Early stage risk communication and community engagement (RCCE) strategies and measures against the coronavirus disease 2019 (COVID-19) pandemic crisis

COVID-19 Risk Communication and Community Engagement (RCCE) in Malawi: Challenges and Response

The outbreak of COVID-19 created a global health crisis that has impacted our everyday lives. Risk communication and community engagement (RCCE) is one of the strategic pillars the World Health Organization (WHO) recommends when dealing with public health emergencies like COVID-19. In Malawi, the COVID-19 RCCE response was coordinated by the country's Ministry of Health and involved various organizations that distributed COVID-19 risk communication materials and engaged communities on important infection preventive practices. Furthermore, the Ministry of Information was involved in ensuring the messages were put across at national and subnational levels. Despite the efforts, most Malawians were reluctant to embrace set public health measures for COVID-19. Guided by a phenomenological approach, we used in-depth interviews with senior officials from 10 organizations, including the Ministry of Health, who were involved in RCCE response in Malawi, to understand the challenges that were faced in the implementation of RCCE activities in Malawi. We also reviewed project reports from three organizations, taken from the same implementing local organizations, to understand the experiences of implementing RCCE strategies in Malawi. We established that misconceptions, poor coordination, lack of political will, low-risk perceptions, and social norms undermined the response in Malawi. The results underscore the need for the authorities in Malawi to invest more in RCCE and strengthen the capacity to handle future epidemics. There is also a need to develop a national RCCE strategy with guidelines and protocols on methods of coordination, flow of communication, responsible ministry, tools for handling dis/misinformation and myths, and community engagement.

Community interventions for pandemic preparedness: A scoping review of pandemic preparedness lessons from HIV, COVID-19, and other public health emergencies of international concern

Community action is broadly recognised as central to comprehensive and effective system responses to pandemics. However, there is uncertainty about how and where communities can be best supported to bolster long-term resilience and preparedness. We applied a typology of community interventions (Community Informing, Consulting, Involving, Collaborating or Empowering-or CICICE) to cover the diverse range of interventions identified across the literature and used this to structure a scoping review addressing three linked topics: (i) how CICICE interventions have been understood and applied in the literature on epidemic and pandemic preparedness; (ii) the spectrum of interventions that have been implemented to strengthen CICICE and (iii) what evidence is available on their effectiveness in influencing preparedness for current and future emergencies. We drew on peer-reviewed and grey literature from the HIV (from 2000) and COVID-19 pandemics and recent public health emergencies of international concern (from 2008), identified through systematic searches in MEDLINE, Scopus, the Cochrane Collaboration database, supplemented by keyword-structured searches in GoogleScholar and websites of relevant global health organisations. Following screening and extraction, key themes were identified using a combined inductive/deductive approach. 130 papers met the criteria for inclusion. Interventions for preparedness were identified across the spectrum of CICICE. Most work on COVID-19 focused on informing and consulting rather than capacity building and empowerment. The literature on HIV was more likely to report interventions emphasising human rights perspectives and empowerment. There was little robust evidence on the role of CICICE interventions in building preparedness. Evidence of effect was most robust for multi-component interventions for HIV prevention and control. Much of the reporting focused on intermediate outcomes, including measures of health service utilisation. We put forward a series of recommendations to help address evidence shortfalls, including clarifying definitions, organising and stratifying interventions by several parameters and strengthening evaluation methods for CICICE.

Design and psychometric properties of a tool to assess the knowledge, attitude and practice of health care workers for infodemic management (KAPIM-Tool)

BACKGROUND

Infodemics, defined as the rapid spread of misinformation during an epidemic or pandemic, can have serious public health consequences. Healthcare workers(HCWs) play a critical role in managing infodemics, but their knowledge, attitudes, and practices(KAP) related to infodemic management are not well understood. This study aimed to design and validate a tool to assess healthcare workers' KAP related to infodemic management.

METHODS

The knowledge, attitude, and practice of HCWs for the infodemic management assessment tool were designed through exploratory factor analysis. At first, primary items were extracted through two separate studies (face-to-face interviews with 17 participants and a systematic review). Then Face validity, Content validity, and Construct validity were done with the 15 participants of healthcare workers who had sufficient knowledge and experience. The content validity ratio (CVR) and content validity index (CVI) was checked for each item. The construct validity of the tool was also calculated through exploratory factor analysis with the participation of 250 healthcare workers (6.25 participants per item). The intraclass correlation coefficient (ICC), and Cronbach's alpha was calculated to evaluate the reliability of the findings using IBM SPSS Statistics V21.0.

RESULTS

The primary KAPIM (Knowledge, Attitude, and Practice) of healthcare workers in (the Infodemics Management) tool has 53 items, in content, face, and construct validity 13 items were removed. Factor analysis revealed three factors: knowledge (24 items), attitudes (8 items), and practice (8 items). The overall reliability of the tool was reported as adequate with a Cronbach's alpha of 0.905. The ICC of the entire tool was calculated as 0.827.

