Health Coaching Across the Stages of Vaccine Readiness and Action: A Practical Guide for Public Health Nurses

Yet, lack of vaccine uptake puts in peril the goal of controlling the spread ofthe virus, particularly among communities that are at greatest risk of contracting and dying ofthe illness.8 The reasons for the lack of COVID-19 vaccine uptake among some communities in the United States are multifaceted, some of which include concerns about the safety or effectiveness ofthe vaccines, the speed in which the vaccines were developed, misinformation about the vaccines, and systemic barriers affecting community access (i.e., online appointment systems, inadequate transportation, and lack of child care).9,10 For many communities of color, including African American and Latinx individuals, COVID-19 vaccine reluctance is rooted in both historical and contemporary experiences of systemic racism, forced sterilization of Latinx women in California, the Tuskegee Study of Untreated Syphilis in the Negro Male (renamed as the US Public Health Service Syphilis Study at Tuskegee), marginalization, medical distrust, neglect from the scientific and medical communities, poor public health infrastructure, and institutional abandonment.2,3,10 In addition to those reasons, the politicization ofthe vaccine development process and efforts to increase vaccination after the 2020 US presidential election have deepened distrust among some communities. A 2021 Kaiser Family Foundation survey found that 79% of US adults who have not yet been vaccinated say they would likely turn to a trusted nurse, doctor, or other health care provider when deoiding wherher to ger a vaooination.11 As health oare professionals, nurses and other public health workers are often a patient's first clinical contact and are among the most trusted sources of information about the vaccines. Nurses are leading the nation's vaccine administration efforts and, to many, are the most accessible source of information for questions about safety, side effects, and benefits.11,12 To be effective, nurses and other public health workers require an understanding of the reasons that prevent people from getting vaccinated and have practical tools to support people with their decisions regarding if, when, and how they get vaccinated against COVID-19. The relationship between the stages in the framework are cyclical, and individuals can move in either direction at different points in time when exposed to new information tog., negative news reports) or negative experiences (e.g., a family member who had an adverse reaction).

Virtual Trainings Effectively Prepared the Public Health Workforce to Support Schools During the COVID-19 Pandemic in California in 2021.

CONTEXT: School closures in California due to COVID-19 have had a negative impact on the learning advancement and social development of K-12 students. Since March 2020, the achievement gap has grown between high-income and low-income students and between White students and students of color. PROGRAM: In November 2020, a team from the California Department of Public Health, University of California, San Francisco, and University of California, Los Angeles, developed the School Specialist training for local health department and state employee redirected staff to the COVID-19 response to equip them to support schools as they reopen. IMPLEMENTATION: A pilot of the virtual School Specialist training was carried out in December 2020, which informed subsequent biweekly half-day virtual trainings. The training consisted of lectures from experts and skill development activities led by trained facilitators. EVALUATION: The objectives of the evaluation of the training were to understand whether (1) knowledge of key concepts improved from pre- to posttraining; (2) confidence in skills central to the role of a School Specialist improved from pre- to posttraining; and (3) course learners who were activated to work as School Specialists felt the training adequately prepared them for the role. The School Specialist training team sent pre- and posttraining surveys to learners between February 8 and May 18, 2021. Of the 262 learners who responded, a significant improvement was seen in knowledge, with a mean score increase of 15.6%. Significant improvement was also observed for confidence, with a 20.1% score improvement seen posttraining. DISCUSSION: Overall, the School Specialist training was shown to be effective in increasing knowledge and confidence in preparation for School Specialist deployment. Adequate training and partnerships for local health department and school staff are critical to keep K-12 students safe and to reduce the learning achievement gap during the ongoing COVID-19 pandemic.

Establishment and Evaluation of a Large Contact-Tracing and Case Investigation Virtual Training Academy.

During the COVID-19 pandemic, the Virtual Training Academy (VTA) was established to rapidly develop a contact-tracing workforce for California. Through June 2021, more than 10 000 trainees enrolled in a contact-tracing or case investigation course at the VTA. To evaluate program effectiveness, we analyzed trainee pre- and postassessment results using the Wilcoxon signed-rank test. There was a statistically significant (P < .001) improvement in knowledge and self-perceived skills after course completion, indicating success in training a competent contact-tracing workforce. (Am J Public Health. 2021;111(11):1934-1938. https://doi.org/10.2105/AJPH.2021.306468).

California's COVID-19 Virtual Training Academy: Rapid Scale-Up of a Statewide Contact Tracing and Case Investigation Workforce Training Program.

Case investigation (CI) and contact tracing (CT) are key to containing the COVID-19 pandemic. Widespread community transmission necessitates a large, diverse workforce with specialized knowledge and skills. The University of California, San Francisco and Los Angeles partnered with the California Department of Public Health to rapidly mobilize and train a CI/CT workforce. In April through August 2020, a team of public health practitioners and health educators constructed a training program to enable learners from diverse backgrounds to quickly acquire the competencies necessary to function effectively as CIs and CTs. Between April 27 and May 5, the team undertook a curriculum design sprint by performing a needs assessment, determining relevant goals and objectives, and developing content. The initial four-day curriculum consisted of 13 hours of synchronous live web meetings and 7 hours of asynchronous, self-directed study. Educational content emphasized the principles of COVID-19 exposure, infectious period, isolation and quarantine guidelines and the importance of prevention and control interventions. A priority was equipping learners with skills in rapport building and health coaching through facilitated web-based small group skill development sessions. The training was piloted among 31 learners and subsequently expanded to an average weekly audience of 520 persons statewide starting May 7, reaching 7,499 unique enrollees by August 31. Capacity to scale and sustain the training program was afforded by the UCLA Extension Canvas learning management system. Repeated iteration of content and format was undertaken based on feedback from learners, facilitators, and public health and community-based partners. It is feasible to rapidly train and deploy a large workforce to perform CI and CT. Interactive skills-based training with opportunity for practice and feedback are essential to develop independent, high-performing CIs and CTs. Rigorous evaluation will continue to monitor quality measures to improve the training experience and outcomes.