COVID-19 Preparedness and Response: Validation of a Rapid Assessment Tool to Evaluate Priorities of Health Workers at the Grassroots Level

Since the initial phases of the COVID-19 outbreak, international recommendations for disease control have been readily available. However, blind implementation of these recommendations without grassroot-level support could result in public distrust and low adherence. This study evaluated the use of a public health priorities survey to rapidly assess perceptions of local health workers. A cross-sectional study using a web-based survey was conducted among 5,847 health workers and medical students from January to February 2020 to evaluate the level of prioritization of various public health measures. Measures with the highest levels of prioritization were “Early prevention, environmental sanitation, and improvement of population health” and “Mobilization of community participation in disease control,” which were concordant with policies implemented by the Vietnamese government. This study also demonstrated a high level of internal validity among survey items and shared ranking of priorities among all occupational groups. The use of this public health priorities survey was found to be effective in identifying priorities as identified by grassroots health workers to provide real-time feedback to the national government. However, future iterations of this survey should consider limiting the use of each prioritization score to ensure that responses represent the reality of source limitations and consider focusing on medical professionals and community workers due medical students' limited experience with Vietnam's healthcare infrastructure.

Download Full-text

Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-020-10146-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jinghua Li ◽

Jingdong Xu ◽

Huan Zhou ◽

Hua You ◽

Xiaohui Wang ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Health Status ◽

Health Outcomes ◽

Working Conditions ◽

Health Workers ◽

Front Line ◽

Cross Sectional ◽

Self Rated Health ◽

Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

Download Full-text

Public Health Workforce Burnout in the COVID-19 Response in the U.S.

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084369 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4369

Author(s):

Kahler W. Stone ◽

Kristina W. Kintziger ◽

Meredith A. Jagger ◽

Jennifer A. Horney

Keyword(s):

Public Health ◽

Health Workforce ◽

Work Experience ◽

Large Scale ◽

Health Workers ◽

Public Health Workforce ◽

Cross Sectional Survey ◽

Public Health Response ◽

Cross Sectional ◽

The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

Download Full-text

Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis

Health Promotion Practice ◽

10.1177/1524839920972982 ◽

2020 ◽

pp. 152483992097298

Author(s):

Alexis K. Grant

Keyword(s):

Public Health ◽

Cluster Analysis ◽

Determinants Of Health ◽

Local Health ◽

Health Departments ◽

Local Health Departments ◽

Structural Determinants ◽

Cluster Assignment ◽

Cross Sectional ◽

Top Executive

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.

Download Full-text

OSCE: An Effective Tool of Assessment for Medical Students

10.53350/pjmhs211582235 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2235-2239

Author(s):

Farrukh Sarfraz ◽

Fahad Sarfraz ◽

Imran Jawad ◽

Mohammad Zia-Ul-Miraj ◽

Rizwan Zafar Ahmad ◽

...

Keyword(s):

Medical Students ◽

Time Allocation ◽

Assessment Tool ◽

Clinical Skills ◽

Cross Sectional Study ◽

Cross Sectional ◽

Clinical Competencies ◽

Medical College ◽

Data Collection Procedure

Background: To assess the competency of a student different tools are used. Since its introduction in 1975 by Dr. Harden and his team, OSCE has gained tremendous strides to assess the clinical competencies. Since 1975 onward OSCE has been very successfully used to assess the clinical competencies of medical student globally. OSCE is an assessment tool in which student is observed for performance of different tasks at specified stations. In the current study perception of medical students about OSCE examination was done which shall give room for positive criticism and further improvement of the system where ever required. Objective: To expedite view of final year MBBS students of Azra Naheed College about OSCE Material and Method Study design: Quantitative, cross sectional study. Settings: Azra Naheed College, Lahore. Duration: Six months i.e. 1st July2020 to 31st December 2020 Data Collection procedure: After an informed consent and appropriate briefing, the questionnaire was distributed among the final year medical students of Azra Naheed Medical College. Questionnaire developed by Russell et al was used. Results: Out of 148 students who participated in the study, 66(45%) students were females and 82(55%) were male. Majority of the students were satisfied with the quality of the exam. Consensus about the quality of exam was that, 29.7% were aware about the nature of the exam, 52.7% were satisfied that the syllabus taught was asked in the exam, 58.1% were satisfied about the time allocation for each station. Majority i.e. 60% considered OSCE an exam of practical nature which is not biased by gender or ethnicity. More than 50% of the students were satisfied with the standard of the exam. At the same time more than 50% students considered essay exam the easiest format of assessment. However, OSCE was considered to be fairest form of assessment 73%. 68.9% perceived that learning is enhanced by MCQs rather than other formats of assessment. Conclusion: To conclude this study, it is very much clear that the perception of students about OSCE as an assessment tool was very encouraging, as it not only provided them the opportunity to highlight their weaknesses but also helped them to perform well in the exam, manage time during exam and to overcome them stress which influenced their results. Key words: OSCE, Objective, Examinations, Clinical skills, qualitative analysis

Download Full-text

Medical students’ perception of sexual orientation in Sagamu, southwestern Nigeria: implications for access to HIV care

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-10-2017-0066 ◽

2018 ◽

Vol 11 (5) ◽

pp. 347-355 ◽

Cited By ~ 1

Author(s):

Oluwafolahan Oluwagbemiga Sholeye ◽

Victor Jide Animasahun ◽

Abimbola A. Oyelekan

Keyword(s):

