ABSTRACT
Introduction: Health-care worker desire to receive coronavirus disease-2019 (COVID-19) vaccination can affect public perception and adoption of vaccination. The present study surveyed the health beliefs of health-care staff regarding COVID-19 vaccination. Methods: In this cross-sectional online survey conducted in Iran between May and June 2021, 537 health-care staff (73.8% females) participated. Health-care staff were assessed on the following constructs: health locus of control, trust in the health-care system, subjective norms, fear of COVID-19, attitude and feelings toward vaccination, physical distancing, intention to engage in preventative behaviors, and perceived behavioral control. Multivariate logistic regression models were used to examine the influence of demographic, clinical factors, fear of COVID-19, and health beliefs, in predicting openness toward vaccination. Results: About 67.5% of subjects received COVID-19 vaccination (first or second dose), with 57.2% reporting feeling confident in getting vaccinated and 32% expressing hesitancy in getting vaccinated. Trust in the health-care system, fear of COVID-19, and positive attitude toward vaccination were significantly higher in vaccinated participants than unvaccinated ones, P < 0.05. Conclusion: Being vaccinated and openness toward vaccination are influenced by health-care professionals' demographic and clinical characteristics, and health perceptions (i.e., fear of COVID-19). Whereas being overwhelmed with fear of COVID-19 is unadvisable, realistic concern balanced with appropriate action (e.g., vaccination) may be reasonable. © 2022 Medknow. All rights reserved.
ABSTRACT
OBJECTIVE: The purpose is to determine whether a facilitated local change team (LCT) intervention improves linkage to medication for opioid use disorder (MOUD) and implementation outcomes, and whether participant-level outcomes are further enhanced by use of peer support specialists (PSS). METHODS: This Type 1 hybrid implementation-effectiveness study involves a pre-post design (implementation study) followed by a randomized trial of PSS (effectiveness study). Participants are at least 114 justice and service staff from 7 sites in three states: probation officers, community treatment providers, a supervisor from each agency, and key stakeholders. The study will recruit up to 680 individuals on probation from seven adult community probation offices; eligible individuals will be recently committed, English speakers, with opioid use disorder (OUD). Core Implementation Study: The study will use the exploration, preparation, implementation, sustainability (EPIS) framework to guide system-change through facilitated LCTs of probation and community treatment staff given a core set of implementation strategies to set goals. The study will collect program-level and staff survey data at the end of each EPIS stage. Implementation outcomes: Organizational engagement in MOUD (primary), plus changes in staff knowledge/attitudes and organizational outcomes (secondary). Effectiveness Study of PSS: After completing implementation, the study will randomize adults on probation to receive PSS vs. treatment as usual, with assessments at baseline, 3, 6 and 12 months. Effectiveness outcomes include participant engagement in MOUD (primary), probation revocation, illicit opioid use, and overdoses. Other aims include identifying barriers and facilitators, and cost-benefit analysis of PSS. Adaptations in response to COVID-19 included moving many procedures to remote methods.