COVID-19 Workplace Mitigation Strategies and Employee Leave Policies Implemented during the Height of the Pandemic, United States, Fall 2020 and 2021.

COVID-19 workplace mitigation strategies implemented within US businesses have been effective at preventing disease and protecting workers, but the extent of their use is not well understood. We examined reported COVID-19 workplace mitigation strategies by business size, geographic region, and industry using internet panel survey data from US adult respondents working full- or part-time outside the home (fall 2020, N = 1168) andfull- or part-time, inside or outside the home (fall 2021, N = 1778). We used chi-square tests to assess the differences in the strategies used (e.g., masking and COVID-19 screening) and ANOVA tests to examine the group differences on a mitigation strategies summative score. Fewer COVID-19 mitigation strategies were reported by respondents in fall 2021 (compared to fall 2020) across businesses of different sizes and regions. The participants in microbusinesses (1-10 employees) reported significantly (p < 0.05) lower mitigation scores than all other business sizes, and the respondents in these businesses were significantly less likely (p < 0.05) to have paid leave than those in enterprises with >10 employees. The healthcare and education sectors had the highest reported mean score of COVID-19 workplace mitigation strategies. Small and essential businesses are critical to the US economy. Insight is needed on their use of mitigation strategies to protect workers during the current and future pandemics.

Parental intentions to vaccinate children against COVID-19: Findings from a U.S. National Survey.

We examined parents' COVID-19 vaccination intentions for their children, reasons for not vaccinating, and the potential impact of a school/daycare vaccination requirement or pediatrician's recommendation on vaccination intentions. Two online surveys were conducted in June-July and September-October 2021, before pediatric COVID-19 vaccines were authorized for emergency use in children age < 12 years, with an internet-based, non-probability sample of U.S. adults. Respondents with children (age < 18 years) in the household were asked about their intention (likelihood) of vaccinating these children against COVID-19. Weighted Chi-square tests using a Rao-Scott correction were performed. Vaccinated (45.7 %) versus unvaccinated (6.9 %) parents were almost seven times more likely to have vaccinated their 12-17-year-old children against COVID-19. Approximately 58.4 % of respondents with unvaccinated children ages 2-11 years and 42.4 % of those with children < 2 years said they are "very" or "extremely likely" to vaccinate these children against COVID-19. Female parents were significantly more likely (p < .01 to p < .001) to express lower levels of COVID-19 vaccine intentions. Across all age groups of children unvaccinated against COVID-19, parental vaccine intentions increased with increased household income and education levels. COVID-19 vaccine side effects and safety concerns were primary reasons for not vaccinating children. Strategies including school vaccination requirements and recommendations from pediatricians were shown to increase parental COVID-19 vaccination intentions for some. More research is needed on factors that increase/hinder COVID-19 pediatric vaccine uptake.

Characteristics Associated With a Previous COVID-19 Diagnosis, Vaccine Uptake, and Intention to Be Vaccinated Among Essential Workers in the US Household Pulse Survey.

Objectives. To explore previous COVID-19 diagnosis and COVID-19 vaccination status among US essential worker groups. Methods. We analyzed the US Census Household Pulse Survey (May 26-July 5, 2021), a nationally representative sample of adults aged 18 years and older. We compared currently employed essential workers working outside the home with those working at home using adjusted prevalence ratios. We calculated proportion vaccinated and intention to be vaccinated, stratifying by essential worker and demographic groups for those who worked or volunteered outside the home since January 1, 2021. Results. The proportion of workers with previous COVID-19 diagnosis was highest among first responders (24.9%) working outside the home compared with workers who did not (13.3%). Workers in agriculture, forestry, fishing, and hunting had the lowest vaccination rates (67.5%) compared with all workers (77.8%). Those without health insurance were much less likely to be vaccinated across all worker groups. Conclusions. This study underscores the importance of improving surveillance to monitor COVID-19 and other infectious diseases among workers and identify and implement tailored risk mitigation strategies, including vaccination campaigns, for workplaces. (Am J Public Health. 2022;112(11):1599-1610. https://doi.org/10.2105/AJPH.2022.307010).

Strategies to increase the intention to get vaccinated against COVID-19: Findings from a nationally representative survey of US adults, October 2020 to October 2021.

OBJECTIVES: We examined COVID-19 vaccination status, intention, and hesitancy and the effects of five strategies to increase the willingness of unvaccinated adults (≥18 years) to get a COVID vaccine. METHODS: Online surveys were conducted between October 1-17, 2020 (N = 14,946), December 4-16, 2020 (N = 15,229), April 8-22, 2021 (N = 14,557), June 17-July 6, 2021 (N = 30,857), and September 3-October 4, 2021 (N = 33,088) with an internet-based, non-probability opt-in sample of U.S. adults matching demographic quotas. Respondents were asked about current COVID-19 vaccination status, intention and hesitancy to get vaccinated, and reasons for vaccine hesitancy. Unvaccinated respondents were assigned to treatment groups to test the effect of five strategies (endorsements, changing social restrictions, financial incentives, vaccine requirements for certain activities, and vaccine requirements for work). Chi-square tests of independence were performed to detect differences in the response distributions. RESULTS: Willingness to be vaccinated (defined as being vaccinated or planning to be) increased over time from 47.6 % in October 2020 to 81.1 % in October 2021. By October 2021, across most demographic groups, over 75 % of survey respondents had been or planned to be vaccinated. In terms of strategies: (1) endorsements had no positive effect, (2) relaxing the need for masks and social distancing increased Intention to Get Vaccinated (IGV) by 6.4 % (p < 0.01), (3) offering financial incentives increased the IGV between 12.3 and 18.9 % (p <.001), (4) vaccine requirements for attending sporting events or traveling increased IGV by 7.8 % and 9.1 %, respectively (p = 0.02), and vaccine requirement for work increased IGV by 35.4 %. The leading causes (not mutually exclusive) for hesitancy were concerns regarding vaccine safety (52.5 %) or side effects (51.6 %), trust in the government's motives (41.0 %), and concerns about vaccine effectiveness (37.6 %). CONCLUSIONS: These findings suggest that multiple strategies may be effective and needed to increase COVID-19 vaccination among hesitant adults during the pandemic.

