scholarly journals National variability in Americans’ COVID-19 protective behaviors: Implications for vaccine roll-out

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259257
Author(s):  
John A. Schneider ◽  
Bruce G. Taylor ◽  
Anna L. Hotton ◽  
Phoebe A. Lamuda ◽  
Jonathan Ozik ◽  
...  
Keyword(s):  
Public Health ◽  
Criminal Justice ◽  
Low Income ◽  
Scale Up ◽  
Survey Study ◽  
Party Affiliation ◽  
Protective Behaviors ◽  
Cross Sectional Survey ◽  
Criminal Justice Involvement ◽  
Health Messaging

Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimates of five self-reported COVID-19 protective behaviors and correlates of such behaviors. In this cross-sectional survey study of US adults, surveys were administered via internet and telephone. Adults were surveyed from April 30-May 4, 2020, a time of peaking COVID-19 incidence within the US. Participants were recruited from the probability-based AmeriSpeak® national panel. Brief surveys were completed by 994 adults, with 73.0% of respondents reported mask wearing, 82.7% reported physical distancing, 75.1% reported crowd avoidance, 89.8% reported increased hand-washing, and 7.7% reported having prior COVID-19 testing. Multivariate analysis (p critical value .05) indicates that women were more likely to report protective behaviors than men, as were those over age 60. Respondents who self-identified as having low incomes, histories of criminal justice involvement, and Republican Party affiliation, were less likely to report four protective behaviors, though Republicans and individuals with criminal justice histories were more likely to report having received COVID-19 testing. The majority of Americans engaged in COVID-19 protective behaviors, with low-income Americans, those with histories of criminal justice involvement, and self-identified Republicans less likely to engage in these preventive behaviors. Culturally competent public health messaging and interventions might focus on these latter groups to prevent future infections. These findings will remain highly relevant even with vaccines widely available, given the complementarities between vaccines and protective behaviors, as well as the many challenges in delivering vaccines.

Challenges Faced by B.P.L. Population in Availing Public Healthcare – Analysing Government Initiatives, Technology and Cultural Barriers in Aligarh District, U.P

2021 ◽  
Vol 2 (5) ◽  
pp. 1-19
Author(s):  
Fahad Afzal ◽  
P.S. Raychaudhuri ◽  
Mohd Atif Afzal ◽  
Afaq Amir Ahmad
Keyword(s):  
Public Health ◽  
Data Analysis ◽  
Low Income ◽  
Rural Areas ◽  
Uttar Pradesh ◽  
Secondary Data ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Low Income Population

Public healthcare and government health initiative have always been in question regarding their availability, efficiency, and quality. This matter most for the poor section of society who have to go through various hurdles to avail the basic treatment, besides financial problems. The aim of this survey study was to analyze the present scenario of public healthcare system and the challenges in availing public healthcare faced by BPL (Below Poverty Line) and low-income population of Uttar Pradesh. A cross-sectional survey (direct interview) of 104 respondents was conducted in March 2021. Thematic analysis of generated qualitative data was done using ATLAS.ti (version 9.0.15). The quantitative data was analyzed by using SPSS (version 22.0.0.0). The respondents were from 2 rural areas near the Aligarh district in UP. The secondary data from published research articles and government sources were also analyzed. Analysis of data revealed there are various challenges faced by low-income population while availing public healthcare services. The nature of challenges has a considerable variation, from lack of information to documents’ unavailability, from technical issues in government schemes to cultural pressure. Data analysis revealed, the majority of respondents (59%) faced one or more types of challenges during treatment from public health facilities. Awareness level is identified as a significant problem among respondents. Analysis of secondary data and literature review revealed uneven resource allocation and discrepancies in government initiatives toward UHC (Universal Health Coverage). Results indicated the contrasting nature of healthcare in Uttar Pradesh. Data analysis revealed the disparity of ‘average OOP travelling expenditure’ for male and female. The correlation analysis revealed that there is negative correlation (y = -0.1377x + 11.119) of ‘age of respondent’ and ‘average satisfaction from public health service’ (r = -0.911; R² = 0.8301). This research article provides the evidence that there exists a communication gap between policymakers and end-users (BPL & low-income section). This article underscored some technical flaw in the UHC policies that act as a barrier for low socio economic and BPL population. This article suggests strategies to control various identified challenges.