CONCLUSION

The KAPIM tool is a valid and reliable tool for assessing healthcare workers' knowledge, attitudes, and practices related to infodemic management with 40 items. The tool can inform targeted interventions to improve healthcare workers' preparedness and response to infodemics.

Science communication in the media and human mobility during the COVID-19 pandemic: a time series and content analysis

OBJECTIVES

The relationship between human mobility and nature of science (NOS) salience in the UK news media was examined.

STUDY DESIGN

This is a mixed-method study.

METHODS

A time series NOS salience data set was established from the content analysis of 1520 news articles related to non-pharmaceutical interventions of COVID-19. Data were taken from articles published between November 2021 and February 2022, which correlates with period of the change from pandemic to endemic status. Vector autoregressive model fitting with human mobility took place.

RESULTS

The findings suggest that it was not the number of COVID-19 news articles nor the actual number of cases/deaths, but the specific NOS content that was associated with mobility change during the pandemic. Data indicate a Granger causal negative direction (P < 0.1) for the effect of the NOS salience represented in the news media on mobility in parks, as well as the effect of scientific practice, scientific knowledge and professional activities communicated in news media on recreational activities and grocery shopping. NOS salience was not associated with the mobility for transit, work or residential locations (P > 0.1).

CONCLUSIONS

The findings of the study suggest that the ways in which the news media discuss epidemics can influence changes in human mobility. It is therefore essential that public health communicators emphasise the basis of scientific evidence to eliminate potential media bias in health and science communication for the promotion of public health policy. The present study approach, which combines time series and content analysis and uses an interdisciplinary lens from science communication, could also be adopted to other interdisciplinary health-related topics.

Engaging diverse populations in aging research during the COVID-19 pandemic: Lessons learned from four National Institutes of Health funded-Centers

Background

The COVID-19 pandemic's impact on our personal and professional lives required a rapid adaptation to the evolving health crisis and accumulating social stresses. Established measures to reduce the spread of infection and potential death had a direct effect on ongoing research that involved older adults and underrepresented racial/ethnic groups. Although important to preserve public health, these measures risk further isolation of vulnerable research participant populations and threatened established community partnerships. To address the social and research challenges evolving from the COVID-19 pandemic, four National Institutes of Health funded-Centers that engage with community members to enhance research and advance the science of aging came together to learn from each other's efforts, approaches, and communication with community partners.

Methods

Monthly meetings served as a venue to discuss the challenges of engagement with research participants and support community partners during the pandemic. The developed learning community also contributed to recognize and address research staff stress and isolation. We describe how these conversations led our Centers to address unprecedented challenges and sustain community engagement within diverse populations, especially Black/African Americans, Latinos, Middle Eastern/Arab Americans and the oldest-old.

Results

The exchange of information resulted in maintaining long standing community relationships and partnerships in the face of the uncertainties generated by the pandemic. The strategies included adapting education programs to reduce risk of infection, recognizing symptoms, promoting vaccination and understanding of the effect of COVID-19 to the brain. Different strategies were used to address the effects of isolation and maintain community engagement. Although new research participant enrollment was a challenge, telephone and virtual visits allowed research participants to remain active in research. Community members participation in virtual learning events was variable, ranging from a dozen to hundreds of participants. Invitations to organize panels about newly developed topics indicated the need for information from trusted sources.

Conclusion

In sum, the COVID-19 pandemic re - directed all four Centers' commitment to community service led to developing strategies for social support, which will potentially contribute to transforming public perceptions about research and researchers.

Research on Korean Translation in the Context of Epidemic Prevention and Control

An emergency like COVID-19 requires a theoretical framework for policy implementation that involves public and private sector collaborations. After policy failures, new institutions have formed that trigger PPP's later, allowing the incumbent administration to continue in office longer. It focuses on novel approaches to dealing with pandemics. The present administration put these rules in place to keep COVID-19 under control. When it comes to Real Time - polymerase chain reaction (RT-PCR) testing, South Korea's government and corporations partnered to swiftly raise the quantity of testing in the country. Models of policy change are shown to be dynamic, cyclical, and recursive. During the COVID-19 outbreak in South Korea, an empirical content research was conducted. Even though South Korea's leader was at risk of losing public support to the point where impeachment was mentioned as a possible option, he dramatically reversed public mood to win general elections by a wide margin in April 2020, while the pandemic scenario persisted. To win reelection, democratic administrations are under more pressure to effectively perform crisis management when faced with a crisis. As a result, they are under even more pressure to immediately mobilize public and private resources. The emergency use authorization (EUA) protocol for test kits is an example of "leapfrogging actors" – up-and-coming innovators – who helped turn a pandemic tragedy into a possibility for sustained leadership and for them. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45.

Public conformism with health regulation is crumbling as COVID-19 becomes a chronic threat: Repeated Cross-sectional Studies

BACKGROUND

The purpose of this study is to analyze the long terms trends in public attitudes toward the COVID-19 pandemic and compliance with self-quarantine regulations.

