Educational Intervention to Increase COVID-19 Vaccine Uptake in Rural Patients with Chronic Diseases: Lessons Learned from An Innovative Academic-Community Partnership.

BACKGROUND: The pandemic has disproportionately impacted rural communities with a higher burden of chronic disease and COVID-19 infection. West Virginia is a rural state with a high rate of diabetes, hypertension, and COPD, which are known risk factors for severe COVID-19 and long COVID. Yet, there is a significant hesitancy regarding COVID-19 vaccination uptake in the state. The purpose of this study was to use an educational intervention to increase vaccine knowledge and vaccine acceptance in rural patients with chronic disease(s) in West Virginia. This project used an academic-community partnership comprised of researchers, practitioners, community organizations, community-engaged partners, and patient stakeholders to increase COVID-19 health literacy and increase vaccine acceptance among rural West Virginians with chronic conditions. MATERIALS AND METHODS: A quasi-experimental study design was used to deliver an educational intervention by trained Health Navigators using short videos to increase COVID-19 health literacy and address participants' vaccine concerns. Eligibility included adults (18 years and older) who have at least one chronic condition. A statewide community advisory board (CAB) guided the development of the educational training curriculum and implementation strategies. An adapted version of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework guided the development of the intervention. Health Navigators (n = 45) delivered the educational intervention in their local communities between November 2022 and October 2023 (project implementation is still ongoing). Intervention fidelity checks, an adaptable script, and a flow chart allowed tailoring of brief videos to address participants' specific COVID-19 questions and vaccine concerns. A validated online survey, monitored by an online Research Electronic Data Capture (REDCap) database, assessed participants' knowledge, perceived susceptibility, and vaccine intention. RESULTS: Health Navigators delivered the intervention to 1368 West Virginians in 52 counties (59.2% women; 61.8% without a college degree). Participants reported living with an average of 2.1 ± 1.4 chronic conditions. The mean age was 43.5 ± 18.8 years. The majority of participants (81.2%) had received the primary vaccination series, and 63.1% had at least one booster. However, 18% were unvaccinated or did not complete the primary COVID-19 vaccine series. Discussions to improve vaccine literacy focused on how the vaccine was so quickly developed and protects against variants, addressing concerns related to the safety, short- and long-term side effects, and importance of vaccine uptake for immunocompromised individuals. Participants with higher concerns were more likely to be unvaccinated and to have not completed their primary series or boosters (p < 0.001). However, the educational intervention improved the willingness of individuals who were either unvaccinated or did not complete their primary vaccine series to get vaccinated (11.4%). DISCUSSION: Our findings highlight the importance of vaccine literacy in increasing vaccination rates among rural patients with chronic diseases. Using the EPIS framework allowed us to reflect upon the challenges, ensure resilience during changing local contexts, and plan and implement a promising, cost-effective intervention in rural areas. CONCLUSIONS: This study provides insights into the need for tailored educational interventions based on disease status, which has implications for public health and patient care in rural and underserved communities. Academic-community partnerships can be useful for successful knowledge transfer for vaccine acceptance to reduce rural health disparities.

High School Students' Learning During the COVID-19 Pandemic: Perspectives from Health Sciences and Technology Academy Participants.

This paper examines the perspectives of Health Sciences and Technology Academy (HSTA) participants as they navigate through their West Virginia (WV) high school learning environments (i.e., in-person, blended/hybrid, complete virtual) during the novel coronavirus, SARS-CoV-19 (COVID-19) pandemic. In March of 2020, the participants in this out-of-school-time (OST) academic enrichment program for exceptionally driven, yet underprivileged, at-risk students, with over 70% living in rural areas, started receiving remote learning instruction through learning management systems or via paper packets. In August of 2020, school systems provided parents and caregivers alternative learning environments for their student(s). In order to understand the learning experiences of HSTA students during these unprecedented times, HSTA released the 2020 Learning Outcomes Survey to participants in December of 2020. We performed chi-square test of independence to test the relationship between participants' learning environments, their satisfaction with the education they were receiving, their ability to keep up with their school-work, teacher availability to help when needed and teacher feedback supporting them in their learning environment. The results show significant differences between the learning environments and keeping up with school-work as well as teacher feedback supporting them in their learning; however, Phi and Cramer's V tests for effect size show weak correlations. This study provides a small glimpse into HSTA students' learning experiences as they attempted to continue to learn in their regular school environment during the COVID-19 pandemic while in HSTA.

The Health Sciences and Technology Academy: Re-Imagining Programmatic Delivery During the COVID-19 Pandemic.

Out-of-school time academic/STEM programs provide educational enrichment to a myriad of student populations with some designed to assist those underrepresented and at-risk who desire to purse post-secondary studies. One such program in West Virginia (WV) is the Health Sciences and Technology Academy (HSTA), which provides hands-on, in person and engaging educational enrichment with the intent to increase the college going rates of Appalachia's most vulnerable youth. In March 2020, HSTA key personnel encountered the task of redesigning program delivery due to the immediate shutdown of all in person operations resulting from the novel coronavirus, SARS-CoV-19 (COVID-19) pandemic. This paper discusses the programmatic changes of program delivery during HSTA's key program components-the Summer Institute and the Community Based Programming. This paper also utilizes repeated measures one-way multivariate analysis (MANOVA) and paired t-test analysis to examine participants' perspectives on learning, enjoyment and satisfaction of the aforementioned components prior to and during the COVID-19 pandemic.

The Health Sciences and Technology Academy (HSTA): Providing 26 Years of Academic and Social Support to Appalachian Youth in West Virginia.

