Fear of COVID-19 among nonsmokers and smokers/former smokers: Implications for health promotion practice.

INTRODUCTION: Fear of COVID-19 may differ for individuals with compromised health and those with unhealthy behaviors, placing them at greater risk. Based on previous analysis of academic medical center faculty and staff, the authors predicted that workers who were smokers/previous smokers would express the greater fear of COVID-19 relative to nonsmokers. METHODS: The present study used the Fear of COVID-19 Scale to assess fear among nonsmokers (n = 1,489) and smokers/previous smokers (n = 272) from a larger population of academic medical center members (N = 1,761). This study assessed nonsmokers' and smokers/previous smokers' demographic and background variables on Fear of COVID-19 scores. RESULTS: In this academic community, smokers/previous smokers had higher fear of COVID-19 scores than did nonsmokers (p < 0.05). Smokers/previous smokers differed from nonsmokers on three Fear of COVID-19 scale items (most afraid of COVID-19, fear of losing life, and physiological fear of COVID-19). DISCUSSION/CONCLUSIONS: These results provide a better understanding of how fear of COVID-19 can differ based on one's smoking status. These findings inform public health smoking cessation efforts aimed at reducing morbidity and mortality, both in response and secondary to COVID-19 exposure.

Sex Differences between Medical Students in the Assessment of the Fear of COVID-19.

Background: Differing expressions of the fear of COVID-19 between men and women can potentially increase both immediate and long-term physical health risks. We predicted that women students would express greater fear of COVID-19. Methods: We used an Internet-delivered Fear of COVID-19 Scale (FCV-19S) to assess fear among men (n = 100) and women (n = 272) from a larger population of academic medical center members (n = 1761). Sex differences in emotional and physical symptoms were assessed as subcategories within fear scores. Results: Women reported greater fear of COVID-19 than men (p < 0.001). Women reported greater emotional fear (p < 0.001) on specific scale items (thinking of COVID-19, watching news stories about COVID-19, and losing sleep due to fear of contracting COVID-19). Discussion/Conclusions: These results provide a better understanding of how fear of COVID-19 can differ based on sex and how that fear may be expressed differently through emotional and physical symptoms. This information will inform academic health centers of COVID-19 prevention and management policies that may include a gender-specific focus.

Fear of COVID-19 among nonsmokers and smokers/former smokers: Implications for health promotion practice.

INTRODUCTION: Fear of COVID-19 may differ for individuals with compromised health and those with unhealthy behaviors, placing them at greater risk. Based on previous analysis of academic medical center faculty and staff, the authors predicted that workers who were smokers/previous smokers would express the greater fear of COVID-19 relative to nonsmokers. METHODS: The present study used the Fear of COVID-19 Scale to assess fear among nonsmokers (n = 1,489) and smokers/previous smokers (n = 272) from a larger population of academic medical center members (N = 1,761). This study assessed nonsmokers' and smokers/previous smokers' demographic and background variables on Fear of COVID-19 scores. RESULTS: In this academic community, smokers/previous smokers had higher fear of COVID-19 scores than did nonsmokers (p < 0.05). Smokers/previous smokers differed from nonsmokers on three Fear of COVID-19 scale items (most afraid of COVID-19, fear of losing life, and physiological fear of COVID-19). DISCUSSION/CONCLUSIONS: These results provide a better understanding of how fear of COVID-19 can differ based on one's smoking status. These findings inform public health smoking cessation efforts aimed at reducing morbidity and mortality, both in response and secondary to COVID-19 exposure.

Assessing fear of COVID-19 at an academic medical center.

PURPOSE: This study measured the degree of COVID-19-related fear among academic medical center employees, identified subsections with high COVID-19 fear, and validated the Fear of COVID-19 Scale with medical professionals in the United States. METHODS: This study is a cross-sectional, internet-based survey delivered by Qualtrics. The survey was conducted at the Oklahoma University Health Sciences Center between May 21 and June 18, 2020. The medical center is composed of seven healthcare colleges, child and adult hospitals, a Veterans Hospital, and outpatient services clinics across the Oklahoma city area. Faculty, staff, and students (N = 1,761) from the Oklahoma University Health Sciences Center completed the survey. RESULTS: COVID-19 fear is highest among nonclinical employees, smokers, and those with pre-existing conditions. Males and females, both clinicians and nonclinicians, appear to express their COVID-19 fears differently. Employees worried most about their families contracting the virus. The Fear of COVID-19 Scale is a valid and reliable assessment instrument among US healthcare workers. Responses were compared based on pre-existing medical condition(s), patient care or nonpatient care, sex, and occupational specialization. Analyses reveal a strong Cronbach's α measure of internal consistency (α = 0.87). Significant differences were observed among employees with a nonclinical emphasis (p = 0.02), with a predisposing medical health condition (p < 0.001), and with a nonacademic occupational specialization (p < 0.01), and by sex (p < 0.001). CONCLUSIONS AND DISCUSSION: COVID-19 fear significantly impacts academic medical center employees. Medical centers should address both healthcare and nonhealthcare workers' COVID-19-related fears. It is important to recognize that men and women may have different types of fears and express them differently, necessitating a gender-specific approach to managing COVID-19 fears. Employees with pre-existing conditions or who have vulnerable family members require additional support to remain fully functional and on the job.

Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

OBJECTIVE: Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. METHOD: Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. RESULTS: In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. CONCLUSION: Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear understanding of teaching techniques, and report spending less time educating patients than do family medicine residents. The differences might be due to different patient populations and treatment settings. The study suggests that psychiatry residents may have difficulty adapting the One-Minute Preceptor technique in psychiatric settings. Results serve as a benchmarking study in a performance-improvement program to enhance psychiatry residents' teaching skills.

Latino/as in substance abuse treatment: substance use patterns, family history of addiction, and depression.

This study describes a sample of Latino/as in substance abuse treatment. We were interested in substance use patterns, gender differences, family history of addiction, and depression. Questionnaires completed by Latino/as (N = 209) were identified from 12,000 sets completed by participants in treatment from 1993-2003. Significant gender differences emerged, with Latinas reporting higher rates of stimulant abuse and depression. A family history of substance use disorders in primary or secondary family members was reported by 91% of participants. These data suggest that understanding gender differences related to substance use and depression among Latino/as in treatment warrants attention.

Learning from Katrina: environmental health observations from the SWCPHP response team in Houston.

Hurricane Katrina provided an opportunity to observe the public health and medical care response system in practice and provided vital lessons about identifying and learning critical response measures as well as about ineffective investments of time and effort. The Southwest Center for Public Health Preparedness (SWCPHP) response team, while working among evacuees housed at Reliant Park in Houston, Texas, made a number of observations related to environmental public health. This summary reports firsthand observations which are, to a great extent, supported by the Federal Response to Hurricane Katrina: Lessons Learned report, and it provides a contextual backdrop for improvement in the areas of volunteer and citizen preparedness training and education. Katrina provided an opportunity to see public health in a highly stressed practice setting and to identify and reinforce the fundamental tenets of public health with which all individuals responding to an event should be familiar. Knowledge gained from Katrina should be integrated into future efforts related to disaster response planning; specifically, it is imperative that volunteers receive standardized training in the areas of incident command systems (ICS), basic hygiene, transmission of disease, and food and water safety principles.

Partnering for preparedness: the project public health ready experience.

Effective partnerships between local and state public health agencies and schools of public health have tremendous potential to improve the health of communities nationwide. This article highlights successful collaboration between local public health agencies (LPHA), state health departments, and Academic Centers for Public Health Preparedness (ACPHP) in schools of public health developed through participation in Project Public Health Ready, a program to recognize LPHA emergency preparedness. The project's pilot phase illustrated that LPHAs, state health departments, and ACPHP can effectively work together to improve individual public health worker competency and organizational response capacity in local public health agencies nationwide.

Are public health workers aware of what they don't know?

OBJECTIVES: Training of public health workers is an important part of preparedness. Self-assessment is often used to measure how well workers are trained and whether they are ready to respond to an emergency event. The current study assessed how well self-assessment predicts actual knowledge. METHODS: Public health workers at a Public Health Ready pilot site self-assessed their general level of confidence, answered objective knowledge items about their local response plan, and self-assessed whether they were correct on the objective knowledge items. Correlational analysis was used to assess how well workers could assess what they knew and did not know. RESULTS: In the first analysis, for 15 objective knowledge items, the median correlation between self-assessment and actual performance was 0.18. When the average self-assessment on the core competencies was correlated with the number of correct answers to the objective knowledge items, the correlation was 0.34. CONCLUSIONS: The modest sizes of the correlations suggest that workers are weak judges of what they know and do not know. To prepare public workers for emergency events, it is suggested that two steps are important: (1) using the core competencies, develop a local response plan, and (2) develop an objective knowledge test to assess workers' knowledge of the local response plan.

Self-assessment in the measurement of public health workforce preparedness for bioterrorism or other public health disasters.

OBJECTIVE: The purpose of this study was to examine effective ways to evaluate public health workers' competence for preparedness. METHODS: The Public Health Ready project, developed by the National Association of County and City Public Health Officials and the Centers for Disease Control and Prevention, is a pilot program designed to prepare local public health agencies to respond to emergency events. Workers at a Public Health Ready site (N=265) rated their need for training and their competence in meeting generic emergency response goals. Cluster analysis of cases was conducted on the self-assessed need for training. RESULTS: Three groups of workers emerged, differing in their overall ratings of need for training. A given worker tended to report similar needs for training across all training goals. CONCLUSIONS: In this study, workers' ratings of need for training may reflect an overall interest in training rather than need for training in a particular area. Caution should be exercised in interpretation when generic goals and self-assessment are used to measure need for training. Future assessments of training needs may be more effective if they use objective measures of specific local plans.

Anger types and the use of cigarettes and smokeless tobacco among Native American adolescents.

BACKGROUND: Although tobacco use appears common among Native Americans, the study of dual use of cigarettes and smokeless tobacco has been neglected. The current study examines tobacco use among a sample of Native American adolescents. Also, it considers how the psychological factor of anger may relate to tobacco use. METHODS: The participants were 513 Native American students from a national sample in grades 6, 8, and 10 in the United States. Cluster analysis was used to identify anger types, and these types were compared on their tobacco use. RESULTS: Cluster analysis identified four anger types. One type was the Externalizing Type, characterized by the tendency to show externalizing behaviors such as fighting and yelling. This type had an elevated rate of tobacco use. In terms of an odds ratio, the Externalizing Type was about 10 times more likely to smoke, about 6 times more likely to use smokeless tobacco, and about 8 times more likely to show dual use. The majority of dual users were the Externalizing Type. CONCLUSIONS: The results suggest that externalizing anger types are more likely to use tobacco, and that smoking cessation programs for teens could be more effective when they address anger issues.