Cutting through the noise during crisis by enhancing the relevance of research to policymakers

Background:It is widely recognised that policymakers use research deemed relevant, yet little is understood about ways to enhance perceived relevance of research evidence. Observing policymakers' access of research online provides a pragmatic way to investigate predictors of relevance.Aims and objectives:This study investigates a range of relevance indicators including committee assignments, public statements, issue prevalence, or the policymaker's name or district.Methods:In a series of four rapid-cycle randomised control trials (RCTs), the present work systematically explores science communication strategies by studying indicators of perceived relevance. State legislators, state staffers, and federal staffers were emailed fact sheets on issues of COVID (Trial 1, N = 3403), exploitation (Trial 2, N = 6846), police violence (Trial 3, N = 3488), and domestic violence (Trial 4, N = 3888).Findings:Across these trials, personalising the subject line to the legislator's name or district and targeting recipients based on committee assignment consistently improved engagement. Mentions of subject matter in public statements was inconsistently associated, and state-level prevalence of the issue was largely not associated with email engagement behaviour.Discussion and conclusions:Together, these results indicate a benefit of targeting legislators based on committee assignments and of personalising the subject line with legislator information. This work further operationalises practical indicators of personal relevance and demonstrates a novel method of how to test science communication strategies among policymakers. Building enduring capacity for testing science communication will improve tactics to cut through the noise during times of political crisis.

SciComm Optimizer for Policy Engagement: a randomized controlled trial of the SCOPE model on state legislators' research use in public discourse.

BACKGROUND: While prior work has revealed conditions that foster policymakers' use of research evidence, few studies have rigorously investigated the effectiveness of theory-based practices. Specifically, policymakers are most apt to use research evidence when it is timely, relevant, brief, and messaged appropriately, as well as when it facilitates interactive engagement. This study sought to experimentally evaluate an enhanced research dissemination intervention, known as the SciComm Optimizer for Policy Engagement (SCOPE), implemented during the COVID-19 pandemic among US state legislators. METHODS: State legislators assigned to health committees and their staff were randomized to receive the SCOPE intervention. This involved providing academic researchers with a pathway for translating and disseminating research relevant to current legislative priorities via fact sheets emailed directly to officials. The intervention occurred April 2020-March 2021. Research language was measured in state legislators' social media posts. RESULTS: Legislators randomized to receive the intervention, relative to the control group, produced 24% more social media posts containing research language related to COVID-19. Secondary analyses revealed that these findings were driven by two different types of research language. Intervention officials produced 67% more COVID-related social media posts referencing technical language (e.g., statistical methods), as well as 28% more posts that referenced research-based concepts. However, they produced 31% fewer posts that referenced creating or disseminating new knowledge. CONCLUSIONS: This study suggests that strategic, targeted science communication efforts may have the potential to change state legislators' public discourse and use of evidence. Strategic science communication efforts are particularly needed in light of the role government officials have played in communicating about the pandemic to the general public.

The effect of letter writing on a long-term care resident with loneliness.

Older adults living in long term care (LTC) facilities may experience increased isolation and loneliness. This was compounded with the Coronavirus Disease 2019 (COVID-19) pandemic. Loneliness and isolation increase the risk for physical, psychological, and social decline. This case report discusses the effect of a letter writing initiative on feelings of loneliness and connection in a long-term care resident. Personalized care is the standard in the long-term care setting and letter writing between two people can contribute to personalized meaningful care as evidenced by the example provided. Further research is needed to explore social connection and loneliness and methods to combat these issues with a personalized approach for different populations within LTC facilities.

Cutting through the noise during crisis by enhancing the relevance of research to policymakers

It is widely recognised that policymakers use research deemed relevant, yet little is understood about ways to enhance perceived relevance of research evidence. Observing policymakers' access of research online provides a pragmatic way to investigate predictors of relevance. Aims and objectives This study investigates a range of relevance indicators including committee assignments, public statements, issue prevalence, or the policymaker's name or district. Methods In a series of four rapid-cycle randomised control trials (RCTs), the present work systematically explores science communication strategies by studying indicators of perceived relevance. State legislators, state staffers, and federal staffers were emailed fact sheets on issues of COVID (Trial 1, N = 3403), exploitation (Trial 2, N = 6846), police violence (Trial 3, N = 3488), and domestic violence (Trial 4, N = 3888). Findings Across these trials, personalising the subject line to the legislator's name or district and targeting recipients based on committee assignment consistently improved engagement. Mentions of subject matter in public statements was inconsistently associated, and state-level prevalence of the issue was largely not associated with email engagement behaviour. Discussion and conclusions Together, these results indicate a benefit of targeting legislators based on committee assignments and of personalising the subject line with legislator information. This work further operationalises practical indicators of personal relevance and demonstrates a novel method of how to test science communication strategies among policymakers. Building enduring capacity for testing science communication will improve tactics to cut through the noise during times of political crisis.

