Staying Connected During a Global Pandemic: Telephone Support for Vulnerable Populations

This qualitative organisational ethnography explores and analyses the ways in which a local government-provided volunteer telephone support program for vulnerable and older members of the community quickly adapted to continue working during the pandemic. Thematic analysis of data collected through researcher participation in 26 weekly zoom debrief sessions with local government staff and volunteers captures the experience of providing telephone support during a pandemic. Three key themes emerged as integral to the shaping and reshaping of the service: (1) the importance of care and relationships in service provision;(2) the need for flexibility to make service change;and (3) like a beating heart, the regular calls became part of the rhythm of life, providing certainty for staff, volunteers, and those they called. This program offers a model for best practice in low cost, low risk, place-based interventions that can increase social connection for vulnerable community members. IMPLICATIONS Organisational flexibility and a focus on care and relationships underpin best-practice human service delivery—this is emphasised in times of crisis. Volunteer engagement, commitment, and performance are enhanced by positive and caring relationships with paid staff. Befriending schemes can provide a vital means of social support that contributes to maintaining the health and wellbeing of the ageing population.

Promoting the Participation of "Hard-to-Reach" Migrant Populations in Qualitative Public Health Research during the COVID-19 Pandemic in Chile.

The COVID-19 pandemic has further deepened socioeconomic and health inequities worldwide, especially among populations experiencing social vulnerability, such as international migrants. Sustained lockdowns and social distancing have raised challenges to conducting public health research with hard-to-reach populations. This study aims at exploring strategies to recruit "hard-to-reach" international migrants for qualitative public health research during the pandemic in Chile, based on the authors' experience. A retrospective qualitative evaluation process was carried out on the recruitment processes of three qualitative research projects focused on international migrants in Chile. All projects were implemented during the COVID-19 pandemic, demanding complementary and flexible strategies: (i) social media; (ii) snowball sampling; (iii) referrals from social workers and pro-migrant and migrant-led organizations; (iv) vaccination centers and healthcare centers; and (v) community-based recruitment. The strategies are qualitatively evaluated around seven emerging qualitative categories: (i) feasibility during lockdown periods; (ii) speed of recruitment; (iii) geographical coverage; (iv) sample diversity; (v) proportion of successful interviews; (vi) ethical considerations; and (vii) cost. Engaging hard-to-reach international migrants in public health research during the pandemic required constantly adapting recruitment strategies. Furthermore, relying on strategies that were not only Internet-based promoted the participation of populations with limited access to the Internet and low-digital literacy.

Patient and Provider Perceptions of COVID-19-Driven Telehealth Use From Nurse-Led Care Models in Rural, Frontier, and Urban Colorado Communities.

The purpose of this study was to characterize the patient and provider engagement in the sudden telehealth implementation that occurred with the onset of the COVID-19 pandemic. Patients and providers from 3 nurse-led models of care (federally qualified health centers, nurse midwifery practices, and the Nurse-Family partnership program) in Colorado were surveyed. Data from the Patient Attitude toward Telehealth survey and Provider Perceptions about Telehealth were collected. Patient respondents (n = 308) who resided primarily in rural or frontier communities were female, white, and Hispanic. Patients in urban areas used telehealth more frequently than in rural or frontier areas (P < .001). Rural/Frontier patients had significantly lower attitude scores than urban patients across each of 5 domains assessed. Telehealth modality differed across location (P < .023), with video calls, used more frequently by urban providers, and phone calls used by rural/frontier providers. Our data highlight differences in telehealth access and attitudes across rurality. These findings may contribute to future policy while addressing barriers to telehealth access and delivery.

Patient and Family Factors Associated with Use of Telemedicine Visits for Pediatric Acute Respiratory Tract Infections, 2018-2019.

