"Its no use saying it in English": A qualitative study exploring community leaders perceptions of the challenges and opportunities with translating and interpreting COVID-19 related public health messaging to reach ethnic minorities in Australia (preprint)

Background: The Australian Government implemented a range of public health response strategies and communication approaches to reduce the spread of COVID-19; however, concerns have been raised around a failure to consider culturally and linguistically diverse (CaLD) communities sufficiently in these processes. This research aimed to understand the factors that have impacted COVID-19 communication and engagement efforts during the pandemic from the perspective of key CaLD community stakeholders and community members. A further aim was to understand the processes that could be adopted to support future communication strategies, including the promotion of pandemic-related vaccines. Approach: This study included 29 key informant interviews with community and faith-based leaders in New South Wales, Australia. Results: The overwhelming message from community leaders was a sense of shared responsibility between their organisations and the government in communicating pertinent and accurate COVID-19 related information to CaLD communities. They expressed a sense of duty to keep their community members safe. While acknowledging this shared responsibility, community leaders and others shouldered significant costs related to resources and time that need to be acknowledged by governments in preparing for future disease outbreaks. They felt that governments should consider: 1) improving communication between governments and CaLD organisations; 2) responding to the specific CaLD needs with greater agility; 3) foregrounding social media in their communication strategy; 4) reinvesting in local public health units to know their population; 5) investing in a health ambassadors model program; 6) preparing a hybrid model of translators/interpreters to fill the gap; and, 7) reimagining vaccine information campaigns to better target CaLD communities. Conclusion: Given the technical details about the COVID-19 virus conveyed in government information campaigns and the media, ensuring the most vulnerable populations, including people from CaLD backgrounds, access clear, concise and timely public health messaging from both governments and community organisations requires further attention.

Psychological and financial impacts of COVID-19-related travel measures: An international cross-sectional study (preprint)

Background: The impact of COVID-19 international travel restrictions has to date, not been fully explored, and with the ongoing threat that new variants could potentially restrict movement further, it is important to consider the impacts that travel restrictions have on community members. This study aimed to evaluate the psychological and financial impact of COVID-19 travel restrictions on those separated from their partners or immediate families, as well as temporary visa holders who were unable to migrate. Methods: Between 4 November 2021 to 1 December 2021, we executed a cross-sectional online survey targeting three specific groups; (1) those stranded from their partners; (2) those stranded from immediate families; and (3) temporary visa holders unable to migrate or cross international borders. We collected data on respondents demographic profile; the nature of COVID-19-related travel impacts; depression, anxiety, and stress levels (using the validated DASS-21); and finally, data on respondents financial, employment and accommodation situation. Results: 1363 respondents located globally completed the survey. 71.2% reported financial stress, 76.8% reported moderate-to-extremely severe depression, 51.6% moderate-to-extremely severe anxiety, and 62.6% moderate-to-extremely severe stress levels. Statistically significant factors associated with moderate-to-extremely severe depression, anxiety, and stress included being female, chronic illness, and experiencing financial stress. Employment during COVID-19, specifically essential services workers or unemployed, was associated with higher levels of anxiety and stress, with only essential workers being a predictor of higher stress severity. Factors that provided psychological protection included being older and having children. Conclusion: This study is one of the first to explore the impact COVID-19-related international travel restrictions have had on the financial status and psychological health of affected individuals. It highlights the significant human cost associated with the restrictions and identifies psychologically vulnerable populations. These results will help the design of targeted health and social policy responses.

The Role of Community Leaders and Other Information Intermediaries During the COVID-19 Pandemic: Insights from the Multicultural Sector (preprint)

Community and religious leaders, as well as other natural leaders, from culturally and linguistically diverse (CaLD) backgrounds have been posited as a gateway into communities, acting as information intermediaries that enabler or broker public health messages about the COVID-19 pandemic. However, there are currently limitations regarding our understanding of the capacity, role and reach of these leaders. In-depth interviews were undertaken to understand the perceptions of those working in services and other social support roles focused on CaLD communities towards the role and impact of information intermediaries in promoting and supporting COVID-19 public health communication and engagement activities. Forty-six semi-structured telephone interviews were undertaken with key stakeholders who have an active role in the delivery of services and other social support to CaLD communities in Australia. Four key themes emerged related to the role of information intermediaries during the interviews. Ideas around the role they fulfil in “bridging the gap” and supporting the delivery of pandemic related information into communities. Participants suggested that there had been a failure by Federal government agencies to recognise the role of these stakeholders early in the pandemic, as well as a failure to provide sufficient resources and support. However, concerns were also raised that information may be inappropriately interpreted or translated by the community information intermediaries or potentially blocked, if the message does not align with the broker’s own beliefs. Finally, concerns were raised about the potential for burn-out amongst information intermediaries. It is critical that in preparing and responding to pandemics and other disasters, that there is recognition of the role of community leaders and other information intermediaries and that resources are identified to enhance and sustain their involvement.