Moderating role of healthcare disruptions on friend and family pandemic-related negative life events predicting latines' anxiety and alcohol use over time

The Latine community has experienced a disproportionate amount of pandemic-related negative life events during the COVID-19 pandemic. The current study, therefore, adopted a contextual and environmental lens to understand the moderating role of healthcare disruptions on friend and family pandemic-related negative life events (e.g., PRNLE) predicting anxiety and alcohol use over time. The current study was part of a more extensive longitudinal study on students' genetic and environmental experiences. Findings indicated that among Latines who experienced more significant healthcare disruptions, increased family PRNLE predicted greater alcohol use but not anxiety over time. Additionally, friend PRNLE did not significantly predict alcohol or anxiety with high or low healthcare disruptions present. Our findings suggest that Latines may rely on the family to navigate their concerns and mitigate the PRNLE when experiencing healthcare disruptions. Therefore, clinical and policy implications are discussed to reduce alcohol-related inequalities during the ongoing global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Exploring Alternate Visions of Caring in a World of Social Distancing.

Compounded by the COVID-19 pandemic, both loneliness and isolation are a growing concern for the older adult population. An intergenerational holistic exchange, Cardinals CARE (Cardinals, Adopt, Residents for Engagement), was developed as a way to connect older adults in long-term care facilities (LTCFs) with nursing students while demonstrating the meeting of student service learning outcomes. Students shared correspondence with residents in LTCFs for a 10-week period, sending mail weekly in the form of letters, artwork, crafts, an appropriate joke, or anything to encourage engagement. Jean Watson's Theory of Transpersonal Caring was used as a framework for the project. Students (n = 109) participating in the program provided interaction with 734 residents in 11 LTCFs in 3 counties. Students utilized reflective journaling to demonstrate the meeting of service learning outcomes and described the power of connection and the opportunity to provide holistic care. A result of the project was the intergenerational connectedness showcasing the reciprocal nature of the CARE project. Further research is needed to build an evidence base for the use of such interaction to promote connection and combat loneliness.

Uptake of COVID-19 Vaccination Among Frontline Workers in California State Prisons.

Importance: Prisons and jails are high-risk environments for COVID-19. Vaccination levels among workers in many such settings remain markedly lower than those of residents and members of surrounding communities. The situation is troubling because prison staff are a key vector for COVID-19 transmission. Objective: To assess patterns and timing of staff vaccination in California state prisons and identify individual-level and community-level factors associated with remaining unvaccinated. Design Setting and Participants: This cohort study used data from December 22, 2020, through June 30, 2021, to quantify the fractions of staff and incarcerated residents who remained unvaccinated among 23 472 custody and 7617 health care staff who worked in roles requiring direct contact with residents at 33 of the 35 prisons operated by the California Department of Corrections and Rehabilitation. Multivariable probit regressions assessed demographic, community, and peer factors associated with staff vaccination uptake. Main Outcomes and Measures: Remaining unvaccinated throughout the study period. Results: Of 23 472 custody staff, 3751 (16%) were women, and 1454 (6%) were Asian/Pacific Islander individuals, 1571 (7%) Black individuals, 9008 (38%) Hispanic individuals, and 6666 (28%) White individuals. Of 7617 health care staff, 5434 (71%) were women, and 2148 (28%) were Asian/Pacific Islander individuals, 1201 (16%) Black individuals, 1409 (18%) Hispanic individuals, and 1771 (23%) White individuals. A total of 6103 custody staff (26%) and 3961 health care staff (52%) received 1 or more doses of a COVID-19 vaccine during the first 2 months vaccines were offered, but vaccination rates stagnated thereafter. By June 30, 2021, 14 317 custody staff (61%) and 2819 health care staff (37%) remained unvaccinated. In adjusted analyses, remaining unvaccinated was positively associated with younger age (custody staff: age, 18-29 years vs ≥60 years, 75% [95% CI, 73%-76%] vs 45% [95% CI, 42%-48%]; health care staff: 52% [95% CI, 48%-56%] vs 29% [95% CI, 27%-32%]), prior COVID-19 infection (custody staff: 67% [95% CI, 66%-68%] vs 59% [95% CI, 59%-60%]; health care staff: 44% [95% CI, 42%-47%] vs 36% [95% CI, 36%-36%]), residing in a community with relatively low rates of vaccination (custody staff: 75th vs 25th percentile:, 63% [95% CI, 62%-63%] vs 60% [95% CI, 59%-60%]; health care staff: 40% [95% CI, 39%-41%] vs 34% [95% CI, 33%-35%]), and sharing shifts with coworkers who had relatively low rates of vaccination (custody staff: 75th vs 25th percentile, 64% [95% CI, 62%-66%] vs 59% [95% CI, 57%-61%]; health care staff: 38% [95% CI, 36%-41%] vs 35% [95% CI, 31%-39%]). Conclusions and Relevance: This cohort study of California state prison custody and health care staff found that vaccination uptake plateaued at levels that posed ongoing risks of further outbreaks in the prisons and continuing transmission from prisons to surrounding communities. Prison staff decisions to forgo vaccination appear to be multifactorial, and vaccine mandates may be necessary to achieve adequate levels of immunity in this high-risk setting.

