“I may be essential but someone has to look after my kids”: women physicians and COVID-19

Objectives This paper analyzes results from focus groups held with women physicians in British Columbia which explored questions around how gender norms and roles influenced their experiences during COVID-19. Methods Four virtual focus groups were organized between July and September 2020. Participants (n = 27) were voluntarily recruited. Data were analyzed using applied thematic analysis. Results In addition to the COVID-19-related changes experienced across the profession, women physicians faced distinct challenges related to an increase in unpaid care responsibilities, and often felt excluded from, and occasionally dismissed by, leadership. Women leaders often felt their contributions were unrecognized and undervalued. Participants drew strength from other women leaders, peer networks, and professional support, but these strategies were limited by unpaid care and emotional labour demands, which were identified as increasing risk of burnout. Discussion Even though women physicians hold a degree of relative privilege, unpaid care work and gender norms contribute to distinct secondary effects of COVID-19. Women physicians link these to pre-pandemic assumptions (within families and communities) that women would absorb care deficits at their own cost. Health system leadership continues to reflect a masculine normative experience wherein the personal and professional are separated, and which devalues the emotional labour often associated with feminine leadership. The strategies participants employed to address negative impacts, while demonstrating resourcefulness and peer support, reflect individualistic responses to social-structural challenges. There is a need for greater recognition of women’s contributions at home and work, increased representation in decision-making, and practical supports such as childcare and counselling.

Understanding the perceptions of UK COVID-19 contact tracing app in the BAME community in Leicester

Purpose Digital contact tracing technologies are critical to the fight against COVID-19 in many countries including the UK. However, a number of ethical, legal and socio-economic concerns that can affect uptake of the app have been raised. The purpose of this research is to explore the perceptions of the UK digital contact tracing app in the Black, Asian and Minority Ethnic (BAME) community in Leicester and how this can affect its deployment and implementation. Design/methodology/approach Data was collected through virtual focus groups in Leicester, UK. A total of 28 participants were recruited for the study. All participants are members of the BAME community, and data was thematically analysed with NVivo 11. Findings A majority of the participants were unwilling to download and use the app owing to legal and ethical concerns. A minority were willing to use the app based on the need to protect public health. There was a general understanding that lack of uptake will negatively affect the fight against COVID-19 in BAME communities and an acknowledgement of the need for the government to rebuild trust through transparency and development of regulatory safeguards to enhance privacy and prevent misuse. Originality/value To the best of the authors’ knowledge, the research makes original contributions being the first robust study conducted to explore perceptions of marginalised communities, particularly BAME which may be adversely impacted by the deployment of the app. By exploring community-based perceptions, this study further contributes to the emerging citizens’ perceptions on digital contact tracing which is crucial to the effectiveness and the development of an efficient, community-specific response to public attitudes towards the app. The findings can also help the development of responsible innovation approaches that balances the competing interests of digital health interventions with the needs and expectations of the BAME community in the UK.

Lessons on Learning in Later Life With the MIT AgeLab 85+ Lifestyle Leaders

Previous research has established the role of lifelong learning in promoting psychological wellbeing and active aging. Population aging necessitates an understanding of the unique opportunities and challenges around formal and informal learning in later life. This paper will share findings from a mixed methods study with the MIT AgeLab 85+ Lifestyle Leaders, a panel comprised of octogenarians and nonagenarians from across the United States. Drawing on an online survey and virtual focus groups with 29 Lifestyle Leaders from January 2021, findings suggest the Lifestyle Leaders most often learned new things from talking with others (46%) and reading print (54%) or online (54%) sources. The majority were familiar with attending in-person lectures or classes (89.7%) and were now using videoconferencing to do these (78.6%). A majority (56.7%) had or are currently participating in a lifelong learning program. Most consider themselves lifelong learners and described this around remaining curious and engaged with life, choices around what one learns, and greater enjoyment of learning. In the survey, a plurality of Lifestyle Leaders indicated the top two challenges affecting their ability to learn were sensory burdens (e.g., hearing loss, declining eyesight) (35%) and their energy level (32.4%); focus group data revealed that recall also is a barrier. Focus group data further highlighted generational experiences around early life learning and career paths, specifically how gender roles, diagnoses of learning disabilities, and evolving digital technology have affected these and changed over the course of their lifetimes.

