Collecting Data During the COVID-19 Pandemic: Lessons From an In-Person Survey of People Who Use Opioids

2022 ◽  
pp. 003335492110634
Author(s):  
Lauren Jessell ◽  
Izza Zaidi ◽  
Leonardo Dominguez-Gomez ◽  
Alex Harocopos
Keyword(s):  
Public Health ◽  
New York ◽  
Data Collection ◽  
Service Use ◽  
Lessons Learned ◽  
People Who Use Drugs ◽  
Staff Members ◽  
Service Programs ◽  
Department Of Health ◽  
Control And Prevention

Objectives: In response to the COVID-19 pandemic, much in-person data collection has been suspended or become tele-remote. However, tele-remote methods often exclude marginalized groups, including people who use drugs, many of whom lack the technology to participate. To inform future surveillance and research during the pandemic and other public health disasters, we report methods and lessons learned from an in-person survey of people who use opioids conducted by the New York City Department of Health and Mental Hygiene (DOHMH) during the COVID-19 pandemic. Materials and Methods: This public health surveillance was a component of the Centers for Disease Control and Prevention Overdose Data to Action initiative and aimed to inform overdose prevention efforts. Survey domains inquired about participants’ drug use patterns, risk behaviors, overdose history, and service use. Results: From June 16 through September 9, 2020, DOHMH staff members conducted 329 surveys with participants from 4 syringe service programs (n = 148, 44.9%) and via street intercept (n = 81, 55.1%). To survey participants safely and effectively, it was important to build rapport upfront so that requests to maintain distance were not perceived as stigmatizing. DOHMH staff members offered all participants, regardless of survey eligibility, Narcan and hygiene products, including face masks and soap. Practice Implications: Surveys administered outdoors during the COVID-19 pandemic should be limited to 30 minutes. Although conducting in-person surveys poses unique challenges, this method should be considered so marginalized populations are included in data collection and public health responses.

scholarly journals (A169) Strategic National Stockpile: American Preparedness to a Domestic Biological Attack

2011 ◽  
Vol 26 (S1) ◽  
pp. s59-s59
Author(s):  
A.E. Piombino
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
Large Scale ◽  
Technical Assistance ◽  
Lessons Learned ◽  
Department Of Health ◽  
The Us ◽  
Control And Prevention ◽  
Public Health Emergency Preparedness ◽  
Strategic National Stockpile

This session offers an overview of the Strategic National Stockpile (SNS) and the Cities Readiness Initiative (CRI), including CHEM PACK. Managed by the US Department of Health and Human Services Centers for Disease Control and Prevention (CDC), “push-packs” of this critical federal cache of pharmaceuticals and medical materiel are at sites located throughout the country. The CDC's CRI is a federally funded program designed to compliment the SNS and enhance preparedness in the nation's largest cities and Metropolitan Statistical Areas (MSA) where more than 50% of the US population resides. Through CRI, state and large metropolitan public health departments continue refining plans to respond to a large-scale bioterrorism attack by dispensing antibiotics to the entire population of an identified MSA with 48 hours. The SNS Technical Assistance Review (TAR) will be reviewed, as well as best practices and lessons learned from successful public health emergency preparedness and response programs throughout the US.

A Functional Needs Approach to Emergency Planning

2014 ◽  
Vol 8 (4) ◽  
pp. 301-309 ◽  
Author(s):  
Rebecca Zod ◽  
Robin Fick-Osborne ◽  
Eleanor B. Peters
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
Emergency Planning ◽  
Verbal Cues ◽  
Staff Members ◽  
Emergency Situations ◽  
Department Of Health ◽  
Response Measures ◽  
Emergency Actions ◽  
New Guidelines

AbstractObjectiveThis study was conducted to test the ability of the St Louis County Department of Health to efficiently dispense medication to individuals with functional needs during a public health emergency and develop new guidelines for future emergency planning. Historically, people with functional needs have been vulnerable in emergency situations, and emergency planners are responsible for creating equal access for mass prophylaxis events.MethodsMeasures to create access for individuals with functional needs were tested in a countywide exercise in which 40 volunteers with functional needs walked through an open point of dispensing location to collect medication as if it were a real emergency. Actions were informed by representatives from the functional needs community in the St Louis area.ResultsDuring the exercise, medications were successfully dispensed to all participants. Many participants offered feedback for future program design.ConclusionsOutcomes indicated the importance of working closely with the community organizations that serve people with functional needs in designing appropriate response measures, providing sensitivity training to staff members, employing useful technology, and using visual and verbal cues. The lessons learned from this exercise apply to emergency planning nationwide, as planning efforts for persons with functional needs still lag significantly.(Disaster Med Public Health Preparedness. 2014;0:1–9)