scholarly journals Knowledge, attitudes and potential response to menu labelling in an urban public health clinic population

2009 ◽  
Vol 13 (4) ◽  
pp. 550-555 ◽  
Author(s):  
Jennifer Piron ◽  
Lisa V Smith ◽  
Paul Simon ◽  
Patricia L Cummings ◽  
Tony Kuo
Keyword(s):  
Public Health ◽  
Los Angeles ◽  
Low Income ◽  
Fast Food ◽  
Health Clinic ◽  
Potential Response ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinic Population ◽  
Public Health Clinic

AbstractObjectiveThe present study examines the receptivity to and potential effects of menu labelling on food choices of low-income and minority individuals – a group often at disproportionate risk for preventable, lifestyle-related health conditions (e.g. obesity, diabetes and CVD).DesignWe conducted a cross-sectional survey to examine the knowledge, attitudes and potential response to menu labelling in an urban public health clinic population.SettingUnited States.SubjectsA total of 639 clinic patients were recruited in the waiting rooms of six, large public health centres in Los Angeles County (2007–2008). These centres provide services to a largely uninsured or under-insured, low-income, Latino and African-American population.ResultsAmong those approached and who met eligibility criteria, 88 % completed the survey. Of the 639 respondents, 55 % were overweight or obese based on self-reported heights and weights; 74 % reported visiting a fast food restaurant at least once in the past year, including 22 % at least once a week; 93 % thought that calorie information was ‘important’; and 86 % thought that restaurants should be required to post calorie information on their menu boards. In multivariate analyses, respondents who were obese, female, Latino and supportive of calorie postings were more likely than others to report that they would choose food and beverages with lower calories as a result of menu labelling.ConclusionsThese findings suggest that clinic patients are receptive to this population-based strategy and that they would be inclined to change their food selections in response to menu labelling.

scholarly journals Factors that influence the scale up of new interventions in low-income settings: a qualitative case study of the introduction of chlorhexidine cleansing of the umbilical cord in Bangladesh

2020 ◽  
Vol 35 (4) ◽  
pp. 440-451
Author(s):  
Jennifer A Callaghan-Koru ◽  
Munia Islam ◽  
Marufa Khan ◽  
Ardy Sowe ◽  
Jahrul Islam ◽  
...  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Umbilical Cord ◽  
Low Income ◽  
Qualitative Case Study ◽  
National Level ◽  
Scale Up ◽  
New Drugs ◽  
Low Income Countries

Abstract There is a well-recognized need for empirical study of processes and factors that influence scale up of evidence-based interventions in low-income countries to address the ‘know-do’ gap. We undertook a qualitative case study of the scale up of chlorhexidine cleansing of the umbilical cord (CHX) in Bangladesh to identify and compare facilitators and barriers for the institutionalization and expansion stages of scale up. Data collection and analysis for this case study were informed by the Consolidated Framework for Implementation Research (CFIR) and the WHO/ExpandNet model of scale up. At the national level, we interviewed 20 stakeholders involved in CHX policy or implementation. At the district level, we conducted interviews with 31 facility-based healthcare providers in five districts and focus group discussions (FGDs) with eight community-based providers and eight programme managers. At the community level, we conducted 7 FGDs with 53 mothers who had a baby within the past year. Expanded interview notes were thematically coded and analysed following an adapted Framework approach. National stakeholders identified external policy and incentives, and the engagement of stakeholders in policy development through the National Technical Working Committee for Newborn Health, as key facilitators for policy and health systems changes. Stakeholders, providers and families perceived the intervention to be simple, safe and effective, and more consistent with family preferences than the prior policy of dry cord care. The major barriers that delayed or decreased the public health impact of the scale up of CHX in Bangladesh’s public health system related to commodity production, procurement and distribution. Bangladesh’s experience scaling up CHX suggests that scale up should involve early needs assessments and planning for institutionalizing new drugs and commodities into the supply chain. While the five CFIR domains were useful for categorizing barriers and facilitators, additional constructs are needed for common health systems barriers in low-income settings.

scholarly journals Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey

10.2196/23488 ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. e23488
Author(s):  
Ken Resnicow ◽  
Elizabeth Bacon ◽  
Penny Yang ◽  
Sarah Hawley ◽  
M Lee Van Horn ◽  
...  
Keyword(s):  
Public Health ◽  
Health Communication ◽  
Online Survey ◽  
Lessons Learned ◽  
Vaccine Hesitancy ◽  
Central Component ◽  
Protective Behaviors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Conspiracy Beliefs

