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1.
Glob Public Health ; 16(8-9): 1439-1453, 2021.
Article in English | MEDLINE | ID: covidwho-1364687

ABSTRACT

Responses to COVID-19 have included top-down, command-and-control measures, laissez-faire approaches, and bottom-up, community-driven solidarity and support, reflecting long-standing contradictions around how people and populations are imagined in public health-as a 'problem' to be managed, as 'free agents' who make their own choices, or as a potential 'solution' to be engaged and empowered for comprehensive public health. In this rapid review, we examine community-engaged responses that move beyond risk communication and instead meaningfully integrate communities into decision-making and multi-sectoral action on various dimensions of the response to COVID-19. Based on a rapid, global review of 42 case studies of diverse forms of substantive community engagement in response to COVID-19, this paper identifies promising models of effective community-engaged responses and highlights the factors enabling or disabling these responses. The paper reflects on the ways in which these community-engaged responses contribute to comprehensive approaches and address social determinants and rights, within dynamics of relational power and inequality, and how they are sometimes able to take advantage of the ruptures and uncertainties of a new pandemic to refashion some of these dynamics.


Subject(s)
COVID-19 , Community Participation , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Pandemics/prevention & control
3.
PLoS One ; 16(2): e0239247, 2021.
Article in English | MEDLINE | ID: covidwho-1362081

ABSTRACT

BACKGROUND: The success of a government's COVID-19 control strategy relies on public trust and broad acceptance of response measures. We investigated public perceptions of the UK government's COVID-19 response, focusing on the relationship between trust and perceived transparency, during the first wave (April 2020) of the COVID-19 pandemic in the United Kingdom. METHODS: Anonymous survey data were collected (2020-04-06 to 2020-04-22) from 9,322 respondents, aged 20+ using an online questionnaire shared primarily through Facebook. We took an embedded-mixed-methods approach to data analysis. Missing data were imputed via multiple imputation. Binomial & multinomial logistic regression were used to detect associations between demographic characteristics and perceptions or opinions of the UK government's response to COVID-19. Structural topic modelling (STM), qualitative thematic coding of sub-sets of responses were then used to perform a thematic analysis of topics that were of interest to key demographic groups. RESULTS: Most respondents (95.1%) supported government enforcement of behaviour change. While 52.1% of respondents thought the government was making good decisions, differences were apparent across demographic groups, for example respondents from Scotland had lower odds of responding positively than respondents in London. Higher educational levels saw decreasing odds of having a positive opinion of the government response and decreasing household income associated with decreasing positive opinion. Of respondents who thought the government was not making good decisions 60% believed the economy was being prioritised over people and their health. Positive views on government decision-making were associated with positive views on government transparency about the COVID-19 response. Qualitative analysis about perceptions of government transparency highlighted five key themes: (1) the justification of opacity due to the condition of crisis, (2) generalised mistrust of politics, (3) concerns about the role of scientific evidence, (4) quality of government communication and (5) questions about political decision-making processes. CONCLUSION: Our study suggests that trust is not homogenous across communities, and that generalised mistrust, concerns about the transparent use and communication of evidence and insights into decision-making processes can affect perceptions of the government's pandemic response. We recommend targeted community engagement, tailored to the experiences of different groups and a new focus on accountability and openness around how decisions are made in the response to the UK COVID-19 pandemic.


Subject(s)
Attitude , COVID-19/psychology , Communicable Disease Control , Public Policy , Trust , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Socioeconomic Factors , Surveys and Questionnaires , United Kingdom
4.
Int J Health Plann Manage ; 36(S1): 174-181, 2021 May.
Article in English | MEDLINE | ID: covidwho-1318709

ABSTRACT

Healthcare workers, who are in low-resource settings, are critically vulnerable during the COVID-19 pandemic. The increasing rate of coronavirus infection in a developing country such as Bangladesh caused the highest death rate of doctors among frontline service providers and resulted in fear and anxiety among healthcare workers. Even with the preliminary measures of hospitals and clinics to protect healthcare workers, the growing casualties are alarming. This research uses case study approach to explore the issues doctors and nurses face in 'priority intervention areas' (PIA) in order to improve the health system quality. Qualitative in-depth semi-structured interviews were conducted from 12 May to 4 June 2020 among doctors and nurses from two different private hospitals in Dhaka city. Data were analysed using thematic content analysis. The two significant areas that required immediate attention were identified from the PIA framework as 'patient and staff safety, infection control' and 'cultural aspects and community engagement'. Each area of the PIA framework showed previously ignored issues in the current health system. The adaptation of the PIA framework helped identify critical health system issues. Possible corrective actions including proper planning and management of isolating the infected patients and provision of adequate personal protective equipment are recommended to management and policymakers to save the lives of healthcare workers and to minimise the spread of infection.