Background: Pediatric acute respiratory tract infections (ARTIs) were a common reason for commercial direct-to-consumer (DTC) telemedicine use before the COVID-19 pandemic, but the factors associated with this use are unknown. Objective: To identify child and family factors associated with use of commercial DTC telemedicine for ARTIs in 2018-2019. Methods: We performed a retrospective cohort analysis of claims data from the Optum Clinformatics® Data Mart Database. Among children with ARTI visits, we fitted logit models to examine child and family characteristics associated with DTC telemedicine use. Results: Of 660,725 children with ARTI visits, 12,944 (2.0%) had ≥1 commercial DTC telemedicine encounter. The odds of DTC telemedicine use were higher for children with age ≥12 years, lower parent educational attainment, higher household income, white non-Hispanic race/ethnicity, and residency in the West South Central census division. Conclusion: In 2018-2019, commercial DTC telemedicine use varied with child age, child race/ethnicity parent educational attainment, household income, and geography.

A Health Equity Lens Contributes to an Effective Pandemic Response: A Canadian Regional Perspective.

As cases of COVID-19 began to increase in Ontario, Canada, throughout 2020, early evidence from surveillance and media highlighted disproportionately higher rates of COVID-19 infection, hospitalization and mortality among racialized and low-income populations. This disproportionate impact on underserved populations calls for a shift in approach away from what has traditionally occurred in health protection, that is the use of a universal approach which assumes everyone is affected and benefits equally from the same type and intensity of interventions. In this article, public health agencies are, therefore, being called to consider moving away from using a purely universal approach, often used in the control of communicable diseases, and apply a more tailored approach and use principles of health equity and proportionate universalism to reduce COVID-19 cases and their impacts among underserved groups and address health inequities exacerbated by the pandemic. We highlight examples from York Region Public Health, one of the largest health units in Ontario, to demonstrate areas of possible impact of this paradigm shift. It is clear that with a health equity lens applied to the pandemic response, the impact of COVID-19 can be further reduced and health inequities that predated the global pandemic can improve.

Students in out‐of‐home care: Their experiences of Transforming Educational Achievement for Children at Risk, an Australian education programme

Children living in out‐of‐home care are at greater risk of poor educational outcomes compared to other children. To address their educational needs, several programs have been developed. Within a qualitative paradigm, this study explored the experiences of students about their involvement in TEACHaR (Transforming Educational Achievement for Children at Risk), a specialized education programme. Eight students (aged 13 to 18 years) from the programme participated in individual, semi‐structured interviews. Responses were analysed using Interpretive Phenomenological Analysis. Participants indicated that the programme provided individualized and flexible academic support, reduced their shame and embarrassment and provided them with more than academic support. They highlighted the importance of the student–educator relationship, and the need for encouragement and motivation to pursue their educational goals. Finally, findings report on how COVID‐19 impacts on student experiences of the programme. Recommendations for the development and improvement of education programs for students in out‐of‐home care conclude this paper.

Learning Loss in Vulnerable Student Populations After the First Covid-19 School Closure in the Netherlands

School closures due to the COVID-19 pandemic raised concerns about increases in educational inequality. We examined the magnitude of the impact of the first school closure for vulnerable student groups in particular. This study was conducted among 886 Grade 3 - 5 students in the Netherlands in schools serving a high percentage of students from disadvantaged backgrounds. Piecewise growth analyses indicated that the school closures caused discontinuity in students' achievement growth on national standardized tests and led to an average learning loss of 2.47 months in mathematics and 2.35 in reading comprehension, exceeding the duration of the school closure. Findings suggest that school closures contribute to educational inequality and indicate which students may particularly need additional support to overcome the adverse consequences of the lockdowns.

How does a Rational Agent Act in an Epidemic?

