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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.

E-cigarette use among young adults is a major public health concern. Approximately 17.7-40% of college students have tried or are currently using e-cigarettes. While a few studies have examined e-cigarette use among youth, opportunity exists to understand psychosocial factors that influence college students' e-cigarette behavior. The main purpose of this study is to examine the associations between the constructs of self-efficacy, knowledge, depression and anxiety symptoms, and e-cigarette use among college students. A retrospective cross-sectional survey (20-items) design was used for data collection. Bivariate analysis and analysis of variance (ANOVA) were used to evaluate associations between the independent variables and the dependent variable. A total of 872 college students between the ages of 18 and 25 completed the survey in Qualtrics. A significant association between gender and frequency of e-cigarette use was found (χ2 = 22.94, p < .001). ANOVA results showed significant relationships between knowledge [F (3, 808) = 9.01, p < 0.001], self-efficacy [F (3, 808) = 4.85, p < 0.01], depression [F (3,808) = 8.31, p < .05], and e-cigarette use. Post hoc analysis revealed students who never used e-cigarettes scored higher on knowledge and self-efficacy than students who used every day, somedays or rarely, indicating never-users have higher knowledge of negative effects associated with e-cigarette use and have higher self-confidence than e-cigarette users. The study's findings highlight that modifiable factors such as knowledge about harmful effects of e-cigarettes and self-confidence are associated with low e-cigarette use. Interventions could be designed to target these modifiable factors.

Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National Association of Community Health Centers, the YMCA of the USA, and Association of State and Territorial Health Officials to develop cross-sector care models to offer SMBP to patients with hypertension. The project aimed to increase the use of SMBP through the coordinated action of health department leaders, community organizations and clinical providers. From 1/31/2017 to 6/30/2018, nine health centers in Kentucky, Missouri, and New York partnered with seven local Y associations (local Y) and their local health departments to design and implement care models that adapted existing primary care SMBP practices by leveraging capacities and resources in community and public health organizations. Nine collaborative care models emerged, shaped by available community assets, strategic priorities, and organizational culture. Overall, 1421 patients were recommended for SMBP; of those, 795 completed at least one cycle of SMBP (BP measurements morning and evening for at least three consecutive days). Of those recommended for SMBP, 308 patients were referred to a local Y to receive additional SMBP and healthy lifestyle support. Community and public health organizations can be brought into the health care delivery process and can play valuable roles in supporting patients in SMBP.

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

Examine COVID-19 knowledge, concerns, behaviors, stress, and sources of information among patients in a safety-net health system in Louisiana. Research assistants surveyed participants via structured telephone interviews from April to October 2020. The data presented in this study were obtained in the pre-vaccine availability period. Of 623 adult participants, 73.5% were female, 54.7% Black, and 44.8% lived in rural small towns; mean age was 48.69. Half (50.5%) had spoken to a healthcare provider about the virus, 25.8% had been tested for COVID-19; 11.4% tested positive. Small town residents were less likely to be tested than those in cities (21.1% vs 29.3%, p = 0.05). Knowledge of COVID-19 symptoms and ways to prevent the disease increased from (87.9% in the spring to 98.9% in the fall, p

We reviewed data from the electronic health data system used by Community Health Workers (CHWs) in the Richmond/Henrico Health District of the Virginia Department of Health from January 1st 2013 to December 31st 2020, to map the Community Health Workers’ impact on Social Determinants of Health. We also interviewed the CHWs to obtain demographic information and information about the challenges their communities face. Most referrals were for Healthcare Access (48.7%) and Economic Stability (38.3%), while Neighborhood and Built Environment (0.09%) was the least used referral in the Social Determinants of Health during the time under review. Community Health Workers also carried out 1367 and 565 Blood Pressure and Blood Sugar measurements respectively during the period. The Community Health workers were all women and their education ranged from High School graduate to Master’s degree graduate and they served as Community Health Workers for time ranging from 1 to 8 years. We found their answers to the questions on the issue plaguing the community they serve to indicate empathy and understanding of the issues of low-income communities. Having CHWs working as part of the public health system to deliver health promotion and provide referrals for social determinants of health could serve as a model for improving health access and impacting Social Determinants of Health positively for low-income populations across the country.