Subject(s)
COVID-19 , Nurses/psychology , Physicians/psychology , Bangladesh , Hospitals, Private , Humans , Infection Control , Interviews as Topic , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
5.
Glob Health Sci Pract ; 9(2): 355-364, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1305892

ABSTRACT

Global misinformation and information overload have characterized the coronavirus disease (COVID-19) pandemic. Rumors are unverified pieces of information spreading online or person-to-person that reduce trust in health authorities and create barriers to protective practices. Risk communication and community engagement can increase transparency, build trust, and stop the spread of rumors. Building on previous work on Ebola and Zika viruses using Global Health Security Agenda systems strengthening support, the U.S. Agency for International Development-funded Breakthrough ACTION project developed a process and technology for systematically collecting, analyzing, and addressing COVID-19 rumors in real-time in Côte d'Ivoire. Rumors were submitted through community-based contributors and collected from callers to the national hotlines and then processed on a cloud-hosted database built on the open-source software District Health Information System 2 (DHIS2). Hotline teleoperators and data managers coded rumors in near-real-time according to behavioral theory frameworks within DHIS2 and visualized the findings on custom dashboards. The analysis and response were done in full collaboration with the Government of Côte d'Ivoire and implementing partners to ensure a timely and coordinated response. The system captured both widespread rumors consistent with misinformation in other settings, such as suspicions about case counts and the belief that masks were deliberately contaminated, as well as very localized beliefs related to specific influencers. The qualitative findings provided rapid insights on circulating beliefs, enabling risk communicators to nuance and tailor messaging around COVID-19.


Subject(s)
COVID-19 , Communication , Health Knowledge, Attitudes, Practice , Information Management/methods , Pandemics , Residence Characteristics , Trust , Communicable Disease Control , Cote d'Ivoire , Data Collection/methods , Databases, Factual , Government , Hotlines , Humans , International Cooperation , Internet , SARS-CoV-2
6.
Int J Infect Dis ; 110 Suppl 1: S17-S24, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1275372

ABSTRACT

OBJECTIVE: We aimed to identify the barriers and enablers that Health Care Workers (HCWs) in Papua New Guinea experienced in swabbing for COVID-19. METHODS: We conducted a cross-sectional multi-methods study: a qualitative scoping exercise and a telephone survey. The target population was COVID-19-trained HCWs from all provinces of Papua New Guinea. A descriptive analysis of survey responses was conducted alongside a rapid qualitative analysis of interviews and open-ended survey questions. RESULTS: Four thematic areas were identified: human resources, logistics, HCW attitudes and community attitudes. The survey response rate was 70.3% (407/579). Commonly reported barriers to COVID-19 swabbing were insufficient staff trained (74.0%, n = 301), inadequate staffing in general (64.9%, n = 264), insufficient supply of personal protective equipment (60.9%, n = 248) and no cold chain to store swabs (57.5%, n = 234). Commonly reported enablers to swabbing were community awareness and risk communication (80.8%, n = 329), consistent and sufficient supplies of personal protective equipment (67.8%, n = 276), increased surge workforce (63.9%, n = 260) and having a fridge to store swabs (59.7%, n = 243). CONCLUSIONS: A comprehensive community and HCW engagement strategy combined with innovations to improve the supply chain are needed to increase COVID-19 swabbing in Papua New Guinea to reach national testing targets. Investments in increasing numbers of frontline workforce, consistent supplies of PPE, swabs, transport medium, cold boxes and ability to make ice packs, in addtion to establishing regular tranport of specimens from the facility to the testing site will strengthen the supply chain. Innovations are needed to address these issues.