METHODS

Repeated cross-sectional studies looking into data collected from nationally representative samples (N = 2568) of the adult population in Israel at five points in time representing the five morbidity waves of the COVID-19 pandemic. This study examined public trust in Israeli health regulations, levels of public panic, feelings of personal worry, and compliance with health regulations, specifically self-quarantine.

RESULTS

Public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value of nearly 75% measured in March 2020. While reported worry is steadily reducing, the perception of public panic is increasing. In earlier rounds, public compliance with self-quarantine was reported close to 100%; however, it has dropped to 38% by January 2022 when compensation is not assumed. Regression analysis suggests that trust is a major predictor of compliance with health regulations.

CONCLUSIONS

The "fifth wave" of the COVID-19 pandemic brought about an all-time low in public trust in health regulations. The Israeli public, normally a highly compliant one, is showing signs of crumbling conformity.

Community pandemic prevention and control measures and their influence on citizen satisfaction during the COVID-19 pandemic in China

At the forefront of the fight against the pandemic, the community' s measures and services would have a greater impact than ever before on citizen satisfaction. However, the influence of citizen satisfaction on community pandemic prevention and control measures (CPPCM) during the pandemic is poorly understood. This study aims to investigate the allocation of CPPCM and its impact on CS. The Chinese national data was analyzed for the outcome. (1) Pandemic prevention propaganda (PPP), disinfection (DT), and body temperature tests (BTTs) were the primary measures taken by the Chinese community. (2) The CS for pandemic prevention and control is high, and urban and central Chinese communities express greater satisfaction. (3) The impact of disinfection, body temperature tests, free supplies, and assistance purchasing supplies on CS was greater in rural areas than in urban areas. (4) Regional variations exist in the impact of CS on CPPCM. (5) The number of measures has an inverted U-shaped relationship with citizen satisfaction. This study also suggests that the government should disseminate information about pandemic prevention in a timely manner, provide basic health and medical services, and evaluate the measures taken to avoid the discount effect.

Communicating risk during early phases of COVID-19: Comparing governing structures for emergency risk communication across four contexts

Background

Emergency risk communication (ERC) is key to achieving compliance with public health measures during pandemics. Yet, the factors that facilitated ERC during COVID-19 have not been analyzed. We compare ERC in the early stages of the pandemic across four socio-economic settings to identify how risk communication can be improved in public health emergencies (PHE).

Methods

To map and assess the content, process, actors, and context of ERC in Germany, Guinea, Nigeria, and Singapore, we performed a qualitative document review, and thematically analyzed semi-structured key informant interviews with 155 stakeholders involved in ERC at national and sub-national levels. We applied Walt and Gilson's health policy triangle as a framework to structure the results.

Results

We identified distinct ERC strategies in each of the four countries. Various actors, including governmental leads, experts, and organizations with close contact to the public, collaborated closely to implement ERC strategies. Early integration of ERC into preparedness and response plans, lessons from previous experiences, existing structures and networks, and clear leadership were identified as crucial for ensuring message clarity, consistency, relevance, and an efficient use of resources. Areas of improvement primarily included two-way communication, community engagement, and monitoring and evaluation. Countries with recurrent experiences of pandemics appeared to be more prepared and equipped to implement ERC strategies.

Conclusion

We found that considerable potential exists for countries to improve communication during public health emergencies, particularly in the areas of bilateral communication and community engagement as well as monitoring and evaluation. Building adaptive structures and maintaining long-term relationships with at-risk communities reportedly facilitated suitable communication. The findings suggest considerable potential and transferable learning opportunities exist between countries in the global north and countries in the global south with experience of managing outbreaks.

Process and components of disaster risk communication in health systems: A thematic analysis

Risk communication (RC) is one of the necessary functions in disaster management. Establishing communication processes such as planning, transparency of policies and guidelines, RC expert training, providing communication infrastructure and evaluation in the shortest period reduces confusion and management inconsistency. One of the existing challenges is not knowing the exact dimensions of risk communication and its components in disasters. The aim was to identify the components of disaster risk communication in the health system. This research was conducted by systematic review and searching of the databases of PubMed, Scopus, Web of Science, ProQuest, Google Scholar and ScienceOpen 2000-2021 to identify the components of disaster risk communication in the health system. Thematic content analysis was used for data analysis. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 chart was used for systematic search, and a modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used for quality determination. Out of 12 342 articles extracted, 25 studies were included for analysis. The components of disaster risk communication were analysed in 6 categories and 19 subcategories. These categories include communication (communication processes, communication features and infrastructure), information (content production, content characteristics and publishing), risk communication management (risk perception assessment, planning, coordination and logistics), monitoring and control (monitoring and evaluation, accreditation, documentation), education and training (public and organisational) and ethics and values (culture and social beliefs, ethics and trust). According to this research, the establishment of communication infrastructure and advanced equipment such as various structured formats for communication and artificial intelligence; online and offline communication support systems; and timely and accurate notice can help achieve goals such as coordination and organisation in the health system and increase social participation.

Contribution

This study has clarified and explained all the main components and measures of risk communication that can be used for planning scientifically.