The evolution of a disease in a large population is a function of the top-down policy measures from a centralized planner and the self-interested decisions (to be socially active) of individual agents in a large heterogeneous population. This paper is concerned with understanding the latter based on a mean-field type optimal control model. Specifically, the model is used to investigate the role of partial information on an agent's decision-making and study the impact of such decisions by a large number of agents on the spread of the virus in the population. The motivation comes from the presymptomatic and asymptomatic spread of the COVID-19 virus, where an agent unwittingly spreads the virus. We show that even in a setting with fully rational agents, limited information on the viral state can result in epidemic growth. © 2022 IEEE.

EVERY CLOUD HAS A SILVER LINING: SHORT-TERM PSYCHOLOGICAL EFFECTS OF COVID-19 ON BRITISH UNIVERSITY STUDENTS

There are widespread concerns about the mental health implications of the pandemic, particularly among university students, an already at-risk population for poor mental health. This study looked at 1,281 UK university students, recruited through the Prolific website. Participants were asked to complete the Attitudes towards COVID-19 Scale, the CORE-10, the PERMA Profiler, the GAD-7 and the Office for National Statistics wellbeing questions (ONS4). The first survey was conducted between May 14th and 16th, when the UK was in national lockdown. The second survey was carried out between June 26th and July 15th. There was only an 11% attrition rate between the two time points. Well-being improved overall between the two time points. Some findings were contradictory as overall well-being, anxiety and levels of flourishing improved, but reports of psychological distress increased. It is also important to note that levels of positivity about the pandemic increased as time went on. There was evidence that higher levels of positivity were linked to better mental health outcomes. Encouraging a positive mindset and outlook in students, probably through positive psychology-based interventions, might act as a protective factor against severe mental illness. The wider relevance and practical implications for higher education are discussed.

Quantitative and Qualitative Composition of Lymphocyte Populations and Subpopulations in Patients with Varying Severity of a New Coronavirus Infection

SARS-CoV-2 can cause a decrease in the number of lymphocytes and their functional activity. In patients with COVID-19, especially with a severe course of the disease, a decrease in the quantitative composition of the main populations of lymphocytes is recorded. These indicators do not recover for a long time after recovery. However, it is still not known how long the quantitative and qualitative changes in the composition of lymphocytes will last and whether the severity of the infection affects this process. The aim of our study was to assess the quantitative and qualitative composition of the main populations and subpopulations of lymphocytes in patients with a new coronavirus infection of varying severity. 65 patients with a new coronavirus infection were examined. The average age of the subjects was 47.3 +/- 14.5 years. The volunteers were divided into three groups according to the severity of the infection: asymptomatic (n = 21);moderate (n = 32);severe (n = 12). The relative and absolute number of T-lymphocytes (CD3(+)), T-helper cells (CD3(+)CD4(+)), cytotoxic lymphocytes (CD3(+)CD8(+)), natural killers (CD3(-)CD16(+)CD56(+)), TNK-lymphocytes (CD3(+)CD16(-)CD56(+)) and B-lymphocytes (CD45(+)CD19(+)) were determined. To calculate the percentage of lymphocytes, whole blood was lysed with OPTILYSE C solution (Beckman Coulter, USA) and stained with monoclonal antibodies CD3(+)-FITC/CD8(+)-ECD/CD4(+)PC5/CD16(+)CD56(+)PE and CD45(+)-Pacific Blue/CD19(+)-PC5 (Beckman Coulter, USA). Cytofluorometry was performed on a flow cytofluorometer "NaviosT" (Beckman Coulter, USA). The results of our studies showed that there were no statistically significant changes in the relative and absolute number of immunocompetent cells in asymptomatic patients with a new coronavirus infection, compared with the control group. With an average severity of the disease, a decrease in the relative and absolute content of CD3(+) and CD8(+) lymphocytes was revealed, these indicators were restored to control values six months after recovery. In patients with severe infection, there was a decrease in the relative and absolute number of T cells and cytotoxic lymphocytes. These values remained significantly below normal for six months and returned to normal only seven to eight months after recovery. Also, the volunteers of this group were found to have a decrease in the number of natural killers and TNK cells. Thus, the data obtained by us indicate that pathological changes concerning the relative and absolute number of the main populations and subpopulations of lymphocytes in patients with COVID-19 depend on the severity of the disease. The number of T-lymphocytes, cytotoxic lymphocytes, natural killer cells, that is, populations of cells that play a crucial role in effective antiviral protection, has been reduced in those who have undergone a new coronavirus infection in moderate and severe form. This information can be useful for expanding methodological approaches to the diagnosis, treatment of a new coronavirus infection, as well as measures for the rehabilitation of those who have suffered it.