Background A central component of the public health strategy to control the COVID-19 pandemic involves encouraging mask wearing and social distancing to protect individuals from acquiring and transmitting the virus. Objective This study aims to understand the psychological factors that drive adoption or rejection of these protective behaviors, which can inform public health interventions to control the pandemic. Methods We conducted an online survey of a representative sample of 1074 US adults and assessed three novel potential predictors of COVID-19 behaviors: trait reactance, COVID-19 conspiracy beliefs, and COVID-19 apocalypse beliefs. Key outcomes (dependent variables) included an index of COVID-19 protective behaviors, the number of trips taken from the home, and COVID-19 knowledge. Results In bivariate analyses, all three predictors were significantly correlated in the hypothesized direction with the three COVID-19 outcomes. Specifically, each predictor was negatively (P<.01) correlated with the COVID-19 protective behaviors index and COVID-19 knowledge score, and positively correlated with trips taken from home per week (more of which was considered higher risk). COVID-19 protective behaviors and COVID-19 knowledge were significantly lower in the top median compared to the bottom median for all three predictors. In general, these findings remained significant after adjusting for all novel predictors plus age, gender, income, education, race, political party, and religiosity. Self-identified Republicans (vs other political affiliations) reported the highest values for each of the novel predictors. Conclusions This study can inform the development of health communication interventions to encourage the adoption of COVID-19 protective behaviors. Interestingly, we found that higher scores of all three novel predictors were associated with lower COVID-19 knowledge, suggesting that lack of an accurate understanding of the virus may be driving some of these attitudes; although, it is also possible that these attributes may interfere with one’s willingness or ability to seek and absorb accurate health information. These individuals may be particularly immune to accepting new information and yielding their beliefs. Health communication professionals may apply lessons learned from countering similar beliefs around climate change and vaccine hesitancy. Messages designed for individuals prone to reactance may be more effective if they minimize controlling language and emphasize the individual’s independence in adopting these behavioral recommendations. Messaging for those who possess conspiracy beliefs should similarly not assume that providing evidence contrary to these beliefs will alone alter behavior. Other communication techniques such as rolling with resistance, a strategy used in motivational interviewing, may be helpful. Messaging for those with apocalyptic beliefs may require using religious leaders as the message source and using scripture that would support the adoption of COVID-19 protection behaviors.

Community-Based Health Promotion in Occupational Therapy: Assess Before You Assess

2020 ◽  
pp. 073346482092132
Author(s):  
Sclinda L. Janssen ◽  
Marilyn Klug ◽  
Sara Johnson Gusaas ◽  
April Schmiesing ◽  
Danielle Nelson-Deering ◽  
...  
Keyword(s):  
Health Promotion ◽  
Occupational Therapy ◽  
Low Income ◽  
The United States ◽  
Assessment Process ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Design Data ◽  
Housing Complex

In the United States, the role of occupational therapy (OT) in provision of community-based health promotion is supported well in the literature; however, few practitioners are working in this arena. This mixed methods multiphase design study presents an example of a needs assessment process: assess before you assess. Participants included OT practitioners, residents in a low-income community housing complex, and older adult residents in another community housing complex. Methods included phenomenological and nonexperimental cross-sectional survey study design. Data analysis included coding, categorizing, and creating themes; composite scoring, Spearman correlations, and independent t tests for comparing variables. Results indicated that OT practitioners need more guidance and involvement to shift their paradigm from rehabilitation to community health promotion. Conducting needs assessments in three phases supports effective health promotion programming in community settings.

scholarly journals Smoking and Smoking Cessation Among Criminal Justice–Involved Older Adults

2019 ◽  
Vol 12 ◽  
pp. 1179173X1983335
Author(s):  
Cyrus Ahalt ◽  
Timothy Buisker ◽  
Janet Myers ◽  
Brie Williams
Keyword(s):  
Older Adults ◽  
Smoking Cessation ◽  
Criminal Justice ◽  
Tobacco Use ◽  
Age Groups ◽  
Integrated Treatment ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes Toward Smoking

