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2.
PLoS One ; 16(10): e0257346, 2021.
Article in English | MEDLINE | ID: covidwho-1456083

ABSTRACT

Due to the COVID-19 pandemic, higher educational institutions worldwide switched to emergency distance learning in early 2020. The less structured environment of distance learning forced students to regulate their learning and motivation more independently. According to self-determination theory (SDT), satisfaction of the three basic psychological needs for autonomy, competence and social relatedness affects intrinsic motivation, which in turn relates to more active or passive learning behavior. As the social context plays a major role for basic need satisfaction, distance learning may impair basic need satisfaction and thus intrinsic motivation and learning behavior. The aim of this study was to investigate the relationship between basic need satisfaction and procrastination and persistence in the context of emergency distance learning during the COVID-19 pandemic in a cross-sectional study. We also investigated the mediating role of intrinsic motivation in this relationship. Furthermore, to test the universal importance of SDT for intrinsic motivation and learning behavior under these circumstances in different countries, we collected data in Europe, Asia and North America. A total of N = 15,462 participants from Albania, Austria, China, Croatia, Estonia, Finland, Germany, Iceland, Japan, Kosovo, Lithuania, Poland, Malta, North Macedonia, Romania, Sweden, and the US answered questions regarding perceived competence, autonomy, social relatedness, intrinsic motivation, procrastination, persistence, and sociodemographic background. Our results support SDT's claim of universality regarding the relation between basic psychological need fulfilment, intrinsic motivation, procrastination, and persistence. However, whereas perceived competence had the highest direct effect on procrastination and persistence, social relatedness was mainly influential via intrinsic motivation.


Subject(s)
COVID-19/epidemiology , Education, Distance/statistics & numerical data , Motivation , Procrastination , Universities/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Male , Pandemics , Personal Autonomy , Young Adult
3.
MMWR Morb Mortal Wkly Rep ; 70(39): 1374-1376, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1444555

ABSTRACT

Beginning in January 2021, the U.S. government prioritized ensuring continuity of learning for all students during the COVID-19 pandemic (1). To estimate the extent of COVID-19-associated school disruptions, CDC and the Johns Hopkins University Applied Physics Laboratory used a Hidden Markov Model (HMM) (2) statistical approach to estimate the most likely actual learning modality based on patterns observed in past data, accounting for conflicting or missing information and systematic Internet searches (3) for COVID-19-related school closures. This information was used to assess how many U.S. schools were open, and in which learning modalities, during August 1-September 17, 2021. Learning modalities included 1) full in-person learning, 2) a hybrid of in-person and remote learning, and 3) full remote learning.


Subject(s)
COVID-19/prevention & control , Education/methods , Education/statistics & numerical data , Schools/organization & administration , Adolescent , COVID-19/epidemiology , Child , Child, Preschool , Education, Distance/statistics & numerical data , Humans , United States/epidemiology
4.
Sch Psychol ; 36(5): 367-376, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1442726

ABSTRACT

The purpose of this study was to explore how returning to teaching during the Coronavirus disease (COVID-19) pandemic impacted teachers' stress and anxiety. Specifically, the study investigated how teachers' anxiety changed during the first month of school. Additionally, the study explored the association of teachers' stress and anxiety and predictor variables for changes in teacher anxiety while teaching during the COVID-19 pandemic. The present study included 329 elementary teachers from across the United States who completed a survey during the first week of October 2020. The results found that most teachers saw no change or an increase in anxiety during the first month. Significant predictors of increased teacher anxiety included stress and communication within the school, with virtual instruction teachers having the most increase in anxiety. In comparison, the no change in anxiety group included significant predictors of stress, virtual instruction, and communication within the school. The present study provides applicable information to schools and districts as there is limited empirical research on the impact of the COVID-19 pandemic on teachers. Teachers are working as frontline workers during the pandemic; thus, schools and districts need to monitor teacher stress and anxiety during the COVID-19 pandemic and provide the necessary support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Anxiety/epidemiology , COVID-19 , Education, Distance/statistics & numerical data , Occupational Stress/epidemiology , School Teachers/psychology , School Teachers/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , Schools/statistics & numerical data , United States/epidemiology
5.
Sch Psychol ; 36(5): 388-397, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1442724

