AJPM focus最新文献

Editorial Board and Journal Information 编辑委员会和期刊信息

AJPM focus

Pub Date : 2024-09-24 DOI: 10.1016/j.focus.2024.100275

引用次数: 0

AJPM focus

Pub Date : 2024-08-30 DOI: 10.1016/j.focus.2024.100272

Introduction

During the COVID-19 pandemic, grocery workers experienced new (in addition to existing) work-related stressors that put them at risk for psychological distress. This study uses the job demands-resources theory to identify and describe the job demands and resources associated with grocery worker distress.

Methods

This study analyzed data from 75 90-minute interviews focusing on grocery workers’ experiences during the COVID-19 pandemic. During the interviews, participants also answered questions associated with the Patient Health Questionnaire 4, a validated measure of psychological distress.

Results

Overall, the study found that 36% of study participants exhibited mild to severe psychological distress at the time of their interviews, and a greater proportion of young, female, and White participants reported mild to severe psychological distress than did participants in other subgroups. Qualitative data suggest that the prevalence of psychological distress among participants was likely higher at the beginning of the pandemic and resulted from fear of SARS-CoV-2 exposure, conflict with customers, workplace discrimination, increased workload, and designation as an essential worker. Although about half of the participants in the sample said that their employers provided support to improve workers’ mental health, the interviews suggest that more could be done.

Conclusions

These findings may lead to opportunities to improve worker well-being during the COVID-19 pandemic and to prepare for future public health emergencies. Proposed strategies include implementing public health measures as advised by infectious disease experts; offering information and training; providing sick leave, long-term hazard pay, higher wages, and mental health benefits; and better distribution of workloads.

导言在 COVID-19 大流行期间，杂货店员工经历了与工作相关的新压力（除了已有的压力），这些压力使他们面临心理困扰的风险。本研究采用工作需求-资源理论来识别和描述与杂货店员工心理困扰相关的工作需求和资源。研究方法本研究分析了 75 个 90 分钟访谈中的数据，访谈的重点是杂货店员工在 COVID-19 大流行期间的经历。在访谈过程中，参与者还回答了与患者健康问卷 4 相关的问题，患者健康问卷 4 是一种有效的心理压力测量方法。结果总体而言，研究发现，36% 的研究参与者在访谈时表现出轻度至重度心理压力，与其他亚群的参与者相比，更多的年轻女性和白人参与者报告了轻度至重度心理压力。定性数据表明，在大流行初期，参与者的心理压力可能会更大，其原因可能是害怕接触 SARS-CoV-2、与客户发生冲突、工作场所受到歧视、工作量增加以及被指定为重要工作者。尽管样本中约有一半的参与者说他们的雇主为改善工人的心理健康提供了支持，但访谈表明还可以做得更多。建议的策略包括按照传染病专家的建议实施公共卫生措施；提供信息和培训；提供病假、长期危险津贴、更高的工资和心理健康福利；以及更好地分配工作量。

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引用次数: 0

Lifestyle Differences in the Metabolic Comorbidity Score of Adult Population From South Asian Countries: A Cross-Sectional Study 南亚国家成人代谢综合症评分的生活方式差异：一项横断面研究

AJPM focus

Pub Date : 2024-08-24 DOI: 10.1016/j.focus.2024.100273

Introduction

Metabolic comorbidities are involved in the development and progression of noncommunicable diseases. There is convincing evidence that lifestyles are important contributors to metabolic comorbidities. This study measured the metabolic comorbidity score of South Asian adults and identified its relationship with lifestyles.

