Using Respondent-Driven Sampling (RDS) to Recruit Women With Criminal Legal System-Involvement (CLSI) During the COVID-19 Pandemic.

Recruiting women participants with criminal legal system involvement (CLSI) has always presented challenges, whether gaining access to them in prisons and jails or locating them after release. This research brief describes how the COVID-19 pandemic required us to change our recruitment strategies from previously successful approaches to a hybrid strategy using techniques from respondent-driven sampling (RDS) to recruit CLSI women. The RDS techniques, with internet social media, enabled us to capitalize on the community-based social networks of CLSI women to recruit 255 into our clinical trial of a health education intervention. This new avenue for recruitment can be useful beyond pandemic conditions.

COVID-19 and influenza vaccine uptake in women with criminal-legal system involvement.

OBJECTIVE: Given their vulnerable health status and resource constraints, the perspectives of women with criminal-legal involvement (WCLI) are important but not usually represented in the literature on vaccine interest and vaccine hesitancy. This study aims to examine how the COVID-19 pandemic and vaccine affected the influenza vaccine uptake among WCLI. METHODS: A cross-sectional secondary analysis was conducted using data collected from the Tri-City study, which followed WCLI in three U.S. cities from 2019 to 2023. We mapped the distribution of influenza vaccine uptake in 2019-2023 and developed a composite outcome that reflected participants' patterns of Y/N to influenza vaccine, which were categorized into four groups: Influenza Vaccine Supportive, Influenza Vaccine Adaptive, Influenza Vaccine Discontinued, and Influenza Vaccine Resistant. RESULTS: Out of 507 people: 23.7% were Supportive, 8.5% Adaptive, 15.2% Discontinued and 38.3% Resistant. People who received the COVID vaccine had significantly lower odds of being identified as Discontinued (OR = 0.42, 95%CI = 0.20-0.87, p = .020) and Resistant (OR = 0.23, 95%CI = 0.13-0.43, p < .001), compared to the Supportive group. Mistrust toward COVID-19-related information was a significant independent predictor of being Adaptive (OR = 1.59, 95%CI = 1.08-2.35, p = .019), Discontinued (OR = 1.61, 95%CI = 1.15-2.25, p = .006), and Resistant (OR = 1.54, 95%CI = 1.19-2.00, p < .001) relative to Supportive. CONCLUSIONS: Vaccine hesitancy poses significant challenges to public health efforts, with apparent dampening effect across vaccines. Public health messaging and clinical interactions informed by best practices in communication tailored to the lived experience of all people, including women with criminal-legal system involvement, will be necessary to inform future interventions aimed at increasing vaccine uptake.

Pandemic antecedents - Exploring predictivity and relationships between COVID-19 vaccine uptake and influenza, shingles, and HPV vaccination.

BACKGROUND: A wealth of extant research focuses on identifying barriers to, and predictors of, COVID-19 vaccination. In addition to treating COVID-19 vaccination and related experiences as antecedents, this study analyzes the relationships between COVID-19 vaccination experiences and intent to receive the flu, shingles, and HPV vaccines. METHOD: Analyses were performed on the responses from U.S. survey panel of 1,024 participants (n = 1,024), 530 (51.8 %) who received at least a dose of the COVID-19 vaccine and 494 (48.2 %) who had not. Descriptive and inferential statistics identify participant demographic characteristics, prior vaccination behavior, vaccination intentions, risk behavior assessment, vaccination attitudes and beliefs, and the predictivity of COVID-19 vaccination, when treated as an antecedent. RESULTS: Receiving a first dose of the COVID-19 vaccine interacted with receiving a past influenza vaccine, predicting the future intention to receive a COVID-19 vaccine or booster. Vaccine hesitancy in parents is significantly related to vaccination behaviors for themselves and their children. Analyses also showed differences between the vaccinated group (VG) and the unvaccinated group (UVG) on hesitancy, beliefs, and attitudes toward the COVID-19 vaccine. CONCLUSION: Experience with COVID-19 vaccination and the relationship of those experiences with other vaccinations provide useful insight on leveraging vaccine uptake. Healthcare professionals should improve the COVID-19 vaccination experience and use vaccination appointments to promote other vaccinations. Research should continue to compare vaccination experiences and how they may persuade or dissuade vaccination intent for other vaccinations.