Home health care (HHC) focuses on delivering skilled health care services to patients in their homes. Over 82% of HHC patients are 65 and older, and living with chronic health conditions. In an effort to respond to the risk the COVID-19 pandemic presented for patients, a HHC agency designed "The Outreach Phone Call Project". This program was developed to provide telephone support to at-risk patients who had received HHC prior to the COVID-19 lockdown. In total, 16 Care Transition Managers participated in the project and over 4,000 patients received a call from the clinical team. Approximately 44% of the calls did not require any further follow up, 20% of the patients did not answer the call, and 3% of patients were referred back to HHC. Another 13% needed education and assistance with social issues. The calls provided a means of safe connection and support between providers and patients during the pandemic and facilitated access to health and social resources. However, the most beneficial aspect of the program was the opportunity for seasoned HHC nurses to identify clinical changes in the health of patients and to assist them in the triage process. Results of this study demonstrate that the implementation of a calling project during the pandemic shutdown provided invaluable connection and outreach to vulnerable populations. This simple change in practice enabled HHC professionals to reach patients who were isolated and in need of education and assistance. As a result of the implementation of an "Outreach Phone Call Project", the HHC agency learned many lessons which may be helpful to others who would like to create a similar program in the future. It facilitated clinical assessment, education and intervention for isolated patients during the COVID 19 pandemic and implementation of similar practice should be considered in the post-pandemic world.

In this cross-sectional study, adverse events after the first and second dose of BNT162b2 mRNA (Pfizer-BioNTech, Comirnaty) vaccine against coronavirus disease 2019 were investigated among employees of clinics in central Italy. A 42-items questionnaire was administrated to vaccine recipients. Adverse events were classified based on severity and occurrence as reported in the literature. A descriptive/univariate analysis using Chi-square or Fisher’s Exact tests was performed. Odds ratio (OR) and 95% confidence intervals were calculated to assess risk factors. 340 individuals (61.5% females; median age 49 years) participated. Adverse events were reported by 279 (82%) and 281 (82.6%) individuals as induced by the first and second dose, respectively. Mild reactions were mainly reported (80.9% and 80.3%), followed by moderate (11.8% and 37.1%) and severe (3.8% and 4.7%). Adverse events were identical to those already described as very common (81.8% and 80.6%), although vaccine-coincidental events not cited in the literature were reported by 6% and 15.6% following each dose. Age ≤ 55 years was a risk factor for any adverse event after each injection (ORs: 2.942 and 2.818), as well as female sex for those mild (ORs: 1.856 and 2.818) and common (ORs: 3.452 and 2.145). Findings were consistent with national reports as most of the adverse events were mild and associated with female sex and young age, while investigations are needed for reactions not described elsewhere. Data are useful to support the vaccine safety profile, also because largely targeted healthcare personnel more skilled than general population in self-diagnosis of health-related issues.

Current day youth have an important role in climate activism, as the decisions and policies made now will have long lasting impacts on the climate and sustainability. Climate change is becoming an increasing concern for younger generations. As such, the purpose of this study was to describe content related to climate change on TikTok. This study included 100 English-language videos related to climate change featured on TikTok. The hashtag #climatechange was chosen because it had the most views of any related hashtag at the time of the study. The number of views, comments, and likes were recorded for each video. Each video was also observed for the presence of predetermined content characteristics. The 100 videos sampled collectively received 205,551,200 views, 40, 203,400 likes, and 666,089 comments. Only eight of the 100 videos included information from a reputable source. Only three of the characteristics were featured in a majority (> 50) of the videos. These were, presents climate change as real (93), affected populations (76), and climate anxiety/frustration (57). Videos mentioning natural disasters garnered 63,453,100 (30.87%) views, 14,245,200 (35.43%) likes, and 236,493 (35.50%) comments. In all, 73 of the 100 videos mentioned at least one environmental impact. Videos including this theme earned 156,677,200 (76.22%) views, 32,000,700 (79.60%) likes, and 563,195 (84.55%) comments. Social media platforms such as TikTok are important tools for understanding popular opinion regarding public health issues such as global climate change. However, the presence of credible professionals is essential on platforms such as TikTok to increase the chances that messaging is as comprehensive as time allows, while also being scientifically sound.

