivity; one had ambiguous confirmatory test results which was non-reactive in further testing. Regardless of order and type of RT used, RTAs demonstrated high concordant results in the population surveyed. Additional laboratory testing on DBS following discordant results confirmed no infection. Implementing RTAs in the context of anonymous venue-based HIV testing could be an option when laboratory follow-up is not practicable.

The COVID-19 pandemic has become a major public health challenge globally with countries of the world adopting unprecedented infection prevention and control (IPC) measures to urgently curtail the spread of the COVID-19 virus. The knowledge, attitudes and practices (KAP) of the people toward COVID-19 is critical to understanding the epidemiological dynamics of the disease and the effectiveness, compliance and success of IPC measures adopted in a country. This study sought to determine the levels of KAP toward COVID-19 among residents of north-central Nigeria. A cross-sectional online survey with a semi-structured questionnaire using a Snowball sampling technique was conducted during the national lockdown. Data collected were analyzed using descriptive statistics, analysis of variance (ANOVA), Pearson's correlation and regression tests. From a total of 589 responses received, 80.6, 59.6, 90.4 and 56.2% were from respondents between ages 18-39 years, males, had a college (Bachelor) degree or above and reside in urban areas respectively. Respondents had good knowledge (99.5%) of COVID-19, gained mainly through the internet/social media (55.7%) and Television (27.5%). The majority of the respondents (79.5%) had positive attitudes toward the adherence of government IPC measures with 92.7, 96.4 and 82.3% practicing social distancing/self-isolation, improved personal hygiene and using face mask respectively. However, 52.1% of the respondents perceived that the government is not doing enough to curtail COVID-19 in Nigeria. Pearson's correlation showed significant relationship between knowledge of COVID-19 and attitude towards preventive measures (r = 0.177, p = 0.004, r = 0.137, p = 0.001). Although 61.8% of the respondents have no confidence in the present intervention by Chinese doctors, only 29.0% would accept COVID-19 vaccines when available. This study recorded good knowledge and attitudes among participants, however, community-based health campaigns are necessary to hold optimistic attitudes and practice appropriate intervention measures devoid of misconceptions.

An online cross-sectional study was carried out to evaluate the knowledge, attitude, and practice about coronavirus disease 2019 (COVID-19) among primary health care providers (PHPs) at three tertiary care hospital, Peshawar, Pakistan. Data was collected via email and online social media platforms. Statistical package for social science (SPSS) version 25.0 was used for data analysis. Among the total participants (n = 114), 74 (66.7%) were male and 37 (33.3%) were female. The mean scores for knowledge, attitude and practice were 12.7 ± 0.89, 8.9 ± 4.1 and 7.3 ± 1.2, respectively. Most of the participants knew the term COVID-19 and its mode of transmission (90%), signs and symptoms (84%) and risk factors (72%) associated with it. Most of the participants agreed that COVID-19 can be transmitted through coughing and sneezing (74.3%) and 84.6% were in favor that COVID-19 can be prevented by adopting preventive measures. Around 68.8% of the participants disagreed with the use of antibiotics in the prevention of COVID-19. Ninety percent of the respondents were avoiding close contact with the people having cough and flu-like symptoms. Most PHPs had good knowledge, positive attitude and reasonable practices regarding COVID-19. Moreover, focused training programs for PHPs at the Government level can further improve their understanding of risks and preventive strategies related to COVID-19, which will help them to provide appropriate care to their patients as well as to protect themselves from this infection.

This study aimed to assess the prevalence of smoking and associated sociodemographic and economic factors as well as students' knowledge about and attitudes towards smoking among university students in Oman. A proportionate random sampling technique recruited 401 students from three universities in a cross-sectional study. The prevalence of smoking was 9.0%. Significant differences in gender, place of residence, if participants had received medical advice, years spent at the university, student income/day, family members who smoked, knowledge and attitude scores were identified. Universities in collaboration with health care providers should be leading the development of strategies to reduce the prevalence of smoking and to sustain the current knowledge and attitude towards smoking. Gender-specific approaches to smoking interventions need to be developed., This research was funded by Sultan Qaboos University [IG/CON/FACN/19/02].