Methodology for assessment of public health preparedness and response synergies between institutional authorities and the community

2020 ◽  
Author(s):  
Daniel H. de Vries ◽  
John Kinsman ◽  
Judit Takacs ◽  
Svetla Tsolova ◽  
Massimo Ciotti
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Methodological Approach ◽  
Effective Means ◽  
Field Work ◽  
Lessons Learned ◽  
Outbreak Response ◽  
Study Approach ◽  
Rich Data

Abstract Background: This paper describes a participatory methodology that supports investigation of the collaboration between communities affected by infectious disease outbreak events and relevant official institutions. The core principle underlying the methodology is the recognition that synergistic relationships, characterised by mutual trust and respect, between affected communities and official institutions provide the most effective means of addressing outbreak situations. Methods: The methodological approach and lessons learned were derived from four qualitative case studies including (i) two tick-borne disease events: Crimean-Congo haemorrhagic fever in Spain, and tick-borne encephalitis in the Netherlands (2016); and (ii) two outbreaks of acute gastroenteritis (norovirus in Iceland, 2017, and verocytotoxin-producingEscherichia coli [VTEC] in Ireland, 2018). These studies were conducted in collaboration with the respective national public health authorities in the affected countries by the European Centre for Disease Prevention and Control (ECDC). Results: An after-event qualitative case study approach was taken using mixed methods. Lessons highlight the critical importance of collaborating with national focal points during preparation and planning, and interviewer reflexivity during fieldwork. Field work for each case study was conducted over one working week, which although limiting the number of individuals and institutions involved, still allowed for rich data collection due to the close collaboration with local authorities. The analysis focused on the specific actions undertaken by the participating countries’ public health and other authorities in relation to community engagement, as well as the view from the perspective of the community. Conclusions: The overall objective of the assessment to identify synergies between institutional decision-making bodies and community actors and networks before, during and after an outbreak response to a given public health emergency. The methodology is generic and could be applied to a range of public health emergencies, zoonotic or otherwise. The methodology emphasises reflexivity among fieldworkers, a relatively short time needed for data collection, potential generalisability of findings, insider-outsider perspectives, politically sensitive findings, and how to deal with ethical and language issues.

scholarly journals Lessons Learned From an Intensive Writing Training Course for Applied Epidemiologists

2020 ◽  
Vol 135 (4) ◽  
pp. 428-434
Author(s):  
Jessica Arrazola ◽  
Malorie Polster ◽  
Paul Etkind ◽  
John S. Moran ◽  
Richard L. Vogt
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
Publishing Process ◽  
Writing Courses ◽  
Training Course ◽  
Public Health Professionals ◽  
Control And Prevention ◽  
Council Of State

Although writing is a valued public health competency, authors face a multitude of barriers (eg, lack of time, lack of mentorship, lack of appropriate instruction) to publication. Few writing courses for applied public health professionals have been documented. In 2017 and 2018, the Council of State and Territorial Epidemiologists and the Centers for Disease Control and Prevention partnered to implement a Morbidity and Mortality Weekly Report Intensive Writing Training course to improve the quality of submissions from applied epidemiologists working at health departments. The course included 3 webinars, expert mentorship from experienced authors, and a 2-day in-person session. As of April 2020, 39 epidemiologists had participated in the course. Twenty-four (62%) of the 39 epidemiologists had submitted manuscripts, 17 (71%) of which were published. The program’s evaluation demonstrates the value of mentorship and peer feedback during the publishing process, the importance of case study exercises, and the need to address structural challenges (eg, competing work responsibilities or supervisor support) in the work environment.

scholarly journals P005 Diphtheria treatment

2019 ◽  
Vol 104 (7) ◽  
pp. e2.7-e2
Author(s):  
Claire Hannah
Keyword(s):  
Public Health ◽  
Qt Interval ◽  
Kidney Injury ◽  
Test Dose ◽  
Left Ventricular ◽  
Lessons Learned ◽  
List Type ◽  
Staff Members ◽  
Diphtheria Antitoxin ◽  
Corynebacterium Diphtheria