Managing COVID-19 transmission in long-term care: A qualitative study of high performing facilities.

Ever since its emergence, COVID-19 has posed a serious threat to members of the population who are older and have underlying health conditions, with those residing in Long-Term Care Facilities being particularly susceptible. The purpose of this study was to explore initiatives implemented by Long-Term Care Facilities which had lower COVID-19 transmission compared to their regional counterparts. Of the facilities interviewed, the majority implemented a routine testing schedule for residents utilizing both PCR and Rapid Antigen nasal tests, while also separately housing residents who may be at an increased risk. The results of this study could serve as a guidance for other facilities.

Expanding Access to Naloxone: A Necessary Step to Curb the Opioid Epidemic.

The COVID-19 Pandemic has exacerbated the already worsening opioid epidemic within the United States. With a continuing increase in opioid overdose deaths, measures are needed to halt the needless number of deaths and begin on a path of recovery to address all the factors that impact the epidemic. The CDC has provided various recommendations to combat the increases in opioid overdose deaths. These recommendations have included expanded distribution and use of naloxone and overdose prevention education as essential services for people most at risk of overdose. While strategies should include the increase in community resources for those with opioid disorder and shifting the perspectives of healthcare to view opioid disorder as a chronic illness that can be treated with medication such as buprenorphine, these methods are not immediate enough to stop the trend in deaths. The United States must take immediate action to expand access to and use of Naloxone for the public and first responders. Naloxone alone cannot address the magnitude of this epidemic, but it is an essential first step in preventing immediate death while a multimodal strategy is enacted to fully protect those most at risk.

Early identification of a COVID-19 outbreak detected by wastewater surveillance at a large homeless shelter in Toronto, Ontario.

SETTING: Toronto (Ontario, Canada) is a large urban centre with a significant population of underhoused residents and several dozen shelters for this population with known medical and social vulnerabilities. A sizeable men's homeless shelter piloted a facility-level SARS-CoV-2 wastewater surveillance program. INTERVENTION: Wastewater surveillance was initiated at the shelter in January 2021. One-hour composite wastewater samples were collected twice weekly from a terminal sanitary clean-out pipe. The genetic material of the SARS-CoV-2 virus was extracted from the solid phase of each sample and analyzed using real-time qPCR to estimate the viral level. Wastewater results were reported to facility managers and Toronto Public Health within 4 days. OUTCOMES: There were 169 clients on-site at the time of the investigation. Wastewater surveillance alerted to the presence of COVID-19 activity at the site, prior to clinical detection. This notification acted as an early warning signal, which allowed for timely symptom screening and case finding for shelter managers and the local health unit, in preparation for the declaration of an outbreak. IMPLICATIONS: Wastewater surveillance acted as an advanced notification leading to the timely deployment of enhanced testing prior to clinical presentation in a population with known vulnerabilities. Wastewater surveillance at the facility level is beneficial, particularly in high-risk congregate living settings such as shelters that house transient populations where clinical testing and vaccination can be challenging. Open communication, established individual facility response plans, and a balanced threshold for action are essential to an effective wastewater surveillance program.