Speaking COVID-19: Supporting COVID-19 communication and engagement efforts with people from Culturally and Linguistically Diverse Communities (preprint)

Background Since the emergence of COVID-19, issues have been raised regarding the approach used to engage with culturally, and linguistically diverse (CaLD) communities during this public health crisis. This study aimed to understand the factors impacting communication and engagement efforts during the COVID-19 pandemic from the perspective of key CaLD community stakeholders and opinion leaders.Methods Forty-six semi-structured telephone interviews were undertaken with key stakeholders who have an active role (established prior to the pandemic) in the delivery of services and other social support to CaLD communities in Australia.Results Seven key themes emerged: (1) the digital divide and how to really connect with people; (2) information voids being filled by international material; (3) differentiating established with new and emerging community needs; (4) speaking COVID-19; (5) ineffectiveness of direct translations of English language resources; (6) Coordination is needed to avoid duplication and address gaps and (7) recognising the improvements in governments’ approach.Conclusion It is critical that alliances be set up that can be activated in the future to reduce issues around resource development, translation, and dissemination of messages to minimise gaps in the response. Financial assistance must be provided in a timely way to community organisations to support the development and dissemination of culturally appropriate communication materials.

Stranded abroad during the COVID-19 pandemic: examining the psychological and financial impact of border restrictions (preprint)

ObjectiveWith the easing of COVID-19-related international travel restrictions in late 2021 it is time to consider the direct and indirect social, emotional, and financial impacts that these border closures have had. The study aims to evaluate the psychological and financial distress reported by people stranded abroad due to international travel restrictions introduced in response to the COVID-19 pandemic. MethodsBetween July and September 2021, we implemented a cross-sectional online survey targeting individuals stranded abroad due to international travel restrictions. The survey collected data about COVID-19 travel restriction-related travel impacts; personal stress, anxiety, and depression (using the validated DASS-21tool); as well as impacts on housing and financial security; and demographic data. FindingsWe had 1054 participants complete the survey; most were trying to return to the Oceania region (75.4%), with 45% stranded in Europe. Overall, 64.2% reported financial distress while stranded abroad. 64.4% ([x] =9.43, SD=5.81) reported either a moderate or severe (based on the DASS-21 classification) level of depression, 41.7% for anxiety ([x] =5.46, SD=4.74), and 58.1% for stress ([x] =10.64, SD=5.26). Statistically significant factors associated with moderate to extremely severe depression, anxiety, and stress were financial stress, an employment change, being <30yrs, having a high perceived risk of contracting COVID-19 abroad and being stranded for >2 months. ConclusionThe study is among the first to explore the psychological and financial distress-related impacts associated with being stranded abroad due to COVID-19 travel restrictions. It highlights a range of unintended consequences that arise from pandemic-related travel restriction, identifies the health and social needs for a particularly vulnerable population, and provides clues as to the types of support that may be adopted to best support them. This research will assist policymakers in identifying support packages for people stranded abroad due to global disaster.

How have governments supported citizens stranded abroad due to COVID-19 travel restrictions? A comparative analysis of the financial and health support in eleven countries (preprint)

Background: In response to the continuing threat of COVID-19, many countries have implemented some form of border restriction. A repercussion of these restrictions has been that some travellers have been stranded abroad unable to return to their country of residence, and in need for government support. Our analysis explores the COVID-19-related information and support options provided by 11 countries to their citizens stranded overseas due to travel restrictions. We also examined the quality (i.e., readability, accessibility, and useability) of the information that was available from selected governments’ web-based resources. Methods: : Between June 18 to June 30, 2021, COVID-19-related webpages from 11 countries (Australia, New Zealand, Fiji, Canada, United States of America (USA), United Kingdom (UK), France, Spain, Japan, Singapore, and Thailand) were reviewed and content relating to information and support for citizens stuck overseas analysed. Government assistance-related data from each webpage was extracted and coded for the following themes: travel arrangements, health and wellbeing, finance and accommodation, information needs, and sources. Readability was examined using the Simplified Measure of Gobbledygook (SMOG) and the Flesch Kincaid readability tests; content ‘accessibility’ was measured using the Web Content Accessibility Guidelines (WCAG) Version 2.1; and content ‘usability’ assessed using the usability heuristics for website design tool. Results: : Ninety-eight webpages from 34 websites were evaluated. No country assessed covered all themes analysed. Most provided information and some level of support regarding repatriation options; border control and re-entry measures; medical assistance; and traveller registration. Only three countries provided information or support for emergency housing while abroad, and six provided some form of mental health support for their citizens. Our analysis of the quality of COVID-19-related information available on a subset of four countries’ websites found poor readability and multiple accessibility and usability issues. Conclusion: With large variance in the information and services available across the countries analysed, our results highlight gaps, inconsistencies, and potential inequities in support available, and raise issues pertinent to the quality, accessibility, and usability of information. This study will assist policymakers plan and communicate comprehensive support packages for citizens stuck abroad due to the COVID-19 situation and design future efforts to prepare for global public health emergencies.

Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine (preprint)

BackgroundThere is an indication that vaccine(s) for COVID-19 could be available by early 2021. As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions regarding a future COVID-19 vaccine in Australia. MethodsA national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariate logistic regression analysis. ResultsParticipants generally held positive views towards vaccination. Eighty percent (n=1143) agreed with the statement that getting myself vaccinated for COVID-19 would be a good way to protect myself against infection. Females (614, 83%) were more likely to agree with the statement than males (529, 78%) (aOR=1.4 (95% CI: 1.1-1.8); P=0.029), while 90.9% aged 70 and above agreed compared to 76.6% aged 18-29 year old (aOR=2.3 (95% CI:1.2-4.1); 0.008). Agreement was also higher for those with a self-reported chronic disease (aOR=1.4 (95% CI: 1.1-2.0); P=0.043) and among those who held private health insurance (aOR=1.7 (95% CI: 1.3-2.3); P<0.001). Beyond individual perceptions, 78% stated that their decision to vaccinate would be supported by family and friends ConclusionThis study presents an early indication of public perceptions towards a future COVID-19 vaccine and represents a starting point for mapping vaccine perceptions. To support an effective launch of these new vaccines, governments need to use this time to understand the communities concerns and to identify the strategies that will support engagement.

YouTube as a source of information for do-it-yourself face masks: A content analysis (preprint)

Background Homemade cloth products are increasingly being used as a preventive measure against COVID-19, with various methods promoted through do-it-yourself (DIY) videos available on YouTube and other websites. While guidance has been provided by key organisations on how to create face masks, the extent to which this is being accurately disseminated is currently unknown.Methods A key word search of YouTube using the terms “face/cloth mask” and “diy face/cloth mask” was completed on 18 April 2020. Total and category video content scores determined using the 18-point scoring system in the author-designed checklist. Criteria grouped by: reasons and caveats for use (three criteria), manufacturing instructions (six criteria), instructions for use (five criteria), re-use (three criteria), and cleaning instructions (one criteria). Total scores of ≥ 9 were classified as useful, and those < 9 classified as not useful out of a maximum score of 18.Results Of the 400 videos screened, 261 videos were retained for analysis. 91.7% (n = 242) were categorised as non-useful, compared to 8.3% (n = 22) as useful. Overall, useful videos scored higher across all assessed content evaluation categories. Manufacturing instructions were the most common content featured in the videos, with re-use and cleaning instructions featuring the least.Conclusions Currently, there is a lack of comprehensive, best-practice information on face masks being disseminated through YouTube. The information gaps identified in these findings present an opportunity for authoritative sources to focus communication efforts on promoting best-practice guidance while advice continues to be updated on universal face mask use.

COVID-19 is rapidly changing: Examining public perceptions and behaviors in response to this evolving pandemic (preprint)

BackgroundSince the emergence of SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) in late 2019, communities have been required to rapidly adopt community mitigation strategies rarely used before, or only in limited settings. This study aimed to examine the attitudes and beliefs of Australian adults towards the COVID-19 pandemic, and willingness and capacity to engage with these mitigation measures. In addition, we aimed to explore the psychosocial and demographic factors that are associated with adoption of recommended hygiene-related and avoidance-related behaviors. MethodsA national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between the 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariate logistic regression analysis. FindingsThe survey of 1420 respondents found 50% (710) of respondents felt COVID-19 would somewhat affect their health if infected and 19% perceived their level of risk as high or very high. 84{middle dot}9% had performed [≥]1 of the three recommended hygiene-related behaviors and 93{middle dot}4% performed [≥]1 of six avoidance-related behaviors over the last one month. Adopting avoidance behaviors was associated with trust in government/authorities (aOR: 5{middle dot}5, 95% CI 3-9{middle dot}0), higher perceived rating of effectiveness of behaviors (aOR: 4{middle dot}3, 95% CI: 2{middle dot}8-6{middle dot}9) and higher levels of perceived ability to adopt social distancing strategies (aOR: 1{middle dot}8, 95% CI 1{middle dot}1-3{middle dot}0). InterpretationIn the last two months, members of the public have been inundated with messages about hygiene and social (physical) distancing. However, our results indicate that a continued focus on supporting community understanding of the rationale for these strategies, as well as instilling community confidence in their ability to adopt or sustain the recommendations is needed. FundingNone