Sexual Orientation ◽

Medical Students ◽

Health Workers ◽

Medical Curriculum ◽

Public Hospitals ◽

Hiv Care ◽

Southwestern Nigeria ◽

Cross Sectional ◽

Content Type ◽

Sex With Men

Purpose The prevalence of Human Immunodeficiency Virus (HIV) is about four times higher among individuals with same-sex orientation as against the general population. This may be partly due to judgmental, heteronormative attitudes among health workers, thereby affecting access to care. Therefore, the purpose of this paper is to assess the perception of final-year medical students of Olabisi Onabanjo University, Nigeria on sexual orientation and its implications on access to HIV care and support services. Design/methodology/approach A cross-sectional descriptive study was conducted among final-year medical students. Data were collected using an interviewer-administered questionnaire and analyzed using SPSS 20. Relevant descriptive and inferential statistics were calculated. Participation was fully voluntary. Findings More males (70 percent) were aware of the concept of sexual orientation than females (60.4 percent). Most (94 percent) males and all female respondents felt homosexuality was against the order of nature. More males (76 percent) than females (62.3 percent) felt men having sex with men and homosexuality were synonymous. More females (50.9 percent) than males (48 percent) felt gay doctors should not be employed in public hospitals. Originality/value Respondents had a poor perception of sexual orientation and there were no significant differences between genders. This could contribute to existing stigmatization against individuals with minority sexual orientations. It should be addressed in the medical curriculum.

Download Full-text

The Relationship of Lifestyle with Hypertension Incidence in Antang Public Health Center of Makassar City

Health Sciences ◽

10.15342/hs.2020.254 ◽

2020 ◽

Vol 2020 ◽

Author(s):

Agussalim

Keyword(s):

Public Health ◽

Blood Pressure ◽

Health Center ◽

Health Workers ◽

Circulatory System ◽

Simple Random Sampling ◽

Bivariate Analysis ◽

Cross Sectional ◽

Public Health Center ◽

The Relationship

Hypertension is a disease that usually occurs in the circulatory system which can cause an increase in blood pressure above the normal value, which exceeds 140/90 mmHg. The intention of this study aims to understand the relationship between lifestyle and the incidence of hypertension in Antang Makassar Public Health Center in 2018. This research method uses quantitative analytic motives using a cross sectional approach with a population of 46 people and a sample of 36 respondents. This research was conducted on July 14-16 June. The method used is simple random sampling and the tool used to obtain data is a questionnaire. The scale used is Liker and Guttmann scale with univariate, bivariate analysis and chi-square test with significant a = 0, 05. The results of this study indicate there is a relationship between lifestyle and the incidence of hypertension in the Makassar Antang Health Center with P = 0, 01 smaller than the value of a = 0.05. Suggestions are for hypertensive patients, namely the need to check their health routinely to health workers in order to know the development of blood pressure and obtain information from health workers.

Download Full-text

Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0246085 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0246085

Author(s):

Muhammad Riaz ◽

Ghazala Shah ◽

Muhammad Asif ◽

Asma Shah ◽

Kaustubh Adhikari ◽

...

Keyword(s):

Public Health ◽

Urban Areas ◽

Health Workers ◽

Health Concern ◽

Case Control Studies ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Negatively Associated ◽

Factors Associated ◽

Health Related

Background High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population. Methods We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies. Results We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30–60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension. Conclusion We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

Download Full-text

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph121114244 ◽

2015 ◽

Vol 12 (11) ◽

pp. 14244-14259 ◽

Cited By ~ 8

Author(s):

Zhifei He ◽

Zhaohui Cheng ◽

Hang Fu ◽

Shangfeng Tang ◽

Qian Fu ◽

...

Keyword(s):

Public Health ◽

Health Workers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Chongqing Municipality ◽

Public Health Workers ◽

Township Hospitals

Download Full-text

Rapid urban health security assessment tool: a new resource for evaluating local-level public health preparedness

BMJ Global Health ◽

10.1136/bmjgh-2020-002606 ◽

2020 ◽

Vol 5 (6) ◽

pp. e002606 ◽

Cited By ~ 1

Author(s):

Matthew R Boyce ◽

Rebecca Katz

Keyword(s):

Public Health ◽

Urban Health ◽

Assessment Tool ◽

Local Level ◽

Local Health ◽

Security Assessment ◽

Direct Function ◽

Health Security ◽

Public Health Emergencies ◽

Sustainable Capacity

Urbanisation will be one of the defining demographic trends of the 21st century—creating unique opportunities for sustainable capacity development, as well as substantial risks and challenges for managing public health and health emergencies. Plans and policies for responding to public health emergencies are generally framed at higher levels of governance, but developing, improving and sustaining the capacities necessary for implementing these policies is a direct function of local-level authorities. Evaluating local-level public health capacities is an important process for identifying strengths and weaknesses that can impact the preparedness for, detection of and response to health security threats. However, while various evaluations and assessments exist for evaluating capacities at other levels, currently, there are no readily available health security assessments for the local-level. In this paper, we describe a tool—the Rapid Urban Health Security Assessment (RUHSA) Tool—that is based on a variety of other relevant assessments and guidance documents. Assessing capacities allow for local-level authorities to identify the strengths and weaknesses of their local health security systems, create multiyear action plans and prioritise opportunities for improving capacities, effectively engage with development partners to target resources effectively and develop compelling narratives and a legacy of leadership. While the RUHSA Tool was not designed to be used in the midst of a public health emergency, such as the ongoing COVID-19 pandemic, it may also be adapted to inform a checklist for prioritising what capacities and activities a city needs to rapidly develop or to help focus requests for assistance.

Download Full-text