RéSUMé: LIEU: Toronto (Ontario, Canada) est un grand centre urbain qui compte une importante population de résidents mal logés et plusieurs douzaines de refuges pour cette population aux vulnérabilités médicales et sociales connues. Un assez gros refuge pour hommes sans-abri a mis à l'essai dans ses installations un programme de surveillance des eaux usées pour le SRAS-CoV-2. INTERVENTION: La surveillance des eaux usées du refuge a commencé en janvier 2021. Des échantillons composites d'une heure ont été prélevés deux fois par semaine à partir d'un regard de nettoyage à l'extrémité du drain sanitaire. Le matériel génétique du virus du SRAS-CoV-2 a été extrait du support solide de chaque échantillon et analysé par PCR quantitative en temps réel pour estimer le niveau du virus. Les résultats des eaux usées ont été déclarés aux gestionnaires du refuge et à Santé publique Toronto dans un délai de quatre jours. RéSULTATS: Il y avait 169 usagers sur place au moment de l'enquête. La surveillance des eaux usées a averti de la présence d'une activité de la COVID-19 sur les lieux avant sa détection clinique. Cet avertissement a servi de signal d'alerte précoce, ce qui a permis aux gestionnaires du refuge et au bureau de santé local de procéder au dépistage rapide des symptômes et à la recherche des cas en préparation pour la déclaration d'une éclosion. CONSéQUENCES: La surveillance des eaux usées a servi de notification préalable et entraîné le déploiement opportun d'un dépistage complémentaire avant la manifestation clinique dans une population qui présente des vulnérabilités connues. La surveillance des eaux usées d'une installation est avantageuse, surtout dans des milieux d'hébergement collectif à risque élevé comme les refuges qui hébergent des populations de passage, où le dépistage clinique et la vaccination peuvent être difficiles. Une communication ouverte, des plans d'intervention établis pour chaque installation et un seuil d'intervention équilibré sont essentiels à l'efficacité d'un programme de surveillance des eaux usées.

The Digital Divide and Smartphone Reliance for Disadvantaged Students in Higher Education

The digital divide as it pertains to information inequality among disadvantaged student populations in higher education is a pertinent problem, and has been further exacerbated by the increase in online learning due to COVID -19. This study explores Technological Access challenges of students at a small public midwestern university in the US that serves a disproportionately higher number of underserved and underrepresented students. Survey data from 535 undergraduate students indicate that a critical subset (n=61) of the sample who were first generation, low income, and non-white had significantly lower levels of technological access with respect to access to devices and Internet access, when compared to the larger sample. Additionally, nearly half of the sample used smartphones to access courses online. Educational implications on smartphone dependence and consequent digital divide is discussed to bridge the barrier for disadvantaged student groups. As technology induced online learning proliferates, addressing such gaps will be a step toward mitigating those inequities plaguing higher education. Copyright 2022. © by the International Institute of Informatics and Systemics. All rights reserved.

Optimal Capacity-Constrained COVID-19 Vaccination for Heterogeneous Populations

COVID-19 and the ensuing vaccine capacity constraints have emphasized the importance of proper prioritization during vaccine rollout. This problem is complicated by heterogeneity in risk levels, contact rates, and network topology which can dramatically and unintuitively change the efficacy of vaccination and must be taken into account when allocating resources. This paper proposes a general model to capture a wide array of network heterogeneity while maintaining computational tractability and formulates vaccine prioritization as an optimal control problem. Pontryagin's Maximum Principle is used to derive properties of optimal, potentially highly dynamic, allocation policies, providing significant reductions in the set of candidate policies. Extensive numerical simulations of COVID-19 vaccination are used to corroborate these findings and further illicit optimal policy characteristics and the effects of various system, disease, and population parameters. © 2022 IEEE.

Exploring the COVID-19 Knowledge, Attitudes, and Practices (KAPs) in the Black Community: a Scoping Review.