Factors Related to COVID-19 Vaccine Uptake in Black American Communities

Black/African Americans represent 13% of the population, yet account for about a quarter of COVID-19 deaths. Black Americans receive COVID-19 vaccines at lower rates than whites. To address this gap, we examined effects of the COVID-19 pandemic among Black Americans, emphasizing understanding trust and vaccines. Data were collected (July to September 2020) using 8 virtual focus groups in Detroit and San Francisco with 33 older Black Americans and 11 caregivers. Content analysis was used to identify themes. The first theme pointed to a sense of feeling abandoned by healthcare providers and the government, which exacerbated uncertainty and fear. The second theme emphasized distrust towards healthcare providers and government. The third theme pointed to a reluctance in receiving the vaccine because of distrust of pharmaceutical companies and government, as well as misinformation. These findings suggest that underlying systemic issues need to be addressed to accelerate vaccine uptake among older Black Americans.

Factors Related to COVID-19 Vaccine Uptake in Black American Communities

Black/African Americans represent 13% of the population, yet account for more than 24% of COVID-19 deaths. Emerging evidence indicates that Black Americans are receiving COVID-19 vaccines at lower rates than whites. However, there is minimal information about why vaccination rates are lower. To address this gap, we examined the effects of the COVID-19 pandemic among Black Americans, with an emphasis on understanding trust and vaccine uptake. Data were collected between July and September 2020 using 8 virtual focus groups in Detroit, MI and San Francisco Bay Area, CA with 33 older Black Americans and 11 caregivers of older Black Americans with cognitive impairment. Inductive/deductive content analysis was used to identify themes. The first theme pointed to a sense of feeling abandoned by healthcare providers and the government at local and state levels, which exacerbated uncertainty and fear about the vaccine and in general. The second theme emphasized a sense of deep distrust towards healthcare providers and the government, especially during the pandemic. The third theme pointed to a reluctance in receiving the vaccine because of distrust of pharmaceutical companies and the government, as well as misinformation and the rapid speed of vaccine development. These findings suggest that underlying systemic issues need to be addressed immediately to accelerate vaccine uptake among older Black Americans. New initiatives are needed to foster trust and address abandonment by healthcare and government systems. In addition, public health campaigns with reliable information about the COVID-19 vaccine are needed.

Navigating the online world of lifestyle health information: an adolescent perspective (Preprint)

BACKGROUND Adolescence is a critical life stage characterised by an interplay of biological, social and environmental factors. Such factors influence lifestyle health related trajectories, including dietary behaviours, physical activity levels, body weight and sleep hygiene. Generation Z (born 1995-2015) are the most internet-dependent and technologically savvy generation in history with increasing rates of smartphone ownership in both developed and developing nations. Gaps exist in our understanding of what online platforms adolescents are using and the barriers and facilitators of these platforms to seek lifestyle health information. OBJECTIVE We evaluated adolescents’ perceptions on the use of contemporary digital platforms (websites, social media platforms and smartphone apps) to seek information or advice related to lifestyle heath. METHODS Virtual focus groups were held via Zoom teleconference between July to August 2021. Eligible participants were 13-18 years, living in Australia and had searched for online lifestyle health information in the previous three months. For this study, lifestyle health information referred to key behaviours and risk factors for chronic disease, namely, diet, physical activity, weight management and sleep. Participants were recruited through an existing database of research participants and networks of the research team. Focus groups were analysed using the Framework approach, where data is systematically searched to recognize patterns in the data and manage, analyse and identify themes. Focus group audio files were transcribed verbatim and independently coded by two researchers (RR, SJ). Through an iterative and reflexive process, a final coding matrix was agreed on by all researchers and used to thematically analyse the data. RESULTS Five focus groups were held (n=32, mean age 16.3(1.4), 18/32, 56% female, 13/32, 41% spoke language other than English at home). Thematic analysis revealed participants searched for information both actively (e.g., on Google or YouTube) and passively (e.g., scrolling social media and using existing apps preloaded to their smartphone such as Apple ‘Health’, Samsung ‘Health’ or ‘Google Fit’ apps). Participants identified that the most helpful information was well-organised in terms of aesthetic appeal and layout, came from a credible and reliable source (e.g. any sponsorships disclosed) and expressed the need for the information to be relatable. Mixed views were reported for the application of lifestyle health information found online. Some participants reported behaviour change, while others noted that certain advice was hard to maintain and incorporate into their lifestyle. CONCLUSIONS This study highlights the abundance and complexity of lifestyle health information online for adolescents. Adolescents in the digital age seek access to information that is appealing, credible, relevant and actionable for lifestyle health behaviours. To appeal to the needs of adolescents, future interventions for adolescents relating to lifestyle health must consider co-design methodological approaches. Furthermore, the regulation of lifestyle health information available online warrants further investigation.

