Well-being Content Inclusion in Pharmacy Education Across the United States and Canada

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment. Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content. Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. Well-being content was most prevalent within the cocurricular realm and incorporated into didactic and elective more than experiential curricula. The most content came from intellectual, emotional, and physical pillars, and the least content came from financial, spiritual, and environmental pillars. Less than 50% of schools and colleges of pharmacy include well-being within their strategic plans or core values. Funding is primarily at the level of the university (59%) or the school or college of pharmacy (59%). Almost half of respondents reported inclusion of some assessment, with a need for more training, expertise, and standardization. Conclusion. Survey results revealed a wide range of implementation and assessment of well-being programs across the United States and Canada. These results provide a reference point for the state of well-being programs that can serve as a call to action and research across the Academy.

Examining General Vaccine Acceptance and COVID-19 Vaccine Intention: Comparison across Pharmacies in California and Ohio.

Given the complexities surrounding vaccine acceptance of COVID-19 and other vaccines, it is important to determine the underlying health beliefs of patients in order to bridge gaps and promote vaccine confidence. With pharmacies as key hubs for vaccinations and vaccine conversations, examining patient perspectives through the lens of community pharmacy may provide a targeted insight into their patient populations. The primary objectives of this study were to measure COVID-19 vaccine intention and compare vaccine acceptance at pharmacies and clinics between California and Ohio. The secondary objectives included subgroup comparisons of vaccine intention and vaccine acceptance based on demographic characteristics. A previously validated survey instrument (5C survey tool) was administered at pharmacy sites in California and Ohio to examine respondents' vaccine acceptance (confidence, complacency, constrains, calculation, and collective responsibility). Additional items were added to capture flu and COVID-19 vaccine intention. Reliability and confirmatory factor analysis were completed for the 13-item 5C. Comparisons were made between sites and within different demographic groups. Good reliability (Cronbach's alpha = 0.768) was found, with nearly all items loading on their hypothesized domains. Respondents from Ohio had significantly higher complacency and constraints domain scores. Highest acceptance was revealed in females, individuals with a Master's degree or higher, and individuals with the intention to receive a flu vaccine. The adapted 5C is a reasonable tool to measure vaccine intention in English-speaking populations in the US. Certain demographic groups may have lower vaccine acceptance; pharmacists could consider implementing a tool, such as the 5C tool, to identify low acceptance. Given that the 5C tool gathers information on different domains of vaccine acceptance, healthcare professionals could utilize these results to improve trust and vaccine confidence in their patient populations; focused conversations concerning any of the respective domains could best address individual concerns and barriers about vaccinations, notably the COVID-19 and flu vaccines.

COVID-19 Vaccine Attitudes and Barriers among Unvaccinated Residents in Rural Northern/Central Illinois.

Background: Rural communities have lower COVID-19 vaccine uptake and poorer health outcomes compared to non-rural communities, including in rural, northern/central Illinois. Understanding community perceptions about vaccination is critical for developing targeted responses to improve vaccine uptake in rural communities and meet global vaccination targets. Purpose: This study examines COVID-19 vaccine attitudes and barriers as well as the impact of COVID-19 on specific health behaviors of residents in rural northern/central Illinois to inform efforts to increase vaccine uptake. Methods: In collaboration with community partners and local health departments, we conducted a 54-item, English-language, online questionnaire from Feb 11 to March 22, 2021; the questionnaire included the COVID behavioral questionnaire scale (CoBQ), as well as questions on intention to vaccinate, vaccination attitudes, and barriers to vaccine access. Descriptive and bivariate analyses assessed participant differences based on intention to vaccinate. Results: Most unvaccinated survey respondents (n = 121) were White (89.3%) and female (78.5%), with an average age of 52.3±14.1 years. Lack of intention to vaccinate was negatively associated with trust in the science behind vaccine development (P = .040), belief in the safety of the vaccine (P = .005) and belief that the vaccine was needed (P=.050). CoBQ scores of respondents who intended to get vaccinated differed significantly from those who did not (P<.001), showing a greater negative impact of COVID-19 on engaging in health behaviors for vaccine-hesitant participants. Conclusion: Study findings show mistrust of science and lack of confidence in vaccine safety are barriers to vaccination in rural northern Illinois residents. Similar results have been reported in low- and middle-income countries.

