Health care professional's perceived stress levels and novel brief COPE-4 factor structure-based assessment of coping methods during COVID-19 pandemic in India: A multi-modal cross-sectional study.

Background: SARS-CoV-19 or popularly known as COVID-19 is recognized as a global public health emergency and a pandemic necessitating readiness of the health system and its operational work force to address the unprecedent challenge. Objective: To assess perceived stress and coping methods using novel brief COPE-4 factor structure and narrate thematic testimonials among health care professionals involved in COVID care in India. Settings and Designs: Health care settings and multi-state cross-sectional study. Methods and Material: A cross sectional mixed-methods study, with multi-modal aids was undertaken during April-May, 2020 using a novel brief COPE-4 Factor structure. Oral informed consent was obtained to document narrative testimonials verbatim from interviews among doctors, nurse practitioners. Statistical Analysis Used: The web-survey data from Google forms analyzed using STATA (Ver 12.0) statistical package. The interview content was subjected to manual inductive thematic coding, grouped into piles to identify broad themes as main categories. Results: Among total 218 respondents, 75 (34.4%) were female and 143 (65.6%) male, mean age of 34.71 (SD = 8.9) years. Majority of the respondents were medical post-graduates on duty (38%) followed by nurses (25%) and public health professionals (14%). Slightly higher levels of stress seen among respondents involved in COVID-19 duty, compared to those not involved (p < 0.001) and positive thinking is the major coping method adopted. Conclusions: Appraising the coping mechanisms of health care professionals reveals positive outlook amidst medium levels of perceived stress while providing COVID-19 pandemic related health care services.

Social determinants in access to tobacco prevention and cessation support services among migrant construction workers in Urban Chennai, India.

CONTEXT: In spite of the high burden of tobacco consumption among migrants, disparities in the awareness of tobacco-related harms, health-seeking behaviors, and intention to switch to lower risk alternatives remain understudied area. AIMS: Assess the social determinants in access to tobacco prevention and cessation support services among migrant construction workers in urban Chennai, India. SETTINGS AND DESIGNS: A community-based, cross-sectional study design. MATERIALS AND METHODS: A questionnaire adapted from GATS survey was used among migrants working across 13 construction sites of Chennai during May-September 2019. A counseling session was provided for the migrant workers who were willing to quit. STATISTICAL ANALYSIS USED: Data entered in MS Excel was analyzed using SPSS and multivariate analysis was performed. RESULTS: Among 345 migrants, 338 (98%) were currently using tobacco and smokeless tobacco (57.4%) consumers. In spite of awareness (84.6%) about tobacco ill-effects on health, only 48% care providers enquired of the tobacco use in the previous one year. Pictorial health warnings were seen by 315 migrants (91.3%) in the past one month, but only 110 migrants (34.9%) considered quitting. The majority (341 migrants, 98.4%) have not heard of the lower risk alternatives such as nicotine gums and lozenges and only 89 migrants (26.33%) agreed to try lower risk alternatives for tobacco on trial basis. Migrant construction workers who were using tobacco less than 5 years (P = 0.001) were more likely to try lower risk alternatives. CONCLUSIONS: Reappraising social determinants in access to tobacco prevention and cessation support services to migrant construction workers may be a promising strategy to reduce health harms of tobacco intake.