Methods

The authors studied 5 South Asian countries, including Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka, using the World Health Organization's STEPwise approach to noncommunicable disease risk factor surveillance data between 2014 and 2019. This was a nationally representative and cross-sectional survey on participants aged 15–69 years. The sample size was 27,616. The outcome was metabolic comorbidity score, calculated on the basis of total cholesterol, fasting plasma glucose, blood pressure, and abdominal obesity. Total metabolic comorbidity score of each participant varied between 0 and 8. It was then divided into 3 ranges: the lowest range (total metabolic comorbidity score <3), medium range (total metabolic comorbidity score ≥3 and ≤5), and the highest range (total metabolic comorbidity score ≥6). On the basis of the outcome of nonparametric receiver operating characteristics analysis, the medium and the highest ranges together were considered as higher metabolic comorbidity score. The lowest range was considered as lower metabolic comorbidity score. The higher metabolic comorbidity score was coded as 1, and the lower metabolic comorbidity score was coded as 0. Thus, the outcome variable, metabolic comorbidity score, became a binary variable. Exposures included physical inactivity (<150 minutes of medium-to-vigorous physical activity/week), high daily sedentary time (≥9 hours/day), use of tobacco (present or past smoking or daily use of smokeless tobacco products), and consumption of alcohol (at least once per month in the last 1 year). Binomial logistic regression model produced the OR with corresponding 95% CIs.

Results

The prevalence of higher metabolic comorbidity score was 34% among South Asian adults, 25% among the male respondents, and 41% among the female respondents. Participants who were physically inactive (OR=1.26; 95% CI= 1.17, 1.36), had high sedentary time (OR=1.24; 95% CI=1.11, 1.33), and consumed alcohol (OR=1.40; 95% CI=1.23, 1.53) showed higher metabolic comorbidity score than participants who were physically active, had low sedentary time, and did not consume alcohol respectively. However, the authors found an inverse association (OR=0.75; 95% CI=0.71, 0.81) between the use of tobacco and metabolic comorbidity score.

Conclusions

One third of South Asian adults had higher metabolic comorbidity score. Physical inactivity, daily sedentary hours, and minimal alcohol consumption were associated with higher metabolic comorbidity score.

导言代谢合并症与非传染性疾病的发生和发展有关。有令人信服的证据表明，生活方式是导致代谢合并症的重要因素。这项研究测量了南亚成年人的代谢合并症得分，并确定了其与生活方式的关系。方法作者使用世界卫生组织的 STEPwise 方法，对 2014 年至 2019 年期间的非传染性疾病风险因素监测数据进行了研究，研究对象包括阿富汗、孟加拉国、不丹、尼泊尔和斯里兰卡等 5 个南亚国家。这是一项具有全国代表性的横断面调查，调查对象为 15-69 岁的参与者。样本量为 27616 份。结果是代谢合并症得分，根据总胆固醇、空腹血浆葡萄糖、血压和腹部肥胖计算得出。每位受试者的代谢合并症总分介于 0 和 8 之间。然后将其分为 3 个范围：最低范围（代谢合并症总分 <3）、中等范围（代谢合并症总分≥3 和≤5）和最高范围（代谢合并症总分≥6）。根据非参数接收器操作特征分析的结果，中等和最高范围加在一起被认为是较高的代谢合并症得分。最低范围被认为是较低的代谢合并症得分。因此，代谢合并症得分这一结果变量成为一个二元变量。暴露因素包括缺乏运动（每周进行 150 分钟中度到剧烈运动）、每天久坐时间长（≥9 小时/天）、吸烟（现在或过去吸烟或每天使用无烟烟草制品）和饮酒（过去 1 年中每月至少饮酒 1 次）。结果在南亚成年人中，代谢合并症得分较高的患病率为 34%，男性受访者为 25%，女性受访者为 41%。身体不活跃（OR=1.26；95% CI=1.17，1.36）、久坐时间长（OR=1.24；95% CI=1.11，1.33）和饮酒（OR=1.40；95% CI=1.23，1.53）的受试者分别比身体活跃、久坐时间少和不饮酒的受试者代谢合并症得分高。然而，作者发现吸烟与代谢合并症得分之间存在反比关系（OR=0.75；95% CI=0.71，0.81）。结论三分之一的南亚成年人代谢合并症得分较高，缺乏运动、每天久坐不动的时间以及饮酒量极少与代谢合并症得分较高有关。