"A Friendly Conversation." Developing an eHealth Intervention to Increase COVID-19 Testing and Vaccination Literacy Among Women with Criminal and Legal System Involvement.

Many women leaving jails are ill-prepared to follow recommended COVID-19 mitigation practices, including testing and vaccination. Low COVID-19-related health literacy, exposure to disinformation, and mistrust in authorities put women at increased risk. Research on this population has shown significant use of mobile devices for communication and web access and public Wi-fi for the internet. Using inductive (formative empirical research with the community) and deductive (theory-based) practices, we designed, developed, and pilot-tested a multimedia, culturally tailored web-based electronic health (eHealth) application to increase COVID-19-specific health literacy and promote testing and vaccination among women with criminal and legal system involvement (CLSI). The intervention included a serialized animated multimedia component and a telenovela-style series, complementing each other and addressing knowledge needs identified in the formative research phase of the project. The eHealth intervention was pilot-tested with 13 CLSI women by using online activity logs and semi-structured telephone interviews. Findings confirmed that eHealth interventions employing multimodal information delivery had increased chances of engaging audiences, especially when developed with input from the target population and are culturally tailored. In addition, using a web-based delivery optimized for mobile made the intervention accessible on various devices and decreased the risk of technical problems.

Knowledge overconfidence is associated with anti-consensus views on controversial scientific issues.

Public attitudes that are in opposition to scientific consensus can be disastrous and include rejection of vaccines and opposition to climate change mitigation policies. Five studies examine the interrelationships between opposition to expert consensus on controversial scientific issues, how much people actually know about these issues, and how much they think they know. Across seven critical issues that enjoy substantial scientific consensus, as well as attitudes toward COVID-19 vaccines and mitigation measures like mask wearing and social distancing, results indicate that those with the highest levels of opposition have the lowest levels of objective knowledge but the highest levels of subjective knowledge. Implications for scientists, policymakers, and science communicators are discussed.

Walking the party line: The growing role of political ideology in shaping health behavior in the United States.

OBJECTIVE: To assess the extent to which political ideology affects COVID-19 preventive behaviors and related beliefs and attitudes in the U.S. METHODS: Two surveys, one using a convenience sample and another using a nationally representative sample, were conducted in September and November 2020, respectively. Multiple regressions compared political ideology with identified COVID-19 risk factors and demographics as well as knowledge measures. Surveys were followed by a review of the emerging COVID-19 behavioral literature (completed in January 2021) to assess the frequency of ideological effects in publicly reported data. RESULTS: In the survey data, political ideology was a significant predictor for all dependent variables in both surveys, and the strongest predictor for most of them. Out of 141 estimates from 44 selected studies, political ideology was a significant predictor of responses in 112 (79%) and showed the largest effect on COVID-19-related measures in close to half of these estimates (44%). CONCLUSIONS: This study reinforces previous research that found partisan differences in engaging in behaviors with long-term health consequences by showing that these ideologically-driven differences manifest in situations where the possibility of severe illness or death is immediate and the potential societal impact is significant. The substantial implications for public health research and practice are both methodological and conceptual.

COVID-19 vaccine hesitancy among women leaving jails: A qualitative study.

In many correctional facilities across the United States, COVID-19 vaccine refusal rates are as high as 50%. Most women leaving jails have low SES, health literacy, and mistrust of governmental institutions, thus exacerbating existing health disparities and making women leaving jail vulnerable. Data from 25 interviews with recently released women suggest that interventions to promote vaccines to this population will have to address health education and mitigate mistrust, misinformation, and conspiracy theories.

Kansans in the Middle of the Pandemic: Risk Perception, Knowledge, Compliance with Preventive Measures, and Primary Sources of Information about COVID-19.