Background: In jails and prisons worldwide, older adults are among the fastest growing demographic groups. Criminal justice–involved populations smoke tobacco at high rates. Older adults are also disproportionate smokers and have more difficulty quitting smoking than other age groups. Yet, little is known about tobacco use or knowledge and attitudes toward smoking cessation among the growing population of incarcerated older adults. Methods: A descriptive, cross-sectional survey study of 102 adults aged 55 years or older recently incarcerated in an urban jail using items from the Global Adult Tobacco Survey (GATS). Results: More than 70% of participants reported being current smokers despite strong knowledge (95%) of the connection between smoking and serious illness. More than half of current smokers reported a past failed quit attempt (62%) and/or said they would like to quit (60%). Conclusions: High rates of tobacco use in this population suggest that correctional institutions represent a critical site for the delivery of appropriate smoking cessation interventions to older adults, including integrated treatment approaches for those with co-occurring behavioral health diagnoses.

scholarly journals Changes in social behavior over time in the COVID-19 pandemic

2020 ◽  
Author(s):  
Megan M Sheehan ◽  
Elizabeth R. Pfoh ◽  
Sidra Speaker ◽  
Michael B. Rothberg
Keyword(s):  
Public Health ◽  
United States ◽  
Social Behavior ◽  
The United States ◽  
Survey Study ◽  
Age Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Group A ◽  
Over Time

Public health recommendations aimed at limiting spread of SARS-CoV-2 have encouraged social distancing and masks as economies across the United States re-open. Understanding adherence to these guidelines will inform further efforts to reduce transmission. In this repeated cross-sectional survey study, we describe changes in social behavior in Ohio during periods of declining and rising cases. While essential activities remained consistent over time, more individuals attended gatherings of 10 or more people as cases rose, particularly in the 18-29 age group. A majority of individuals wore masks. It appears necessary to continue limiting gatherings and encourage mask-wearing, particularly among younger groups.

scholarly journals Vaccine hesitancy and reasons for refusing the COVID-19 vaccination among the U.S. public: A cross-sectional survey

2021 ◽  
Author(s):  
Ali S. Raja ◽  
Joshua D. Niforatos ◽  
Nancy Anaya ◽  
Joseph Graterol ◽  
Robert M. Rodriguez
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Amazon Mechanical Turk ◽  
Vaccine Hesitancy ◽  
Party Affiliation ◽  
Critical Question ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional

AbstractImportanceAlthough widespread vaccination will be the most important cornerstone of the public health response to the COVID-19 pandemic, a critical question remains as to how much of the United States population will accept it.ObjectiveDetermine: 1) rate of COVID-19 vaccine hesitancy in the United States public, 2) patient characteristics associated with hesitancy, 3) reasons for hesitancy, 4) healthcare sites where vaccine acceptors would prefer to be vaccinated.Design43-question cross-sectional survey conducted November 17-18, 2020, distributed on Amazon Mechanical Turk, an online labor marketplace where individuals receive a nominal fee (here, $1.80) for anonymously completing tasks.Eligible ParticipantsUnited States residents 18-88 years of age, excluding healthcare workers. A total 1,756 volunteer respondents completed the survey (median age 38 years, 53% female).Main Outcome MeasureMultivariable logistic regression modeled the primary outcome of COVID-19 vaccine hesitancy (defined as non-acceptance or being unsure about acceptance of the COVID-19 vaccine) with respondent characteristics.ResultsA total 663 respondents (37.8%) were COVID-19 vaccine hesitant (374 [21.3%] non-acceptors and 289 [16.5%] unsure about accepting). Vaccine hesitancy was associated with not receiving influenza vaccination in the past 5 years (odds ratio [OR] 4.07, 95% confidence interval [CI] 3.26-5.07, p<0.01), female gender (OR 2.12, 95%CI 1.70-2.65, p<0.01), Black race (OR 1.54, 95%CI 1.05-2.26, p=0.03), having a high school education or less (OR 1.46, 95%CI 1.03-2.07, p=0.03), and Republican party affiliation (OR 2.41, 95%CI 1.88-3.10, p<0.01). Primary reasons for hesitancy were concerns about side effects, need for more information, and doubts about vaccine efficacy. Preferred sites for vaccination for acceptors were primary doctors’ offices/clinics, pharmacies, and dedicated vaccination locations.ConclusionsIn this recent national survey, over one-third of respondents were COVID-19 vaccine hesitant. To increase vaccine acceptance, public health interventions should target vaccine hesitant populations with messaging that addresses their concerns about safety and efficacy.

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