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引用次数: 0

Corrigendum: Associations of Historical Redlining With BMI and Waist Circumference in Coronary Artery Risk Development in Young Adults 更正：历史红线与年轻人冠状动脉风险发展中的体重指数和腰围的关系

AJPM focus

Pub Date : 2024-08-23 DOI: 10.1016/j.focus.2024.100271

引用次数: 0

The COVID-19 Pandemic's Effect on Preventive Imaging COVID-19 大流行对预防性成像的影响

AJPM focus

Pub Date : 2024-08-22 DOI: 10.1016/j.focus.2024.100270

Introduction

This study assessed the effect of the COVID-19 pandemic on preventive care imaging and potential disparities because preventive care may be perceived as nonurgent. The objective was to identify the associations between the COVID-19 pandemic and changes in preventive imaging volumes for patients in general and as affected by race and ethnicities.

Methods

The authors performed a retrospective observational study by extracting the weekly volumes of all imaging studies between January 7, 2019 and May 1, 2022 from a radiology data warehouse at a tertiary care medical center (n=92,105 preventive imaging studies and 3,493,063 total radiology imaging studies) and compared preshutdown with postshutdown periods using a 2-sample t-test. Additional comparisons stratified by race and ethnicity were performed for mammograms and bone density examinations using interrupted time series models with negative binomial error distribution to assess the immediate level change and trends over time of preventive imaging volumes after shutdown.

Results

The authors found a significant decrease in bilateral mammograms, bone density examinations, and aortic ultrasound examinations in the postshutdown period compared with those in the preshutdown period (p<0.001, p=0.003, and p=0.001, respectively). There were no significant changes in low-dose computed tomography chest examinations (p=0.46). The shutdown was associated with a significant immediate decrease in mammograms in the Hispanic and Latino group to approximately three quarters of its preshutdown level (p=0.04). For bone density examinations, postshutdown weekly volumes tripled compared with the preshutdown volumes for Hispanic or Latino patients and doubled for non-Hispanic Black patients (p<0.0001 for both). In comparison, a significant decrease was seen for Other patients (reduced to nearly a fifth of preshutdown volume) (p<0.0001).

Conclusions

There was a significant decrease in overall volume of bilateral mammograms, bone density examinations, and aortic ultrasound examinations after pandemic shutdown. For mammograms, some of this decreasing trend was already seen before shutdown (such as for patients with Other race), so the shutdown was only specifically associated with an immediate decrease in mammogram levels in the Hispanic and Latino group. For bone density examinations, the shutdown was unexpectedly associated with an increase in volumes for Hispanic or Latino patients and non-Hispanic Black patients, which was countered by a significant steep decrease in volumes only for patients of Other race. Health systems should carefully explore their preventive screening examination volumes to determine which patients should be actively engaged to assure catch up on recommended care.

导言本研究评估了 COVID-19 大流行对预防性保健成像的影响，以及由于预防性保健可能被视为非急诊而可能存在的差异。方法作者进行了一项回顾性观察研究，从一家三级医疗中心的放射学数据仓库中提取了2019年1月7日至2022年5月1日期间所有影像学研究的每周数量（n=92,105项预防性影像学研究和3,493,063项总放射学影像学研究），并使用2样本t检验比较了关闭前和关闭后的情况。结果作者发现，与关闭前相比，关闭后的双侧乳房 X 光检查、骨密度检查和主动脉超声检查显著减少（分别为 p<0.001、p=0.003 和 p=0.001）。低剂量计算机断层扫描胸部检查没有明显变化（p=0.46）。关机后，西班牙裔和拉丁裔群体的乳房 X 线照片数量立即大幅下降，约为关机前的四分之三（P=0.04）。在骨密度检查方面，与停机前相比，停机后西班牙裔或拉丁裔患者的每周检查量增加了两倍，非西班牙裔黑人患者的每周检查量增加了一倍（两者的 p<0.0001）。结论大流行停诊后，双侧乳房 X 光检查、骨密度检查和主动脉超声检查的总检查量明显减少。就乳房 X 光检查而言，部分减少趋势在大流行停诊前就已出现（如其他种族患者），因此大流行停诊只与西班牙裔和拉丁裔群体的乳房 X 光检查量立即减少特别相关。在骨密度检查方面，关机出乎意料地导致西班牙裔或拉丁裔患者以及非西班牙裔黑人患者的检查量增加，而只有其他种族患者的检查量出现了显著的急剧下降。医疗系统应仔细研究他们的预防性筛查检查量，以确定哪些患者应积极参与，确保赶上推荐的护理。