BackgroundDiphtheria is a life threatening but vaccine preventable disease. 5 cases were identified by Public Health England (PHE) in 2017.1 Respiratory diphtheria is characterised by a pseudomembrane which obstructs the airways. Corynebacterium diphtheria produces an exotoxin that causes local tissue necrosis, myocarditis, polyneuropathy, paralysis, respiratory failure and death.Clinical caseA 4 year old boy was admitted via A&E with suspected croup requiring intubation and ventilation on intensive care unit (ICU). Throat swabs confirmed diphtheria diagnosis, PHE was contacted and diphtheria antitoxin was obtained. The patient received two subcutaneous doses of diphtheria-antitoxin. He developed myocarditis, Acute Kidney Injury (AKI), impaired left ventricular function and polyneuropathy. He was treated with 14 days intravenous vancomycin and clindamycin following multiple antibiotic changes.Pharmacy contributionAnti-toxin: Diphtheria anti- toxin was obtained and advice was provided regarding an appropriate dose and route of administration. Ward staff were reluctant to give a subcutaneous infusion. A pharmacist provided reassurance that this was the only way to treat the infection and a subcutaneous cannula was inserted. He was given 0.2 ml subcutaneously as a test dose followed by the remaining 40,000 units. His second dose was given as a test dose of 0.2 ml followed by 60,000 units between two sites due to multi-organ involvement. Chemoprophylaxis: The patient’s family and 34 staff members required prophylactic antibiotics. They received azithromycin 500 mg once daily for 3 days. Staff members had throat swabs and were to remain off work until these swabs were negative which resulted in the Trust cancelling elective operations and admissions. Pharmacy confirmed azithromycin was safe for 34 adult patients and checked for interactions with currently prescribed medicines and advised appropriately.Critical careCreatinine doubled and the pharmacist reviewed drugs to account for renal impairment. The pharmacist highlighted that clarithromycin can prolong QT interval. An echocardiogram revealed the patient had prolonged QT interval and clarithromycin was switched to an alternative after discussion with the microbiologist.Vancomycin therapeutic levels were reached on day 5. The dose remained unchanged for the remainder of the course and levels taken every 3 days were appropriate. The pharmacist prepared a weaning plan for morphine and clonidine. The pharmacist advised reducing dexamethasone and stopping when no longer required due to raised blood glucose measurements.Lessons learnedHow to obtain and administer diphtheria antitoxin. What chemoprophylaxis to provide to family and staff, the difficulties of supplying this to so many adults in a children’s hospital and the pressure the hospital faced having 34 staff members excluded for 48 hours while cultures were taken The importance of personal protective equipment to protect staff and other patients Monitoring parameters: vancomycin levels, renal function, cardiac function, blood sugars Importance of encouraging parents to have their children vaccinated with all the primary immunisations to protect their children and othersReferencePublic health England: Diphtheria in England 2017. Accessed via: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/711453/hpr1818_dphthr17.pdf

Evaluation of a Standardized Morbidity Surveillance Form for Use during Disasters Caused by Natural Hazards

2011 ◽  
Vol 26 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Amy H. Schnall ◽  
Amy F. Wolkin ◽  
Rebecca Noe ◽  
Leslie B. Hausman ◽  
Petra Wiersma ◽  
...  
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Hurricane Katrina ◽  
Kappa Statistics ◽  
Rapid Responses ◽  
Clinical Presentations ◽  
Morbidity Data ◽  
Control And Prevention ◽  
Alternative Settings ◽  
Disaster Event

AbstractIntroduction: Surveillance for health outcomes is critical for rapid responses and timely prevention of disaster-related illnesses and injuries after a disaster-causing event. The Disaster Surveillance Workgroup (DSWG) of the US Centers for Disease Control and Prevention developed a standardized, single-page, morbidity surveillance form, called the Natural Disaster Morbidity Surveillance Individual Form (Morbidity Surveillance Form), to describe the distribution of injuries and illnesses, detect outbreaks, and guide timely interventions during a disaster.Problem: Traditional data sources can be used during a disaster; however, supplemental active surveillance may be required because traditional systems often are disrupted, and many persons will seek care outside of typical acute care settings. Generally, these alternative settings lack health surveillance and reporting protocols. The need for standardized data collection was demonstrated during Hurricane Katrina, as the multiple surveillance instruments that were developed and deployed led to varied and uncoordinated data collection methods, analyses, and morbidity data reporting. Active, post-event surveillance of affected populations is critical for rapid responses to minimize and prevent morbidity and mortality, allocate resources, and target public health messaging.Methods: The CDC and the Georgia Department of Public Health (GDPH) conducted a study to evaluate a Morbidity Surveillance Form to determine its ability to capture clinical presentations. The form was completed for each patient evaluated in an emergency department (ED) during triage from 01 August, 2007 through 07 August, 2007. Data from the form were compared with the ED discharge diagnoses from electronic medical records, and kappa statistics were calculated to assess agreement.Results: Nine hundred forty-nine patients were evaluated, 41% were male and 57% were Caucasian. According to the forms, the most common reasons for seeking treatment were acute illness, other (29%); pain (12%); and gastrointestinal illness (8%). The frequency of agreement between discharge diagnoses and the form ranged from 3 to 100%. Kappa values ranged from 0.23–1.0, with nine of the 12 categories having very good or good agreement.Conclusion: With modifications to increase sensitivity for capturing certain clinical presentations, the Morbidity Surveillance Form can be a useful tool for capturing data needed to guide public health interventions during a disaster. A validated collection instrument for a post-disaster event facilitates rapid and standardized comparison and aggregation of data across multiple jurisdictions, thus, improving the coordination, timeliness, and accuracy of public health responses. The DSWG revised the Morbidity Surveillance Form based on information from this study.

