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McDermid P, Abdi I, Mustafa K, Blazek K, Harris-Roxas B, Jackson CJ, Seale H. Examining the influence of community leaders and other community actors on immunisation practices in Australia: A national cross-sectional study. Vaccine 2024; 42:3647-3654. [PMID: 38704260 DOI: 10.1016/j.vaccine.2024.04.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Variation in COVID-19 vaccination coverage and increasing vaccine hesitancy are well documented, especially amongst ethnic minority populations and current channels of vaccine and communication have been found to be inadequate. It has been suggested that more be done to utilise community-led pathways to improve vaccine readiness in ethnic minority communities in Australia. The study aimed to explore receptiveness towards the role of different actors and methods of communication about immunisation. METHODS A cross-sectional survey of 1,227 adults in Australia was conducted to examine the roles of various actors in promoting vaccine uptake. Chi-square analyses and independent samples t-tests were used to identify significant associations between sociodemographic characteristics, vaccine practices, and vaccine information-seeking behaviours and (1) COVID-19 vaccine uptake (at least one dose) and (2) speaking a language other than English. RESULTS At the time of the survey, 93% of respondents had received at least one dose of the COVID-19 vaccine. There were significant associations between COVID-19 vaccine uptake and: perceived capacity to locate accurate and timely vaccine information; receiving the COVID-19 vaccination information from a Nurse or Pharmacist; and receiving a vaccine recommendation by a GP. Additionally, respondents who spoke a language other than English reported were significantly more likely to have received information from family, friends, workplaces, local councils, religious centres, community leaders, and religious leaders than those who only spoke English. CONCLUSION Significant variations in vaccine practices and vaccine information-seeking behaviours were found, especially in those who speak a language other than English. To enhance vaccine uptake and to address vaccine hesitancy in Australia, vaccine promotion strategies and health communication efforts require significant consideration of information accessibility and communication source preferences.
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Affiliation(s)
- Pippa McDermid
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ikram Abdi
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Kinza Mustafa
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Katrina Blazek
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ben Harris-Roxas
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Public Health, University of Technology Sydney, Australia
| | - Chris J Jackson
- UNSW Business School, University of New South Wales, Sydney, NSW, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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Sakala M, Johnson C, Chirombo J, Sacks JA, Baggaley R, Divala T. COVID-19 self-testing: Countries accelerating policies ahead of WHO guidelines during pandemics, a global consultation. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002369. [PMID: 38498477 PMCID: PMC10947679 DOI: 10.1371/journal.pgph.0002369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024]
Abstract
The widespread use of antigen-detection rapid diagnostic tests (Ag-RDTs) has revolutionized SARS-CoV-2 (COVID-19) testing, particularly through the option of self-testing. The full extent of Ag-RDT utilization for self-testing, however, remains largely unexplored. To inform the development of WHO guidance on COVID-19 self-testing, we conducted a global consultation to gather the views and experiences of policy makers, researchers, and implementers worldwide. The consultation was conducted by disseminating a WHO questionnaire through professional networks via email and social media, encouraging onward sharing. We used a cross-sectional design with both closed and open-ended questions related to policy and program information concerning the regulation, availability, target population, indications, implementation, benefits, and challenges of COVID-19 self-testing (C19ST). We defined self-testing as tests performed and interpreted by an untrained individual, often at home. Descriptive summaries, cross-tabulations, and proportions were used to calculate outcomes at the global level and by WHO region and World Bank income classifications. All information was collated and reported according to WHO guideline development standards and practice for global consultations. Between 01 and 11 February 2022, 844 individuals from 139 countries responded to the survey, with 45% reporting affiliation with governments and 47% operating at the national level. 504 respondents from 101 countries reported policies supporting C19ST for a range of use cases, including symptomatic and asymptomatic populations. More respondents from low-and-middle-income countries (LMICs) than high-income countries (HICs) reported a lack of an C19ST policy (61 vs 11 countries) and low population-level reach of C19ST. Respondents with C19ST experience perceived that the tests were mostly acceptable to target populations, provided significant benefits, and highlighted several key challenges to be addressed for increased success. Reported costs varied widely, ranging from specific programmes enabling free access to certain users and others with high costs via the private sector. Based on this consultation, systems for the regulatory review, policy development and implementation of C19ST appeared to be much more common in HIC when compared to LIC in early 2022, though most respondents indicated self-testing was available to some extent (101 out of 139 countries) in their country. Addressing such global inequities is critical for ensuring access to innovative and impactful interventions in the context of a public health emergency of international concern. The challenges and opportunities highlighted by key stakeholders could be valuable to consider as future testing strategies are being set for outbreak-prone diseases.