INTRODUCTION: As we conduct this study, the world is in the grasp of a deadly pandemic. In less than six months since its first diagnosis in Wuhan, China, the COVID-19 infectious disease due to the novel coronavirus has infected over 5,000,000 people and claimed over 350,000 lives. In the United States, most of the cases are in large urban settings along the coasts, but the disease is slowly progressing through the mainland. Kansas, with its particular location in the midwest United States, has seen a relatively small number of cases, but these are increasing. The Kansas government took radical measures to prevent the spread of the disease. According to the Health Beliefs Model, an individual's perception of risk will dictate engagement with preventive behaviors. Knowledge about the disease and preventive measures drive the risk assessment. Knowledge is dependant on the sources of information used. This study explored these metrics in a sample of Kansans living in the times of the COVID-19 pandemic. METHODS: A combination of snowball samples and random distribution through social media was used to recruit participants to an online survey. The risk and knowledge instrument was developed and validated by WHO Europe. Data collection lasted 96 hours. RESULTS: The attitudes and behaviors of Kansans concerning COVID-19 were consistent with its location in an area of the country with a relatively lower incidence of the disease. Participants had good knowledge about the disease and preventive measures and were willing to comply with recommendations from local authorities. CONCLUSION: Localized information sources that cater to the community are often primary, while social media is not a valuable source for information pertinent to COVID-19.

Homosexuality and the Heartbeat of a Locker Room: An Analysis of Quotations in the Context of Hegemonic and Inclusive Masculinity Theories.

This qualitative textual analysis examines the attitudes and beliefs of the U.S. sports industry reflected in news stories through quotations (n = 405) employed by writers in the media. The researchers analyzed quotations from U.S. national newspapers regarding Jason Collins (National Basketball Association) and Michael Sam (National Football League), the first openly gay athletes in their sports leagues, and their coming-out announcements. The findings from the quotations suggest that the National Basketball Association is more accepting toward the presence of gay male teammates than adhering to a more inclusive definition of masculinity. The National Football League, however, is more resistant to the presences of gay male teammates, with more attitudes aligned with a traditional hegemonic masculinity. Whereas both organizations openly state their support for equality, there are still obstacles to achieving GLBT equality in professional sports leagues.

Use of online health information resources by American Indians and Alaska Natives.

According to the Office of Minority Health, an estimated 4.9 million people living in the United States consider themselves American Indian or Alaska Native, either alone or in combination with one or more races/ethnicities. American Indians or Alaska Natives comprise a racial/ethnic group experiencing serious health disparities, with little if any improvement in health outcomes over the past several decades. This study was designed to explore use of the Internet as a health information source among American Indians in the Central Plains region of the United States. The authors recruited 998 Natives in the region from May 2008 to December 2009 at powwows, health fairs, focus groups, career fairs and conferences, and other social and cultural events, and asked them to complete a self-administered survey. Although compared with data from the general population, American Indians or Alaska Natives in this sample may seem to be more frequent Internet users, their use of modern wireless devices is limited, and their use of the Internet to access health information is lower in comparison with the adult U.S. population. Natives living in the Central Plains region face generational differences in general and health-related use of the Internet. Inadequate availability of culturally appropriate health information websites may drive American Indians or Alaska Natives toward search engines and general information websites.

Improving health promotion to American Indians in the midwest United States: preferred sources of health information and its use for the medical encounter.

American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences. National representative sample surveys such as the Health Information National Trends Survey provide some data on minority groups but are underpowered to provide useful information on American Indians. The present study analyzes data from a survey of over 900 American Indians from the Midwest United States and explores their sources of health information, their preferences for information presentation, and their use of health information prior to and during medical encounters. We conclude that campaigns targeting Natives should be narrowly focused and be community driven or employing community resources. American Indians use a diversity of media sources to obtain health information, with the Internet being underutilized compared to the general population. Partnership with Indian Health Service providers and pharmacists, as well as traditional healers, in the development and dissemination of new health information for Natives may provide the "expert" tone needed to promote health improvements in American Indians.

A computerized intervention to promote colorectal cancer screening for underserved populations: theoretical background and algorithm development.

OBJECTIVE: The aim of this exploratory study was to assess factors deemed by patients as "important" as they planned and considered undergoing colorectal cancer (CRC) screening, and to use this data to design a computer-delivered intervention to promote screening. METHODS: Fifty participants 50 years or older, not up-to-date with current recommended CRC screening guidelines, were recruited from a primary care clinic. A semi-structured interview focused on aspects of preparing for colorectal cancer screening was administered; after transcription, researchers used triangulation and consensus to identify relevant themes and concepts. RESULTS: Four main themes were identified that dealt with issues important for both FOBT and colonoscopy planning: personal concerns, reminders, communication with healthcare providers and obtaining test results. FOBT specific themes included: sample collection and return. For colonoscopy screening, themes included: scheduling, intervention questions, colonoscopy preparation, and transportation. These can be classified as barrier, process and accessory themes. The developed computer-administered implementation intentions algorithm addressed all the identified concerns in a planned and sequential manner, in order to facilitate planning for CRC screening. CONCLUSIONS: The results of this study suggest that appropriate reminders, explanations of procedures, and patient understanding of temporary life disruptions, help patients develop and accept a detailed screening plan.