scholarly journals Point-of-Care Testing as an Influenza Surveillance Tool: Methodology and Lessons Learned from Implementation

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Lisa H. Gren ◽  
Christina A. Porucznik ◽  
Elizabeth A. Joy ◽  
Joseph L. Lyon ◽  
Catherine J. Staes ◽  
...  
Keyword(s):  
Data Collection ◽  
Disease Surveillance ◽  
Point Of Care ◽  
Lessons Learned ◽  
Research Network ◽  
Influenza Surveillance ◽  
Statistical Process ◽  
University Of Utah ◽  
Department Of Health ◽  
The University

Objectives. Disease surveillance combines data collection and analysis with dissemination of findings to decision makers. The timeliness of these activities affects the ability to implement preventive measures. Influenza surveillance has traditionally been hampered by delays in both data collection and dissemination. Methods. We used statistical process control (SPC) to evaluate the daily percentage of outpatient visits with a positive point-of-care (POC) influenza test in the University of Utah Primary Care Research Network. Results. Retrospectively, POC testing generated an alert in each of 4 seasons (2004–2008, median 16 days before epidemic onset), suggesting that email notification of clinicians would be 9 days earlier than surveillance alerts posted to the Utah Department of Health website. In the 2008-09 season, the algorithm generated a real-time alert 19 days before epidemic onset. Clinicians in 4 intervention clinics received email notification of the alert within 4 days. Compared with clinicians in 6 control clinics, intervention clinicians were 40% more likely to perform rapid testing () and twice as likely to vaccinate for seasonal influenza () after notification. Conclusions. Email notification of SPC-generated alerts provided significantly earlier notification of the epidemic onset than traditional surveillance. Clinician preventive behavior was not significantly different in intervention clinics.

scholarly journals Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study

10.2196/22411 ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. e22411
Author(s):  
Alex S Bennett ◽  
Robert Freeman ◽  
Don C Des Jarlais ◽  
Ian David Aronson
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Shared Responsibility ◽  
Opioid Antagonist ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Negative Consequences ◽  
Qualitative Interview Study

Background Many people use opioids and are at risk of overdose. Naloxone is an opioid antagonist used to counter the effects of opioid overdose. There is an increased availability of naloxone in New York City; however, many who use opioids decline no-cost naloxone even when offered. Others may have the medication but opt not to carry it and report that they would be reluctant to administer it if they were to witness an overdose. Objective We aim to better understand why people who use opioids may be reluctant to accept, carry, and administer naloxone, and to inform the development of messaging content that addresses barriers to its acceptance and use. Methods We conducted formative qualitative interviews with 20 people who use opioids who are 18 years and older in New York City. Participants were recruited via key informants and chain referral. Results Participants cited 4 main barriers that may impede rates of naloxone acceptance, possession, and use: (1) stigma related to substance use, (2) indifference toward overdose, (3) fear of negative consequences of carrying naloxone, and (4) fear of misrecognizing the need for naloxone. Participants also offered suggestions about messaging content to tackle the identified barriers, including messages designed to normalize naloxone possession and use, encourage shared responsibility for community health, and elicit empathy for people who use drugs. Taken together, participants’ narratives hold implications for the following potential messaging content: (1) naloxone is short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is critical to accurately identify an opioid-involved overdose; (3) anyone can overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the medication can help ensure that someone can enjoy another day. Finally, participants suggested that messaging should also debunk myths and stereotypes about people who use drugs more generally; people who use opioids who reverse overdoses should be framed as lay public health advocates and not just “others” to be managed with stigmatizing practices and language. Conclusions It must be made a public health priority to get naloxone to people who use opioids who are best positioned to reverse an overdose, and to increase the likelihood that they will carry naloxone and use it when needed. Developing, tailoring, and deploying messages to address stigma, indifference toward overdose, fear and trepidation about reversing an overdose, and fear of police involvement may help alleviate fears among some people who are reluctant to obtain naloxone and use the medication on someone in an overdose situation.

Sign in / Sign up

Export Citation Format

Share Document