Measuring the Evolution of Risk Communication Strategy for Health Authorities During the COVID-19 Pandemic: An Empirical Comparison Between China and the United States

Objectives: Investigate how the speech context of news conferences reveals the risk communication strategies for health authorities during COVID-19 and measure the evolution of those risk communication strategies.

Methods: We collected news conference transcripts concerning COVID-19 for the first quarter from the official websites of the Centers for Disease Control and Prevention (CDC) and the National Health Commission of the People’s Republic of China (NHC) in 2020. Quantitative analyses were conducted on the topics and emotions of transcripts to measure the evolution of risk communication strategy. A total of three types of analysis were carried out in our study: topic, sentiment, and risk communication evolution analyses.

Results: The trending topics and the number of these in the two institutions evolved with the infection status. The CDC and NHC maintained primarily neutral sentiment, while the non-neutral sentiment of the CDC swung more dramatically. Furthermore, the changing pattern of risk communication evolution for the CDC and NHC varied, where the latter had a more stable change routine.

Conclusion: Our study finds that the strategies could be measured by topic variation, emotional expressions, and confirmed cases. The CDC and NHC tend to adopt different risk communication strategies and have specific change routines facing the pandemic. In addition, our findings contribute to addressing the WHO research agenda for managing risk communication during the COVID-19 pandemic, which helps health authorities formulate and measure risk communication strategies.

Outcomes of a Community Engagement and Information Gathering Program to Support Telephone-Based COVID-19 Contact Tracing: Descriptive Analysis

BACKGROUND

Contact tracing is an important public health tool for curbing the spread of infectious diseases. Effective and efficient contact tracing involves the rapid identification of individuals with infection and their exposed contacts and ensuring their isolation or quarantine, respectively. Manual contact tracing via telephone call and digital proximity app technology have been key strategies in mitigating the spread of COVID-19. However, many people are not reached for COVID-19 contact tracing due to missing telephone numbers or nonresponse to telephone calls. The New York City COVID-19 Trace program augmented the efforts of telephone-based contact tracers with information gatherers (IGs) to search and obtain telephone numbers or residential addresses, and community engagement specialists (CESs) made home visits to individuals that were not contacted via telephone calls.

OBJECTIVE

The aim of this study was to assess the contribution of information gathering and home visits to the yields of COVID-19 contact tracing in New York City.

METHODS

IGs looked for phone numbers or addresses when records were missing phone numbers to locate case-patients or contacts. CESs made home visits to case-patients and contacts with no phone numbers or those who were not reached by telephone-based tracers. Contact tracing management software was used to triage and queue assignments for the telephone-based tracers, IGs, and CESs. We measured the outcomes of contact tracing-related tasks performed by the IGs and CESs from July 2020 to June 2021.

RESULTS

Of 659,484 cases and 861,566 contact records in the Trace system, 28% (185,485) of cases and 35% (303,550) of contacts were referred to IGs. IGs obtained new phone numbers for 33% (61,804) of case-patients and 11% (31,951) of contacts; 50% (31,019) of the case-patients and 46% (14,604) of the contacts with new phone numbers completed interviews; 25% (167,815) of case-patients and 8% (72,437) of contacts were referred to CESs. CESs attempted 80% (132,781) of case and 69% (49,846) of contact investigations, of which 47% (62,733) and 50% (25,015) respectively, completed interviews. An additional 12,192 contacts were identified following IG investigations and 13,507 following CES interventions.

CONCLUSIONS

Gathering new or missing locating information and making home visits increased the number of case-patients and contacts interviewed for contact tracing and resulted in additional contacts. When possible, contact tracing programs should add information gathering and home visiting strategies to increase COVID-19 contact tracing coverage and yields as well as promote equity in the delivery of this public health intervention.

Community-level survey of coronavirus disease 2019 (COVID-19) preventive measures in Kwara State, Nigeria: good knowledge vs poor attitude

Background

The public knowledge and adherence to the established coronavirus disease 2019 (COVID-19) precautionary measures are crucial to Nigeria's war against the pandemic. Public health education on its preventive practices at the grassroots level was initially crucial to achieving a lower COVID-19 incidence in Kwara State, Nigeria.

Methods

We assessed the knowledge of, and adherence to COVID-19 precautionary measures at the community level among 795 respondents from the three senatorial zones of Kwara State.

Results

54.5% (433/795) of the respondents were aged between 21 and 40 years, and 45.9% (365/795) of the respondents had a bachelor's degree or higher. Study participants had a good knowledge of COVID-19, its symptoms, and its mode of transmission. 91.8% of the respondents (730/795) had a positive perception of the COVID-19 preventive measures while 96.1% (763/795) of the respondents agreed that maintaining social distance was important in curbing the COVID-19 pandemic. However, only 38% (302/795) of them used face masks and only 25.7% (204/795) of the respondents used hand sanitizers. In addition, only 31.9% (253/795) of the respondents isolated themselves when they were ill. Multi-variable logistic regression analysis revealed that education, occupation, gender, and ethnicity were significantly associated with positive COVID-19 preventive practices among residents of Kwara State. Civil servants were more likely (AOR: 3.14; 95% confidence interval [CI]: 0.67 to 14.82; P = 0.034) to have positive preventive attitudes than other respondents. Study participants with tertiary education and those that were Yoruba (ethnicity) were 14.81 times more likely (95% CI: 4.29 to 51.05; P = 0.001) and 5.19 times more likely (95% CI: 1.82 to 14.84; P = 0.007) to have positive attitudes towards the laid-down COVID-19 preventive measures respectively.