Objective To assess perceptions of risk and related factors concerning COVID-19 epidemic among residents in Chongqing city, China. Methods With convenience sampling, a web questionnaire survey was conducted among 476 residents living in Chongqing on February 13rd to 14th in 2020, when citizens just started to get back to work. Results Residents’ estimated perceived risks were (4.63 ± 0.57), (4.19 ± 0.76), (3.23 ± 0.91) and (2.29 ± 0.96) for the infectivity, pathogenicity, lethality and self-rated infection possibility of COVID-19, respectively. Females (OR = 4.234), people with income ≥ 2000 yuan (2000–4999 yuan: OR = 5.052, 5000–9999 yuan: OR = 4.301, ≥ 10,000 yuan: OR = 23.459), the married status (OR = 1.811), the divorced status, widows or widowers (OR = 3.038), people living with families including children (OR = 5.085) or chronic patients (OR = 2.423) had a higher perceived risk level, as well as people who used free media websites (OR = 1.756), community workers (OR = 4.064) or community information platforms (OR = 2.235) as main media information sources. The perceived risk increased by 4.9% for every one-year increase of age. People who used WeChat contacts (OR = 0.196) as the main media information source, reported a lower perceived risk. Conclusion Residents reported a high level of risk perception towards COVID-19 in Chongqing and it was impacted by the population demographic characteristics. Media information sources, including community information platforms and community workers may cause the increase of public risk perceptions.

The increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public’s knowledge and attitudes regarding this pandemic. To determine the correlation between the general public’s knowledge and attitudes regarding the COVID-19 outbreak 1 month after the first cases were reported in Indonesia. This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people’s responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.

The pandemic of novel Coronavirus (SARS-CoV-2) is currently spreading rapidly across the United States. We provide a comprehensive overview of COVID-19 epidemiology across the state of Texas, which includes vast rural & vulnerable communities that may be disproportionately impacted by the spread of this new disease. All 254 Texas counties were included in this study. We examined the geographic variation of COVID-19 from March 1 through April 8, 2020 by extracting data on incidence and case fatality from various national and state datasets. We contrasted incidence and case fatality rates by county-level demographic and healthcare resource factors. Counties which are part of metropolitan regions, such as Harris and Dallas, experienced the highest total number of confirmed cases. However, the highest incidence rates per 100,000 population were in found in counties of Donley (353.5), Castro (136.4), Matagorda (114.4) and Galveston (93.4). Among counties with greater than 10 cases, the highest CFR were observed in counties of Comal (10.3%), Hockley (10%), Hood (10%), and Castro (9.1%). Counties with the highest CFR (> 10%) had a higher proportion of non-Hispanic Black residents, adults aged 65 and older, and adults smoking, but lower number of ICU beds per 100,000 population, and number of primary care physicians per 1000 population. Although the urban areas of Texas account for the majority of COVID-19 cases, the higher case-fatality rates and low health care capacity in rural areas need attention.

Community health workers (CHWs) can reduce health disparities for low income patients but type of contact and outcomes has had limited study. Low-income Hispanic primary care patients with hemoglobin A1c [HbA1c] ≥ 9% received care managment (CM) over 6 months classified as: (CM1) telephone only; (CM2) clinic visit but no calls; (CM3) clinic visit with calls; and (CM4) ≥ 2 visits ± calls. Type of CM delivery and time to DM control (HbA1c

The objective of the study was to assess the knowledge and perception of COVID-19 and relevant universal safety measures among the Nepalese population. A web-based cross-sectional study was conducted among Nepalese adults from March 29 to April 07, 2020. A 13- and 15- items structured questionnaire assessed the COVID-19 related knowledge and perception of the universal safety measure. Kruskal–Wallis test and Mann–Whitney U test evaluated the differences in knowledge between the groups. Data analysis was performed using IBM SPSS Statistics for Windows Version 21.0 (IBM Corp. Armonk, NY, USA). Of the 884 surveys accessed, a total of 871 consented (electronically) and completed the online survey (response rate 98.52%). The median knowledge score of the participants was 10.0 (± 3.0 IQR). Although participants’ overall knowledge score was high, only about half of the participants knew about the concept of quarantine and the ideal distance to be maintained between individuals to prevent the transmission. Though the majority of the participants had positive perception towards universal safety measure of COVID-19, about 18% perceived that coronavirus infected only older people, 11% opined that the infection was highly fatal with no chances of survival and 70% considered that limiting consumptions of poultry and meat would prevent the spread of COVID-19. A statistically significant difference in knowledge was noted by participants’ age, educational status, occupational type, and household monthly income. This study found optimal knowledge and perception of universal safety measures of COVID-19 among the Nepalese population, but misinformation and misunderstanding prevailed. Electronic supplementary material The online version of this article (10.1007/s10900-020-00839-3) contains supplementary material, which is available to authorized users.

