RESUMO
Introduction: Antimicrobial resistance (AMR) is a serious concern to public health, causing an estimated 35,000 deaths annually in the U.S. Misuse of antimicrobials increases the rate of AMR. Self-medication with antibiotics (SMA) is a primary contributor to AMR that can be addressed through education. SMA has been reported at rates of 3% to 66% in the U.S. but has not been evaluated in Appalachia.1 Low health literacy and barriers to accessing care have been correlated with SMA and are common in many areas of Appalachia. Purpose: This study aims to assess factors associated with SMA, demographic differences in knowledge of / beliefs about SMA, and describe practices and beliefs of those who self-medicate in the Cumberland Gap region. Methods: Structured interviews were conducted in a rural health clinic and in a dental office to ascertain demographic information, knowledge of appropriate antibiotic use, and behaviors associated with self-medication. Inferential statistics (chi-squared, Fisher's exact, and ANOVA tests) were conducted. Results: In the last 3 years, 41% of the 78 respondents had practiced SMA. A higher percentage of those who believed that antibiotics are used to treat viral infections have self-treated compared to those who did not hold that belief. Of those who SMA, convenience was the most common reason, while the common symptoms treated were congestion and fever. Implications: The current study provides a first estimate of SMA in the Central Appalachian Region and finds the prevalence to be higher than previously reported in other regions of the U.S. Future studies could include larger, more representative samples and longitudinal study designs to confirm these findings.
RESUMO
Introduction: In response to the coronavirus disease (COVID-19) pandemic, most universities experienced drastic operational changes with shifts to online learning, work-from-home policies, and social distancing measures. These changes have caused concern for social isolation and mental health. Purpose: This cross-sectional study explores differences in COVID-19 experiences, behaviors, beliefs, and well-being among students and employees (faculty and staff) at a rural Appalachian university. Methods: Data were collected with an online anonymous survey in September-October 2020 using convenience sampling. The survey measured multiple domains including COVID-19-related (1) beliefs, (2) symptoms and diagnoses, (3) exposure and preventive behavior, and (4) social, mental, and financial health. Chi-square tests and linear regression models were used to determine differences in survey responses between students and employees. Results: The final sample used for analysis included 416 respondents. The majority of respondents believed COVID-19 was a serious disease and followed mask and social distancing guidelines, although employees were more likely to adhere to mask and social distancing guidelines compared to students. Most of the respondents (>50%) reported feeling more stressed, anxious, and sad since the pandemic began. Students were more impacted by the pandemic compared to employees as measured by the mental, social, and financial impact scale. A limitation of this study was that convenience sampling was used instead of a probability sampling technique, which limits the inference that can be made from the results. Implications: There may be a need for greater mental health support among university employees and students. However, future studies should confirm these findings.