Conclusion

The poor community adherence to the COVID-19 preventive practices could pre-dispose Kwara to more COVID-19 cases. More community engagement activities are needed to fully curb the spread of the COVID-19. Public health education should focus on preventive measures, vaccine acceptance, and community monitoring of COVID-19.

Adherence to Coronavirus Disease 2019 Preventive Measures in a Representative Sample of the Population of the Canton of Vaud, Switzerland

Objectives: We quantified adherence to COVID-19 preventive measures and explored associated factors, after the first and during the second Swiss epidemic waves.

Methods: With an observational cohort study in a representative sample of individuals aged 15 years and more, we analysed the association between self-reported adherence to COVID-19 preventive measures (respect of simple hygiene rules; respect of social distancing rules; wearing a mask) and socio-demographic factors, the existence of a chronic disease, and the existence of a previous confirmed COVID-19 episode.

Results: Highest adherence was to simple hygiene rules, followed by social distancing rules and mask wearing, with a slight decrease for simple hygiene rules and a strong increase for mask wearing between visits. Men were significantly less likely to respect simple hygiene rules and wear a mask in public. Participants aged 65 years and more (versus 25–64 years) and those with at least one chronic disease (versus none) were two times more likely to respect social distancing rules and wear a mask.

Conclusion: Adherence to social distancing rules and mask wearing was rather poor, especially compared to other countries.

Community-Based Workforce for COVID-19 Contact Tracing and Prevention Activities in New York City, July-December 2020

OBJECTIVES

High rates of hospitalization and death disproportionately affected Black, Latino, and Asian residents of New York City at the beginning of the COVID-19 pandemic. To suppress COVID-19 transmission, New York City implemented a workforce of community engagement specialists (CESs) to conduct home-based contact tracing when telephone numbers were lacking or telephone-based efforts were unsuccessful and to disseminate COVID-19 information and sanitary supplies.

MATERIALS AND METHODS

We describe the recruitment, training, and deployment of a multilingual CES workforce with diverse sociodemographic backgrounds during July-December 2020 in New York City. We developed standard operating procedures for infection control and safety measures, procured supplies and means of transportation, and developed protocols and algorithms to efficiently distribute workload.

RESULTS

From July through December 2020, 519 CESs were trained to conduct in-person contact tracing and activities in community settings, including homes, schools, and businesses, where they disseminated educational materials, face masks, hand sanitizer, and home-based specimen collection kits. During the study period, 94 704 records of people with COVID-19 and 61 246 contacts not reached by telephone-based contact tracers were referred to CESs. CESs attempted home visits or telephone calls with 84 230 people with COVID-19 and 49 303 contacts, reaching approximately 55 592 (66%) and 35 005 (71%), respectively. Other CES activities included monitoring recently arrived travelers under quarantine, eliciting contacts at point-of-care testing sites, and advising schools on school-based COVID-19 mitigation strategies.

PRACTICE IMPLICATIONS

This diverse CES workforce allowed for safe, in-person implementation of contact tracing and other prevention services for individuals and communities impacted by COVID-19. This approach prioritized equitable delivery of community-based support services and resources.

Global Experiences of Community Responses to COVID-19: A Systematic Literature Review

Objective

This study aimed to conduct a systematic review of the global experiences of community responses to the COVID-19 epidemic.

Method

Five electronic databases (PubMed, Embase, CINAHL, ScienceDirect, and Web of Science) were searched for peer-reviewed articles published in English, from inception to October 10, 2021. Two reviewers independently reviewed titles, abstracts, and full texts. A systematic review (with a scientific strategy for literature search and selection in the electronic databases applied to data collection) was used to investigate the experiences of community responses to the COVID-19 pandemic.

Results

This review reported that community responses to COVID-19 consisted mainly of five ways. On the one hand, community-based screening and testing for Coronavirus was performed; on the other hand, the possible sources of transmission in communities were identified and cut off. In addition, communities provided medical aid for patients with mild cases of COVID-19. Moreover, social support for community residents, including material and psychosocial support, was provided to balance epidemic control and prevention and its impact on residents' lives. Last and most importantly, special care was provided to vulnerable residents during the epidemic.

Conclusion

This study systematically reviewed how communities to respond to COVID-19. The findings presented some practical and useful tips for communities still overwhelmed by COVID-19 to deal with the epidemic. Also, some community-based practices reported in this review could provide valuable experiences for community responses to future epidemics.