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引用次数: 0

Mpox and Vaccine Knowledge, Beliefs, and Sources of Trusted Information Among Gay, Bisexual, and Other Men Who Have Sex With Men in the U.S. 美国男同性恋、双性恋和其他男男性行为者对麻疹病毒和疫苗的了解、信仰以及可信信息的来源。

AJPM focus

Pub Date : 2024-08-22 DOI: 10.1016/j.focus.2024.100267

Introduction

This research aims to characterize disparities in mpox- and vaccine-related knowledge in gay, bisexual, and other men who have sex with men in the U.S.

Methods

The authors conducted a study using the American Men's Internet Survey, which includes 823 cisgender (defined as their gender identity matching their sex assigned at birth) males aged ≥15 years from August 5 to 15, 2022. The authors evaluated sociodemographic and behavioral factors associated with mpox knowledge, including race/ethnicity, region, age group, and HIV pre-exposure prophylaxis use using chi-square tests.

Results

The authors identified knowledge gaps, with many participants unsure about whether individuals need 2 doses of the vaccine (34.4%) and whether the vaccine confers immediate protection (27.2%). The authors observed racial and regional disparities (p<0.01), with 24.4% of non-Hispanic Black men and 18.1% of men living in the South reporting little to no mpox awareness. Among the 707 self-reported HIV-negative participants, people who used pre-exposure prophylaxis within the past year were more likely to exhibit high awareness about mpox than people who did not use pre-exposure prophylaxis.

Conclusions

Findings suggest the potential to leverage existing networks (i.e., sexually transmitted infection or general health care services with pre-exposure prophylaxis use) for future targeted health service programming or education campaigns for mpox vaccination among gay, bisexual, and other men who have sex with men.

引言本研究旨在描述美国男同性恋、双性恋和其他男男性行为者在水痘和疫苗相关知识方面的差异。方法作者利用美国男性互联网调查进行了一项研究，该调查包括 823 名年龄≥15 岁的顺性别（定义为其性别认同与其出生时的性别相符）男性，调查时间为 2022 年 8 月 5 日至 15 日。作者使用卡方检验评估了与水痘知识相关的社会人口和行为因素，包括种族/民族、地区、年龄组和艾滋病暴露前预防措施的使用情况。结果作者发现了知识差距，许多参与者不确定个人是否需要接种两剂疫苗（34.4%），也不确定疫苗是否能立即提供保护（27.2%）。作者观察到了种族和地区差异（p<0.01），24.4%的非西班牙裔黑人男性和18.1%的南方男性对麻疹疫苗知之甚少或一无所知。在 707 名自我报告 HIV 阴性的参与者中，过去一年内使用过暴露前预防措施的人比未使用暴露前预防措施的人更有可能表现出对水痘的高度认识。结论研究结果表明，未来有可能利用现有网络（即性传播感染或使用暴露前预防措施的一般医疗保健服务）在男同性恋、双性恋和其他男男性行为者中开展有针对性的医疗服务计划或水痘疫苗接种教育活动。

