One year later: What role did trust in public officials and the medical profession play in decisions to get a booster and to overcome vaccine hesitancy?

Physicians may have an important role to play in promoting boosters as well as reducing COVID-19 vaccine hesitancy, but the relationship between hesitancy and trust in the medical profession and these behaviors has been underexplored. A representative online panel of 1,967 US adults that included oversamples of minoritized and rural populations were surveyed in April 2021 and June 2022 regarding their booster and vaccine status and intentions, their views of the medical profession, and their levels of trust in their own doctors, and national and state/local officials. Eighty percent of those vaccinated in 2021 had received a booster by 2022, while fewer than half of those initially reluctant to get a vaccine had gotten one by Wave 2 of the survey. Mean factor scores were calculated for response to a validated scale measuring trust in the medical profession. Linear and logistic regression models estimated the relationship between these factors scores and trust in other officials for those vaccinated as well initial hesitaters/refusers in Wave 1, controlling for population factors. Trust in one's own physician was associated with those vaccinated/eager to be vaccinated getting a booster, while trust in the medical profession was associated with getting a vaccine among those who had previously refused or were hesitant. Trust in other experts was not significantly associated with these behaviors, but wide confidence intervals suggest a need for future research. Innovative strategies, including mobilizing the medical community is needed to address reluctance, uncertainty, and distrust of therapeutic agents in pandemic response.

Reasons for Turnover of Kansas Public Health Officials during the COVID-19 Pandemic.

Public health officials played a critical role in COVID-19 mitigation and response efforts. In Kansas, 51 local health department (LHD) administrators and/or local health officers left their positions due to the pandemic between 15 March 2020 and 31 August 2021. The purpose of this study was to identify factors that led to turnover of Kansas local public health officials during the COVID-19 pandemic. Those eligible to participate in this study included former LHD administrators and/or health officers who were employed at or contracted by a Kansas LHD on 15 March 2020 and resigned, retired, or were asked to resign prior to 31 August 2021. Researchers used a demographic survey, a focus group, and key informant interviews to collect data. Twelve former LHD leaders participated in this study. Four themes emerged from phenomenological analysis: politicization of public health; a perceived lack of support; stress and burnout; and the public health infrastructure not working. The findings of this study can guide the Kansas public health system to address the issues leading to turnover of leadership and prevent future turnover. Future research must explore strategies for mitigating leadership turnover and identify alternative public health structures that could be more effective.

Association between COVID-19 vaccine hesitancy and trust in the medical profession and public health officials.

One's personal physician, national and state or local public health officials, and the broader medical profession play important roles in encouraging vaccine uptake for COVID-19. However, the relationship between trust in these experts and vaccine hesitancy has been underexplored, particularly among racial/minority groups where historic medical mistrust may reduce uptake. Using an April 2021 online sample of US adults (n = 3041) that explored vaccine hesitancy, regression models estimate levels of trust in each of these types of experts and between trust in each of these experts and the odds of being COVID-19 vaccine takers vs refusers or hesitaters. Interaction terms assess how levels of trust in the medical profession by race/ethnicity are associated with vaccine hesitancy. Trust in each expert is positively associated with trust in other experts, except for trust in the medical profession. Only trust in one's own doctor was associated with trust in the medical profession, as measured by factor scores derived from a validated scale. Lower levels of trust in experts were significantly associated with being either a hesitater or a refuser compared to being a taker. Black respondents had higher odds of being either a hesitater or a refuser compared to white respondents but the interaction with trust was insignificant. For Hispanic respondents only, the odds of being a hesitater declined significantly when trust in the medical profession rose. Mistrust in the medical profession, one's doctor and national experts contributes to vaccine hesitancy. Mobilizing personal physicians to speak to their own patients may help.

Tensions and opportunities in the roles of senior public health officials in Canada: A qualitative study.