ABSTRACT

The coronavirus disease of 2019 (COVID-19) has had multifaceted effects on students, their families, and the educators who support their learning. Early in the COVID-19 pandemic, one of the most notable changes for schools was the sudden move to distance learning-an unprecedented disruption to academic, social, and emotional instruction. Social and emotional learning (SEL) skills play an important role in human development by supporting academic success and overall well-being, including skills for effectively coping with stressors such as those imposed by the COVID-19 pandemic. Building on previous work, we created the Crisis Response Educator SEL Survey (CRESS) to examine predictors of SEL implementation during the pandemic. Structural equation models (SEMs) were used to predict: (a) educators' reported challenges implementing SEL during distance learning; (b) educator SEL implementation with students and use of social and emotional (SE) strategies for themselves; and (c) educator self-judgment and emotional exhaustion. Predictors included school/district guidance to support SEL, school/district support of educator SE needs, and the priority on SEL for the school and the educator. Our sample consisted of 219 educators committed to SEL who reported on their experience with SEL during distance learning toward the end of the 2019-2020 school year. Findings suggest that school/district support of educator SE needs predicts lower levels of challenge implementing SEL during distance learning and lower levels of educator burnout and self-judgment, whereas greater school/district guidance to support SEL was associated with more SEL implementation with students and more educator use of SE strategies for themselves. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19 , Education, Distance , Educational Personnel , Emotions , Schools , Social Learning , Teaching , Adult , Aged , Education, Distance/statistics & numerical data , Educational Personnel/statistics & numerical data , Female , Humans , Latent Class Analysis , Male , Middle Aged , Schools/statistics & numerical data , Teaching/statistics & numerical data , Young Adult
6.
PLoS One ; 16(9): e0257394, 2021.
Article in English | MEDLINE | ID: covidwho-1430537

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic led to far-reaching restrictions of social and professional life, affecting societies all over the world. To contain the virus, medical schools had to restructure their curriculum by switching to online learning. However, only few medical schools had implemented such novel learning concepts. We aimed to evaluate students' attitudes to online learning to provide a broad scientific basis to guide future development of medical education. METHODS: Overall, 3286 medical students from 12 different countries participated in this cross-sectional, web-based study investigating various aspects of online learning in medical education. On a 7-point Likert scale, participants rated the online learning situation during the pandemic at their medical schools, technical and social aspects, and the current and future role of online learning in medical education. RESULTS: The majority of medical schools managed the rapid switch to online learning (78%) and most students were satisfied with the quantity (67%) and quality (62%) of the courses. Online learning provided greater flexibility (84%) and led to unchanged or even higher attendance of courses (70%). Possible downsides included motivational problems (42%), insufficient possibilities for interaction with fellow students (67%) and thus the risk of social isolation (64%). The vast majority felt comfortable using the software solutions (80%). Most were convinced that medical education lags behind current capabilities regarding online learning (78%) and estimated the proportion of online learning before the pandemic at only 14%. In order to improve the current curriculum, they wish for a more balanced ratio with at least 40% of online teaching compared to on-site teaching. CONCLUSION: This study demonstrates the positive attitude of medical students towards online learning. Furthermore, it reveals a considerable discrepancy between what students demand and what the curriculum offers. Thus, the COVID-19 pandemic might be the long-awaited catalyst for a new "online era" in medical education.


Subject(s)
COVID-19/epidemiology , Education, Distance/statistics & numerical data , Education, Medical/methods , Attitude , Humans
9.
Invest Ophthalmol Vis Sci ; 62(10): 37, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1379697

ABSTRACT

Purpose: To investigate the effect of home quarantine during the COVID-19 pandemic on myopia progression in children and its associated factors. Methods: Myopic children aged 7 to 12 years with regular follow-up visits every half a year from April 2019 to May 2020 were included. Cycloplegic refraction was measured at baseline and at two follow-up visits. The first follow-up visit (visit 1) was conducted before the COVID-19 home quarantine, whereas the second (visit 2) was four months after the home quarantine. Myopia progression at visits 1 and 2 were compared. Factors associated with changes in myopia progression were tested with a multiple regression analysis. Results: In total, 201 myopic children were enrolled. There was a significantly greater change in spherical equivalent at visit 2 (-0.98 ± 0.52 D) than at visit 1 (-0.39 ± 0.58 D; P < 0.001). Students were reported to have spent more time on digital devices for online learning (P < 0.001) and less time on outdoor activities (P < 0.001) at visit 2 than at visit 1. Children using television and projectors had significantly less myopic shift than those using tablets and mobile phones (P < 0.001). More time spent on digital screens (ß = 0.211, P < 0.001), but not less time on outdoor activities (ß = -0.106, P = 0.110), was associated with greater myopia progression at visit 2. Conclusions: Changes in behavior and myopic progression were found during the COVID-19 home quarantine. Myopic progression was associated with digital screen use for online learning, but not time spent on outdoor activities. The projector and television could be better choices for online learning.


