The value of community technology workers for LPG use: A pilot in Shirati, Tanzania

Background Sustainable Development Goal (SDG) 7 calls for the adoption and continued use of clean-burning stoves by the 2.9 billion people relying on unclean fuels (both solid biomass and kerosene). However, to date, the clean cooking literature has found low rates of efficient stove adoption and continued use. This paper presents the application of a public health community engagement model to the use of clean cooking fuels. We implemented a pilot study with Community Technology Workers (CTWs) as a means to overcome maintenance, education, and behavioral barriers to clean fuel use in rural Tanzania. Methods The intervention was a free 6 kg Liquified Petroleum Gas (LPG) cylinder and stove coupled with education from a local technically trained CTW on LPG use. We evaluated the training, work, and impact of a CTW on LPG use on 30 randomly selected households from two villages in a rural district of Tanzania over a 1-year period. After an initial baseline survey, technically trained local CTWs educated the households on safe LPG use and conducted 34 follow up surveys over the next year on their cooking fuel use. Additionally, we conducted qualitative interviews with all households and a focus group with six of the households. Results The results from the mixed methods approach show that 80% of families (n = 24) consistently refilled their LPG cylinders and ~ 40% of households exclusively used LPG. Households reported appreciating the CTWs’ visits for providing education and maintenance support, giving them confidence to use LPG safely, reminding them to save for their cylinder, and providing a community driven effort to use clean fuel. Conclusions The findings demonstrate the feasibility of this type of community infrastructure model to promote and facilitate consistent LPG use, but suggest the need to couple this local support with financial mechanisms (e.g., a microsavings program). This model could be a mechanism to increase LPG use, particularly in rural, low-income areas.

Estimating the Proportion of Asymptomatic COVID-19 Cases in an Italian Region with Intermediate Incidence during the First Pandemic Wave: An Observational Retrospective Study

Early in the COVID-19 pandemic, asymptomatic transmission represented an important challenge for controlling the spread of SARS-CoV-2 through the traditional public health strategies. Further understanding of the contribution of asymptomatic infections to SARS-CoV-2 transmission has been of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak (February 29-July 7, 2020). We analyzed data collected in a regional platform developed to manage surveillance activities, namely, investigation and follow-up of cases and contacts, contact tracing, and laboratory and clinical data collection. We included all asymptomatic cases that were laboratory-confirmed during the appropriate follow-up, defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease. Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193,757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95% CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95% CI: 0.83-0.96; p = 0.001 ), in individuals with underlying comorbidities (OR: 0.55, 95% CI: 0.41-0.73; p < 0.001 ), and in males (OR: 0.69, 95% CI: 0.54-0.87; p = 0.002 ). The median asymptomatic SARS-CoV-2 RNA positive period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%. As the public health community is debating the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host. This has important implications for future COVID-19 surveillance and prevention.

SRA and Genbank BioSample-Linked Submission with Mercury_Prep and Mercury_Batch v2

Submitting sequencing data to public data repositories is a meaningful yet tedious procedure. Linking submissions between SRA and Genbank will enhance the value of both submissions the the public health community. The Mercury protocols offered by Theiagen Genomics allows users to efficiently and accurately produce all required inputs for SRA and Genbank submissions (the Mercury workflows also allow for GISAID submission, but that will not be covered in this protocol). This protocol provides a detailed procedure for submitting BioSample-linked sequencing data to SRA and Genbank.

Examining Online Health Community Users’ Information Adoption Intention

Due to the doubt on information credibility, users often hesitate to adopt the health information posted on online health communities (OHC). This may undermine the sustainable development of OHC. The purpose of this research is to identify the determinants of OHC users’ information adoption intention. The results indicated that both information factors and social interaction affect the adoption intention. Information factors include argument quality and source credibility, whereas social interaction includes perceived similarity and familiarity. The results imply that OHC need to ensure information quality and support users’ interaction in order to facilitate their information adoption.

Program Report: Nîsohkamâtowak—Helping Patients and Families Living With Kidney Disease in Northern Saskatchewan

Purpose of the Program: Nîsohkamâtowak, the Cree word for Helping Each Other, is an initiative to close gaps in kidney health care for First Nations and Métis patients, their families, and communities in northern Saskatchewan. Nîsohkamâtowak emerged from a collaboration between the Kidney Health Community Program and First Nations and Métis Health Services to find ways to deliver better care and education to First Nations and Métis people living with kidney disease while acknowledging Truth and Reconciliation and the Calls to Action. Sources of Information: This article describes how traditional Indigenous protocols and storytelling were woven into the Nîsohkamâtowak events, gathering of patient and family voices in writing and video format, and how this work led to a collaborative co-designed process that incorporates the Truth and Reconciliation: Calls to Action into kidney care and the benefits we have seen so far. The teachings of the 4 Rs—respect, reciprocity, responsibility, and relevance, were critical to ensuring that Nîsohkamâtowak reports and learning were shared with participants and the communities represented in this initiative. Methods: Group discussions and sharing circles were facilitated in several locations throughout northern and central Saskatchewan. Main topics of discussion were traditional medicines, residential schools impact, community and peer supports for kidney disease patients, and cultural safety education for health care providers. Key Findings: The general themes selected for improvement were education, support within the local community, traditional practices and cultural competency, and delivery of services. To address these gaps in kidney care, the following objectives were co-created with First Nations and Métis patients, families, and communities for Kidney Health to provide culturally appropriate education and resources, to ensure appropriate follow-up support to include strengthening connections to communities and other health authorities, to incorporate traditional practices into program design, and to ensure appropriate service delivery across the spectrum of care with a focus on screening and referral, which is strongly linked to coordination of care with local health centers. Implications: As a result of this work, the Kidney Health Community Program restructured the delivery of services and continues to work with Nîsohkamâtowak advisors on safety initiatives and chronic kidney disease awareness, prevention, and management in their respective communities. The Truth and Reconciliation and Calls to Action are honored to close the gaps in kidney care. Limitations: Nîsohkamâtowak is a local Kidney Health initiative that has the good fortune of having dedicated funding and staff to carry out this work. The findings may be unique to the First Nations and Métis communities and people who shared their stories. Truth and Reconciliation is an ongoing commitment that must be nurtured. Although not part of this publication, the effects of COVID-19 have made it difficult to further advance the Calls to Action, with more limited staff resources and the inability to meet in person as in the past.