INTRODUCTION AND BACKGROUND: Racial minorities have been the focal point of media coverage, attributing the disproportionate impact of COVID-19 to their individual actions; however, the ability to engage in preventative practices can also depend on one's social determinants of health. Individual actions can include knowledge, attitudes, and practices (KAPs). Since Black communities are among those disproportionately affected by COVID-19, this scoping review explores what is known about COVID-19 KAPs among Black populations. METHODS: A comprehensive literature search was conducted in 2020 for articles written in English from the Medline, Embase, and PsycInfo databases. Reviews, experimental research, and observational studies were included if they investigated at least one of COVID-19 KAP in relation to the pandemic and Black communities in OECD peer countries including Canada, the United States, and the United Kingdom. RESULTS AND ANALYSIS: Thirty-one articles were included for analysis, and all employed observational designs were from the United States. The following KAPs were examined: 6 (18.8%) knowledge, 21 (65.6%) attitudes, and 22 (68.8%) practices. Black communities demonstrated high levels of adherence to preventative measures (e.g., lockdowns) and practices (e.g., mask wearing), despite a strong proportion of participants believing they were less likely to become infected with the virus, and having lower levels of COVID-19 knowledge, than other racial groups. CONCLUSIONS AND IMPLICATIONS: The findings from this review support that Black communities highly engage in COVID-19 preventative practices within their realm of control such as mask-wearing and hand washing and suggest that low knowledge does not predict low practice scores among this population.

The Organization of Outreach Work for Vulnerable Patients in General Practice during COVID-19: Results from the Cross-Sectional PRICOV-19 Study in 38 Countries.

The COVID-19 pandemic disproportionately affected vulnerable populations' access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. Linear mixed model analyses with practices nested in countries were performed on the data of 4982 practices from 38 countries. A 4-item scale on outreach work was constructed as the outcome variable with a reliability of 0.77 and 0.97 at the practice and country level. The results showed that many practices set up outreach work, including extracting at least one list of patients with chronic conditions from their electronic medical record (30.1%); and performing telephone outreach to patients with chronic conditions (62.8%), a psychological vulnerability (35.6%), or possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager (p < 0.05) or paramedical support staff (p < 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.

Barriers to and solutions for representative inclusion across the lifespan and in life course research: The need for structural competency highlighted by the COVID-19 pandemic.

Exclusion of special populations (older adults; pregnant women, children, and adolescents; individuals of lower socioeconomic status and/or who live in rural communities; people from racial and ethnic minority groups; individuals from sexual or gender minority groups; and individuals with disabilities) in research is a pervasive problem, despite efforts and policy changes by the National Institutes of Health and other organizations. These populations are adversely impacted by social determinants of health (SDOH) that reduce access and ability to participate in biomedical research. In March 2020, the Northwestern University Clinical and Translational Sciences Institute hosted the "Lifespan and Life Course Research: integrating strategies" "Un-Meeting" to discuss barriers and solutions to underrepresentation of special populations in biomedical research. The COVID-19 pandemic highlighted how exclusion of representative populations in research can increase health inequities. We applied findings of this meeting to perform a literature review of barriers and solutions to recruitment and retention of representative populations in research and to discuss how findings are important to research conducted during the ongoing COVID-19 pandemic. We highlight the role of SDOH, review barriers and solutions to underrepresentation, and discuss the importance of a structural competency framework to improve research participation and retention among special populations.

[Reregistration of the population residing in Foz do Iguaçu, Brazil, in compliance with the Primary Health Care PolicyReinscripción de la población residente en Foz do Iguaçu, Brasil, en cumplimiento de la Política de atención primaria de salud]. / Recadastramento da população residente em Foz do Iguaçu, Brasil, em atendimento à Política de Atenção Primária à Saúde.