Subject(s)
COVID-19/epidemiology , Computers/statistics & numerical data , Education, Distance/statistics & numerical data , Myopia/diagnosis , Myopia/epidemiology , Quarantine/statistics & numerical data , SARS-CoV-2 , Child , China/epidemiology , Computer Terminals , Disease Progression , Female , Humans , Male , Refraction, Ocular/physiology , Risk Factors , Screen Time , Surveys and Questionnaires
10.
PLoS Comput Biol ; 17(8): e1009264, 2021 08.
Article in English | MEDLINE | ID: covidwho-1374131

ABSTRACT

The COVID-19 epidemic has forced most countries to impose contact-limiting restrictions at workplaces, universities, schools, and more broadly in our societies. Yet, the effectiveness of these unprecedented interventions in containing the virus spread remain largely unquantified. Here, we develop a simulation study to analyze COVID-19 outbreaks on three real-life contact networks stemming from a workplace, a primary school and a high school in France. Our study provides a fine-grained analysis of the impact of contact-limiting strategies at workplaces, schools and high schools, including: (1) Rotating strategies, in which workers are evenly split into two shifts that alternate on a daily or weekly basis; and (2) On-Off strategies, where the whole group alternates periods of normal work interactions with complete telecommuting. We model epidemics spread in these different setups using a stochastic discrete-time agent-based transmission model that includes the coronavirus most salient features: super-spreaders, infectious asymptomatic individuals, and pre-symptomatic infectious periods. Our study yields clear results: the ranking of the strategies, based on their ability to mitigate epidemic propagation in the network from a first index case, is the same for all network topologies (workplace, primary school and high school). Namely, from best to worst: Rotating week-by-week, Rotating day-by-day, On-Off week-by-week, and On-Off day-by-day. Moreover, our results show that below a certain threshold for the original local reproduction number [Formula: see text] within the network (< 1.52 for primary schools, < 1.30 for the workplace, < 1.38 for the high school, and < 1.55 for the random graph), all four strategies efficiently control outbreak by decreasing effective local reproduction number to [Formula: see text] < 1. These results can provide guidance for public health decisions related to telecommuting.


Subject(s)
COVID-19/prevention & control , Disease Outbreaks/prevention & control , SARS-CoV-2 , Teleworking , Basic Reproduction Number/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Computational Biology , Computer Simulation , Contact Tracing , Education, Distance/methods , Education, Distance/statistics & numerical data , France/epidemiology , Humans , Models, Biological , Personnel Staffing and Scheduling/statistics & numerical data , Public Health , Schools , Stochastic Processes , Teleworking/statistics & numerical data , Time Factors , Workplace
11.
PLoS One ; 16(8): e0255635, 2021.
Article in English | MEDLINE | ID: covidwho-1341506

ABSTRACT

The current pandemic has revolutionized medical education with a rapid shift to online teaching and learning strategies. The students have coped by turning to the online resources to keep pace with the change. To determine the type and practice of online resources used by undergraduate medical students and compare the use of online resources with gender and GPA. This was a cross-sectional study in which an online self-administered questionnaire was used to evaluate the type and practices of the online resources used by the medical students during the Covid-19 pandemic. Complete enumeration sampling method was used to collect the data from 180 medical students studying at College of Medicine, Majmaah University, Saudi Arabia. One hundred and thirty students (72.2%) were unaware of the free online resources offered by the University. Most students (58.3%, n = 105) consulted peers for online references. Male students preferred PowerPoint presentations and consulting online resources for studying as compared to the females, whereas females preferred to study textbooks predominantly as compared to males (p = 0.005). Male students significantly shifted to the online resources during the COVID-19 pandemic as compared to females (p = 0.028). Students with the highest GPA scores shifted to online educational resources during pandemic. A significant proportion of the undergraduate medical students at College of Medicine, Majmaah University used online educational resources for learning. We recommend that the college administration for deliberation with the medical educationalists for necessary curricular amendments and taking necessary steps to make the college Academic supervision and mentorship program more proactive to meet the challenges of students' use of online educational resources.