To understand how observed COVID-19 diagnostic testing disparities across New York City (NYC) have impacted infection rates and COVID-19 spread, we examined neighborhood-level factors associated with, and the spatial distribution of, antibody test and infection rates, and compared changes over time by NYC ZIP code tabulation area (ZCTA). Data were obtained from 2019 American Community Survey 5-year estimates to create an SES index by ZCTA. Other predictors obtained from 2018 census data were the proportions of white residents, Hispanic residents and residents ≥ 65 years old. Multivariable Poisson regressions were performed to assess the rate of change for antibody testing and positivity, and to assess the independent associations with SES, race and age. Results: There was a significant association between the rate of antibody tests and SES quartiles (Q1: βadj = 0.04, Q2: βadj = 0.03 and Q3: βadj = − 0.03, compared to Q4), and the proportion of residents who are white (βadj = 0.004, p < .0001), Hispanic (βadj = 0.001, p < .0001), and ≥ 65 years (βadj = 0.01, p < .0001). Total number of positive antibody tests was significantly inversely associated with SES quartile (Q1: βadj = 0.50, Q2: βadj = 0.48 and Q3: βadj = 0.29, compared to Q4), and proportion of white residents (β = − 0.001, p < .0001) and ≥ 65 years (β = − 0.02, p < .0001), and significantly positively associated with proportion of Hispanic residents (β = 0.003, p < .0001). There are disparities in antibody testing and positivity, reflecting disproportionate impacts and undercounts of COVID-19 infection across NYC ZCTAs. Future public health response should increase testing in these vulnerable areas to diminish infection spread.

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.

Intimate partner violence (IPV) is an important public health concern with higher prevalence among women. Community health workers (CHWs) are trusted frontline public health workers that bridge gaps between communities and healthcare services. Despite their effectiveness in delivering services and improving outcomes for different chronic conditions, there is a dearth of understanding regarding CHW management of IPV. The purpose of this study is to examine knowledge, attitudes, practices, and readiness to manage IPV among a sample of CHWs (n = 152). Participants completed an online version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), which was modified for CHW practice. Psychometrics of the newly adapted tool, along with empirical relationships between knowledge, attitudes, and readiness to manage IPV were examined. Most sub-scales yielded moderate to high reliability (0.70

The introduction of emtricitabine/tenofovir diphosphate (FTC/TDF) as pre-exposure prophylaxis (PrEP) for HIV prevention has raised questions regarding which clinicians will serve as prescribers and how providers will be educated about this HIV prevention strategy. We piloted an HIV Prevention Education Program called PrEP University (PrEP U) to address knowledge gaps in HIV prevention among medical trainees. We examined PrEP awareness and assessed learning as a result of the program, measuring knowledge before and after the lectures with an anonymous 5-question multiple choice test. A total of 198 learners participated in PrEP University, which included 127 first year medical students, and post-graduate trainees in internal medicine (n = 23), family medicine (n = 16), OBGYN (n = 13) and pharmacy (n = 19). Prior to PrEP U, 27% of all participants were not aware of PrEP and an additional 8% were unsure if they had heard of it. Knowledge increased significantly after the education program among trainees in OBGYN (2.3 vs 3.8, p

To analyze the impact of housing instability and social risk facts on food insecurity using resource center client information. We utilized 2-1-1 San Diego’s client database to analyze the association of food insecurity and housing instability among residents from August 2017 to March 2020. 3468 clients had food or housing needs assessed by a risk rating scale. A multiple logistic regression model analyzed the associations between food insecurity and social risk factors including housing, transportation, utility bills, criminal justice, and medical debt. Multiple logistic regression indicates that those with housing instability encounter significantly greater risk of food insecurity (AOR 1.2) for homeless-sheltered, (AOR 2.1) for homeless-unsheltered. Also, utility needs (AOR 1.2) is significantly associated with food insecurity. However, those with medical debt are 48% less likely to have food insecurity. Approximately 77% of clients experienced food insecurity. Those with food insecurity also experienced higher needs in housing and other social risk factors. By further researching the association of food insecurity, housing instability, and other social needs in a population, we can better inform public health strategies that focus on proactive community and resource planning.

Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work they do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.

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.

Mystery patient drills using simulated patients have been used in hospitals to assess emergency preparedness for infectious diseases, but these drills have seldom been reported in primary care settings. We conducted three rounds of mystery patient drills designed to simulate either influenza-like illness (ILI) or measles at 41 community health centers in New York City from April 2015 through December 2016. Among 50 drills conducted, 49 successfully screened the patient–actor (defined as provision of a mask or referral to the medical team given concern of infection requiring potential isolation), with 35 (70%) drills completing screening without any challenges. In 47 drills, the patient was subsequently isolated (defined as placement in a closed room to limit transmission), with 29 (58%) drills completing isolation without any challenges. Patient–actors simulating ILI were more likely to be masked than those simulating measles (93% vs. 59%, p = 0.007). Median time to screening was 2 min (interquartile range [IQR] 2–6 min) and subsequently to isolation was 1 min (IQR 0–2 min). Approximately 95% of participants reported the drill was realistic and prepared them to deal with the hazards addressed. Qualitative analysis revealed recurring themes for strengths (e.g., established protocols, effective communication) and areas for improvement (e.g., hand hygiene, explaining isolation rationale). We conclude that mystery patient drills are an effective and feasible longitudinal collaboration between health departments and primary care clinics to assess and inform emergency preparedness for infectious diseases.

An unlikely partnership between a private, place-based foundation and the University of New Mexico's Office for Community Health resulted in an innovative approach for addressing a critical shortage of health professionals in an isolated, rural setting in the southeastern corner of New Mexico. Many place-based private foundations are focused locally and are naturally disinclined to engage distally located public universities for local projects. Large public universities do not often focus resources on small communities located far from their campuses. However, this unusual partnership resulted in a compelling vision of how atypical partners can collaborate in a way that is uniquely beneficial for a rural setting. Combining the entrepreneurial nature, flexible discretionary grant-making and local convening capabilities of a private foundation with the comprehensive set of resources of a public university allowed for a genuinely community-based approach in overcoming longstanding and systemically acute shortages in the local health care delivery workforce. Multi-party agreements were developed involving the JF Maddox Foundation, a local community college, local community hospitals and the University (the state's only academic health center, based in Albuquerque), to engage both the University and local partners in ways that allowed for an entirely new approach to more effectively recruit, support, and retain local health care professionals. Results included significant increases in recruitment of key health care professionals, a more cohesive medical community, a school-based clinic and support for other community challenges, including prevention of teen pregnancy. The University has since exported this model to other rural communities in the state.

Willingness and reasons to be vaccinated against COVID-19 were examined among 26,324 respondents who completed a survey on willingness and questions related to Confidence in vaccine safety, Complacency about the disease, Convenience of vaccination, tendency to Calculate risks versus benefits, and Concern for protecting others. Willingness to be vaccinated differed by age (p

We conducted a survey of community health worker (CHW) employers in Texas to understand the employment context and workforce development needs of Texas CHWs. An electronic, mixed-methods survey was emailed to 841 CHW employers across Texas in Spring 2020. The survey consisted of 51 questions. The response rate was 22% (n = 182). Responses were analyzed using SPSS, Microsoft Excel, and N.Vivo. We found that most CHW employers directly employ their CHWs, and CHWs are typically part of a multidisciplinary healthcare team. Most respondents required their CHWs be certified by the state’s health department and have at least a high school diploma or GED. The most common services that CHWs provide are health education/promotion and information referral. The main health issues that CHWs address are diabetes, hypertension, and mental/behavioral health. Current CHW workforce development needs include continued training on topics including chronic disease self-management and health promotion. CHW employers differ in their capacity to implement workforce development activities. There is significant variety in the employment context and workforce development needs of CHWs across Texas. Results reinforce previous findings on the need for specialized, continuing training for CHWs and the development of pathways, resources, and opportunities that could advance the CHW profession even more. These results can inform those interested in employing CHWs in their CHW program development. Findings from this study can be used to guide development of tailored curriculum for continuing education units, specialized certifications, or other professional development resources for CHWs.