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Affiliation(s)
- Melody Sakala
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - James Chirombo
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Titus Divala
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi
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3
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Seale H, Harris-Roxas B, Heywood AE, Abdi I, Mahimbo A, Woodland L, Waller E. "It's no use saying it in English": A qualitative study exploring community leaders' perceptions of the challenges and opportunities with translating and interpreting COVID-19 related public health messaging to reach ethnic minorities in Australia. PLoS One 2024; 19:e0284000. [PMID: 38422070 PMCID: PMC10903877 DOI: 10.1371/journal.pone.0284000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The Australian Government implemented a range of public health response strategies and communication approaches to reduce the spread of COVID-19; however, concerns have been raised around a failure to sufficiently consider culturally and linguistically diverse (CaLD) communities in these processes. This research aimed to understand the factors that have impacted COVID-19 communication and engagement efforts during the pandemic from the perspective of key CaLD community and faith-based leaders. A further aim was to understand the processes that could be adopted to support future communication strategies, including promoting pandemic-related vaccines. APPROACH This study included 29 key informant interviews with community and faith-based leaders in New South Wales, Australia. RESULTS The overwhelming message from community leaders was a sense of shared responsibility between their organisations and governments in communicating pertinent and accurate COVID-19 related information to CaLD communities. They expressed a sense of duty to keep their community members safe. However, community leaders and others shouldered significant costs related to resources and time that need to be acknowledged by governments in preparing for future disease outbreaks. They felt that governments should consider: 1) improving communication between governments and CaLD organisations; 2) responding to the specific CaLD needs with greater agility; 3) foregrounding social media in their communication strategy; 4) reinvesting in local public health units to know their population; 5) developing a health ambassadors model program; 6) preparing a hybrid model of translators/interpreters to fill the gap; and, 7) reimagining vaccine information campaigns to target CaLD communities better. CONCLUSION Given the technical details about the COVID-19 virus conveyed in government information campaigns and the media, ensuring the most vulnerable populations, including people from CaLD backgrounds, access clear, concise and timely public health messaging from governments and community organisations requires further attention.
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Affiliation(s)
- Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales (NSW), Australia
| | - Ben Harris-Roxas
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales (NSW), Australia
| | - Anita E. Heywood
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales (NSW), Australia
| | - Ikram Abdi
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Abela Mahimbo
- School of Public Health, Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Lisa Woodland
- NSW Multicultural Health Communication Service, South Eastern Sydney Local Health District, NSW Health, Sydney, NSW, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Emily Waller
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales (NSW), Australia
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4
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Palu E, McBride KA, Simmons D, Thompson R, Cavallaro C, Cooper E, Felila M, MacMillan F. Adequacy of health message tailoring for ethnic minorities: Pasifika communities in Sydney, Australia, during COVID-19. Health Promot Int 2024; 39:daad197. [PMID: 38365189 DOI: 10.1093/heapro/daad197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Ethnic minorities, such as Pasifika, residing in high-income countries were at higher risk of COVID-19 infection during the pandemic. To understand the experiences of Pasifika, including message dissemination and barriers to tailored public health messaging during the pandemic, a qualitative study was undertaken, underpinned by Laswell's Model of Communication and Bandura's social cognitive theory with data collected using Pasifika methods. Pasifika adults (n = 65) were recruited across Sydney from July 2020 to March 2022. Health care professionals (HCP) (n = 17) employed by four local health districts (LHDs) and Pasifika community-based organizations delivering multicultural COVID-19-related work within the study catchment, were also recruited. Five themes were constructed from the data of: (i) prevailing fear and uncertainty over COVID-19 infection and losing employment; (ii) limited knowledge of government perpetuating distrust in Government as a benevolent source of information; (iii) faith and trust as priorities for health decision-making; (iv) 'Coconut wireless'-the role of family, friends and community in disseminating public health messages through word of mouth; and (v) limited health literacy affecting compliance with public health orders. Community members identified important messages and resources had not been sufficiently distributed. Most HCPs understood the necessity of grassroots-level engagement but reported existing approaches were inadequate to navigate challenges. These findings highlight the need for public health promotion and communication strategies that consider both the social and cultural determinants of health. We propose a 7-point checklist as a cultural appropriateness lens to assist the development and rating of existing or new health promotion messaging and resources.