Subject(s)
COVID-19/epidemiology , Education, Distance , Education, Medical, Undergraduate , Adolescent , Adult , Consumer Behavior/statistics & numerical data , Cross-Sectional Studies , Education, Distance/statistics & numerical data , Education, Medical, Undergraduate/methods , Education, Medical, Undergraduate/organization & administration , Educational Measurement , Female , Humans , Male , Pandemics , SARS-CoV-2 , Saudi Arabia/epidemiology , Schools, Medical/organization & administration , Students, Medical/psychology , Students, Medical/statistics & numerical data , Surveys and Questionnaires , Universities/organization & administration , Young Adult
12.
PLoS One ; 16(8): e0249872, 2021.
Article in English | MEDLINE | ID: covidwho-1341484

ABSTRACT

This paper analyzes the application of various telemedicine services in Gansu Province, China during the COVID-19 epidemic, and summarizes the experiences with these services. In addition, the satisfaction levels of patients and doctors with the application of telemedicine in COVID-19 were investigated, the deficiencies of telemedicine in Gansu were determined, and recommendations for modification were proposed. Coronavirus Disease 2019 (COVID-19) has broken out in China, and Gansu Province in Northwest of China has not been spared. To date, there are 91 local COVID-19 cases and 42 imported cases. 109 hospitals were selected as designated hospitals during the COVID-19 outbreak, and most of them were secondary hospitals. However, it was unsatisfactory that the ability of medical services is relatively low in most of secondary hospitals and primary hospitals. Therefore, we helped the secondary hospitals cope with COVID-19 by means of remote consultation, long-distance education, telemedicine question and answer (Q&A). Our practical experience shows that telemedicine can be widely used during the COVID-19 epidemic, especially in developing countries and areas with lagging medical standards.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Telemedicine/organization & administration , China/epidemiology , Disease Outbreaks , Education, Distance/organization & administration , Education, Distance/statistics & numerical data , Education, Medical, Continuing/methods , Education, Medical, Continuing/organization & administration , Education, Medical, Continuing/statistics & numerical data , Education, Nursing, Continuing/methods , Education, Nursing, Continuing/organization & administration , Education, Nursing, Continuing/statistics & numerical data , Epidemics , Geography , Health Services Accessibility/organization & administration , Health Services Accessibility/statistics & numerical data , Humans , Physician-Patient Relations , Remote Consultation/instrumentation , Remote Consultation/methods , Remote Consultation/organization & administration , Remote Consultation/statistics & numerical data , SARS-CoV-2/physiology , Software , Telemedicine/instrumentation , Telemedicine/methods
13.
Clin Ter ; 172(4): 284-304, 2021 Jul 05.
Article in English | MEDLINE | ID: covidwho-1304849

ABSTRACT

Abstract: Many Italian universities during the COVID-19 pandemic had numerous students attending hospital wards. The training of health care students was necessary to prepare for good practices in implementing knowledge about COVID-19 and minimizing contagion among students who carried out the internship. In February 2020, a course aiming to guide health personnel so that they can appropriately address the health emergency posed by the new coronavirus was created, making use of the scientific evidence currently available as well as official sources of information and updates. The aim of this study was the development and validation of a useful tool to evaluate the progress in knowledge regarding COVID-19 of students in degree courses for the health care professions. The reliability of the test was assessed using Cronbach's alpha (α) coefficient, while the responsiveness of the test between T0 and T1 was measured with a student t test. The standard error of measurement was used to calculate the minimal detectable change of the tool. The test is made up of 31 items with four multiple-choice answers, one of which is correct. Fifteen bachelor's degree courses at the Sapienza University of Rome were enrolled, for a total population of 1,017 students from different course years. The test showed good internal consistency, with Cronbach's α values of 0.82. The item-total analysis also showed good results, with homogeneous α values from 0.80 to 0.82 for each item. The student t test showed a difference of 3.59 between T0 and T1 (p < 0.001). The minimal detectable change was 0.47. The test is a useful tool for assessing progress in skills regarding COVID-19 for students from bachelor's degree courses in the health professions. It allows the improvement and acquisition of skills as well as a qualitative analysis of the organization of internship degree courses.


