Occupational Health Providers' Perceptions of Employee Vaccine Hesitancy.

OBJECTIVE: This study examined the perspectives of occupational health providers (OHPs) on the most frequently encountered clinically relevant reasons for employee vaccine hesitancy. METHODS: We conducted an anonymous, online, cross-sectional survey of US OHPs ( N = 217). The survey asked OHPs about the major reasons that employees cite for being unwilling to receive the following three categories of vaccines: COVID-19, annual influenza, and others relevant to the workplace. RESULTS: Concern about adverse effects was the most frequently reported reason for employee vaccine hesitancy for each vaccine category. Mistrust was reported more frequently for COVID-19 than for the influenza vaccine or other vaccines (χ 2P < 0.05). Targets of employee mistrust included government and researchers or scientists, but mistrust of healthcare providers was uncommon. CONCLUSIONS: These results can be used to inform interventions to address vaccine hesitancy in the occupational health setting.

The syphilis elimination project: targeting the Hispanic community of Baltimore city.

OBJECTIVE: The objective of the Syphilis Elimination Project was to decrease the incidence of syphilis in the Hispanic community of Baltimore City through a culturally appropriate health initiative. DESIGN: Both qualitative and quantitative methods were used in the study design. Surveillance data were used to collect testing information. Comparisons at the start and end of the project measured change in individual knowledge about syphilis. Cross-sectional data from interviews with business owners and qualitative comments from outreach workers evaluated perception of program effectiveness. The local health department collected surveillance data. SAMPLE: A convenience sample of 63 Hispanic community members, 12 business owners/managers, and 8 outreach workers was utilized throughout the evaluation process. INTERVENTION: The project was a culturally appropriate approach to health promotion with street and business outreach. RESULTS: Post intervention there was a statistically significant increase in knowledge about syphilis within the Hispanic community and an increase in testing behaviors. CONCLUSIONS: The Syphilis Elimination Project was created in response to a marked increase in syphilis in Baltimore among the Hispanic population and a health disparity that existed within the city. It increased community members' knowledge of syphilis and positively influenced testing behaviors.

Pediatric emergency department outreach: solving medical problems or revealing community solutions?

Low-acuity (LA) use of emergency departments (EDs) is often viewed as misuse or abuse. We designed a program to help users access services more efficiently. Community health workers (CHWs) functioned as health educators, screeners, and liaisons to care. A participatory curriculum emphasized medical problems. Qualitative ethnographic methods were used for formative evaluation. Ninety families received regular visits from CHWs. Original system-oriented objectives and methods did not fit community needs. Instead, information was gathered regarding service utilization patterns: (1) families mistrusted primary and preventive care, reporting frequent discrimination and humiliation; (2) a primarily biomedical prioritization did not match families' need hierarchies; (3) complex demands of poverty made other uses of the system challenging; (4) primary care services were frequently avoided; and (5) the ED was often preferred. Intangible psychosocial factors and practical complexities of poverty were powerful promoters of LA visits. Families were creative strategists, viewing LA visits as rational use, not misuse, of a challenging system.