Collecting Data During the COVID-19 Pandemic: Lessons From an In-Person Survey of People Who Use Opioids

Centering equity through in-person data collection: short report

BACKGROUND

During the COVID-19 pandemic, data collection activities largely became tele-remote, excluding those who did not have the required technology or digital literacy.

METHODS

Between June and September 2020, we collected data in-person from people who use opioids in New York City. Participants were recruited via street intercept and outside four syringe service programs in the city. Surveys were conducted outdoors, with researchers and participants wearing masks and maintaining physical distance.

RESULTS

A total of 329 people participated in the survey. Participants reported an average age of 45.8 years, 69.6% identified as male, 32.6% identified as Hispanic/Latino/a and 22.3% identified as Black. Many experienced unstable housing/street homelessness (65.9%) and half did not have regular smartphone access (51.1%).

CONCLUSION

Many participants were struggling to meet their basic needs and did not have the resources to participate in tele-remote research or surveillance. In-person engagement may help researchers build trust, explain data security measures, and decrease technology and comprehension barriers. As data inform policies and programs, researchers must center equity by including under-engaged groups in data collection activities.

Understanding Vaccine Perceptions and Willingness to Receive COVID-19 Vaccination: Opportunities to Strengthen Public Health Responses and COVID-19 Services for People Who Use Drugs

Background: People who use drugs (PWUD) are at high risk for COVID-19 infection, morbidity, and mortality. COVID-19 vaccines are safe and effective at reducing serious illness and death from COVID-19. There are sparse data on the perceptions and willingness of PWUD to receive COVID-19 vaccination. Materials and Methods: In order to assess the perceptions of, and willingness to receive, COVID-19 vaccination among PWUD, we conducted a rapid survey-based assessment of 100 PWUD in NYC (Spring 2021) who reported not having received COVID-19 vaccination and who reported past 30-day illicit drug use. Results: More than 80% of respondents agreed that personally receiving a COVID-19 vaccine was important for the health of others in the community, and endorsing this belief was significantly associated with COVID-19 vaccine willingness reflecting a high prevalence of altruistic beliefs (p-value: 0.01). Other reported perceptions that were significantly associated with COVID-19 vaccine willingness were believing that COVID-19 vaccines are safe for PWUD and trusting COVID-19 information from their healthcare providers (p-values < 0.05). That said, 62% reported being unwilling to receive a COVID-19 vaccine, and 70−83% had concerns about general vaccine safety/efficacy. Examining pairs of questions to explore potential ambivalence between vaccine endorsement and vaccine concerns identified that 56−65% simultaneously reported vaccine safety/efficacy concerns and beliefs that vaccination was an important intervention. Of the 75 respondents who reported past 30-day use of harm reduction and/or substance use disorder (SUD) programs, nearly 90% reported these programs as trusted sources of COVID-19 information. Conclusion: Most participants reported altruistic beliefs about the role of vaccines for community health, including COVID-19 vaccines, and this altruism was associated with willingness to be vaccinated against COVID-19. These findings suggest a complex relationship between beliefs about the role of vaccination in community health and the safety/efficacy of vaccines; this ambivalence suggests that COVID-19 vaccine willingness may not be firmly fixed, indicating potential opportunities to address questions and build vaccine confidence. Harm reduction and SUD programs could be leveraged to further engage PWUD in receipt of COVID-19 information and/or vaccination. Recognizing vaccine ambivalence, emphasizing collective and individual benefits of vaccination, and messaging from trusted sources may be promising approaches to increase vaccination in this population.

A prospective longitudinal study with treated hypertensive patients in Northern Bangladesh (PREDIcT-HTN) to understand uncontrolled hypertension and adverse clinical events: A protocol for 5-years follow-up

Introduction

Uncontrolled hypertension is the most common cause of major adverse clinical events (MACE), such as myocardial infarction, strokes, and death due to CVDs, in both developed and developing countries. Western-led studies found that treated hypertensive adults with uncontrolled hypertension were more at-risk of all-cause and CVD-specific mortality than normotensives. The PRospEctive longituDInal sTudy of Treated HyperTensive patients of Northern-Bangladesh (PREDIcT-HTN) study principally aims to estimate the incidence of MACE in treated hypertensive patients and identify the determinants of MACE. The secondary objective is to find the prevalence of uncontrolled hypertension in treated hypertensive patients and the associated risk factors.

Methods and analysis

The treated hypertensive patients were obtained from the Hypertension and Research Center (H&RC), Rangpur, Bangladesh, from January to December 2020. Based on the eligibility criteria, 2643 patients were included to constitute the PREDIcT-HTN cohort. Baseline data was retrieved from the H&RC registry, and five follow-up waves are planned yearly (2021–2025). A questionnaire will be administered at each follow-up visit on hypertension control status, behavioral factors, quality of life, dietary adherence, and high blood pressure compliance-related variables. The participant will be right censored if the patient develops MACE, death due to any cause, loss to follow-up, or at the end of the study. A proportional hazard model will identify the risk factors of MACE. Multinomial logistic regression analyses will be performed to determine the predictors of the hypertension control status by medication and dietary adherence after adjusting confounders.

Ethics and dissemination

The ethical approval for this study was obtained from the Institutional Review Board, North South University [Ref: 2019/OR-NSU/IRB-No.0902]. The participants will provide written consent to participate. The findings will be disseminated through manuscripts in clinical/academic journals and presentations at professional conferences and stakeholder communication.