Subject(s)
COVID-19/diagnosis , COVID-19/therapy , Education, Distance/statistics & numerical data , Educational Measurement/methods , Educational Measurement/statistics & numerical data , Health Knowledge, Attitudes, Practice , Health Personnel/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Reproducibility of Results , SARS-CoV-2 , Students/statistics & numerical data , Surveys and Questionnaires , Young Adult
15.
Curr Pharm Teach Learn ; 13(8): 928-934, 2021 08.
Article in English | MEDLINE | ID: covidwho-1287530

ABSTRACT

INTRODUCTION: Pharmacy student-perceived stress may impact academic experiences. This research aimed to investigate whether there was an increase in student-perceived stress due to the COVID-19 pandemic. METHODS: Current pharmacy students were surveyed in May 2020 at a public pharmacy school that utilizes an active learning design and follows a flipped classroom approach. In addition to measuring perceived stress, the survey measured coping behaviors, self-efficacy, and emotional status. The collected data were compared with archived data that were collected for internal use in 2018. Student's t-test analyses were used to compare 2020 with 2018 data. RESULTS: A total of 66 students completed the 2020 survey (response rate 26.2%) and 192 students completed the 2018 survey (response rate 63.2%). On a scale from 0 (never or not applicable) to 5 (multiple times each day), average student-perceived stress was 1.75 (SD = 0.93) in 2020. This value of perceived stress presented a slight, but not statistically significant, reduction from 1.85 (SD = 1.04) in 2018. Comparing 2018 and 2020 datasets showed no significant differences in coping behavior, self-efficacy, or emotional status. CONCLUSIONS: Based on the sample with the lower response rate that completed the survey in 2020, student-perceived stress did not increase during online, remote learning associated with the COVID-19 pandemic as compared to the sample with a higher response rate prior to the pandemic. Perhaps the COVID-19 related changes were seamless to students due to their aptitude for remote, online learning.


Subject(s)
COVID-19/prevention & control , Education, Distance/methods , Stress, Psychological/psychology , Students, Pharmacy/psychology , Students, Pharmacy/statistics & numerical data , Adult , COVID-19/psychology , Education, Distance/statistics & numerical data , Female , Humans , Male , Pandemics , SARS-CoV-2 , Self Efficacy , Surveys and Questionnaires
16.
PLoS One ; 16(6): e0251580, 2021.
Article in English | MEDLINE | ID: covidwho-1285197

ABSTRACT

This mixed-method study examined the experiences of college students during the COVID-19 pandemic through surveys, experience sampling data collected over two academic quarters (Spring 2019 n1 = 253; Spring 2020 n2 = 147), and semi-structured interviews with 27 undergraduate students. There were no marked changes in mean levels of depressive symptoms, anxiety, stress, or loneliness between 2019 and 2020, or over the course of the Spring 2020 term. Students in both the 2019 and 2020 cohort who indicated psychosocial vulnerability at the initial assessment showed worse psychosocial functioning throughout the entire Spring term relative to other students. However, rates of distress increased faster in 2020 than in 2019 for these individuals. Across individuals, homogeneity of variance tests and multi-level models revealed significant heterogeneity, suggesting the need to examine not just means but the variations in individuals' experiences. Thematic analysis of interviews characterizes these varied experiences, describing the contexts for students' challenges and strategies. This analysis highlights the interweaving of psychosocial and academic distress: Challenges such as isolation from peers, lack of interactivity with instructors, and difficulty adjusting to family needs had both an emotional and academic toll. Strategies for adjusting to this new context included initiating remote study and hangout sessions with peers, as well as self-learning. In these and other strategies, students used technologies in different ways and for different purposes than they had previously. Supporting qualitative insight about adaptive responses were quantitative findings that students who used more problem-focused forms of coping reported fewer mental health symptoms over the course of the pandemic, even though they perceived their stress as more severe. These findings underline the need for interventions oriented towards problem-focused coping and suggest opportunities for peer role modeling.


Subject(s)
COVID-19/psychology , Housing , Students/psychology , Universities/statistics & numerical data , Adolescent , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Cohort Studies , Depression/epidemiology , Education, Distance/statistics & numerical data , Female , Humans , Loneliness , Male , Psychological Distress , Students/statistics & numerical data , Surveys and Questionnaires , Young Adult
17.
Bol Med Hosp Infant Mex ; 78(3): 216-224, 2021.
Article in English | MEDLINE | ID: covidwho-1282791