{"title":"Mpox and Vaccine Knowledge, Beliefs, and Sources of Trusted Information Among Gay, Bisexual, and Other Men Who Have Sex With Men in the U.S.","authors":"","doi":"10.1016/j.focus.2024.100267","DOIUrl":"10.1016/j.focus.2024.100267","url":null,"abstract":"<div><h3>Introduction</h3><p>This research aims to characterize disparities in mpox- and vaccine-related knowledge in gay, bisexual, and other men who have sex with men in the U.S.</p></div><div><h3>Methods</h3><p>The authors conducted a study using the American Men's Internet Survey, which includes 823 cisgender (defined as their gender identity matching their sex assigned at birth) males aged ≥15 years from August 5 to 15, 2022. The authors evaluated sociodemographic and behavioral factors associated with mpox knowledge, including race/ethnicity, region, age group, and HIV pre-exposure prophylaxis use using chi-square tests.</p></div><div><h3>Results</h3><p>The authors identified knowledge gaps, with many participants unsure about whether individuals need 2 doses of the vaccine (34.4%) and whether the vaccine confers immediate protection (27.2%). The authors observed racial and regional disparities (<em>p</em><0.01), with 24.4% of non-Hispanic Black men and 18.1% of men living in the South reporting little to no mpox awareness. Among the 707 self-reported HIV-negative participants, people who used pre-exposure prophylaxis within the past year were more likely to exhibit high awareness about mpox than people who did not use pre-exposure prophylaxis.</p></div><div><h3>Conclusions</h3><p>Findings suggest the potential to leverage existing networks (i.e., sexually transmitted infection or general health care services with pre-exposure prophylaxis use) for future targeted health service programming or education campaigns for mpox vaccination among gay, bisexual, and other men who have sex with men.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000853/pdfft?md5=d696db920c6c34c1789030c21a29e220&pid=1-s2.0-S2773065424000853-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physicians’ Self-Reported Knowledge and Behaviors Related to Prescribing Opioids for Chronic Pain and Diagnosing Opioid Use Disorder, DocStyles, 2020 医生自述的与开具阿片类药物治疗慢性疼痛和诊断阿片类药物使用障碍相关的知识和行为，DocStyles，2020 年

AJPM focus

Pub Date : 2024-08-22 DOI: 10.1016/j.focus.2024.100269

Introduction

In 2016, the Centers for Disease Control and Prevention released the Guideline for Prescribing Opioids for Chronic Pain (2016 Centers for Disease Control and Prevention Guideline) to improve opioid prescribing while minimizing associated risks. This analysis sought to understand guideline-concordant knowledge and self-reported practices among primary care physicians.

Methods

Data from Spring DocStyles 2020, a cross-sectional, web-based survey of practicing U.S. physicians, were analyzed in 2022 and 2023. Demographic, knowledge, and practice characteristics of primary care physicians overall (N=1,007) and among specific subsets—(1) primary care physicians who provided care for patients with chronic pain (n=600), (2) primary care physicians who did not provide care for patients with chronic pain (n=337), and (3) primary care physicians who reported not obtaining or seeking a buprenorphine waiver (n=624)—were examined.

Results

A majority of physicians (72.6%) were unable to select a series of options consistent with diagnostic criteria for opioid use disorder; of those physicians, almost half (47.9%) reported treating at least 1 patient with medications for opioid use disorder. A minority of physicians (17.5%) reported having a buprenorphine prescribing waiver. Among physicians who prescribed opioids for chronic pain (88.5%), 54.4% concurrently prescribed benzodiazepines. About one third (33.5%) reported not taking patients with chronic pain.

Conclusions

There were critical practice gaps among primary care physicians related to 2016 Centers for Disease Control and Prevention Guideline topics. Increasing knowledge of the Centers for Disease Control and Prevention's opioid prescribing recommendations can benefit physician practice, patient outcomes, and public health strategies in addressing the opioid overdose crisis and implementing safer and more effective pain care.

