ABSTRACT
IntroductionDuring the COVID-19 pandemic, numerous states in the United States instituted measures to close schools or shift them to virtual platforms. Understanding parents preferences for sending their children back to school, and their experiences with distance learning is critical for informing school reopening guidelines. This study characterizes parents plans to send their children to school, and examines the challenges associated with school closures during the 2020-2021 academic year. MethodsA national-level cross-sectional online survey was conducted in September 2020. Focusing on a subset of 510 respondents, who were parents of school-aged children, we examined variations in parents plans for their children to return to school by their demographic and family characteristics, and challenges they anticipated during the school-year using multivariable logistic regressions. ResultsFifty percent of respondents (n=249) said that they would send their children back to school, 18% (n=92) stated it would depend on what the district plans for school reopening, and 32% (n=160) would not send their children back to school. No demographic characteristics were significantly associated with parents plans to not return their children to school. Overall, parents reported high-level of access to digital technology to support their childs learning needs (84%). However, those who reported challenges with distance learning due to a lack of childcare were less likely not to return their children to school (aOR=0.33, 95% CI: 0.17, 0.64). Parents who reported requiring supervision after school had higher odds of having plans to not return their children to school (aOR=1.97, 95% CI: 1.03, 3.79). Parents viewed COVID-19 vaccines and face masks important for resuming in-person classes. DiscussionAbout one-third of parents surveyed objected to their children returning to school despite facing challenges with distance learning. Besides access to vaccines and face masks, our findings highlight the need to better equip parents to support remote learning, and childcare.
ABSTRACT
IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related diagnoses, hospitalizations, and deaths have disproportionately affected disadvantaged communities across the United States. Few studies have sought to understand how risk perceptions related to social interaction and essential activities during the COVID-19 pandemic vary by sociodemographic factors, information that could inform targeted interventions to reduce inequities in access to care and information. MethodsWe conducted a nationally representative online survey of 1,592 adults in the United States to understand risk perceptions related to transmission of COVID-19 for various social and essential activities. We assessed relationships for each activity, after weighting to adjust for the survey design, using bivariate comparisons and multivariable logistic regression modeling, between responses of safe and unsafe, and participant characteristics, including age, gender, race, education, income, and political affiliation. ResultsHalf of participants were younger than 45 years (n=844, 53.0%), female (n=800, 50.3%), and White/Caucasian (n=685, 43.0%), Black/African American (n=410, 25.8%), or Hispanic/Latino (n=382, 24.0%). Risk perceptions of unsafe for 13 activities ranged from 29.2% to 73.5%. Large gatherings, indoor dining, and visits with elderly relatives had the highest proportion of unsafe responses (>58%) while activities outdoor, visiting the doctor or dentist, and going to the grocery store had the lowest (<36%). Older respondents were more likely to view social gatherings and indoor activities as unsafe, yet more likely to view activities such as going to the grocery store, participating in outdoor activities, visiting elderly relatives, and visiting the doctor or emergency room as safe. Compared to White/Caucasian respondents, Black/African American and Hispanic/Latino respondents were more likely to view activities such as dining and visiting friends outdoor as unsafe. Generally, men vs. women, Republicans vs. Democrats and independents, and individuals with higher vs. lower income were more likely to view activities as safe. ConclusionsThese findings suggest the importance of sociodemographic differences in risk perception, health behaviors, and access to information and health care when implementing efforts to control the COVID-19 pandemic. Further research should address how evidence-based interventions can be tailored considering these differences with a goal of increased health equity in the pandemic response.
ABSTRACT
A patient tracing programme was implemented at an HIV clinic in Trinidad and Tobago to address the problem of defaulters from HIV care and non-adherence to antiretroviral treatment (ART). The study objective was to evaluate the implementation and outcomes of this programme conducted between April and September 2017. Using patient tracing contact methods, trained social workers attempted to contact 1058 patients lost to follow up (LTFU) between July 2016 and March 2017. Of the 1058 LTFU, 192 were ineligible: 27 (2.5%) were transferred to another clinic, 64 (6%) deceased, 35 (3.3%) hospitalised, 50 (4.7%) migrated and 16 (1.5%) incarcerated. Of the 866 eligible patients for patient tracing, 277 (32%) remained permanently LTFU and 589 (68%) were successfully contacted, re-engaged in care and received adherence counselling. Of the 589 who returned to care, 507 (86%) restarted ART. The three most common barriers reported among the 589 who were reengaged were 'forgetting their appointments' (20%), 'being too busy/work' (16%), and 'not wanting to be seen attending the HIV clinic' (12%). The study findings demonstrated the tracing programme as feasible for re-engaging those who are LTFU and highlighted barriers that can be addressed to further improve retention in HIV care among people living with HIV.