The objective of this study was to evaluate whether bicycling infrastructure changes in the city of Minneapolis effectively reduced the incidence or severity of traumatic bicycling related injuries sustained by patients admitted to our Level 1 Trauma Center. Data for this retrospective cohort study was obtained from the trauma database at our institution and retrospective chart review. The total number of miles of bikeway in the city on a yearly basis was used to demonstrate the change in cycling infrastructure. Adjusted regression analysis demonstrated a significant reduction in ISS when total bike lane miles increased (Coef. − 0.04, P

Shortly after the identification of a novel coronavirus, the coronavirus disease 2019, or COVID-19, a global pandemic was declared. There have been conflicting data about the severity of COVID-19 disease course in pregnant women, with most US data suggesting an increase in severity and increased need for hospitalization and intubation in obstetric patients. In the general population, the disease is more common among racial and ethnic minority populations, and severity is increased with comorbid conditions and obesity. The purpose of this study is to characterize COVID-19 infection in pregnancy in a population of women getting prenatal care at an urban safety-net hospital. Beginning in April, 2020, all women were tested at admission for delivery, and additionally as an outpatient if presenting with COVID-19 symptoms. In three months, there were 208 discrete women tested and 23 (11.1%) who were positive for COVID-19. The incidence of COVID-19 was 5.1% in asymptomatic women being screened upon admission to the hospital. There was a high prevalence of obesity (68.2%) and other comorbid conditions (43.5%) in this population, and all patients were racial/ethnic minorities. Despite these risk factors, the patients uniformly had either mild or asymptomatic disease. No symptomatic patients required hospitalization for their infection. In this population of pregnant women at high risk for severe COVID-19 infection, only mild disease was observed.

Women experience challenges engaging with the healthcare system, but frequently utilize hair salons; these are promising venues for family planning and HIV prevention services. Our objective was to assess the acceptability of nurse-offered contraceptive and PrEP services at hair salons in Durban, South Africa. We interviewed salon owners (N = 10) and clients (N = 42) and conducted focus groups with hair stylists (N = 43 stylists; 6 focus groups across five hair salons) to explore barriers and facilitators to providing contraception and PrEP in salons. After developing a codebook, we performed content analysis to identify themes within each conceptual area; 10% of transcripts were coded by two coders to ensure reliability. Content was analyzed according to the following categories: (1) facilitators of and (2) barriers to utilizing these services, and (3) factors to consider for program implementation. Participants identified convenience and female-oriented, supportive atmosphere as facilitators to offering HIV and contraceptive services in salons. Owners and stylists noted that establishing legitimacy was important for program success, including providing promotional pamphlets and employing nurses. Clients cited privacy concerns surrounding HIV testing in a public space as a significant barrier to using these services. Overall, participants were enthusiastic about the program. Convenience and a conducive environment were noted as facilitators to receiving health services in the hair salon; attention will have to be directed to establishing privacy and program legitimacy. Hair salons represent an innovative venue for reaching young women at high-risk for unintended pregnancy and HIV infection.

