Eliciting Opinions on Health Messaging During the COVID-19 Pandemic: Qualitative Survey Study.

BACKGROUND: Effective public health messaging has been necessary throughout the COVID-19 pandemic, but stakeholders have struggled to communicate critical information to the public, especially in different types of locations such as urban and rural areas. OBJECTIVE: This study aimed to identify opportunities to improve COVID-19 messages for community distribution in rural and urban settings and to summarize the findings to inform future messaging. METHODS: We purposively sampled by region (urban or rural) and participant type (general public or health care professional) to survey participants about their opinions on 4 COVID-19 health messages. We designed open-ended survey questions and analyzed the data using pragmatic health equity implementation science approaches. Following the qualitative analysis of the survey responses, we designed refined COVID-19 messages incorporating participant feedback and redistributed them via a short survey. RESULTS: In total, 67 participants consented and enrolled: 31 (46%) community participants from the rural Southeast Missouri Bootheel, 27 (40%) community participants from urban St Louis, and 9 (13%) health care professionals from St Louis. Overall, we found no qualitative differences between the responses of our urban and rural samples to the open-ended questions. Participants across groups wanted familiar COVID-19 protocols, personal choice in COVID-19 preventive behaviors, and clear source information. Health care professionals contextualized their suggestions within the specific needs of their patients. All groups suggested practices consistent with health-literate communications. We reached 83% (54/65) of the participants for message redistribution, and most had overwhelmingly positive responses to the refined messages. CONCLUSIONS: We suggest convenient methods for community involvement in the creation of health messages by using a brief web-based survey. We identified areas of improvement for future health messaging, such as reaffirming the preventive practices advertised early in a crisis, framing messages such that they allow for personal choice of preventive behavior, highlighting well-known source information, using plain language, and crafting messages that are applicable to the readers' circumstances.

Conducting verbal autopsy by telephone interview during the pandemic to support mortality surveillance: a feasibility study in Malaysia.

Objective: Verbal autopsy (VA) through face-to-face interviews with caregivers is a way to determine cause of death without medical certification. In Malaysia, the use of VA has improved mortality statistics. However, during the coronavirus disease 2019 (COVID-19) pandemic, face-to-face interviews were delayed, reducing VA data collection and affecting data for mortality surveillance. This study aims to investigate the feasibility and acceptability of conducting VA interviews via telephone calls, and the quality of the data gathered. Methods: The study was conducted in Malaysia from September to October 2020 using a cross-sectional design. Participants were health-care workers from established VA teams across the country. They conducted VA interviews via telephone and provided feedback through a customized online form. Data collected from the form were used to assess the feasibility, acceptability and quality of the telephone interviews using IBM SPSS version 23. Results: Responses were received from 113 participants. There were 74 (65.5%) successful interviews, representing 91% of the 81 cases who were able to be contacted. More than two thirds of health-care workers provided positive feedback on the telephone interview method for themselves and the interviewees. Only 10.8% of causes of death were unusable. Discussion: This study provides preliminary evidence that VA via telephone interview is feasible, acceptable and can be used as an alternative to face-to-face interviews without affecting data quality. During times when face-to-face interviews are not advisable, VA telephone interviews can be used for data collection for mortality surveillance.

Prevalence and Influencing Factors of Anxiety and Depression Symptoms Amongst Surgical Nurses During COVID-19 Pandemic: A Large-Scale Cross-Sectional Study (preprint)

BackgroundThe outbreak of novel 2019 coronavirus disease (COVID-19) has imposed an enormous physical and psychological pressure on people across the world. This study focused on evaluating the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the epidemic in China. MethodA cross-sectional, multicenter quantitative study was conducted in Anhui province (China) from March 3, 2020 to March 19, 2020, with a questionnaire package which consisted of general information questionnaire，Zung's self-rating anxiety scale (SAS), Zung's self-rating Depression Scale (SDS) and social support rating scale (SSRS). A total of 3600 surgical nurses participated in the survey by Wechat and QQ. Data were analysed using multiple linear regression models. ResultsA total of 3492 surgical nurses from 12tertiary hospitals and 12 secondary hospitals in one province of mainland China completed the survey. The prevalence rates of anxiety symptoms and depressive symptoms were 24.83% and 22.39%, respectively. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm (P< 0.05).Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety (r = -0.630, P < 0.001) and depression (r = -0.578, P < 0.001). Fertility status (β = 1.469, P = 0.003), hospital (β = -0.611, P < 0.001), participation in care for COVID-19 patients (β = 2.229, P < 0.001), likelihood of being infected with COVID-19 (β = 1.146, P < 0.001), social support (β = -0.623, P < 0.001) were significantly influencing surgical nurses’ anxiety degree. Similarly, these characteristics were significantly associated with the odds of experiencing depression symptoms in surgical nurses. Divorce and widowed surgical nurses (β = -2.654, P < 0.001) were significantly more likely to experience depressive symptoms than single nurses. ConclusionIn this survey, we found that the surgical nurses had high anxiety and depression symptoms during the COVID-19 outbreak in China. The findings suggest that targeted psychological interventions to promote the mental health of surgical nurses with psychological problems need to be immediately implemented.