Community engagement; the master key to preventing Nigeria's obvious pandemic fatigue and the next COVID-19 wave

The index case of COVID-19 in Nigeria was in February 2020. The pandemic has resulted in severe social, economic, and public health challenge in Nigeria. Nigeria has experienced pandemic fatigue (PF) characterized by its low testing capacity, poor public adherence to COVID-19 preventive measures, and the urge to return to normal. This viewpoint examines Nigeria’s obvious PF amongst Nigerians and believed that community engagement would be a master key to reducing Nigeria’s PF and preventing another wave of the pandemic in Nigeria. Community engagement (CE) is a viable way for monitoring the spread of the SARS-CoV-2. CE is cost-effective, improves the chances of people voluntarily presenting themselves for COVID-19 testing at the grass-root level, and could halt the spread of COVID-19 in Nigeria especially with the detection of the delta and omicron variants in Nigeria.

Tourists' Health Risk Threats Amid COVID-19 Era: Role of Technology Innovation, Transformation, and Recovery Implications for Sustainable Tourism

Technology innovation has changed the patterns with its advanced features for travel and tourism industry during the outbreak of COVID-19 pandemic, which massively hit tourism and travel worldwide. The profound adverse effects of the coronavirus disease resulted in a steep decline in the demand for travel and tourism activities worldwide. This study focused on the literature based on travel and tourism in the wake global crisis due to infectious virus. The study aims to review the emerging literature critically to help researchers better understand the situation. It valorizes transformational affordance, tourism, and travel industries impacts posed by the virus COVID-19. The study proposed a research model on reviving the international tourism activities post COVID-19 pandemic to gain sustainable development and recovery. The scholars have debated seeking the best possible ways to predict a sustainable recovery of travel, tourism, and leisure sectors from the devastating consequences of coronavirus COVID-19. In the first phase, the study describes how the current pandemic can become transformational opportunities. It debates the situation and questions related to the emergence of the COVID-19 outbreak. The present research focuses on identifying fundamental values, organizations, and pre-assumptions related to travel and tourism revival and help academia and researchers to a breakthrough in initiating the frontiers based on research and practice. This study aims at exploring the role of technological innovation in the crisis management of COVID-19 tourism impacts, tourists' behavior, and experiences. The travel and tourism industry's main stakeholders include tourism demand and organizations that manage tourists' destinations and policymakers. They have already experienced the stages of responses, recovery, and resetting tourism recovery strategies. The study provides valuable insight into the coronavirus consequences on travel and tourism and practical implications for global tourism and academic research revitalization.

[A new understanding of risk communication in public health emergencies]

Die Risikokommunikation öffentlicher Institutionen soll die Bevölkerung im Falle bestehender Risiken bei der Entscheidungsfindung unterstützen. In gesundheitlichen Notlagen wie der Coronavirus(SARS-CoV-2)-Pandemie spielt sie eine besonders wichtige Rolle. Bereits nach dem SARS-Ausbruch im Jahr 2003 hat die Weltgesundheitsorganisation (WHO) ihre Internationalen Gesundheitsvorschriften (IHR 2005) überarbeitet und gefordert, Risikokommunikation in allen Mitgliedsländern als einen Kernbereich in der Gesundheitspolitik zu etablieren. Während der gesundheitspolitische Akzent begrüßt wurde, konnten die Möglichkeiten der Risikokommunikation in diesem Bereich bisher nicht voll ausgeschöpft werden. Gründe sind u. a. Unstimmigkeiten im Begriffsverständnis der Risikokommunikation und die Vielzahl zur Verfügung stehender Methoden.

Der vorliegende Diskussionsartikel soll dazu beitragen, ein neues Verständnis von Risikokommunikation in Public-Health-Notlagen (Emergency Risk Communication – ERC) zu etablieren. Es wird vorgeschlagen, neben den Risiken die Chancen der Krise stärker einzubeziehen und Risikokommunikation noch mehr als einen kontinuierlichen Prozess zu begreifen, der an verschiedenen Stellen optimierbar ist. Der Earlier-Faster-Smoother-Smarter-Ansatz und hierbei insbesondere die frühere Erkennung von Gesundheitsgefahren (Earlier) könnten das Management von Public-Health-Notlagen zukünftig unterstützen.

The effects of community safety support on COVID-19 event strength perception, risk perception, and health tourism intention: The moderating role of risk communication

The community is crucial in preventing COVID-19 pandemic. By employing 313 online surveys, it is found that the community safety support enhances risk perception, disruption recognition, and criticality recognition but it negatively impacts on novelty recognition. Additionally, risk communication could moderate the relationship between risk perception and health tourism intention. These findings reveal that people would pay more attention to the risk information and they could join health tourism in the post-pandemic period to enhance their personal physical and mental health. Therefore, health tourism enterprises should appropriately strengthen risk communication and improve people's health awareness to further promote healthy tourism consumption.

STOP COVID-19 CA: Community engagement to address the disparate impacts of the COVID-19 pandemic in California

Objective

To describe the early activities and lessons of the Share, Trust, Organize, Partner COVID-19 California Alliance (STOP COVID-19 CA), the California awardee of the NIH-funded multi-state Community Engagement Alliance (CEAL) against COVID-19. The Alliance was established to ensure equity in Coronavirus-19 disease (COVID-19) research, clinical practice, and public health for communities most impacted by the COVID-19 pandemic.