The Health Sciences and Technology Academy's, (HSTA) goals are to increase college attendance of African American, financially disadvantaged, first generation college and rural Appalachian youth and increase health-care providers and STEM professionals in underserved communities. Students enter in the 9th grade and remain in HSTA four years. They engage in a rigorous academic program within the nurturing environment of small after-school clubs punctuated by yearly summer camps on multiple college campuses. A distinctive piece of HSTA is its students' development of research projects under the mentorship of teachers and researchers that examine and address health issues faced by their communities. The projects help HSTA students to understand the health dynamics in their local community, transforming them into community advocates who address health and social issues at home as they prepare to move on to college and beyond. Substantial in-state tuition waivers inspire 99% of the 3,021 HSTA graduates to attend college versus 56% of WV high school graduates. Approximately 85% of matriculating HSTA students graduate with a four-year degree or higher versus less than 50% of all college entrants. To date, 57% of HSTA students go into health and other STEM majors, much higher than the state and national figures.

Providing Oral Health Education to Adolescents with Peer-Assisted Learning.

There is a need to increase oral health knowledge, attitudes and behaviors in children to improve oral health. This research involves peer-assisted learning to determine if high school students can influence rural middle school students' oral health. The study sample consisted of middle school students. After completing pre-test, they were assigned to receive 1) didactic peer-assisted learning with professionally supervised and educated high school students (members of an after-school pipeline program for science, technology, engineering, mathematics, and health science); or, 2) teacher provided handouts/activity sheets. Both groups then completed a post test. The results of the Mann-Whitney U Tests showed that brushing and flossing failed to reach significant improvements between the pre-test and post-test for the handouts/activity sheets group (brushing, P=0.391; flossing, P=0.459). There was improvement within that group for oral health knowledge (P<.001). Brushing, flossing and oral health knowledge failed to reach significant improvement between the pre-test and post-test for the peer-assisted learning group (brushing, P=0.760; flossing, P=0.707; oral health knowledge, P= 0.154). In terms of oral health knowledge, there was no difference between the scores of the two groups on the pre-test (P-value = 0.980) nor on the post-test (P-value= 0.237). Near-peer assisted learning for oral hygiene knowledge, attitudes, and behaviors had similar outcomes as teacher provided handouts and activity sheets in a middle school setting.

Consumption and exchange in Early Modern Cambodia: NAA of brown-glaze stoneware from Longvek, 15th-17th centuries.

An evaluation of the geochemical characteristics of 102 storage jar sherds by k0-neutron activation analysis (k0-NAA) from archaeological contexts in Cambodia and reference samples from stoneware production centres in Thailand provides a new perspective on regional and global trade in mainland Southeast Asia. Identification of seven geochemical groups enables distinctions between production centres, and articulation of their role in trade between northern and central Thailand, South China and Cambodia. Storage jars from Thailand and South China are known in archaeological contexts worldwide because of their durability and intrinsic functional and cultural values. Evidenced by a novel application of k0-NAA, analogous stoneware sherds at Longvek connect the Cambodian capital to a global trading network. Additional proof of ceramics from an undocumented Cambodian kiln demonstrates the gradual and complex transition between the Angkorian past and the Early Modern period.

A Health Professional-Led Synchronous Discussion on Facebook: Descriptive Analysis of Users and Activities.

BACKGROUND: Arthritis is a major cause of pain and disability. Arthritis New Zealand (Arthritis NZ) is a nongovernmental organization that provides advocacy, information, and advice and support services for people with arthritis in New Zealand. Since many people seek health information on the Web, Arthritis NZ has a webpage and a Facebook page. In addition to static content, Arthritis NZ provides synchronous discussions with an arthritis educator each week via Facebook. OBJECTIVE: The aim of this study was to describe participation and structure of synchronous discussion with a health educator on a social media platform and the type of information and support provided to people with arthritis during discussions on this social media platform. METHODS: Interpretive multimethods were used. Facebook Analytics were used to describe the users of the Arthritis NZ Facebook page and to provide descriptive summary statistics. Graphic analysis was used to summarize activity during a convenience sample of 10 arthritis educator-led synchronous discussions. Principles of thematic analysis were used to interpret transcripts of all comments from these 10 weekly arthritis educator-led discussions. RESULTS: Users of the Arthritis NZ Facebook page were predominantly female (1437/1778, 80.82%), aged 18 to 54 years. Three major activities occurred during arthritis educator-led synchronous discussions: (1) seeking or giving support; (2) information enquiry; and (3) information sharing across a broad range of topic areas, largely related to symptoms and maintaining physical functioning. There was limited peer-to-peer interaction, with most threads consisting of two-comment exchanges between the users and arthritis educators. CONCLUSIONS: Arthritis educator-led discussions provided a forum for informational and emotional support for users. The facilitated discussion forum for people with arthritis on Facebook could be enhanced by encouraging increased user participation and increasing peer-to-peer interactions and further training of arthritis educators in facilitation of Web-based discussion. Future research should focus on addressing barriers to user participation and assessing the impact of arthritis educator facilitation training, with the latter leveraging the Action Research paradigm.

Psychopharmacologic intervention after hemorrhagic basal ganglia damage.

Traumatic brain injury (TBI) can result in cognitive and behavioral impairments such as poor attention, learning, memory and planning ability and uncontrolled crying that can be more persistent problems than the physical disabilities. Cognitive enhancers have been shown to improve cognitive and behavioral impairments in patients with hemorrhagic basal ganglia lesions as well as other forms of TBI. There is little research about the use of cognitive enhancers after hemorrhagic basal ganglia damage. We present a case of a 38 year old male who made significant recovery with the use of cognitive enhancers.