Examining self-efficacy and COVID-19 disease prevention behaviors among socially vulnerable populations.

Social vulnerabilities are associated with higher COVID-19 disease morbidity and mortality. Primary forms of COVID-19 disease prevention aside from vaccination, are health behaviors including masking, hand washing, social distancing, and staying home when one is sick. Understanding the self-efficacy of these behaviors in vulnerable populations can inform health interventions to improve COVID-19 disease outcomes. A repeated cross-sectional study with three waves (Wave 1 = pilot, Wave 2, n = 1258, Wave 3, n = 477) was conducted using an online survey. This analysis only included Wave 2 and Wave 3. The study targeted Yakima County, WA, USA, an area with pronounced social, environmental, and health disparities. Measures included demographic, household, and self-efficacy constructs. Binary logistic regression was used to determine which demographic and household factors were related to constructs of self-efficacy. An independent t-test was performed to determine if there were significant differences between population levels of self-efficacy over time (Wave 2 vs. Wave 3). Household size, identifying as Hispanic/Latino, and measures of socioeconomic status were significantly related to various self-efficacy beliefs about COVID-19 disease prevention behaviors and the ability to protect oneself from COVID-19 disease in general. Self-efficacy increased for each measure between Wave 2 and Wave 3 (p < 0.001). Socially vulnerable groups continue to experience disparate health outcomes in the face of COVID-19 disease. Future studies should examine ways to increase self-efficacy among populations that are experiencing lower levels as self-efficacy is a significant factor related to health outcomes.

Pregnancy and Childbirth Expectations During COVID-19 in a Convenience Sample of Women in the United States.

The COVID-19 pandemic has transformed the health care landscape and shifted individuals' expectations for and interactions with essential health services, including pregnancy-related care. This study explores alterations to individuals' pregnancy and childbirth decisions during an infectious disease pandemic. A convenience sample of 380 pregnant individuals with an expected delivery date between April and December 2020 consented to enroll and complete an online questionnaire on their pregnancy and childbirth expectations during the COVID-19 pandemic; a subset of respondents (n = 18) participated in semi-structured phone interviews. Survey data were analyzed quantitatively while interview data were analyzed using a thematic content analysis until a consensus on key themes was achieved. Respondents reported substantial stressors related to shifting policies of health care facilities and rapidly changing information about COVID-19 disease risks. As a result, respondents considered modifying their prenatal and childbirth plans, including the location of their birth (25%), health care provider (19%), and delivery mode (13%). These findings illuminate the concerns and choices pregnant individuals face during the COVID-19 pandemic and offer recommendations to engage in compassionate, supportive, and person-centered care during a time of unprecedented risk and uncertainty.