The first African COVID-19 case was reported in Egypt in February 2020. Since then, Sub-Saharan countries have struggled to respond to the pandemic. Among them, Chad is characterized by a high rate of poverty and mortality, a high burden of infectious diseases, insufficient epidemiological surveillance and underdeveloped infrastructure. In this study, we explore the knowledge, attitudes and practices (KAPs) regarding COVID-19 within the Chadian population, to determine whether there are more vulnerable groups of the population that require greater attention from authorities. This study was designed as a cross-sectional survey conducted in N'Djamena, Chad, using a convenience sampling technique that included 2269 participants. The study was conducted in May and August 2020. Questions regarding technical concepts were answered incorrectly by most participants (83.65%). The population had better knowledge about concrete aspects of the pandemics, such as prevention measures and contagion. Regarding attitudes, 34.55% participants were very concerned about the possibility of being infected, 81.27% were unsatisfied/very unsatisfied with their social relationships after the pandemic began, and 68.44% thought that the pandemic was a disturbing/very disturbing issue. As for practices, 49.41% of men followed all preventive measures compared to 32.07% of women, and 3.04% of people with vulnerable jobs did not respect any of preventive measures compared to 1.19% of people without this condition. Gender, job conditions and educational level impact KAPs within the Chadian population. It is suggested that local authorities in Chad should consider these variables when developing health strategies.

In Italy, as well as in almost all countries, the use of masks in public with several other measures has been an important health measure during the ongoing COVID-19 pandemic. The correct use of masks is essential, as a wrong use and disposal may increase the rate of contagious. Herein, we report a descriptive study evaluating the knowledge and use, reuse and disposal of masks in community settings. An anonymous questionnaire called MaSK (Mask uSe and Knowledge) questionnaire was developed and offered to patients referring at our dermatologic outpatient clinic. A total of 2562 full complete patients’ questionnaires were considered for the study. Our results showed that awareness and information campaigns aimed at the general population are urgently needed in order to implement a correct use of masks and limit as much as possible the infection rate.

The numerous negative health impacts of COVID-19, which include expected changes to psychiatric illness and physical activity (PA), are disproportionately distributed in the United States. Mental illnesses and physical inactivity are prevalent among U.S. college students. This study examined whether there was a change in minutes of PA and depression scores after a stay-at-home order and examined predictors of these changes. An online survey was sent to all undergraduate and graduate students attending a large, diverse university via an electronic newsletter. The survey requested information about demographic and academic data, cardiorespiratory fitness, and depression symptoms. Paired t-tests and logistic regression were employed. Our sample (n=194) was predominantly female (73%), young (mean age of 25), not a sexual minority (82%), and had a mean 3.4 GPA. Students reported worse depression scores (p

As with other countries globally, Rwanda has faced a recent outbreak of the coronavirus disease 2019 (COVID-19) against a backdrop of an HIV epidemic. At present, there is no successful cure or vaccine for both COVID-19 and HIV. People with underlying conditions, including HIV, are at increased risk of severe COVID-19 manifestations. This underscores the need to enhance the knowledge, attitudes, and practice of people living with HIV (PLWH) to protect this population against COVID-19. An institution-based cross-sectional study was conducted from August 31 to September 18, 2020 among 376 participants who were selected by a simple random sampling technique. A pretested and structured self-administered questionnaire was used to collect data. Quality scores were calculated as a measure of the participants’ knowledge, attitudes, and practice (KAP) levels. The student t-test was used to compare continuous variables between low (

Demographic and socioeconomic factors can contribute to community spread of COVID-19. The aim of this study is to describe the demographics and socioeconomic factors in relation to geolocation of COVID-19 patients who were discharged from the emergency department (ED) back into the community. This retrospective study was conducted over a 7-week period, at an urban, adult, level 1 trauma center in New York City. Demographics, socioeconomic factors, and geolocation of COVID-19 patients discharged from the ED were extracted from the electronic medical records. Patients were stratified by gender for data analysis. A total of 634 patients were included in the study, 376 (59.3%) were male and 205 (32.3%) were Hispanic White. The median age of patients was 50 years (IQR: 38, 60, Min:15, Max:96). The unemployment rate in our population was 41.2% and 75.5% reported contracting the virus via community spread. ED mortality rate was 11.8%; the majority of which were male (N = 50, 66.7%) and the median age was 70 years (IQR: 59, 82). There were 9.4% (95% CI 2.9–12.4) more Black males and 5.4% (95% CI 0.4–10.4) more males who had no insurance coverage compared to females. 26.8% (95% CI 14.5–39) more females worked in the healthcare field and 7.1% (95% CI 0.3–13.9) more were infected via primary contact compared to males. COVID-19 disproportionately affected minorities and males. Socioeconomic factors should be taken into consideration when preparing strategies for preventing the spread of the virus, especially for individuals who are expected to self-isolate.