COVID-19 related perception among some community members and frontline healthcare providers for NTD control in Ghana.

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a major breakdown of health service provision in the fight against neglected tropical diseases (NTDs). COVID-19 may impact NTDs service delivery in varied ways. As the Ghana NTD programme planned to resume MDA activities, we examined the COVID-19 related perceptions and practices among some community members and frontline health workers for NTD control activities in the country. METHODS: The study was conducted in seven communities in the Ahanta West district of Ghana. This was a qualitative study using in-depth interviews (IDI) and focus group discussions (FGDs) for data collection. Participants were purposively selected from varied backgrounds to represent both beneficiaries and service providers directly involved in NTD programme implementation. Trained and experienced qualitative data collectors conducted the FGD and IDI sessions in the local Twi language, while health worker sessions were conducted in English. Discussions were audio-recorded and transcribed directly into English. Data was analysed using an iterative process. The transcripts were pre-coded using the broad themes, entered into a computer using Microsoft Word, and then imported into the MAXQDA software for thematic content analysis to select relevant representative narratives for presentation. RESULTS: Participants were aware of the COVID-19 pandemic and referred to it appropriately as 'coronavirus', COVID-19, and often as 'the new disease'. Though many respondents could not describe the route of transmission, most of them reported that it is transmitted through touch or sharing of common items. They reported some signs/symptoms like fever, headache and difficulty breathing, and prevention methods like the use of hand sanitiser, washing of hands and sneezing appropriately. Respondents have reported that COVID-19 has negatively affected their daily lives by limiting their movements and therefore work. It also came to light that COVID-19 has also negatively affected the NTD programme implementation, especially mass drug administration (MDA) activities, leading to the postponement of the yearly MDA. The COVID-19 pandemic has negatively affected clinic attendance; people are afraid that they may be tested for COVID-19 at the clinic. CONCLUSION: COVID-19 has negatively affected the NTD programme. Education and the provision of personal protective equipment will be required to build the confidence of frontline care providers including community drug distributors and community members in order to enhance quality service and participation in future MDA activities.

Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Among Incarcerated People in California State Prisons: Retrospective Cohort Study.

BACKGROUND: Prisons and jails are high-risk settings for coronavirus disease 2019 (COVID-19). Vaccines may substantially reduce these risks, but evidence is needed on COVID-19 vaccine effectiveness for incarcerated people, who are confined in large, risky congregate settings. METHODS: We conducted a retrospective cohort study to estimate effectiveness of messenger RNA (mRNA) vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), against confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among incarcerated people in California prisons from 22 December 2020 through 1 March 2021. The California Department of Corrections and Rehabilitation provided daily data for all prison residents including demographic, clinical, and carceral characteristics, as well as COVID-19 testing, vaccination, and outcomes. We estimated vaccine effectiveness using multivariable Cox models with time-varying covariates, adjusted for resident characteristics and infection rates across prisons. RESULTS: Among 60 707 cohort members, 49% received at least 1 BNT162b2 or mRNA-1273 dose during the study period. Estimated vaccine effectiveness was 74% (95% confidence interval [CI], 64%-82%) from day 14 after first dose until receipt of second dose and 97% (95% CI, 88%-99%) from day 14 after second dose. Effectiveness was similar among the subset of residents who were medically vulnerable: 74% (95% CI, 62%-82%) and 92% (95% CI, 74%-98%) from 14 days after first and second doses, respectively. CONCLUSIONS: Consistent with results from randomized trials and observational studies in other populations, mRNA vaccines were highly effective in preventing SARS-CoV-2 infections among incarcerated people. Prioritizing incarcerated people for vaccination, redoubling efforts to boost vaccination, and continuing other ongoing mitigation practices are essential in preventing COVID-19 in this disproportionately affected population.