Relationships Are Built on Sunny Days: Uncovering Quiet Weather Communication Strategies

This study proposes the concept of quiet weather communication and offers the first framework of quiet weather communication strategies tied to specific public outcomes (e.g., build and maintain organization-public relationships). Most of the risk communication literature focuses on severe weather communication. We posit that through defining and examining quiet weather strategic communication we can better understand how the Weather Enterprise can prepare communities for future severe weather. Through four virtual focus groups with 28 NWS and broadcast meteorologists, we operationalize quiet weather communication strategies (humanize the organization, provide weather education, share the love of blue skies, and showcase quiet weather trends). We then report meteorologists’ perceptions of the strengths and weaknesses of each strategy and propose future directions for research on quiet weather communication.

Exploring COVID-19 Vaccine Hesitancy Among Stakeholders in African American and Latinx Communities in the Deep South Through the Lens of the Health Belief Model

Purpose The purpose of this study was to qualitatively explore perceptions related to COVID-19 vaccination intention among African American and Latinx participants and suggest intervention strategies. Approach Ninety minute virtual focus groups (N = 8), segmented by county, race and ethnicity were conducted with stakeholders from 3 vulnerable Alabama counties. Participants Participants (N = 67) were primarily African American and Latinx, at least 19 years, and residents or stakeholders in Jefferson, Mobile, and Dallas counties. Setting Focus groups took place virtually over Zoom. Methods The semi-structured guide explored perceptions of COVID-19, with an emphasis on barriers and facilitators to vaccine uptake. Focus groups lasted approximately 90 minutes and were audio recorded, transcribed, and analyzed by a team of 3 investigators, according to the guidelines of Thematic Analysis using NVivo 12. To provide guidance in the development of interventions to decrease vaccine hesitancy, we examined how themes fit with the constructs of the Health Belief Model. Results We found that primary themes driving COVID-19 vaccine hesitancy, ordered from most to least discussed, are mistrust, fear, and lack of information. Additionally, interventions to decrease vaccine hesitancy should be multi-modal, community engaged, and provide consistent, comprehensive messages delivered by trusted sources.

A Patient-Prioritized Agenda for Information Needs During the COVID-19 Pandemic: A Qualitative Study of Patients With Inflammatory Bowel Disease

Background Patients with inflammatory bowel disease (IBD) may be at risk for complications due to the COVID-19 pandemic. We performed a qualitative study to better understand IBD patient experiences and concerns when navigating the COVID-19 pandemic, with the goal of prioritizing patients’ information needs. Methods We conducted a series of semistructured virtual focus groups at 6 months, then member checking focus groups 1 year into the COVID-19 pandemic. We included questions on patients’ experiences navigating the pandemic with IBD, differences in their experience as compared to peers, their concerns and fears, as well as preferred information sources. Transcribed focus groups were coded and content analyzed to summarize key areas of interest and identify themes. We focused on 4 areas in our content analysis process: fears, challenges, information preferences, and research questions. Results A total of 26 IBD patient participants were included in the initial focus groups. Findings highlighted the many challenges faced by patients during the COVID-19 pandemic, ranging from access (bathrooms, medications, healthcare) to significant fears and concerns surrounding medications used for IBD worsening risks of COVID-19. Research questions of importance to patients centered on understanding risks for COVID-19 complications, particularly pertaining to medication utilization, with a shift over time toward understanding COVID-19 vaccination. In our member checking focus groups (n = 8 participants), themes were reiterated, with a central focus of research questions pertaining to COVID-19 vaccination. Conclusions Information needs for patients during the COVID-19 pandemic centered upon understanding disease-specific risks. Identified challenges and fears will inform future research agendas and communication with patients.