Objective: To present the experience and results of the reregistration of residents in Foz do Iguaçu, a border town located in the state of Paraná, Brazil, to meet the guidelines of the national Primary Health Care (PHC) Policy and its new financing model (Programa Previne Brasil). Method: A scanning strategy (convenience sample) was used for data collection, with 52 263 households visited and 22 710 interviews conducted from September to November 2019. The interviews were conducted face-to-face by 54 community health workers. Data were collected on the household (ownership status, urban or rural location, type of household, construction material, availability of electrical and sewage networks, water supply and waste disposal). Demographic and health information on the residents was also collected. Results: The reregistration process revealed that most residents were home owners and lived in well-constructed homes, located mostly in urban areas, served by electricity, with access to water supply and garbage collection. Of the reregistered population, 52.8% were women, 62.5% were aged between 15 and 59 years and 60.0% declared themselves white. Among respondents aged 15 or over, 90.0% had completed elementary school. The main occupation was "formal salaried job". Additionally, 18.6% of the interviewees declared themselves to be hypertensive and 7.0%, diabetic. Conclusions: The reregistration process uncovered relevant information to support both PHC planning as well as social assistance, work and housing initiatives; it was also fundamental to define health care strategies in this border town during the COVID-19 pandemic.

Objetivo: Presentar la experiencia y los resultados de la reinscripción de la población residente en Foz do Iguaçu, un municipio fronterizo ubicado en el estado de Paraná (Brasil), en cumplimiento de las directrices de la Política de atención primaria de salud y su nuevo modelo de financiamiento (Programa Previne Brasil). Métodos: Utilizando una estrategia de barrido (muestreo de conveniencia) para la recolección de datos, se visitaron 52 263 hogares y se realizaron 22 710 entrevistas entre septiembre y noviembre de 2019. Las entrevistas fueron presenciales y estuvieron a cargo de 54 trabajadores comunitarios de salud. Se recopilaron datos sobre el hogar (régimen de propiedad de la vivienda, ubicación en una zona urbana o rural, tipo de vivienda, material de construcción, disponibilidad de redes de energía eléctrica y alcantarillado, abastecimiento de agua y eliminación de desechos) e información sobre la composición demográfica y la salud de los residentes. Resultados: La reinscripción reveló que los residentes eran propietarios de sus viviendas y que estas se encontraban ubicadas en zonas urbanas, estaban bien construidas y tenían servicios de energía eléctrica, abastecimiento de agua y recolección de basura. El 52,8% de la población registrada correspondió a mujeres, el 62,5% tenía entre 15 y 59 años y el 60,0% declaró que era de raza blanca. El 90,0% de los entrevistados mayores de 15 años había terminado la escuela primaria. La ocupación principal era "persona asalariada con carnet de trabajo". Además, el 18,6% de los entrevistados indicó que tenía hipertensión y el 7,0%, diabetes. Conclusiones: La reinscripción aportó información relevante para apoyar la planificación de la atención primaria de salud , así como las iniciativas en materia de asistencia social, trabajo y vivienda; también fue fundamental para definir las estrategias de atención de salud en ese municipio fronterizo durante la pandemia de COVID-19.

Leveraging CTSA hubs for rapid, large-scale, high-impact research: A case study during a global public health emergency.

As the COVID-19 pandemic took hold in the USA in early 2020, it became clear that knowledge of the prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic individuals could inform public health policy decisions and provide insight into the impact of the infection on vulnerable populations. Two Clinical and Translational Science Award (CTSA) Hubs and the National Institutes of Health (NIH) set forth to conduct a national seroprevalence survey to assess the infection's rate of spread. This partnership was able to quickly design and launch the project by leveraging established research capacities, prior experiences in large-scale, multisite studies and a highly skilled workforce of CTSA hubs and unique experimental capabilities at the NIH to conduct a diverse prospective, longitudinal observational cohort of 11,382 participants who provided biospecimens and participant-reported health and behavior data. The study was completed in 16 months and benefitted from transdisciplinary teamwork, information technology innovations, multimodal communication strategies, and scientific partnership for rigor in design and analytic methods. The lessons learned by the rapid implementation and dissemination of this national study is valuable in guiding future multisite projects as well as preparation for other public health emergencies and pandemics.