The COVID-19 pandemic has necessitated restrictive orders and programmatic changes that may be associated with disruptions in services, including those for opioid-dependent people who inject drugs (PWID). This study aims to assess the impact of COVID-19 pandemic on access to and utilization of various HIV prevention services among PWID with opioid use disorder (OUD). We interviewed 110 PWID enrolled in medication for opioid use disorder (MOUD) treatment (e.g., methadone) between May and October, 2020 to identify if this sample experienced changed in access to the following services due to the COVID-19 pandemic: (a) HIV or sexually transmitted infection (STI) testing, (b) pre-exposure prophylaxis (PrEP) services, (c) HIV counselor or doctor appointments, and (d) clean injection equipment. A majority of the sample reported that COVID-19 had not changed their access to HIV testing or access to STI testing. Almost half of the sample reported that getting an appointment with a doctor decreased due to COVID-19. Participants reported that access to a lab or blood testing, access to injection equipment, and sessions with a case manager or counselor decreased. One-fourth of the 32 participants who were taking PrEP before the onset of COVID-19 reported that they had trouble getting their PrEP prescription due to COVID-19, and some reported that they had difficulty getting the PrEP prescription filled at their pharmacy. Our results indicate that PWID did not experience reduced access to HIV or STI testing, but difficulties in obtaining appointments with HIV counselors or doctors and limited access to PrEP were presented. Innovative strategies are needed to reduce the adverse effects of COVID-19 on HIV prevention among PWID.

Objective To evaluate participation in COVID-19 case investigation and contact tracing in central Washington State between June 15 and July 12, 2020. Methods In this retrospective observational evaluation we combined SARS-CoV-2 RT-PCR and antigen test reports from the Washington Disease Reporting System with community case investigation and contact tracing data for 3 health districts (comprising 5 counties) in central Washington State. All 3 health districts have large Hispanic communities disproportionately affected by COVID-19. Results Investigators attempted to call all referred individuals with COVID-19 (n = 4,987); 71% were interviewed. Of those asked about close contacts (n = 3,572), 68% reported having no close contacts, with similar proportions across ethnicity, sex, and age group. The 968 individuals with COVID-19 who named specific contacts (27% of those asked) reported a total of 2,293 contacts (mean of 2.4 contacts per individual with COVID-19); 85% of listed contacts participated in an interview. Conclusions Most individuals with COVID-19 reported having no close contacts. Increasing community engagement and public messaging, as well as understanding and addressing barriers to participation, are crucial for CICT to contribute meaningfully to controlling the SARS-CoV-2 pandemic.

The continuing COVID-19 pandemic significantly impacted the Fall reopening plans among institutions of higher education (IHEs) in the United States (U.S.). While recommendations were made to conduct COVID-19 testing of students and staff, it is unclear as to what extent IHEs were able to engage in testing. IHEs also play a critical role in provision of accurate information related to COVID-19 to students and staff. The purpose of this cross-sectional study was to assess available information on COVID-19 testing on IHEs’ websites in the New York City (NYC) metropolitan area. IHEs’ websites were screened for the presence of content related to COVID-19 testing. Larger institutions (> 10,000 students) were more likely than smaller institutions (≤ 5000 students) to provide information on how to make an appointment for COVID-19 testing (χ2(2) = 8.1, P

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.

Mitigating transmission of SARS-Co-2 virus is critical to stopping the COVID-19 pandemic. Messages about the pandemic on YouTube reach millions of people and should be a part of a more comprehensive strategy for educating the public to reduce transmission. We examined successive samples of the 100 most widely viewed YouTube videos regarding COVID-19 at three time points between January and June 2020 and examined characteristics of videos that specifically mentioned COVID-19 transmission. We described the cumulative and mean number of views, video length, and video source and assessed differences across the samples. Historical events and confirmed worldwide cases are compared with cumulative views of videos mentioning disease transmission over time. Across the three successive samples, views for all videos increased from ~ 125 million to over 560 million views, and from ~ 63 million to more than 273 million for those videos specifically mentioning disease transmission, respectively. This increase coincided with the increase in the worldwide number of cases and the occurrence of COVID-19 transmission informational milestones. Despite its importance for community mitigation, the majority of the widely viewed videos we sampled did not specifically mention disease transmission. Because of its very widespread reach, YouTube can be an effective way to communicate with the public, especially to those who have lower levels of reading literacy and who may be inclined to search for information on YouTube. Greater efforts are needed to more fully realize the potential of YouTube for educating the public about COVID-19 transmission.