Subject(s)
COVID-19 , Cross-Sectional Studies , Health Personnel , Humans , Papua New Guinea , SARS-CoV-2
7.
BMC Public Health ; 21(1): 877, 2021 05 07.
Article in English | MEDLINE | ID: covidwho-1224870

ABSTRACT

BACKGROUND: Qualitative Comparative Analysis (QCA) is a method for identifying the configurations of conditions that lead to specific outcomes. Given its potential for providing evidence of causality in complex systems, QCA is increasingly used in evaluative research to examine the uptake or impacts of public health interventions. We map this emerging field, assessing the strengths and weaknesses of QCA approaches identified in published studies, and identify implications for future research and reporting. METHODS: PubMed, Scopus and Web of Science were systematically searched for peer-reviewed studies published in English up to December 2019 that had used QCA methods to identify the conditions associated with the uptake and/or effectiveness of interventions for public health. Data relating to the interventions studied (settings/level of intervention/populations), methods (type of QCA, case level, source of data, other methods used) and reported strengths and weaknesses of QCA were extracted and synthesised narratively. RESULTS: The search identified 1384 papers, of which 27 (describing 26 studies) met the inclusion criteria. Interventions evaluated ranged across: nutrition/obesity (n = 8); physical activity (n = 4); health inequalities (n = 3); mental health (n = 2); community engagement (n = 3); chronic condition management (n = 3); vaccine adoption or implementation (n = 2); programme implementation (n = 3); breastfeeding (n = 2), and general population health (n = 1). The majority of studies (n = 24) were of interventions solely or predominantly in high income countries. Key strengths reported were that QCA provides a method for addressing causal complexity; and that it provides a systematic approach for understanding the mechanisms at work in implementation across contexts. Weaknesses reported related to data availability limitations, especially on ineffective interventions. The majority of papers demonstrated good knowledge of cases, and justification of case selection, but other criteria of methodological quality were less comprehensively met. CONCLUSION: QCA is a promising approach for addressing the role of context in complex interventions, and for identifying causal configurations of conditions that predict implementation and/or outcomes when there is sufficiently detailed understanding of a series of comparable cases. As the use of QCA in evaluative health research increases, there may be a need to develop advice for public health researchers and journals on minimum criteria for quality and reporting.


Subject(s)
Population Health , Public Health , Causality , Exercise , Humans , Mental Health
8.
BMC Public Health ; 21(1): 620, 2021 04 13.
Article in English | MEDLINE | ID: covidwho-1264157

ABSTRACT

BACKGROUND: To understand operational challenges involved with responding to US measles outbreaks in 2017-19 and identify applicable lessons in order to inform preparedness and response operations for future outbreaks, particularly with respect to specific operational barriers and recommendations for outbreak responses among insular communities. METHODS: From August 2019 to January 2020, we conducted 11 telephone interviews with 18 participants representing state and local health departments and community health centers that responded to US measles outbreaks in 2017-19, with a focus on outbreaks among insular communities. We conducted qualitative, thematic coding to identify and characterize key operational challenges and lessons identified by the interviewees. RESULTS: We categorized principal insights into 5 topic areas: scale of the response, vaccination operations, exclusion policies, community engagement, and countering anti-vaccine efforts. These topics address resource-intensive aspects of these outbreak responses, including personnel demands; guidance needed to support response operations and reduce transmission, such as excluding exposed or at-risk individuals from public spaces; operational challenges and barriers to vaccination and other response activities; and effectively engaging and educating affected populations, particularly with respect to insular and vulnerable communities. CONCLUSIONS: Measles outbreak responses are resource intensive, which can quickly overwhelm existing public health capacities. Early and effective coordination with trusted leaders and organizations in affected communities, including to provide vaccination capacity and facilitate community engagement, can promote efficient response operations. The firsthand experiences of public health and healthcare personnel who responded to measles outbreaks, including among insular communities, provide evidence-based operational lessons that can inform future preparedness and response operations for outbreaks of highly transmissible diseases.


Subject(s)
Epidemics , Measles , Disease Outbreaks/prevention & control , Humans , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Public Health , Vaccination
9.
Health Care Women Int ; 41(11-12): 1363-1369, 2020.
Article in English | MEDLINE | ID: covidwho-1263587

ABSTRACT

The COVID-19 pandemic has a severe and immediate impact on unemployment and reduced household income, resulting in global food insecurity. Women play a major role as household food providers who manage food insecurity in Thai community. In this qualitative study researchers aimed to understand how communities engage in management of food insecurity resulting from COVID-19. Participants included 12 female food providers who were community volunteers, four community leaders, and four health providers. Focus group interviews were conducted. Data were analyzed using content analysis. We explain community engagement to manage food insecurity through strategies including connecting through empathy, community empowerment, and engaging for sustainability. We present findings to illustrate how women's groups may work through a public-private partnership to achieve sustainable food security.