The Development of an Experience Measure for an Online Digital Mental Health Community

Online digital mental health communities can contribute to users&rsquo; mental health positively and negatively. Yet the measurement of outcomes and impact relating to digital mental health communities is difficult to capture. In this paper we demonstrate the development of an online experience measure for a specific children and young people&rsquo;s community inside a digital mental health service. The development is informed by three phases: (i) item reduction through Estimate-Talk-Estimate modified Delphi methods, (ii) user testing with participatory action research and (iii) a pilot within the digital service community to explore its use. Rounds of experts talks help to reduce the items. User experience workshops helped to inform the usability and appearance, wording, and purpose of the measure. Finally, the pilot results highlight completion rates, difference in scores for age and community roles and a preference to &lsquo;relate to others&rsquo;; as a mechanism of support. Outcomes frequently selected in the measure show the importance of certain aspects of the community, such as safety, connection, and non-judgment previously highlighted in the literature. Self-reported helpfulness scales like this one could be used as indicators of meaningful engagement within the community and its content but further research is required to ascertain its acceptability and validity. Phased approaches involving stakeholders and participatory action research enhances the development of digitally enabled measurement tools.

Digital visual communication for public health: a design proposal for a vaccinated emoji (Preprint)

UNSTRUCTURED In the 21st century, the internet and particularly social media have become essential platforms for the spread of health information (and disinformation). One of the distinguishing features of communication on these platforms is the widespread use of emojis. Though seemingly trivial, emojis are now used by many if not most public health figures and organizations alongside important health updates. Much of that information has had to do with vaccination. Vaccines are a critical public health tool but one surrounded by falsehoods and phobias, especially in the time of COVID-19. Part of that has to do with their lack of positive representation on social media: the syringe emoji is a plain needle which for many people is an uncomfortable image. We thus argue that vaccination deserves an entirely new emoji, and discuss a design proposal for a vaccinated emoji that has gained traction in the global public health community.

Development and Evaluation of the Canteen Connect Online Health Community: Using a Participatory Design Approach in Meeting the Needs of Young People Impacted by Cancer

Adolescent and young adults (AYAs) impacted by their own or familial cancer require information and peer support throughout the cancer journey to ameliorate feelings of isolation. Online Health Communities (OHC) provide social networks, support, and health-related content to people united by a shared health experience. Using a participatory design (PD) process, Canteen developed Canteen Connect (CC), an OHC for AYAs impacted by cancer. This manuscript outlines the process used to develop CC: (1) A mixed-methods implementation evaluation of Version I of CC (CCv.1); (2) Qualitative workshops utilizing strengths-based approaches of PD and appreciative inquiry to inform the development of CC Version 2 (CCv.2); quantitative implementation evaluation to assess the appropriateness, acceptability, and effectiveness of CCv.2. Through several iterations designed and tested in collaboration with AYAs, CCv.2 had improvements in the user experience, such as the ability to send a private message to other users and the site becoming mobile responsive. Results from the evaluation showed CCv.2 was appropriate for connecting with other AYAs. Most AYAs reported satisfaction with CCv.2 and a positive impact on their feelings of sadness, worry, and/or anxiety. CCv.2 fills an important service provision gap in providing an appropriate and acceptable OHC for AYAs impacted by cancer, with initial promising psychological outcomes.

Estimating the proportion of asymptomatic COVID-19 cases in an Italian region with intermediate incidence during the first pandemic wave: an observational retrospective study

Early in the COVID-19 pandemic, asymptomatic transmission represented an important challenge for controlling the spread of SARS-CoV-2 through the traditional public health strategies. Further understanding of the contribution of asymptomatic infections to SARS-CoV-2 transmission has been of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak (February 29 - July 7, 2020). We analyzed data collected in a regional platform developed to manage surveillance activities, namely investigation and follow-up of cases and contacts, contact tracing, laboratory and clinical data collection. We included all asymptomatic cases that were laboratory-confirmed during the appropriate follow-up, defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease. Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193,757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95%CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95%CI: 0.83-0.96; p=0.001), in individuals with underlying comorbidities (OR: 0.55, 95%CI: 0.41-0.73; p<0.001), and in males (OR: 0.69, 95%CI: 0.54-0.87; p=0.002). The median asymptomatic SARS-CoV-2 RNA positive period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%. As the public health community is debating the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host. This has important implications for future COVID-19 surveillance and prevention.