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

The purpose of this study was to evaluate family physicians’ job strain during the Covid-19 pandemic and determine the effective factors. The study was carried out between 01 May 2020 and 01 June 2020 by applying an online questionnaire to family physicians who worked in primary care in Istanbul and could be reached by telephone application. The survey created by us included socio-demographic information and the Job Strain Scale Short Form. P value was accepted as 0.05, and SPSS 20 package program was used in statistical analysis. 448 Family Physicians participated in the study. Anxiety levels of the participants increased after the pandemic (p

The COVID-19 disease is presently a matter of global public health concern as it could be potentially fatal. Health workers have at the moment, inadequate knowledge of prevention measures, and their erroneous practices may directly increase the risk of spread. As a result, matters are complicated further as far as the chain of infection is concerned. The present cross-sectional study was conducted with 494 Health Worker participants in Cyprus between the 1st and 20th of May and the data were collected via an online questionnaire. The survey was created using information from a previous study as well as current directives published on the WHO website. The statistical software SPSS 22.0 was used for data analysis. The ANOVA test was used for the comparison of quantitative variables, while the Kruskal–Wallis test was used in cases of non-parametric distribution. The Pearson or Spearman coefficients were used to test correlation and the levels of materiality were set to 0,05. Women constituted 66,7% of the participants and 44,8% of all participants were between the age of 30–39 years old. The majority (75,4%) of the participants were Nursing Officers and 44,5% held postgraduate qualifications. HWs appeared to have a positive perception (x̅ = 3.58, SD = 0.53, MR = 1–5) regarding the course of the pandemic and their knowledge of the virus was found to be generally satisfactory. The findings of the current study indicate that in case of a similar global public health crisis, certain educational interventions should be implemented. This could be achieved with the use of an appropriate strategy. As a result, all demographic-working strata of health professionals would be well-educated and informed.

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.

The COVID-19 pandemic has created a sense of threat, and stress that has surged globally at an alarming pace. University students were confronted with new challenges. This study examined university students' functional difficulties and concerns during COVID-19 pandemic in two countries: Israel and Ukraine. Additionally, it examined the similarities and differences in prediction of COVID-related concerns in both countries. Two large samples of university students were drawn from both countries. Results showed that students' main functional difficulties in both countries were: worries about their family health status and their learning assignments. In both countries, COVID-related functional difficulties and stress associated with exposure to the media added a significant amount of the explained variance of COVID-related concerns after controlling for background variables. In conclusion-while the level of exposure and difficulties may differ by country and context, their associations with students' concerns seem robust. Additionally, repeated exposure to media coverage about a community threat can lead to increased anxiety.

Longitudinal data are needed to investigate chronic disease causation and improve prevention efforts for Alaska Native and American Indian (ANAI) people. This paper describes the methods used to conduct follow-up data collection of a longitudinal cohort that enrolled ANAI adults between 2004 and 2006 in south central Alaska. The follow-up study re-examined ANAI participants in a large, urban centre in south central Alaska between 2015 and 2017. Computerized surveys were used to collect self-reported health, lifestyle, physical activity, and diet data. Clinical measurements included blood pressure, fasting blood glucose and lipid panel, urine albumin/creatinine, height, weight, and waist and hip circumference. Participants were provided individual results at the conclusion of their visit. A total of 1320 south central Alaska study participants completed the baseline visit. Study staff attempted to contact all living cohort members for inclusion in the follow-up study. More than 11,000 attempted contacts were made. Of the 637 available for participation, 388 completed the follow-up visit. The proportion of women increased from baseline to follow-up examinations (67 vs. 72%, p

Objectives The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. Methods Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${I}^{2}$$\end{document}I2, and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\tau }^{2}$$\end{document}τ2 tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. Results In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46–21.30), p 65 years vs.

