Examining Black and Hispanic physicians and other healthcare providers' attitudes toward the COVID-19 vaccine.

OBJECTIVES: Recognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers. METHODS: We conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 - March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination. RESULTS: The analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% "as soon as you can" vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22-0.87) and personal family (OR=0.45, 95%CI: 0.22-0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30-10.64). CONCLUSIONS: This is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.

Predictors of COVID-19 perceived susceptibility: insights from population-based self-reported survey during lockdown in the United States.

BACKGROUND: The COVID-19 pandemic during lockdown has highlighted the importance of identifying individuals most at risk of infection with SARS-CoV-2, underscoring the need to assess factors contributing to susceptibility to disease. With the rapidly evolving nature of the pandemic and its new variants, there is an inadequate understanding on whether there are certain factors such as a specific symptom or collection of symptoms that combined with life-style behaviors may be useful to predict susceptibility. The study aims to explore such factors from pre-vaccination data to guide public health response to potential new waves. METHODS: An anonymous electronic survey was distributed through social media during the lockdown period in the United States from April to June 2020. Respondents were questioned regarding COVID testing, presenting symptoms, demographic information, comorbidities, and confirmation of COVID-19 test results. Stepwise logistic regression was used to identify predictors for COVID-19 perceived susceptibility. Selected classifiers were assessed for prediction performance using area under receiver operating characteristic (AUROC) curve analysis. RESULTS: A total of 130 participants deemed as susceptible because they self-reported their perception of having COVID-19 (but without the evidence of positive test) were compared with 130 individuals with documented negative test results. Participants had a mean age of 45 years, and 165 (63%) were female. Final multivariable model showed significant associations with perceived susceptibility for the following variables: fever (OR:33.5; 95%CI: 3.9,85.9), body ache (OR:3.0; 95%CI:1.1,6.4), contact history (OR:2.7; 95%CI:1.1,6.4), age> 50 (OR:2.7; 95%CI:1.1, 6.6) and smoking (OR:3.3; 95%CI: 1.2,9.1) after adjusting for other symptoms and presence of comorbid conditions. The AUROC ranged from poor to fair (0.65-0.76) for cluster of symptoms but improved to a good model (AUROC = 0.803) after inclusion of sociodemographic and lifestyle behaviors e.g., age and smoking tobacco. CONCLUSIONS: Fever and body aches suggest association with perceived COVID-19 susceptibility in the presence of demographic and lifestyle behaviors. Using other constitutional and respiratory symptoms with fever and body aches, the parsimonious classifier correctly predicts 80.3% of COVID-19 perceived susceptibility. A larger cohort of respondents will be needed to study and refine classifier performance in future lockdowns and with expected surge of new variants of COVID-19 pandemic.

Leveraging Public-Private Partnerships During COVID-19: Providing Virtual Field Opportunities for Student Learners and Addressing Social Isolation in Older Adults.

While preventive and management measures are important to mitigate the spread of COVID-19, strategies like social distancing can have devastating effects on older adults who are already at risk for social isolation and loneliness. In response, two Colleges of Health Professions (Social Work and Nursing) at a large public University leveraged a partnership with a national health and wellbeing company to address social isolation and loneliness in Houston area older adults during the COVID-19 pandemic. This intergenerational linkage initiative involved 707 older adults and 177 graduate social work and nursing students. This study describes the process of developing a virtual educational opportunity for students while also meeting the needs of vulnerable older adults in Houston, the third largest, and one of the most diverse cities in the U.S. Findings include student/learner outcomes, as well as self-reported improvements in loneliness scores, and unhealthy physical and mental health days among enrolled older adults.

Multimorbidity and Social Drivers of Homelessness and Health: Introduction to This Special Issue.

This introduction describes the impetus and context for this special issue on multimorbidity in homeless populations. The guest editors begin the introduction by describing the problem of homelessness which has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. The editors then describe the content of this special issue, which includes original research examining special populations such as homeless youth, aging populations, and Veterans as well as medical and behavioral health conditions such as tuberculosis, HIV, and opioid use disorder. Two editorials are also included in this special issue that comment on the history of homelessness and the link between homelessness and suicide. The editors acknowledge the different stakeholders that helped support this special issue and highlight the need for continued research and innovative solutions to improve the health, housing, and well-being of homeless populations.