How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol. (preprint)

IntroductionPregnant people have a higher risk of severe COVID-19 disease. They have been disproportionately impacted by COVID-19 infection control policies, which exacerbated conditions resulting in intimate partner violence, healthcare access, and mental health distress. This project examines the impact of accumulated individual health decisions and describes how perinatal care and health outcomes changed during the COVID-19 pandemic. ObjectivesO_LIQuantitative strand: Describe differences between 2019, 2021, and 2022 birth groups related to maternal vaccination, perinatal care, and mental health care. Examine the differential impacts on racialized and low-income pregnant people. C_LIO_LIQualitative strand: Understand how pregnant peoples perceptions of COVID-19 risk influenced their decision-making about vaccination, perinatal care, social support, and mental health. C_LI Methods and analysisThis is a Canadian convergent parallel mixed-methods study. The quantitative strand uses a retrospective cohort design to assess birth group differences in rates of Tdap and COVID-19 vaccination, gestational diabetes screening, length of post-partum hospital stay, and onset of depression, anxiety, and adjustment disorder, using administrative data from ICES, formerly the Institute for Clinical Evaluative Sciences (Ontario) and PopulationData BC (PopData) (British Columbia). Differences by socioeconomic and ethnocultural status will also be examined. The qualitative strand employs qualitative description to interview people who gave birth between May 2020-December 2021 about their COVID-19 risk perception and health decision-making process. Data integration will occur during design and interpretation. Ethics and disseminationThis study received ethical approval from McMaster University and the University of British Columbia. Findings will be disseminated via manuscripts, presentations, and patient-facing infographics. Strengths and limitations of this studyO_LIPopulation-based administrative data cohorts are very large, ensuring that analyses are high-powered. C_LIO_LIMixed-methods design will allow us to offer explanation for changes in healthcare use observed through administrative data. C_LIO_LICross-provincial design permits examination of the potential impacts of COVID-19 infection prevention and control policies on pregnant peoples health. C_LIO_LIUse of Canadian Index of Multiple Deprivation will allow us to examine differences in healthcare use according to economic, racial, and immigration factors. C_LIO_LITeam includes 5 co-investigators with lived experience of pandemic pregnancies. C_LI

Mitigating Infodemics: The Relationship between News Exposure and Trust and Belief in COVID-19 Fake News and Social Media Spreading (preprint)

Background: Misinformation surrounding COVID-19 poses a global public health problem that adversely affects governments’ abilities to mitigate the disease and causes accidental deaths and self-harm due to false beliefs about the virus, prevention measures, vaccines and cures. We aim to examine the relationship between exposure to and trust in COVID-19 news (from Television, social media, interpersonal communication) and information sources (healthcare experts, government, clerics) and belief in COVID-19 myths and false information, as well as critical social media posting practices (verification before posting). Methods: We use a cross-sectional researcher-administered phone survey of adults between March 27 and April 23, 2020. Findings: The sample included 56.1% men, 37.9% with a university degree, 63.0% older than 30, and 7% with media literacy training. Those who trust COVID-19 news from social media [95%CI:(0.103-1.52)] and interpersonal communication [95%CI:(1.25-1.82)], and those who trust information from clerics [95%CI:(1.25-1.82)] were more likely to believe in COVID-19 myths and false information. University graduates [95%CI:(0.25-0.51)] and those who trust information from government [95%CI:(0.65-0.89] were less likely to believe in myths and false information. Those who believe in COVID-19 myths and false information [95%CI:(0.25-0.70)] were less likely to engage in critical social media posting practices. Only those who underwent media literacy training [95%CI:(1.24-6.55)] were more likely to engage in critical social media posting practices. Interpretation: Higher education and trust in information from government contributed to decreasing belief in COVID-19 myths and false information. Trust in news from social media, interpersonal communication and clerics contributed to increasing belief in COVID-19 myths and false information, which in turn contributed to less critical social media posting practices, thereby contributed to the infodemic. Media literacy training contributed to increasing critical social media posting practices, thereby played a role in mitigating the infodemic.Funding: German Academic Exchange Service (DAAD).Declaration of Interests: All authors have no conflicts of interests nor financial interests to disclose.Ethics Approval Statement: IRB approved the study under protocol number LAU.SAS.JM1.20/Mar/2020.