COVID-19 behavioral questionnaire (CoBQ): Comparing the pandemic's impact on health behavior in three US states.

Background: The COVID-19 pandemic impacted daily routines for a majority of the population, with implications for their health behaviors. Racial and ethnic minorities have been disproportionately impacted by COVID-19. The novel COVID-19 Behavioral Questionnaire (CoBQ) was developed in Fall 2020 to provide a means to measure the impact of the COVID-19 pandemic on the United States population. The study utilized behavioral domains to determine which demographic groups reported that they were made the most vulnerable during Fall-Winter 2020-2021 of the pandemic. Objectives: The study aimed to further validate and test the CoBQ in varied US regions and compare the scores obtained from three states, California, Ohio, and Illinois. Methods: A prospective, multi-site survey-based study was designed to further validate and test the 17-item CoBQ in varied populations. Respondents included patients on routine visits at each pharmacy or clinical site who agreed to complete the survey online via Qualtrics. Data analyses included descriptive statistics, psychometric testing, and comparison of groups using Analysis of Variance. Results: Completed surveys (n = 507) between October 2021 and March 2021 were analyzed. Respondents were mostly female, white, and had some college education. The CoBQ showed improved reliability compared with previous testing and strong construct validity through factor analysis. Overall scores were similar between three states. The most impacted groups included those who reported within the 18-49 age group, a yearly household income <$50 000, or education up to high school. Conclusions: The CoBQ is the first validated tool to measure the negative impact of the COVID-19 pandemic on health behaviors. Results could serve as a baseline to address the most vulnerable patient groups and support identified behavioral needs during a similar pandemic situation.

Report of the 2020-2021 Strategic Engagement Standing Committee

[...]of the ongoing pandemic, members met virtually throughout the 2020-2021 academic year to begin developing a framework and plan to address each of the 4 charges. CHARGE 2 SUBGROUP Background As the COVID-19 pandemic unfolded in the United States (US) in 2020, unprecedented federal expansion of scope of practice ("Scope") for pharmacists has been implemented by the US Department of Health and Human Services (DHHS) via the PREP Act. While the federal government has covered the cost of the vaccines and has provided supplemental funding to support access during the COVID-19 pandemic, payment for advanced patient care services provided by pharmacists in the future will be necessary for these services to be sustainable. CPAs * Continue to support the model that allows all licensed pharmacists with appropriate training to participate in CPAs, and does not restrict participation to subset of licensed pharmacists * Continue supporting the population model of CPAs which increases patient access and does not add undue regulatory burden to the process * Discourage use of patient-specific CPAs in meeting public health needs o Patient-specific CPAs are ineffective during a public health emergency * Encourage state boards of pharmacy to outline

Report of the 2020-2021 Strategic Engagement Standing Committee.

EXECUTIVE SUMMARY For the American Association of Colleges of Pharmacy (AACP), strategic engagement is critical to the success of colleges and schools of pharmacy in expanding pharmacy and public health practice, meeting programmatic needs, and fulfilling institutional missions. The 2020-2021 Strategic Engagement Standing Committee was charged with identifying effective strategies to leverage the temporary expansion of pharmacist practice capabilities granted during the COVID-19 pandemic for sustained practice. The group was also tasked with looking at ways to partner with the Association of American Medical Colleges (AAMC), our medicine counterparts to develop a plan for collaborating with them to advance interprofessional practice. In this unique year, all standing committees were charged with reading all the reports last year to put President Lin's charges into perspective with the hopes of carrying over the overall theme and work of the previous years committee. Overall, throughout the COVID-19 pandemic, there have been several expansions on the scope of practice for pharmacists and vary by state. We hope to draw out some of those expansions to see how we can build upon efforts to make those permanent.

Will they, or Won't they? Examining patients' vaccine intention for flu and COVID-19 using the Health Belief Model.