The purpose of this study was to evaluate the prevalence of depression, anxiety, distress, and insomnia and related factors in healthcare workers during the COVID-19 pandemic in Turkey. We applied the study survey online to HCWs during the pandemic in Turkey between 23 April and 23 May 2020. We used the sociodemographic data form, Patient Health Questionnaire-9, General Anxiety Disorder-7, Insomnia Severity Index, and Impact of Event Scale-Revised. Six hundred twenty (66.0%) of the 939 HCWs taking part in the study were female, 580 (61.8%) were physicians, 569 (60.6%) were working on the front line. Seven hundred twenty-nine (77.6%) participants exhibited depression, 565 (60.2%) anxiety, 473 (50.4%) insomnia, and 717 (76.4%) distress symptoms. Depression, anxiety, insomnia, and distress symptoms were significantly greater among females, individuals with a history of psychiatric illness, and individuals receiving psychiatric support during the COVID-19 pandemic. HCWs serving in Turkey during the COVID-19 pandemic experienced high levels of depression, anxiety, insomnia, and distress symptoms. Female gender, being a nurse, working on the front line, history of psychiatric illness, and being tested for COVID-19 were identified as risk factors for mental health problems.

Preventing the transmission of SARS-CoV-2 (causative agent for COVID-19) requires implementing contact and respiratory precautions. Modifying human behavior is challenging and requires understanding knowledge, attitudes, and practices (KAPs) regarding health threats. This study explored KAPs among people in Ecuador. A cross-sectional, internet-based questionnaire was used to assess knowledge about COVID-19, attitudes toward ability to control COVID-19, self-reported practices related to COVID-19, and demographics. A total of 2399 individuals participated. Participants had moderate to high levels of knowledge. Participants expressed mixed attitudes about the eventual control of COVID-19 in Ecuador. Participants reported high levels of adoption of preventive practices. Binomial regression analysis suggests unemployed individuals, househusbands/housewives, or manual laborers, as well as those with an elementary school education, have lower levels of knowledge. Women, people over 50 years of age, and those with higher levels of schooling were the most optimistic. Men, individuals 18-29, single, and unemployed people took the riskiest behaviors. Generally, knowledge was not associated with optimism or with practices. Our findings indicate knowledge about COVID-19 is insufficient to prompt behavioral change among Ecuadorians. Since current COVID-19 control campaigns seek to educate the public, these efforts' impacts are likely to be limited. Given attitudes determine people's actions, further investigation into the factors underlying the lack of confidence in the ability of the world, and of Ecuador, to overcome COVID-19, is warranted. Edu-communicational campaigns should be accompanied by efforts to provide economically disadvantaged populations resources to facilitate adherence to recommendations to prevent the spread of the virus.

With the proliferation of news and the abundance of unknowns, COVID-19 information became rife with rumors and infiltrated consumers with confusion and information overload. In situations like this, it is important to provide consumers with credible and reliable information about the pandemic which is affecting their lives and livelihoods. Articles about coronavirus published in online versions of USA Today online, Wall Street Journal online and NYTimes.com between January and March 2020 were identified. Only articles where the search terms appeared in the headline were included as it was considered a more effective approach to understanding the health communication trends for this outbreak. These criteria resulted in 5,285 articles published on this topic during this time. All articles were imported into Dedoose mixed-methods software for thematic analysis. The frequency of each identified theme appearing in reviewed articles was counted, together with excerpts illustrating the specific theme. Overall, the five most common themes appearing in reviewed articles were "financial impact of COVID-19" (11.6%), "stories of affected individuals" (7.0%), "death and death rates" (6.8%), "precaution recommendations for public" (6.2%), and "quarantine" (5.9%). The newspapers did not just report the numbers (number of infections, ventilators, deaths, economic losses) but they also reported the context of the pandemic, such as, impact on economy, efforts to slow the spread of infection, switch to working from home, presence of health disparities, scientific search for reliable COVID-19 tests, and effect on supply chains. News media play a vital role in enhancing understanding of pandemic, but also in shaping public response to public health messages.