Subject(s)
COVID-19/epidemiology , Food Insecurity , Social Planning , Female , Humans , Income , Qualitative Research , SARS-CoV-2 , Thailand , Women
10.
Am J Trop Med Hyg ; 104(4): 1179-1187, 2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1262647

ABSTRACT

Most African countries have recorded relatively lower COVID-19 burdens than Western countries. This has been attributed to early and strong political commitment and robust implementation of public health measures, such as nationwide lockdowns, travel restrictions, face mask wearing, testing, contact tracing, and isolation, along with community education and engagement. Other factors include the younger population age strata and hypothesized but yet-to-be confirmed partially protective cross-immunity from parasitic diseases and/or other circulating coronaviruses. However, the true burden may also be underestimated due to operational and resource issues for COVID-19 case identification and reporting. In this perspective article, we discuss selected best practices and challenges with COVID-19 contact tracing in Nigeria, Rwanda, South Africa, and Uganda. Best practices from these country case studies include sustained, multi-platform public communications; leveraging of technology innovations; applied public health expertise; deployment of community health workers; and robust community engagement. Challenges include an overwhelming workload of contact tracing and case detection for healthcare workers, misinformation and stigma, and poorly sustained adherence to isolation and quarantine. Important lessons learned include the need for decentralization of contact tracing to the lowest geographic levels of surveillance, rigorous use of data and technology to improve decision-making, and sustainment of both community sensitization and political commitment. Further research is needed to understand the role and importance of contact tracing in controlling community transmission dynamics in African countries, including among children. Also, implementation science will be critically needed to evaluate innovative, accessible, and cost-effective digital solutions to accommodate the contact tracing workload.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/organization & administration , Contact Tracing/methods , Humans , Nigeria/epidemiology , Practice Guidelines as Topic , Rwanda/epidemiology , SARS-CoV-2 , South Africa/epidemiology , Uganda/epidemiology
11.
Clin Gerontol ; 45(1): 172-188, 2022.
Article in English | MEDLINE | ID: covidwho-1260992

ABSTRACT

OBJECTIVES: The aim of the current study was to investigate meaning-making in 57 older predominantly female adults (M = 72.68) required to temporarily cease attending a university-affiliated integrated care clinic in Australia with a focus on exercise and well-being due to COVID-19 restrictions, specifically regarding consequential grief, loss, hopelessness, and loss of purpose. METHODS: Quantitative and qualitative data were collected by telephone interviews and an online survey. RESULTS: Results indicated that most participants valued attending the Clinic, and experienced a number of physical, social and emotional benefits from attending, including a sense of meaning. Specifically, some participants developed social connections, learned to cope more effectively with mental health conditions, and regained strength following stressful or traumatic events through their attendance at the clinic. CONCLUSIONS: Throughout the pandemic, most participants retained their resilience and continued to derive meaning from various sources, including their families, careers, interests, and attitude toward life. CLINICAL IMPLICATIONS: Older adults may experience enhanced physical, emotional and social health from engaging in community-based programs focused on exercise and overall wellness. Furthermore, meaning-making has the potential to buffer the harmful effects of stress and traumatic events on the physical, emotional and social health of older adults.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Adaptation, Psychological , Aged , Female , Humans , Pandemics , SARS-CoV-2
12.
Bull Acad Natl Med ; 205(7): 726-731, 2021 Aug.
Article in French | MEDLINE | ID: covidwho-1258332

ABSTRACT

The city of Wuhan, capital of Hubei, was the starting point of the Covid-19 epidemic and its doctors were led to develop novel strategies that have benefited the global fight in the country. But whatever strategies we hold up, the basic golden rule for controlling the pandemic has been early detection, reporting, isolation and treatment. The modalities of the battle were: swift action to block transmission with a vigorous, multifaceted response; resource allocation (a nationwide command system); Fangcang shelter hospitals; Broad community engagement: -provision of support via a volunteer network; People embraced behavioral change: -wearing masks and social distancing; Widespread testing: technical innovation; Science and technology curb the pandemic with research and digital technology; Free diagnosis and treatment for COVID-19. The success of our experience has provided valuable information to the international community in the fight against the pandemic.