ABSTRACT

Background: Due to the pandemic, children are undergoing many changes in their daily lives. Methods: We analyzed how parents perceive the effects of the contingency on their children through an online survey shared by digital media for 7 days. Results: We obtained 4000 responses. The most frequent difficulty of the children was online homeschooling (30.4%), followed by sleeping disorders (20.3%). The use of screens increased 30-80% in over 65% of children. Tantrum was detected in 34% and mood swings in 30% of children. The majority of parents (77.8%) considered that distance education does not guarantee children's education and that the level of learning acquired through online classes is not the same as that of face-to-face education (83.5%). In contrast, 70.6% of parents considered that it is not yet time to reopen schools, 78.8% believed that there is sufficient evidence to keep them closed, and 45% indicated that it is better not to return to campus this year. Regarding activities to improve mental health during the contingency, 51.3% have created home games, and 23.6% perform physical activity. However, 74.4% do not have the peace of mind to restart daily life. Among the positive aspects of the contingency, adaptability (35%) and family union (33.5%) were reported. Conclusions: Health professionals in contact with children must be prepared for the problems that this contingency is generating and sensitize parents to observe their children and seek professional help on any alarm data on the emotional or behavioral state of the child.


Subject(s)
COVID-19/psychology , Mental Health , Parents/psychology , Students/psychology , Adolescent , Child , Child, Preschool , Education, Distance/statistics & numerical data , Humans , Internet , Schools/statistics & numerical data , Screen Time , Sleep Wake Disorders/epidemiology , Surveys and Questionnaires
18.
J Nurs Educ ; 60(5): 259-264, 2021 May.
Article in English | MEDLINE | ID: covidwho-1278540

ABSTRACT

BACKGROUND: Students who are more satisfied and engaged in online courses have better learning experiences and outcomes. METHOD: Survey data were collected during a 4-month period in 2019. The research team created a survey to collect demographic information and assess student satisfaction. Student engagement was measured using the 19-item Online Student Engagement Scale. RESULTS: Overall student engagement and satisfaction scores in online programs were moderately high. Generation Z participants and students from PhD programs were the most satisfied and engaged in their programs. CONCLUSION: Students who are more engaged in online coursework are more satisfied and thus are more likely to remain and successfully complete their respective programs. [J Nurs Educ. 2021;60(5):259-264.].


Subject(s)
Education, Distance , Education, Nursing , Personal Satisfaction , Curriculum , Education, Distance/standards , Education, Distance/statistics & numerical data , Education, Nursing/methods , Education, Nursing/standards , Humans , Learning , Students, Nursing/statistics & numerical data , Surveys and Questionnaires
19.
Pediatrics ; 148(3)2021 09.
Article in English | MEDLINE | ID: covidwho-1266575

ABSTRACT

OBJECTIVES: In fall 2020, community hubs opened in San Francisco, California, to support vulnerable groups of students in remote learning. Our objectives were to (1) describe adherence to coronavirus disease 2019 (COVID-19) mitigation policies in these urban, low-income educational settings; (2) assess associations between policy adherence and in-hub COVID-19 transmission; and (3) identify barriers to and facilitators of adherence. METHODS: We conducted a mixed-methods study from November 2020 to February 2021. We obtained COVID-19 case data from the San Francisco Department of Public Health, conducted field observations to observe adherence to COVID-19 mitigation policies, and surveyed hub leaders about barriers to and facilitators of adherence. We summarized quantitative data using descriptive statistics and qualitative data using thematic content analysis. RESULTS: A total of 1738 children were enrolled in 85 hubs (39% Hispanic, 29% Black). We observed 54 hubs (n = 1175 observations of children and 295 observations of adults). There was high community-based COVID-19 incidence (2.9-41.2 cases per 100 000 residents per day), with 36 cases in hubs and only 1 case of hub-based transmission (adult to adult). Sixty-seven percent of children and 99% of adults were masked. Fifty-five percent of children and 48% of adults were distanced ≥6 ft. Facilitators of mitigation policies included the following: for masking, reminders, adequate supplies, and "unmasking zones"; for distancing, reminders and distanced seating. CONCLUSIONS: We directly observed COVID-19 mitigation in educational settings, and we found variable adherence. However, with promotion of multiple policies, there was minimal COVID-19 transmission (despite high community incidence). We detail potential strategies for increasing adherence to COVID-19 mitigation.


Subject(s)
COVID-19/prevention & control , Education, Distance , Guideline Adherence , Students , Vulnerable Populations , Adolescent , Adult , African Americans/education , African Americans/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Child , Child, Preschool , Cohort Studies , Data Analysis , Data Collection , Education, Distance/organization & administration , Education, Distance/statistics & numerical data , Hand Disinfection , /statistics & numerical data , Humans , Incidence , Masks/statistics & numerical data , Physical Distancing , Poverty Areas , San Francisco/epidemiology , Students/statistics & numerical data , Symptom Assessment , Urban Population
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