导言 2016 年，美国疾病控制和预防中心发布了《慢性疼痛阿片类药物处方指南》（2016 年美国疾病控制和预防中心指南），旨在改善阿片类药物的处方，同时最大限度地降低相关风险。本分析旨在了解初级保健医生对指南的一致认识和自我报告的实践情况。方法分析了 2022 年和 2023 年对美国执业医生进行的横断面网络调查 Spring DocStyles 2020 的数据。研究了全科医师总体（1007 人）和特定子集（1）为慢性疼痛患者提供治疗的全科医师（600 人）、（2）不为慢性疼痛患者提供治疗的全科医师（337 人）和（3）报告未获得或寻求丁丙诺啡豁免的全科医师（624 人）的人口统计学、知识和实践特征。结果大多数医生（72.6%）无法选择一系列符合阿片类药物使用障碍诊断标准的选项；在这些医生中，近一半（47.9%）的医生表示至少用药物治疗过一名阿片类药物使用障碍患者。少数医生（17.5%）报告拥有丁丙诺啡处方豁免权。在开阿片类药物治疗慢性疼痛的医生（88.5%）中，54.4%的医生同时开苯二氮卓类药物。约有三分之一（33.5%）的医生表示不接诊慢性疼痛患者。结论初级保健医生在 2016 年美国疾病控制和预防中心指南主题方面存在严重的实践差距。增加对疾病控制和预防中心阿片类药物处方建议的了解有利于医生的实践、患者的治疗效果以及应对阿片类药物过量危机和实施更安全有效的疼痛护理的公共卫生策略。

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引用次数: 0

Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work 建设公共卫生工作人员的能力：能力建设干预对改善社区公共卫生预防工作的长期效果

AJPM focus

Pub Date : 2024-08-22 DOI: 10.1016/j.focus.2024.100268

Introduction

There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials, a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers’ strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; in this paper, the authors report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement.

Methods

A sequential mixed-methods research design was used to assess and explore longer-term outcomes among a sample of Public Health Essentials graduates working in community public health roles.

Results

Some 46% of eligible Public Health Essentials graduates (n=70) completed a skills survey at 3 time points: before Public Health Essentials completion, after Public Health Essentials completion, and 3–6 months after Public Health Essentials completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (beginner → proficient, p<0.005), despite a slight drop in self-perceived ability 3–6 months after Public Health Essentials completion. Qualitative interviews with respondents and focus groups with their supervisors suggest that Public Health Essentials completion benefits participants’ everyday work by developing strategic skills and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health.

Conclusions

Successful completion of Public Health Essentials provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive-facilitated, online asynchronous capacity building programs may be an effective tool.

导言：目前迫切需要对现有和即将加入的公共卫生工作人员进行能力建设，以加强以社区为基础、以预防和促进健康为重点的工作。Public Health Essentials 是一项基于群组的促进性异步在线能力建设干预措施，旨在培养公共卫生工作人员的战略技能和专业信心。早期的研究报告了干预措施的短期学习成果；在本文中，作者报告了长期成果评估的结果，包括技能保留率、技能应用以及劳动力保留和社区健康改善的可能指标。方法采用连续混合方法研究设计，对在社区公共卫生岗位工作的《公共卫生基本知识》毕业生样本进行长期成果评估和探索。结果约 46% 符合条件的《公共卫生基本知识》毕业生（人数=70）在三个时间点完成了技能调查：《公共卫生基本知识》完成前、《公共卫生基本知识》完成后以及《公共卫生基本知识》完成后 3-6 个月。对受访者回答的纵向分析表明，尽管在公共卫生基础知识课程完成 3-6 个月后，受访者的自我认知能力略有下降，但与基线相比，受访者的技能仍有显著提高（初级→熟练，p<0.005）。与受访者进行的定性访谈以及与他们的主管进行的焦点小组讨论表明，完成《公共卫生基本知识》课程可以培养学员的战略技能，并使他们的工作立足于共同的公共卫生语言、范式和价值观，从而有利于他们的日常工作。据报告，更广泛的益处包括将新技能应用于社区公共卫生预防项目的能力，以及继续从事公共卫生工作的积极性。培养和留住一支以社区为重点的称职的公共卫生队伍的重要性怎么强调都不为过。全面促进的在线异步能力建设课程可能是一种有效的工具。