13.
EClinicalMedicine ; 32: 100754, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1242958
14.
J Health Commun ; 25(10): 808-815, 2020 Oct 02.
Article in English | MEDLINE | ID: covidwho-1236161

ABSTRACT

Immunization is a global success story. It has saved millions of lives and prevented disease worldwide and millions more have been spared the permanent disabilities caused by diseases such as polio and the long-term morbidity caused by other diseases such as measles. Despite the compelling evidence of the public health and economic value of vaccines, vaccine hesitancy has become a growing concern globally. By calling into question the safety and efficacy of vaccines, vaccine hesitancy threatens the progress made in combating morbidity and mortality including efforts to introduce COVID-19 vaccines. This paper a) examines key factors that drive limited demand for vaccines and vaccine hesitancy, (b) highlights the role of demand promotion for immunization and of risk communication and community engagement to address those challenges, (c) discusses vaccine demand and hesitancy in Eastern Europe and Central Asia, and (d) makes recommendations for public health policy and programming for the introduction of the COVID-19 vaccine and beyond.Recommendations include strengthen social listening and digital engagement to address the concerns of caregivers and healthcare professionals, improve the availability and use of social data for evidence-based programming, reinforce public trust in health institutions and service providers, mainstream demand for immunization, strengthen the communication competencies of health service providers, test and apply solutions based on behavioral insights to reinforce demand, engage regularly with local governments and local actors, and strengthen resilience and response capacities for diseases outbreaks and public health emergencies.


Subject(s)
COVID-19 Vaccines/therapeutic use , Patient Acceptance of Health Care/statistics & numerical data , Asia , COVID-19/prevention & control , Europe, Eastern , Female , Humans , Male , Patient Acceptance of Health Care/psychology , Trust
15.
J Health Commun ; 25(10): 827-830, 2020 Oct 02.
Article in English | MEDLINE | ID: covidwho-1236160

ABSTRACT

In an era of Freddie Gray and Black Lives Matter, a long history of structural racism, combined with disproportionate rates of COVID-19, the African American community has seen a lot of reasons to demand social justice, equal treatment and immediate access to solutions to health disparities. Despite the promise of COVID-19 vaccines, the community is highly distrustful of the vaccine and institutions given a history of mistreatment and many other current concerns. Trusted messengers such as Black pastors are crucial to protecting the community that faces a disproportionate amount of disease. We present a framework to build trust and acceptance including understanding history and context; listening and empathy; engaging pastors as trusted messengers; creating partnerships with shared responsibility and power; and co-creation of solutions with faith leaders and their community, governments and institutions to create sustainable, long-term change. Efforts to support vaccine acceptance must be customized to the variety of needs and realities of the African American community, not just the topic of concern to the institution. Evaluations are needed to help ensure the community is engaged and feeling heard. Pastors and other religious leaders can work with government and institutions to bring information, facilitate discussion, build trust and develop measurable improvement efforts. Although acceptance of COVID-19 vaccines may not be achieved overnight, the process of focusing on issues that are important to the community is an important step in laying the foundation for both COVID-19 vaccines and future interventions.


Subject(s)
African Americans/psychology , COVID-19 Vaccines/therapeutic use , Clergy , Community Participation/methods , Health Status Disparities , Patient Acceptance of Health Care/ethnology , African Americans/education , African Americans/statistics & numerical data , Health Communication/methods , Humans , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Racism , Trust
16.
BMJ Glob Health ; 6(5)2021 05.
Article in English | MEDLINE | ID: covidwho-1234298

ABSTRACT

Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on the 2 April 2020. The aim of this paper was to document policy decisions made in response to the COVID-19 pandemic from January to August 2020. We reviewed policy documents from the Public Health Institute of Malawi, the Malawi Gazette, the Malawi Ministry of Health and Population and the University of Oxford Coronavirus Government Response Tracker. We found that the Malawi response to the COVID-19 pandemic was multisectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. Key policies identified during the review include international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and public transport, and mandatory face coverings and a testing policy covering symptomatic people. Supportive interventions included risk communication and community engagement in multiple languages and over a variety of mediums, efforts to improve access to water, sanitation, nutrition and unconditional social-cash transfers for poor urban and rural households.


Subject(s)
COVID-19 , Health Policy , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Malawi/epidemiology , Pandemics/prevention & control
17.
Nat Med ; 27(6): 964-980, 2021 06.
Article in English | MEDLINE | ID: covidwho-1232071

ABSTRACT

Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.