Dissemination and Implementation Science Approaches for Occupational Safety and Health Research: Implications for Advancing Total Worker Health.

Total Worker Health® (TWH), an initiative of the U.S. National Institute for Occupational Safety and Health, is defined as policies, programs, and practices that integrate protection from work-related health and safety hazards by promoting efforts that advance worker well-being. Interventions that apply the TWH paradigm improve workplace health more rapidly than wellness programs alone. Evidence of the barriers and facilitators to the adoption, implementation, and long-term maintenance of TWH programs is limited. Dissemination and implementation (D&I) science, the study of methods and strategies for bridging the gap between public health research and practice, can help address these system-, setting-, and worker-level factors to increase the uptake, impact, and sustainment of TWH activities. The purpose of this paper is to draw upon a synthesis of existing D&I science literature to provide TWH researchers and practitioners with: (1) an overview of D&I science; (2) a plain language explanation of key concepts in D&I science; (3) a case study example of moving a TWH intervention down the research-to-practice pipeline; and (4) a discussion of future opportunities for conducting D&I science in complex and dynamic workplace settings to increase worker safety, health, and well-being.

National and State Trends in Anxiety and Depression Severity Scores Among Adults During the COVID-19 Pandemic - United States, 2020-2021.

Recent studies indicate an increase in the percentage of adults who reported clinically relevant symptoms of anxiety and depression during the COVID-19 pandemic (1-3). For example, based on U.S. Census Bureau Household Pulse Survey (HPS) data, CDC reported significant increases in symptoms of anxiety and depressive disorders among adults aged ≥18 years during August 19, 2020-February 1, 2021, with the largest increases among adults aged 18-29 years and among those with less than a high school education (1). To assess more recent national trends, as well as state-specific trends, CDC used HPS data (4) to assess trends in reported anxiety and depression among U.S. adults in all 50 states and the District of Columbia (DC) during August 19, 2020-June 7, 2021 (1). Nationally, the average anxiety severity score increased 13% from August 19-31, 2020, to December 9-21, 2020 (average percent change [APC] per survey wave = 1.5%) and then decreased 26.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -3.1%). The average depression severity score increased 14.8% from August 19-31, 2020, to December 9-21, 2020 (APC = 1.7%) and then decreased 24.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -2.8%). State-specific trends were generally similar to national trends, with both anxiety and depression scores for most states peaking during the December 9-21, 2020, or January 6-18, 2021, survey waves. Across the entire study period, the frequency of anxiety and depression symptoms was positively correlated with the average number of daily COVID-19 cases. Mental health services and resources, including telehealth behavioral services, are critical during the COVID-19 pandemic.

Investigating the Impact of Job Loss and Decreased Work Hours on Physical and Mental Health Outcomes Among US Adults During the COVID-19 Pandemic.

OBJECTIVE: To investigate associations between adverse changes in employment status and physical and mental health among US adults (aged 18 years or older) during the COVID-19 pandemic. METHODS: Data from participants (N = 2565) of a national Internet panel (June 2020) were assessed using path analyses to test associations between changes in self-reported employment status and hours worked and physical and mental health outcomes. RESULTS: Respondents who lost a job after March 1, 2020 (vs those who did not) reported more than twice the number of mentally unhealthy days. Females and those lacking social support had significantly worse physical and mental health outcomes. Participants in the lowest, pre-pandemic household income groups reported experiencing worse mental health. CONCLUSIONS: Results demonstrate the importance of providing economic and social support services to US adults experiencing poor mental and physical health during the COVID-19 pandemic.

Theory-based Behavioral Predictors of Self-reported Use of Face Coverings in Public Settings during the COVID-19 Pandemic in the United States.

BACKGROUND: Investigating antecedents of behaviors, such as wearing face coverings, is critical for developing strategies to prevent SARS-CoV-2 transmission. PURPOSE: The purpose of this study was to determine associations between theory-based behavioral predictors of intention to wear a face covering and actual wearing of a face covering in public. METHODS: Data from a cross-sectional panel survey of U.S. adults conducted in May and June 2020 (N = 1,004) were used to test a theory-based behavioral path model. We (a) examined predictors of intention to wear a face covering, (b) reported use of cloth face coverings, and (c) reported use of other face masks (e.g., a surgical mask or N95 respirator) in public. RESULTS: We found that being female, perceived importance of others wanting the respondent to wear a face covering, confidence to wear a face covering, and perceived importance of personal face covering use was positively associated with intention to wear a face covering in public. Intention to wear a face covering was positively associated with self-reported wearing of a cloth face covering if other people were observed wearing cloth face coverings in public at least "rarely" (aOR = 1.43), with stronger associations if they reported "sometimes" (aOR = 1.83), "often" (aOR = 2.32), or "always" (aOR = 2.96). For other types of face masks, a positive association between intention and behavior was only present when observing others wearing face masks "often" (aOR = 1.25) or "always" (aOR = 1.48). CONCLUSIONS: Intention to wear face coverings and observing other people wearing them are important behavioral predictors of adherence to the CDC recommendation to wear face coverings in public.