Rapid-Cycle Experimentation With State and Federal Policymakers for Optimizing the Reach of Racial Equity Research.

Racial disparities and racism are pervasive public health threats that have been exacerbated by the COVID-19 pandemic. Thus, it is critical and timely for researchers to communicate with policymakers about strategies for reducing disparities. From April through July 2020, across four rapid-cycle trials disseminating scientific products with evidence-based policy recommendations for addressing disparities, we tested strategies for optimizing the reach of scientific messages to policymakers. By getting such research into the hands of policymakers who can act on it, this work can help combat racial health disparities.(Am J Public Health. 2021;111(10):1768-1771. https://doi.org/10.2105/AJPH.2021.306404).

An Educational Intervention to Decrease the Number of Emergency Incidents of Restraint and Seclusion on a Behavioral Health Unit.

BACKGROUND: The objective of this study was to implement an educational intervention on an inpatient, behavioral health care unit with the goal of reducing the number of crisis interventions of seclusion or restraint. METHOD: A quasi-experimental pretest and posttest design using De-escalate Anyone, Anywhere, Anytime training was employed with a focus of an increased understanding of a range of de-escalation techniques to use instead of restraint and seclusion. RESULTS: A convenience sample of 21 mental health employees participated in the training. The rates of restraint declined from a mean of 6 preintervention to 2 postintervention. The number of seclusions on the designated unit declined from a mean of 4.33 preintervention to a mean of 1.667 postintervention. CONCLUSION: These data suggest that an educational intervention to increase the knowledge of direct care staff in a broad range of de-escalation techniques resulted in a reduction in the use of restraint and seclusion. Ongoing training for nursing staff may reassure them of the efficacy of alternative methods for dealing with aggressive patients. [J Contin Educ Nurs. 2022;53(2):70-76.].

Faith Community Nursing: Identifying and Combating Social Isolation and Loneliness in Older Adults.

ABSTRACT: The number of older adults worldwide is growing; the incidence of social isolation and loneliness among this population is also increasing. Social isolation and loneliness can have significant physical, mental, and spiritual impacts. Faith community nurses are in an optimal position to identify and intervene to help faith communities reduce the social isolation and loneliness among community-dwelling older adults. Risk factors and tools to identify both circumstances are discussed along with interventions and a case study.

Outbreaks of COVID-19 variants in US prisons: a mathematical modelling analysis of vaccination and reopening policies.

BACKGROUND: Residents of prisons have experienced disproportionate COVID-19-related health harms. To control outbreaks, many prisons in the USA restricted in-person activities, which are now resuming even as viral variants proliferate. This study aims to use mathematical modelling to assess the risks and harms of COVID-19 outbreaks in prisons under a range of policies, including resumption of activities. METHODS: We obtained daily resident-level data for all California state prisons from Jan 1, 2020, to May 15, 2021, describing prison layouts, housing status, sociodemographic and health characteristics, participation in activities, and COVID-19 testing, infection, and vaccination status. We developed a transmission-dynamic stochastic microsimulation parameterised by the California data and published literature. After an initial infection is introduced to a prison, the model evaluates the effect of various policy scenarios on infections and hospitalisations over 200 days. Scenarios vary by vaccine coverage, baseline immunity (0%, 25%, or 50%), resumption of activities, and use of non-pharmaceutical interventions (NPIs) that reduce transmission by 75%. We simulated five prison types that differ by residential layout and demographics, and estimated outcomes with and without repeated infection introductions over the 200 days. FINDINGS: If a viral variant is introduced into a prison that has resumed pre-2020 contact levels, has moderate vaccine coverage (ranging from 36% to 76% among residents, dependent on age, with 40% coverage for staff), and has no baseline immunity, 23-74% of residents are expected to be infected over 200 days. High vaccination coverage (90%) coupled with NPIs reduces cumulative infections to 2-54%. Even in prisons with low room occupancies (ie, no more than two occupants) and low levels of cumulative infections (ie, <10%), hospitalisation risks are substantial when these prisons house medically vulnerable populations. Risks of large outbreaks (>20% of residents infected) are substantially higher if infections are repeatedly introduced. INTERPRETATION: Balancing benefits of resuming activities against risks of outbreaks presents challenging trade-offs. After achieving high vaccine coverage, prisons with mostly one-to-two-person cells that have higher baseline immunity from previous outbreaks can resume in-person activities with low risk of a widespread new outbreak, provided they maintain widespread NPIs, continue testing, and take measures to protect the medically vulnerable. FUNDING: Horowitz Family Foundation, National Institute on Drug Abuse, Centers for Disease Control and Prevention, National Science Foundation, Open Society Foundation, Advanced Micro Devices.