ABSTRACT
IntroductionSeveral non-pharmaceutical interventions such as physical distancing, hand washing, self-isolation, and schools and business closures, were implemented in British Columbia (BC) following the first laboratory-confirmed case of coronavirus disease 2019 (COVID-19) on January 26, 2020, to minimize in-person contacts that could spread infections. The BC COVID-19 Population Mixing Patterns survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. In this paper, we describe the BC-Mix survey design and the demographic characteristics of respondents. MethodsThe ongoing repeated online survey was launched in September 2020. Participants are mainly recruited through social media platforms (including Instagram, Facebook, YouTube, WhatsApp). A follow up survey is sent to participants two to four weeks after completing the baseline survey. Survey responses are weighted to BCs population by age, sex, geography, and ethnicity to obtain generalizable estimates. Additional indices such as the material and social deprivation index, residential instability, economic dependency, and others are generated using census and location data. ResultsAs of July 26, 2021, over 61,000 baseline survey responses were received of which 41,375 were eligible for analysis. Of the eligible participants, about 60% consented to follow up and about 27% provided their personal health numbers for linkage with healthcare databases. Approximately 50% of respondents were female, 39% were 55 years or older, 65% identified as white and 50% had at least a university degree. ConclusionThe pandemic response is best informed by surveillance systems capable of timely assessment of behaviour patterns. BC-Mix survey respondents represent a large cohort of British Columbians providing near real-time information on behavioural and contact patterns in BC. Data from the BC-Mix survey would inform provincial COVID-19-related control measures.
ABSTRACT
BACKGROUND: Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention. METHODS: Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram. Individual interviews, group project evaluations, and participant observation were also conducted. Quantitative data were analyzed using Wilcoxon signed-rank test. Qualitative data were thematically coded and analyzed using the Kirkpatrick framework. RESULTS: Participants recruited (n = 32) were mostly female (81%) and nurses (56%). Pre-to-post-program mean scores improved in knowledge (+12%, p = 0.002) and skills/practices (+14%, p = 0.002). Pre-program attitude scores were high but did not change. Participants felt empowered and demonstrated attitudinal improvements regarding HIV, TB, infection control, and occupational health. Successful projects were indeed implemented. However, participants encountered considerable difficulties in trying to sustain improvement, due largely to lack of pre-existing knowledge and experience, combined with inadequate staffing and insufficient management support. CONCLUSION: Training is essential to strengthen HCWs' occupational health and infection control knowledge, attitudes, skills, and practices, and workplace-based training programs such as this can yield impressive results. However, the considerable mentorship resources required for such programs and the substantial infrastructural supports needed for implementation and sustainability of improvements in settings without pre-existing experience in such endeavors should not be underestimated.