Study setting

The STOP COVID-19 CA Alliance network of 11 universities and affiliated partner community-based organizations (CBOs) across California.

Study design

Mixed methods evaluation consisting of an analysis of activity (August 2020 to December 2021) detailed in reports submitted by community-academic teams and a survey (August 2021) of academic investigators and affiliated community-based organization (CBO) partners.

Data collection

We summarized activities from the 11 community-academic teams' progress reports and described results from an online survey of academic investigators and CBO partners in the California Alliance.

Principal findings

A review of progress reports (n = 256) showed that teams fielded surveys to 11,000 Californians, conducted 133 focus groups, partnered with 29 vaccine/therapeutics clinical trials, and led more than 300 town halls and vaccine events that reached Californians from communities disproportionately impacted by COVID-19. Survey responses from academic investigators and CBO partners emphasized the importance of learning from the successes and challenges of the California Alliance teams' COVID-19 initiatives. Both academic and CBO respondents highlighted the need for streamlined federal and institutional administrative policies, and fiscal practices to promote more effective and timely operations of teams in their efforts to address the numerous underlying health and social disparities that predispose their communities to higher rates of, and poor outcomes from, COVID-19.

Conclusions

STOP COVID-19 CA represents a new and potentially sustainable statewide community engagement model for addressing health disparities in multiethnic/multicultural and geographically dispersed communities.

Exploring the impact of COVID-19 on tourism: transformational potential and implications for a sustainable recovery of the travel and leisure industry

The study stipulates phases to observe the proposed mechanism in formulating the travel and leisure industry's recovery strategies. The present pandemic COVID-19 has resulted in global challenges, economic and healthcare crises, and posed spillover impacts on the global industries, including tourism and travel that the major contributor to the service industry worldwide. The tourism and leisure industry has faced the COVID-19 tourism impacts hardest-hit and lies among the most damaged global industries. The leisure and internal tourism indicated a steep decline amounting to 2.86 trillion US dollars, which quantified more than 50% revenue losses. In the first step, the study explores the consequences and settings of the COVID-19 pandemic and how innovation and change can contribute to the tourism industry's revival to the next normal. Thus, the study determines that tourism enterprises and scholars must consider and change the basic principles, main assumptions, and organizational situations related to research and practice framework through rebuilding and establishing the tourism sector. In the second step, the study discusses direct COVID-19 tourism impacts, attitudes, and practices in gaining the leisure industry's boom and recovery. In the third phase, the study proposes to observe the characteristics and COVID-19 tourism consequences on the travel and tourism research. The findings provide insights in regaining the tourism industry's operational activities and offer helpful suggestions to government officials, scholars, and tourism firms to reinvest in the tourism industry to set it back to a normal position.

Implementing Public Health Strategies-The Need for Educational Initiatives: A Systematic Review

In the absence of a specific treatment or vaccines, public health strategies are the main measures to use in the initial stages of a pandemic to allow surveillance of infectious diseases. During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), several countries initiated various public health strategies, such as contact tracing and quarantine. The present study aims to conduct a systematic literature review to identify the presence of educational initiatives that promote the implementation of public health strategies before public health emergencies, with a special focus on contact tracing applications. Using Science Direct, PubMed, Scopus, and Gothenburg University search engines, all published scientific articles were included, while conference, reports, and non-scientific papers were excluded. The outcomes of the reviewed studies indicate that the effective implementation of public health strategies depends on the peoples' willingness to participate and collaborate with local authorities. Several factors may influence such willingness, of which ethical, psychological, and practical factors seem to be the most important and frequently discussed. Moreover, individual willingness and readiness of a community may also vary based on the acquired level of knowledge about the incident and its cause and available management options. Educational initiatives, proper communication, and timely information at the community level were found to be the necessary steps to counteract misinformation and to promote a successful implementation of public health strategies and attenuate the effects of a pandemic. The systematic review conducted as a part of this study would benefit the relevant stakeholders and policy makers and assist with effective designing and implementation.

Risk communication and community engagement strategies for COVID-19 in 13 African countries

Background: Coronavirus disease 2019 (COVID-19) outbreak is a major threat facing health systems globally and African countries are not an exception. Stakeholders, governments, and national authorities have mounted responses to contain the pandemic. This study aimed to catalogue the risk communication and community engagement (RCCE) strategies as well as the challenges facing RCCE in 13 African countries.

Methods: We conducted a narrative review of evidence to answer the aim of the study. The search was conducted in March 2021 and evidence published between December 2019 and February 2021 were included. Data reported in this article were obtained from reports, literature in peer-reviewed journals, grey literature and other data sources in 13 African countries. The 13 countries include Ethiopia, Ghana, Kenya, Algeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia. The authors also snowball further data to gather information for this review.