BACKGROUND: The twindemic of influenza and COVID-19 places pharmacists in a position of high-impact to inform and manage vaccination uptake. Given prior vaccine hesitancy in the US and the current high impact of COVID-19 on the population, it is imperative to understand and address factors that drive perceptions and intention to get vaccinated. OBJECTIVES: The objectives of the study were to 1) determine impact of the COVID-19 pandemic on influenza vaccine uptake, on patient perceptions of vaccinations, vaccine intention, and health behaviors and 2) determine vaccine intention through the Health Belief Model. METHODS: An IRB-approved prospective Qualtrics-based survey was administered online to eligible respondents: non-pregnant panel respondents 18 years or older within the United States who could independently complete the entire questionnaire in English. Data analyses included descriptive statistics, psychometric analyses of the 5C and CoBQ tools, one-way ANOVA to compare demographic groups and vaccine intention items with survey scores, and mapping and path analysis of the HBM with one added domain (Decision Making Determinant, DMD). RESULTS: 525 respondents completed the survey from October 23-29, 2020. Respondents aged 18-49, making less than $20,000 or an undisclosed income, and not having anyone close to them directly affected by COVID-19 showed a significant, negative impact of COVID-19 on health behavior and a significantly lower vaccine acceptance. The 5C and CoBQ showed moderately strong reliability. Mapping for the HBM revealed significant correlations between all modifying factors with Individual Perceptions except for Race/Ethnicity. Of the Individual Perceptions, Perceived Benefits (-.114) and Perceived Barriers (.307) significantly predicted DMD and directly impacted Vaccine Intention. DMD was not a significant mediator of Vaccination Intention. CONCLUSIONS: Vaccination messaging should focus on a simple yet balanced view of benefits and risks, targeting those under age 50 and living in low-income households, to motivate uptake of influenza and COVID-19 vaccines.

Pharmacy practice research priorities during the COVID-19 pandemic: Recommendations of a panel of experts convened by FIP Pharmacy Practice Research Special Interest Group.

Across the globe, pharmacists on the frontline continue to fight COVID-19 and its continuously evolving physical, mental, and economic consequences armed by their knowledge, professionalism, and dedication. Their need for credible scientific evidence to inform their practice has never been more urgent. Despite the exponentially increasing number of publications since the start of the pandemic, questions remain unanswered, and more are created, than have been resolved by the increasing number of publications. A panel of leading journal editors was convened by the International Pharmaceutical Federation (FIP) Pharmacy Practice Research Special Interest Group to discuss the current status of COVID-19 related research, provide their recommendations, and identify focal points for pharmacy practice, social pharmacy, and education research moving forward. Key priorities identified spanned a wide range of topics, reflecting the need for good quality research to inform practice and education. The panel insisted that a foundation in theory and use of rigorous methods should continue forming the basis of inquiry and its resultant papers, regardless of topic area. From assessing the clinical and cost effectiveness of COVID-19 therapies and vaccines to assessing different models of pharmaceutical services and education delivery, these priorities will ensure that our practice is informed by the best quality scientific evidence at this very challenging time.

Choosing Evolution over Extinction: Integrating Direct Patient Care Services and Value-Based Payment Models into the Community-Based Pharmacy Setting.

The American healthcare payment model introduced Pharmacy Benefit Managers (PBMs) into a position of power that currently puts into question the state of the pharmacy profession, especially in the community field. Reimbursement plans had been designed to benefit all stakeholders and save patients money but have only been shown to increase costs for these involved parties. There exist unresolved gaps in care as a result of the healthcare structure and underutilized skills of trained pharmacists who do not have the federal means to provide clinical services. Four collaborative payment models have been proposed, offering methods to quell the monetary problems that exist and are predicted to continue with the closure of community pharmacies and sustained influence of PBMs. These models may additionally allow the expansion of pharmacy career paths and improve healthcare benefits for patients. With a reflective perspective on the healthcare structure and knowledge of positive impacts with the inclusion of pharmacists, solutions to payment challenges could present a progressive approach to an outdated system. The impact of the COVID-19 pandemic highlights a dependency on pharmacists and community settings. This outlook on pharmacists may persist and an established expansion of services could prove beneficial to all healthcare stakeholders.