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Affiliation(s)
- Elizabeth Palu
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Kate A McBride
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - David Simmons
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Clinical School, Western Sydney University, Campbelltown, NSW, Australia
| | - Ronda Thompson
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | | | - Ellen Cooper
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Makeleta Felila
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Western Sydney Local Health District, Westmead, NSW, Australia
| | - Freya MacMillan
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Clinical School, Western Sydney University, Campbelltown, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
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Abdi N, Flores M, Hara-Hubbard KK, Turner AM, Gudino J, Jafry S, Harris JR, Hannon PA, Baquero B, Meischke H. Bridging Culture and Language: Encouraging Bilingual/Multicultural Individuals to Act as Information Navigators for Their Loved-Ones and Communities during the COVID-19 Pandemic. JOURNAL OF HEALTH COMMUNICATION 2024; 29:34-48. [PMID: 37961888 DOI: 10.1080/10810730.2023.2279670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Linguistically diverse communities face barriers to receiving appropriate health information. COVID-19 exacerbated these health-communication inequities. University of Washington researchers surveyed bilingual staff, students, and medical interpreters - desiring training to become effective communicators of COVID-19 information to their social networks and language communities. In response, the COVID-19 Information Navigator Training was developed and pre-tested with professional networks and members of the target audience. The final training comprised three interactive modules and short quizzes. Evaluation surveys measured Information Navigators' confidence in providing COVID-19 information to their social networks. Surveys included questions on the participants' language or cultural community, the perceived value of the training, and their ability to communicate COVID-19 information. Among 393 participants who enrolled in the training, 284 completed the survey. Significant differences in confidence before and after the course were found in detecting COVID misinformation in the news and social media (pre-course mean: 3.83, post-course mean: 4.63; absolute mean difference was 0.82 points higher in the post-evaluation on the 5-point likert scale, 95% CI: 0.70-0.93, p < .01). Training multicultural volunteers to disseminate information to their social networks is a promising strategy for reaching linguistically diverse communities with up-to-date information during health emergencies.
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Affiliation(s)
- Najma Abdi
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Miriam Flores
- School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Anne M Turner
- School of Public Health, University of Washington, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Juan Gudino
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Sheharbano Jafry
- College of Arts and Sciences, University of Washington, Seattle, Washington, USA
| | - Jeffrey R Harris
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Peggy A Hannon
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Barbara Baquero
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Hendrika Meischke
- School of Public Health, University of Washington, Seattle, Washington, USA
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Crooks K, Taylor K, Burns K, Campbell S, Degeling C, Williams J, Andrews R, Massey P, McVernon J, Miller A. Having a real say: findings from first nations community panels on pandemic influenza vaccine distribution. BMC Public Health 2023; 23:2377. [PMID: 38037021 PMCID: PMC10691077 DOI: 10.1186/s12889-023-17262-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Recent deliberations by Australian public health researchers and practitioners produced an ethical framework of how decisions should be made to distribute pandemic influenza vaccine. The outcome of the deliberations was that the population should be considered in two categories, Level 1 and Level 2, with Level 1 groups being offered access to the pandemic influenza vaccine before other groups. However, the public health researchers and practitioners recognised the importance of making space for public opinion and sought to understand citizens values and preferences, especially First Nations peoples. METHODS We conducted First Nations Community Panels in two Australian locations in 2019 to assess First Nations people's informed views through a deliberative process on pandemic influenza vaccination distribution strategies. Panels were asked to make decisions on priority levels, coverage and vaccine doses. RESULTS Two panels were conducted with eighteen First Nations participants from a range of ages who were purposively recruited through local community networks. Panels heard