Results: Most of the priority African countries have RCCE strategies to contain the transmission and spread of the coronavirus. Our findings revealed RCCE strategies in the 13 African countries focused on training and capacity building, risk communication systems, internal and partners’ coordination, community engagement, public communication, contending uncertainty, addressing misperceptions and managing misinformation. However, the RCCE response activities were not without challenges, which included distrust in government, cultural, social, and religious resistance, and inertia among others.

Conclusion: With the similar RCCE approaches and interventions seen across the countries, it is clear that countries are learning from each other and from global health organizations to develop COVID-19 RCCE programs. It is important for African countries to address the challenges facing RCCE in order to effectively contain the pandemic and to prepare for future public health emergencies.

Barriers and enablers experienced by health care workers in swabbing for COVID-19 in Papua New Guinea: A multi-methods cross-sectional study

Objective

We aimed to identify the barriers and enablers that Health Care Workers (HCWs) in Papua New Guinea experienced in swabbing for COVID-19.

Methods

We conducted a cross-sectional multi-methods study: a qualitative scoping exercise and a telephone survey. The target population was COVID-19-trained HCWs from all provinces of Papua New Guinea. A descriptive analysis of survey responses was conducted alongside a rapid qualitative analysis of interviews and open-ended survey questions.

Results

Four thematic areas were identified: human resources, logistics, HCW attitudes and community attitudes. The survey response rate was 70.3% (407/579). Commonly reported barriers to COVID-19 swabbing were insufficient staff trained (74.0%, n = 301), inadequate staffing in general (64.9%, n = 264), insufficient supply of personal protective equipment (60.9%, n = 248) and no cold chain to store swabs (57.5%, n = 234). Commonly reported enablers to swabbing were community awareness and risk communication (80.8%, n = 329), consistent and sufficient supplies of personal protective equipment (67.8%, n = 276), increased surge workforce (63.9%, n = 260) and having a fridge to store swabs (59.7%, n = 243).

Conclusions

A comprehensive community and HCW engagement strategy combined with innovations to improve the supply chain are needed to increase COVID-19 swabbing in Papua New Guinea to reach national testing targets. Investments in increasing numbers of frontline workforce, consistent supplies of PPE, swabs, transport medium, cold boxes and ability to make ice packs, in addtion to establishing regular tranport of specimens from the facility to the testing site will strengthen the supply chain. Innovations are needed to address these issues.

Characterization of Vaccine Tweets During the Early Stage of the COVID-19 Outbreak in the United States: Topic Modeling Analysis

BACKGROUND

During the early stages of the COVID-19 pandemic, developing safe and effective coronavirus vaccines was considered critical to arresting the spread of the disease. News and social media discussions have extensively covered the issue of coronavirus vaccines, with a mixture of vaccine advocacies, concerns, and oppositions.

OBJECTIVE

This study aimed to uncover the emerging themes in Twitter users' perceptions and attitudes toward vaccines during the early stages of the COVID-19 outbreak.

METHODS

This study employed topic modeling to analyze tweets related to coronavirus vaccines at the start of the COVID-19 outbreak in the United States (February 21 to March 20, 2020). We created a predefined query (eg, "COVID" AND "vaccine") to extract the tweet text and metadata (number of followers of the Twitter account and engagement metrics based on likes, comments, and retweeting) from the Meltwater database. After preprocessing the data, we tested Latent Dirichlet Allocation models to identify topics associated with these tweets. The model specifying 20 topics provided the best overall coherence, and each topic was interpreted based on its top associated terms.

RESULTS

In total, we analyzed 100,209 tweets containing keywords related to coronavirus and vaccines. The 20 topics were further collapsed based on shared similarities, thereby generating 7 major themes. Our analysis characterized 26.3% (26,234/100,209) of the tweets as News Related to Coronavirus and Vaccine Development, 25.4% (25,425/100,209) as General Discussion and Seeking of Information on Coronavirus, 12.9% (12,882/100,209) as Financial Concerns, 12.7% (12,696/100,209) as Venting Negative Emotions, 9.9% (9908/100,209) as Prayers and Calls for Positivity, 8.1% (8155/100,209) as Efficacy of Vaccine and Treatment, and 4.9% (4909/100,209) as Conspiracies about Coronavirus and Its Vaccines. Different themes demonstrated some changes over time, mostly in close association with news or events related to vaccine developments. Twitter users who discussed conspiracy theories, the efficacy of vaccines and treatments, and financial concerns had more followers than those focused on other vaccine themes. The engagement level-the extent to which a tweet being retweeted, quoted, liked, or replied by other users-was similar among different themes, but tweets venting negative emotions yielded the lowest engagement.

CONCLUSIONS

This study enriches our understanding of public concerns over new vaccines or vaccine development at early stages of the outbreak, bearing implications for influencing vaccine attitudes and guiding public health efforts to cope with infectious disease outbreaks in the future. This study concluded that public concerns centered on general policy issues related to coronavirus vaccines and that the discussions were considerably mixed with political views when vaccines were not made available. Only a small proportion of tweets focused on conspiracy theories, but these tweets demonstrated high engagement levels and were often contributed by Twitter users with more influence.