Sources of health information in a multiethnic, underserved, urban community: does ethnicity matter?

The Latino population is the fastest growing minority in the country, and is expected to reach about 30% of the total U.S. population by 2050. Historically, primary care practitioners are not the preferred source of health information for Latinos living in the United States. Latinos are known to rely more on media, family, and friends to get answers to health-related questions. Choosing the appropriate information source is an important component of health information-seeking behavior; it also represents a major challenge for health communicators trying to deliver information to their target audience. This study explores how ethnicity influences health information source selection among Latinos and White non-Latinos living together in an underserved, multiethnic urban community with poor health status and underlying socioeconomic characteristics. The results suggest that this community manifests a high degree of homogeneity in their usage of health information sources. Nevertheless, there are significant differences between ethnic groups and age groups on perceived usefulness of the health information retrieved from common sources. Our results suggest that health information sources that are interactive, native to the community (e.g., the local pharmacist), and promote active engagement are the most useful in delivering health messages that will be listened to by those living in this underserved, multiethnic urban community.

Engaging diverse underserved communities to bridge the mammography divide.

BACKGROUND: Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. METHODS/DESIGN: In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas-Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2) intervention or a comparison general breast cancer prevention informational intervention (C). CHWs will be armed with notebook computers loaded with our Healthy Living Kansas-Breast Health program and guide their peers through the program. Women in the MI2 condition will receive assistance with operationalizing their screening intentions and identifying and addressing their stated screening barriers with the goal of guiding them toward accessing screening services near their community. Outcomes will be evaluated at 120-days post randomization via self-report and will include mammography utilization status, barriers, and movement along a behavioral stages of readiness to screen model. DISCUSSION: This highly innovative project will be guided and initiated by AI/AN and Latina community members and will test the practical application of emerging behavioral theory among minority persons living in rural communities.

Improving rates for screening colonoscopy: Analysis of the health information national trends survey (HINTS I) data.

BACKGROUND: Colonoscopy is an effective modality for colorectal cancer screening. The objectives of this study were to identify colorectal cancer knowledge and barriers to screening colonoscopy in the general US population. METHODS: Data was obtained from the health information national trends survey (HINTS I). The dataset (n = 6369) examined the influence of age, race, gender, education, income, media usage, and interactions with health care providers on knowledge, attitudes, and behavior regarding colonoscopic screening for colorectal cancer. RESULTS: The term 'colonoscopy' was recognized by 80% of participants (over the age of 35), however only 35% of respondents perceived it as a major method for colon cancer screening. Hispanics had the least awareness of colonoscopic screening (16% versus 39% non-Hispanic). Female gender, education, and income all correlated with knowledge and use of colonoscopic screening. There was a positive correlation between media usage and having a colonoscopy (r = 0.095, p < 0.01). Having a health care provider was strongly correlated with having undergone a colonoscopy (r = 0.249, p < 0.01). Reasons for not having a colonoscopy were 'no reason' (29%), 'doctor didn't order it' (24%), and 'didn't know I needed the test' (15%). Personalized materials were the preferred media for receiving cancer-related information. CONCLUSIONS: Knowledge of and participation in screening colonoscopy is low in the US population, especially among Hispanics. The most important immediate action is to increase physician referral for screening colonoscopy. Education materials focused on specific sociodemographic segments and targeted communication campaigns need to be developed to encourage screening.

Functional foods: delivering information to the oncology nurse.

Recent research suggests a beneficial role of nutrition as possible supportive therapy for cancer patients. A national survey of oncology nurses has shown that nutrition-related issues are an important subject discussed during nurse-patient meetings. The authors applied the activation theory of information exposure to oncology nurses in regard to nutrition information. Findings suggest that oncology nurses who consider nutrition important at a personal level tend to discuss nutrition more with patients and to seek more information about nutrition and cancer. Personal rather than professional motives appear to be triggers for the information search. Implications for health care communication professionals are discussed.