Although public health emergencies like the COVID-19 pandemic thrust senior public health officials into the spotlight, their day-to-day roles remain misunderstood and under-examined. In jurisdictions that follow the Westminster system of government such as Canada, the United Kingdom, and Australia, Chief Medical Officers of Health (CMOHs) are typically senior public servants who are simultaneously positioned as public health professionals with independent expertise, senior advisors to an elected government, and designated protectors of the public health interest. Using Canada's federal and provincial CMOHs as case studies of this role in Westminster governments, we analyzed in-depth key informant interview data to examine how CMOHs navigate the tensions among their duties to the government, profession, and public in order to maximize their public health impact. We demonstrate that CMOHs are variously called upon to be government advisors, public health managers, and public communicators, and that the different emphasis that jurisdictions place on these roles shapes the tools and pathways through which CMOHs can influence government action and public health. We also elucidate the tensions associated with having CMOHs positioned within the senior levels of the public service and the strategies these officials use to balance their internal- and external-facing roles. Finally, we highlight the trade-offs among different institutional design options to inform decisions about the structure of the CMOH position in different contexts.

Comparison of Job Stress, Quality of Life Scale and Health Promotion Behaviors in Public Health Officials and General Administration Officials / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to compare the job stress, health promotion behaviors and quality of life between public health officials and general administration officials. METHODS: Subjects were 60 public health officials and 71 general administration officials in G-City in Korea. Data were collected from January 25 to February 5, 2016 through self-administered questionnaires and analyzed t-test and Pearson's correlation coefficients. RESULTS: Job stress (t=4.060 p<.001) and quality of life (t=3.963, p=.025) were significantly different between public health officials and general administration ones, while health promotion behaviors were not significantly different between these two official groups (t=0.394, p=.606) CONCLUSION: Results of this study suggested that it was necessary for public health officials to develop intervention program aimed at reducing job stress. Also, it would be effective to focus on improving health promotion behaviors and quality of life for them.

Web-Based Instruction For Public Health Officials-A Prototype Development And Preliminary Evaluation / 대한의료정보학회지

Health and Welfare Training Center of Korean National Institute of Health (KNIH) has developed various education curricula for the officials who involved in the public health or welfare sectors. Still almost all education programs are off-line based. In off-line settings, both the lecturers and the students should come to KNIH from their counties to join the education programs, and it is impossible for the students to review or to re-practice the education contents. From September to October, 2000, we conducted a basic survey to evaluate the information infrastructure, internet use and attitude to the cyber education. The 183 institutions and 548 public health officials answered our questionnaire. The informationa infrastructure of each institution was not satisfactory for distance education via world wide web. The proportion of e-mail user was only about 62% of the answered subjects. But cyber- education was highly needed in both institutions and the surveyed officials. They answered that they would actively participate in the cyber-education(97%). The officials expected that the online education would be effective to acquire information, to increase the chance for participation and to reduce the education cost. The expected barriers of the cyber-education were the overload when they should undergo simultaneously education and working, lack of proper infrastructure, disinterest of their low capability of internet use.

Web-Based Instruction For Public Health Officials-A Prototype Development And Preliminary Evaluation / 대한의료정보학회지

We developed a prototype of web-based instruction(WBI) program to provide more convenient and more effective service to the public health officials. This web-based instruction program had specific objectives on vaccination for the public health officials who were working for national immunization program. This course had 21 chapters composed of hypertext or voice-based instruction. Using the WBI courseware of Korean Officials Trainging Institution(KOTI), 32 public health official volunteers joined this prototype 2 week program in April 2001. A Auestionnaire survey for evaluation of subjective satisfaction and related factors, cyber-education behavior, and internet using behavior was performed in April, 2001. Among the answered 29 subjects, 24 were female(82.8%). Mean age was 36.6% 6.16. 79.3% of the 29 subjects connected internet in their office. The highest frequent study duration was < 1 hr(51.7%) per connection. They represented relatively high subjective satisfaction in education form(78.6%), and contents(85.7%). But 62.3% of these subjects answered the subjective relative effectiveness score(which was as 100 in case of classical lecture form) was lower than 100. The place to connect internet was only statistically significant factor between these two groups in bivariable analysis. But we could not found any significant factors in multivariate analysis. 89.7% of the subjects answered they would like to participate any more WBI courses serviced by Korean National Health Institute. This study had restriction of small sample size.