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BackgroundPublic support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine.MethodsA cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations.ResultsOf the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine.ConclusionThese results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake.

Public health measures to reduce COVID-19 transmission include masking in public places, physical distancing, staying home when ill, avoiding high-risk locations, using a contact tracing app, and being willing to take a COVID-19 vaccine. However, adoption of these measures varies greatly. We aimed to improve health messaging to increase adherence to public health behaviours to reduce COVID-19 transmission by: 1) determining attitudes towards public health measures and current behaviours; 2) identifying barriers to following public health measures; and, 3) identifying public health communication strategies. We recruited participants from a random panel of 3000 phone numbers across Alberta to fill a predetermined quota: age (18–29; 30–59; 60+ years), geographic location (urban; rural), and whether they had school-age children. Two researchers coded and themed all transcripts. We performed content analysis and in-depth thematic analysis. Nine focus groups were conducted with 2–8 participants/group in August-September, 2020. Several themes were identified: 1) importance of public health measures; 2) compliance with public health measures; 3) critiques of public health messaging; and 4) suggestions for improving public health messaging. Physical distancing and masking were seen as more important than using a contact tracing app. There were mixed views around willingness to take COVID-19 vaccine. Current public health messaging was perceived as conflicting. Participants felt that consistent messaging and using social media to reach younger people would be helpful. In conclusion, these findings provide insights that can be used to inform targeted (e.g., by age, current behaviour) public health communications to encourage behaviors that reduce COVID-19 transmission.

Background and objectives Due to the multitude of questions in the Hospital-Consumer Assessment of Healthcare Providers and Systems (H-CAHPS) survey, it may be difficult to decide where quality improvement efforts should be focused. Our organisation has supplemented the survey with a ‘patient complaints’ section. The study objectives were to determine (1) the frequency of qualitative complaints and the demographic/clinical profile of patients lodging them, (2) the most frequent complaint themes and their association with overall experience scores and (3) whether overall experience scores varied based upon the complaint action taken by the patient or the degree of patient satisfaction in the handling of complaints. Methods From April 2013 to March 2014, 8929 telephone surveys were completed by patients discharged from 93 acute care hospitals in Alberta, Canada. These were successfully linked with the corresponding inpatient record. Open-ended complaints were themed into categories. Mean differences in overall inpatient experience were assessed for each complaint theme, including overall and multiple complaints. Results 1870 patients (20.9%) reported at least one open-ended complaint. Most frequent complaint themes were nursing (n=491; 5.5% of cohort), medications (n=219; 2.5%) and food (n=193; 2.2%). Increased odds of having a complaint were associated with younger age, being born in Canada and having no documented medical comorbidities. Protective factors were male gender, lower education level, urgent hospital admission, lower resource intensity and length of stay (LOS)

In health survey research, it is paramount that survey respondents are representative of the general target population, thereby ensuring that the policies and program decisions supported by the underlying data are well-informed. In order to assess the representativeness of our survey respondents, we sought to compare selected demographic and clinical attributes of our inpatient hospital experience survey respondents with those of eligible nonrespondents. This retrospective analysis of cross-sectional administrative hospital data included 26,295 survey respondents, and 466,034 non-respondents. These were based on all inpatient hospital discharges that were eligible to be surveyed in the province of Alberta, Canada from April 1, 2011 to March 31, 2014. When compared with eligible nonrespondents, survey respondents had similar patterns in terms of mean age (53.8±20.0 vs. 54.4±21.3 years), sex (35.0% vs. 38.8% male), admission type (60.7% urgent in both groups), and the mean number of comorbidities (0.8±1.2 vs. 1.0±1.3). Compared to nonrespondents, survey respondents tended to be healthier, as evidenced by a shorter mean length of stay (5.4±9.4 vs.7.0±15.4 days), less need for ICU care (2.1% vs. 3.0% of cases), and being more likely to be discharged directly home (95.2% vs. 91.9% of cases). The survey sampling strategy resulted in a sample that was, in most cases, representative of the general inpatient population in our jurisdiction of approximately 4 million residents. Our findings indicate that an adequate sampling strategy may still provide a representative sample, despite a low response rate.