This study aimed to describe knowledge, attitudes, and practices (KAP) in controlling COVID-19 and some related factors among the Vietnamese population in 2020. A cross-sectional study was conducted involving 1999 participants aged 18–59 years old, through an online questionnaire. The results showed that 92.2% of the participants had a high knowledge level regarding COVID-19 prevention measures, 68.6% had a positive attitude toward COVID-19 prevention measures, and 75.8% practiced all six measures for preventing the spread of the virus. Age, sex, marital status, knowledge, and fear were significantly associated with the practices aimed at COVID-19 prevention. Married people and participants with high levels of knowledge were more likely to practice all preventive measures. In contrast, young people, men, and those who fear COVID-19 were less likely to practice all preventative measures. Good KAP among Vietnamese people could be an important factor in helping authorities gain initial success in containing the coronavirus and COVID-19. In addition to continuously raising and maintaining the community's awareness, attitude, and practices in disease prevention, the introduction and strict implementation of sanctions and regulations were also important in ensuring good practices were implemented and sustained over time. Groups with lower KAP levels should be provided with more information and support to promote appropriate disease prevention practices.

Accurate understanding of COVID-19 safety recommendations early in the outbreak was complicated by inconsistencies in public health and media messages. We sought to characterize high-risk adults' knowledge of COVID-19 symptoms, prevention strategies, and prevention behaviors. We used data from the Chicago COVID-19 Comorbidities (C3) survey collected between March 13 thru March 20, 2020. A total of 673 predominately older adults with ≥ 1 chronic condition completed the telephone interview. Knowledge was assessed by asking participants to name three symptoms of COVID-19 and three actions to prevent infection. Participants were then asked if and how they had changed plans due to coronavirus. Most participants could identify three symptoms (71.0%) and three preventive actions (69.2%). Commonly reported symptoms included: fever (78.5%), cough (70.6%), and shortness of breath (45.2%); preventive actions included: washing hands (86.5%) and social distancing (86.2%). More than a third of participants reported social distancing themselves (38.3%), and 28.8% reported obtaining prescription medication to prepare for the outbreak. In multivariable analyses, no participant characteristics were associated with COVID-19 knowledge. Women were more likely than men, and Black adults were less likely than White adults to report practicing social distancing. Individuals with low health literacy were less likely to report obtaining medication supplies. In conclusion, though most higher-risk individuals were aware of social distancing as a prevention strategy early in the outbreak, less than half reported enacting it, and racial disparities were apparent. Consistent messaging and the provision of tangible resources may improve future adherence to safety recommendations.

College counseling centers are assumed to play a vital role in addressing students' mental health needs during the COVID-19 pandemic. The aim of this study was to characterize the extent to which NYC metropolitan area school websites communicated to students their updated mental health service offerings, psychoeducational information related to COVID-19, and community-based resources after the abrupt end to on-campus services during the Spring semester. A total of 138 websites were analyzed. Overall, only half of the surveyed web pages provided information about remote counseling, and just under two thirds of schools (57.97%) had directions for students experiencing a mental health emergency. As predicted, enrollment size was associated with whether psychoeducation about mental health and COVID-19 and information about remote counseling were available on a school's website. In both cases, medium-sized schools were the most likely to have these resources available on their websites as compared to small and large-sized schools. College counseling center web pages should include robust and current information that targets schools' diverse student bodies.

This study aims to understand the knowledge, attitudes and practices of COVID-19 in the Chinese context and to provide insights for developing targeted outbreak prevention and control measures among the general public. We conducted an online survey of urban and rural residents in Henan Province. A total of 517 valid questionnaires were collected via the online platform. The mean scores for knowledge and practice were 5.57/9 and 2.04/3, respectively. More than 90% of the participants believed COVID-19 was serious and preventable, were concerned about the disease process, and actively engaged in learning related knowledge. Our results showed that the COVID-19 knowledge level was significantly different among groups with different ages, genders, education levels and marital statuses; COVID-19 practice was significantly different among different regions. Multiple linear regression analysis showed that education level, female sex, unmarried status, and health care worker status had a significant impact on COVID-19 knowledge; urban area was associated with a higher practice score; COVID-19 knowledge was significantly associated with residents’ attitude toward preventive measures that can prevent COVID-19 infection; urban area was significantly related to the willingness to go to a fever clinic to check for suspected infection. We found that Chinese urban and rural residents held a moderate level of COVID-19 knowledge and practice and showed a positive attitude toward the disease. It is necessary to develop relevant education programs targeting the general population in China to improve COVID-19-related knowledge, attitudes and practices, particularly for rural and undereducated residents.