Subject(s)
COVID-19/epidemiology , Global Health , Pandemics , Public Health , COVID-19/prevention & control , COVID-19/virology , Delivery of Health Care , Government , Government Programs , Humans , SARS-CoV-2/pathogenicity
18.
JAMA Netw Open ; 4(5): e2110090, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1227702

ABSTRACT

Importance: Reimagining university life during COVID-19 requires substantial innovation and meaningful community input. One method for obtaining community input is crowdsourcing, which involves having a group of individuals work to solve a problem and then publicly share solutions. Objective: To evaluate a crowdsourcing open call as an approach to COVID-19 university community engagement and strategic planning. Design, Setting, and Participants: This qualitative study assessed a crowdsourcing open call offered from June 16 to July 16, 2020, that sought ideas to inform safety in the fall 2020 semester at the University of North Carolina at Chapel Hill (UNC). Digital methods (email and social media) were used for promotion, and submissions were collected online for 4 weeks. Participation was open to UNC students, staff, faculty, and others. Main Outcomes and Measures: Submissions were evaluated for innovation, feasibility, inclusivity, and potential to improve safety and well-being. Demographic data were collected from submitting individuals, and submissions were qualitatively analyzed for emergent themes on challenges with and solutions for addressing safety and well-being in the fall semester. Data were shared with UNC leadership to inform decision-making. Results: The open call received 82 submissions from 110 participants, including current UNC students (56 submissions [68%]), people younger than 30 years (67 [82%]), women (55 [67%]), and individuals identifying as a racial/ethnic minority or as multiracial/ethnic (49 [60%]). Seven submissions were identified as finalists and received cash prizes with the encouragement to use these funds toward idea development and implementation. Seventeen runner-up teams were linked to university resources for further development. Thematic analysis of submissions regarding challenges with the fall semester revealed not only physical health concerns and the limitations of remote learning but also challenges that have been exacerbated by the pandemic, such as a lack of mental health support, structural racism and inequality, and insufficient public transportation. Solutions included novel ideas to support mental health among specific populations (eg, graduate students and racial/ethnic minorities), improve health equity, and increase transit access. All 24 finalists and runners-up indicated interest in implementation after being notified of the open call results. Conclusions and Relevance: This study suggests that open calls are a feasible strategy for university community engagement on COVID-19, providing a stakeholder-driven approach to identifying promising ideas for enhancing safety and well-being. Open calls could be formally incorporated into university planning processes to develop COVID-19 safety strategies that are responsive to diverse community members' concerns.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Crowdsourcing , Organizational Innovation , Strategic Planning , Universities/organization & administration , Adult , COVID-19/transmission , Education, Distance , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Mental Health , Minority Groups/psychology , North Carolina , Pandemics/prevention & control , SARS-CoV-2 , Social Support , Students/psychology , Young Adult
19.
J Med Ethics ; 47(8): 539-542, 2021 08.
Article in English | MEDLINE | ID: covidwho-1226766

ABSTRACT

In spring, summer and autumn 2020, one abiding argument against controlled human infection (CHI) studies of SARS-CoV-2 vaccines has been their impact on local communities. Leading scientists and bioethicists expressed concern about undue usage of local residents' direly needed scarce resources at a time of great need and even about their unintended infection. They recommended either avoiding CHI trials or engaging local communities before conducting any CHIs. Similar recommendations were not made for the alternative-standard phase III field trials of these same vaccines. We argue that the health effects of CHI studies on local residents not participating in the study tend to be smaller and more positive than those of field trials. That is all the more so now that tested vaccines are being rolled out. Whether or not local community engagement is necessary for urgent vaccine studies in the pandemic, the case for its engagement is stronger prior to field trials than prior to CHI studies.


Subject(s)
COVID-19 Vaccines , COVID-19/psychology , COVID-19/transmission , Community Participation , Research Design , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2
20.
BJPsych Bull ; : 1-7, 2021 May 12.
Article in English | MEDLINE | ID: covidwho-1225789

ABSTRACT

AIMS AND METHOD: Mental health services have changed the way they operate during the COVID-19 pandemic. We investigated the challenges and innovations reported by staff working in services for people with intellectual disability and/or autism in National Health Service (NHS) and non-NHS sectors, and in in-patient and community settings. RESULTS: Data were drawn from 648 staff who participated in a UK-wide online survey. Issues around infection risk and mitigation were more important to those working in the NHS and in-patient settings. Community staff were more likely to express concern about the practicalities of a rapid shift to remote working and engaging patients remotely. Qualitative data revealed support for maintaining remote staff working and remote service provision post-pandemic. CLINICAL IMPLICATIONS: Given the current emphasis on community support for people with intellectual disability and/or autism, the focus of research and clinical practice should be the development of accessible and effective models of remote service provision.

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