Objectives There remains concern regarding the use of survey data to assess aspects of healthcare quality. The relationship between patient experience and adverse events as documented by patient safety indicators (PSIs) is a timely research topic. The objectives were to document the association of PSIs and patient experience scores, and to determine risk-adjusted odds of high experience scores versus PSI presence. Setting and participants From April 2011 to March 2014, 25 098 patients completed a telephone survey following discharge from 93 inpatient hospitals in Alberta, Canada. Research design A modified version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was used. Surveys were linked to inpatient records and PSI presence was documented using a validated algorithm. Measures Three questions about overall hospital, physician and nurse ratings were scored on an 11-point Likert scale from 0 (worst) to 10 (best). Experience was classified as high (9 or 10) versus low (0–8). Demographic/clinical differences between respondents with/without a PSI were assessed. Logistic regression examined the relationship between factors including PSI and experience ratings. Results Overall, physician and nurse care was rated high by 61.9%, 73.7% and 66.2% of respondents. 1085 patients (4.3%) had a documented PSI. Most frequent PSIs were haemorrhagic events (n=502; 2.0% of sample), events relating to obstetrics (n=373; 1.5%) and surgical-related events (n=248; 1.0%). Risk-adjusted models showed patients with PSIs had decreased odds of having high overall (OR=0.86; 95% CI 0.75 to 0.97), physician (OR=0.76; 95% CI 0.66 to 0.87) and nurse (OR=0.83; 95% CI 0.73 to 0.94) ratings. Conclusions There is clear evidence that inpatient experience ratings are associated with PSIs, one element of quality of care. Future research, examining individual PSIs and patient experience questions, is warranted, as this may inform targeted quality improvement initiatives.

Older adults requiring home care service have a high risk of depression. Instruments for detecting depression among older adults, however, are often too long and detailed for easy administration by nontrained staff in large service-based settings.This study examined the measurement properties (test—retest reliability, concurrent validity, and cross-modality correspondence) of a single-item screener for depressive symptoms among older adults receiving home care services. Reliability was assessed ( n = 65) by administering the single-item depression screener to the same participants on two occasions 7 days apart. Validity was assessed ( n = 191) by comparing depressed participants from the single-item depression screener versus Geriatric Depression Scale (criterion measure). Responses to the single-item depression screener administered by telephone and face-to-face interview were also compared. Findings suggest that the single-item depression screener has fair levels of reliability, validity, and cross-modality correspondence and could be used among home care recipients as a screening tool, provided that depression status is confirmed via in-depth questionnaires, interviews, or a clinical diagnosis.

Objective: To determine which individual patient experience questions and domains were most correlated with overall inpatient hospital experience. Methods: Within 42 days of discharge, 27 639 patients completed a telephone survey based upon the Hospital-Consumer Assessment of Healthcare Systems and Processes instrument. Patients rated their overall experience on a scale of 0 (worst care) to 10 (best care). Correlation coefficients were calculated to assess the relationships between individual survey questions and domains with overall experience. Results: Questions on provider coordination and nursing care were most correlated with overall experience. Hospital cleanliness, quietness, and discharge information questions showed poor correlation. Correlation with overall experience was strongest for the “communication with nurses” domain. Conclusions: Our individual question results are novel, while the domain-based findings replicate those of US-based providers, results which had not yet been reported in the Canadian context—one with universal health care coverage. Our results suggest that our large health care organization may attain initial inpatient experience improvements by focusing upon personnel-based initiatives, rather than physical attributes of our hospitals.

Many health care organizations now include a measure of patient experience among their list of key performance indicators. However, in the infancy of this movement, organizations developed their own instruments to measure patient experience, which may have satisfied an organizational need, but due to a lack of standardized survey instruments and data collection methodologies, did not permit for valid comparisons across organizations. To enable an “apples to apples” comparison, the Hospital-Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was developed and issued inz06. To encourage public transparency, data accessibility, and to provide an incentive for provider improvement, HCAHPS data from the United States are now publicly available on the Internet (Centers for Medicare and Medicaid Services 2014). Aggregate HCAHPS data are also available via an annual National Healthcare Quality Report from the Agency for Healthcare Research and Quality (AHRQ) (Agency for Healthcare Research and Quality 2013). Recently, research has shown that a better patient experience is linked to improved outcomes (Glickman et al. 2010; Isaac et al. 2010; Meterko et al. 2010). Additional works have also shown that some HCAHPS items may be associated with patient-level characteristics such as gender (Elliott et al. 2012), health status, education level, age (Goldstein et al. 2010; Elliott et al. 2012), and ethnicity (Elliott et al. 2012). To date, however, no research or quality improvement initiatives of a similar format have been conducted in a Canadian setting. Evidence to document factors contributing to patient experience in a publicly funded universal health care setting may prove useful in the design of targeted interventions to improve patient experience and/or the development of subsequent outcomes. Therefore, the purpose of the present project was to identify factors that may be associated with a patient’s overall rating of his/her hospital experience during an inpatient stay within a universal health care setting.

Baby Think It Over is a health program that provides Perth adolescents in metropolitan schools with a 'virtual' parenting experience using an infant simulation program. Baby Think It Over seeks to modify attitudes toward teen pregnancy and parenting and to delay pregnancy until the participants have a better understanding of the demands and responsibilities of caring for an infant. At the same time, this program provides an opportunity to introduce adolescents to health services within their community with a particular focus on general practice.This article describes the methodology and qualitative assessment of the program, examines some outcomes associated with its uptake and lessons learnt in its implementation.The program demonstrates that divisions of general practice can work together with schools to deliver innovative programs. The value of projects like this is in the community partnerships and social capital that they build across the health and education sector.