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引用次数: 0

COVID-19 Vaccination in Historically Marginalized Communities: Examining Barriers and Facilitators in a Pediatric Population COVID-19 历史上被边缘化社区的疫苗接种：研究儿科人群中的障碍和促进因素

AJPM focus

Pub Date : 2024-08-10 DOI: 10.1016/j.focus.2024.100266

Introduction

COVID-19 hospitalization rates among unvaccinated children are double of that of vaccinated children, and this difference is greater among racial and ethnic minority children. Vaccination rates among children remain suboptimal. Few studies have characterized barriers to COVID-19 vaccination among historically marginalized communities.

Methods

From January 2022 to May 2022, parents and guardians of children aged 12 months to 18 years presenting for pediatric care at a hospital-based primary care clinic were surveyed about perceptions of COVID-19 vaccines, intentions to vaccinate their child, and trusted sources of information.

Results

A total of 113 parents/guardians participated, with 92% self-identifying with a historically marginalized racial/ethnic group. A total of 54% of respondents either did not plan to vaccinate their child against COVID-19 or were unsure. The obstacles to vaccination most frequently cited were related to (1) unknown side effects, (2) the rapid development of the vaccine, and (3) unsafe ingredients. Worries about being used as experimental subjects and potential impacts on fertility were also reported. Parents who planned to vaccinate their child reported higher rates of trust in doctors, local clinics, hospitals, and health departments.

Conclusions

High rates of COVID-19 vaccination hesitancy exist among parents/guardians from historically marginalized groups. Barriers to vaccination were frequently related to side effects, whereas a high level of trust in healthcare providers as sources of information may be a facilitator. Strategies to improve health outcomes and boost vaccination rates should focus on equipping pediatric healthcare providers with the knowledge and skills necessary to address these known barriers to COVID-19 vaccination.

导言COVID-19 未接种疫苗儿童的住院率是接种疫苗儿童的两倍，在少数民族儿童中这一差异更大。儿童的疫苗接种率仍未达到最佳水平。方法从 2022 年 1 月至 2022 年 5 月，对在医院初级保健诊所接受儿科治疗的 12 个月至 18 岁儿童的父母和监护人进行了调查，内容包括对 COVID-19 疫苗的看法、为孩子接种疫苗的意愿以及可信赖的信息来源。结果共有 113 名父母/监护人参与调查，其中 92% 的人自我认同为历史上被边缘化的种族/族裔群体。共有 54% 的受访者不打算或不确定为其子女接种 COVID-19 疫苗。最常提到的接种障碍涉及 (1) 未知的副作用，(2) 疫苗的快速发展，以及 (3) 不安全的成分。此外，还有人担心被用作实验对象以及对生育能力的潜在影响。计划为孩子接种疫苗的家长对医生、当地诊所、医院和卫生部门的信任度较高。结论在历史上被边缘化群体的家长/监护人中，COVID-19 疫苗接种犹豫率较高。接种疫苗的障碍通常与副作用有关，而对医疗服务提供者作为信息来源的高度信任则可能会起到促进作用。改善健康结果和提高疫苗接种率的策略应侧重于让儿科医疗服务提供者掌握必要的知识和技能，以解决这些已知的 COVID-19 疫苗接种障碍。

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引用次数: 0

2023 Reviewer Acknowledgment 2023 审稿人致谢

AJPM focus

Pub Date : 2024-08-01 DOI: 10.1016/S2773-0654(24)00079-8

引用次数: 0