Search

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

Background: Compared to their cisgender counterparts, genderqueer adults have significantly higher rates of sexually transmitted infections (STIs). Screening guidelines suggest that sexually active genderqueer adults should be screened for STIs annually, yet those living in rural or under resourced areas may be less likely to do so. Methods: Using social media, 438 genderqueer adults were recruited from a five-state region in the mid-Atlantic United States. To participate, adults were required to be 18+ and identify as transgender, genderqueer, nonbinary, or as a gender different than their assigned sex at birth. Via an online survey in REDCap, participants were asked about their history of STI testing and access to routine healthcare. Using log binomial regression, we evaluated the relationship between access to routine healthcare and STI testing. Results: Among participants who had ever had sex (n=354), 50% lived in a rural county, the majority (84%) were aged 18-34, 74% identified as White, and 21% identified as Black. 39% reported being tested for STIs in the past year. 14% reported having no routine care provider, 8% reported having to travel 50+ miles to receive routine care, 13% reported travelling 25-49 miles, and 49% reported < 25 miles. Unadjusted and adjusted log binomial regression revealed that those without a routine care provider were significantly less likely to report STI testing compared to those who travel less than 25 miles. However, those who travel further (25-49,50+ miles) were not significantly different than those reporting a < 25-mile distance. Conclusion: Only participants who reported not having a routine healthcare provider were significantly less likely to have been tested for STIs, while distance to provider was not a significant predictor. These findings suggest that connecting genderqueer populations to routine healthcare providers is of critical importance, regardless of distance. Given the shortage of healthcare providers cognizant of transgender-specific needs in many areas, immediate efforts can be made to ensure that genderqueer adults are connected to healthcare in neighboring communities and regions. [ABSTRACT FROM AUTHOR]

Background: Poverty and rural residency status have long been associated with higher rates of sexually transmitted infections (STI) due to fewer sexual health and medical resources. The continuing increase in STIs across the nation requires nuanced understanding of interacting or compounding roles of these disparities. Persistent poverty counties, those counties who have had >20% of the population at or below the national poverty level for at least 30 consecutive years, are predominately rural, and have higher rates of poor outcomes from other health conditions such as cancer. Despite this evidence, no published literature exists that examines the association between these persistent poverty counties and STI rates in the US. Methods: Drawing on data from the National Electronic Database Surveillance System (NEDSS), American Community Survey (ACS), and County Health Rankings we conducted unadjusted and adjusted binomial regressions, including generalized estimating equations, to examine potential relationships between persistent poverty, as defined by the U.S. Department of Agriculture Economic Research, and STI rates. Results: Of the 3,143 counties or county-level equivalents in the US, 353 (11.2%) are designated as persistent poverty, of which 63.5% are rural. Positive relationships between persistent poverty and gonorrhea (p=0.0023) and chlamydia (p< 0.001) incidence at the county level were observed. When controlling for rurality, sex education policies, and other factors, persistent poverty remained positively associated with STI incidence. Conclusion: These findings provide a more nuanced understanding of the growing literature surrounding the relationship between poverty and negative sexual health outcomes by demonstrating a positive relationship between county-level persistent poverty status with gonorrhea and chlamydia incidence. Negative social determinants may be exacerbated within these communities, which warrants further exploration to help inform community-based interventions. [ABSTRACT FROM AUTHOR]

Objective: Transdermal alcohol concentration (TAC) sensors capture aspects of drinking events that self-reports cannot. The multidimensional nature of TAC data allows novel classification of drinking days and identification of associated behavioral and contextual risks. We used multilevel latent profile analysis (MLPA) to create day-level profiles of TAC features and test their associations with (a) daily behaviors and contexts and (b) risk for alcohol use disorders at baseline., Method: Two hundred twenty-two regularly heavy-drinking young adults ( M age = 22.3) completed the Alcohol Use Disorders Identification Test (AUDIT) at baseline and then responded to mobile phone surveys and wore TAC sensors for six consecutive days. MLPA identified day-level profiles using four TAC features (peak, rise rate, fall rate, and duration). TAC profiles were tested as correlates of daily drinking behaviors, contexts, and baseline AUDIT., Results: Four profiles emerged: (a) high-fast (8.5% of days), (b) moderate-fast (12.8%), (c) low-slow (20.4%), and (d) little-to-no drinking days (58.2%). Profiles differed in the odds of risky drinking behaviors and contexts. The highest risk occurred on high-fast days, followed by moderate-fast, low-slow, and little-to-no drinking days. Higher baseline AUDIT predicted higher odds of high-fast and moderate-fast days., Conclusions: Days with high and fast intoxication are reflective of high-risk drinking behaviors and were most frequent among those at risk for alcohol use disorders. TAC research using MLPA may offer novel and important insights to intervention efforts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).