presentations from public health experts, cross-examined expert presenters and deliberated on the issues. Both panels agreed that First Nations peoples be assigned Level 1 priority, be offered pandemic influenza vaccination before other groups, and be offered two doses of vaccine. Reasons for this decision included First Nations people's lives, culture and families are important; are at-risk of severe health outcomes; and experience barriers and challenges to accessing safe, quality and culturally appropriate healthcare. We found that communication strategies, utilising and upskilling the First Nations health workforce, and targeted vaccination strategies are important elements in pandemic preparedness and response with First Nations peoples. CONCLUSIONS First Nations Community Panels supported prioritising First Nations peoples for pandemic influenza vaccination distribution and offering greater protection by using a two-dose full course to fewer people if there are initial supply limitations, instead of one dose to more people, during the initial phase of the vaccine roll out. The methodology and findings can help inform efforts in planning for future pandemic vaccination strategies for First Nations peoples in Australia.
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Affiliation(s)
- Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.
| | - Kylie Taylor
- Population Health, Hunter New England Local Health District, Tamworth, NSW, Australia
| | - Kiara Burns
- Wuchopperen Health Service, Cairns, QLD, Australia
| | - Sandy Campbell
- Faculty of Health, Charles Darwin University, Casuarina, NT, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Jane Williams
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Ross Andrews
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Peter Massey
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Jodie McVernon
- Victorian Infectious Disease Reference Laboratory Epidemiology Unit, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Adrian Miller
- Office of Indigenous Engagement, Central Queensland University, Townsville, QLD, Australia
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Seale H, Trent M, Marks GB, Shah S, Chughtai AA, MacIntyre CR. Exploring the use of masks for protection against the effects of wildfire smoke among people with preexisting respiratory conditions. BMC Public Health 2023; 23:2330. [PMID: 38001501 PMCID: PMC10668508 DOI: 10.1186/s12889-023-17274-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The impact of wildfire smoke is a growing public health issue, especially for those living with preexisting respiratory conditions. Understanding perceptions and behaviors relevant to the use of individual protective strategies, and how these affect the adoption of these strategies, is critical for the development of future communication and support interventions. This study focused on the use of masks by people living in the Australian community with asthma or chronic obstructive pulmonary disease (COPD). METHODS Semi-structured phone interviews were undertaken with people living in the community aged 18 years and over. Participants lived in a bushfire-prone area and reported having been diagnosed with asthma or COPD. RESULTS Twenty interviews were undertaken between July and September 2021. We found that, during wildfire episodes, there was an overwhelming reliance on closing windows and staying inside as a means of mitigating exposure to smoke. There was limited use of masks for this purpose. Even among those who had worn a mask, there was little consideration given to the type of mask or respirator used. Reliance on sensory experiences with smoke was a common prompt to adopting an avoidance behavior. Participants lacked confidence in the information available from air-quality apps and websites, however they were receptive to the idea of using masks in the future. CONCLUSIONS Whilst COVID-19 has changed the nature of community mask use over the last couple of years, there is no guarantee that this event will influence an individual's mask behavior during other events like bushfires. Instead, we must create social support processes for early and appropriate mask use, including the use of air quality monitoring.
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Affiliation(s)
- Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, 2052, Australia.
| | - M Trent
- The Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - G B Marks
- School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - S Shah
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - A A Chughtai
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, 2052, Australia
| | - C R MacIntyre
- The Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Savoia E, Piltch-Loeb R, Stanton EH, Koh HK. Learning from COVID-19: government leaders' perspectives to improve emergency risk communication. Global Health 2023; 19:86. [PMID: 37968676 PMCID: PMC10652548 DOI: 10.1186/s12992-023-00993-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic highlighted the challenges of effective emergency risk communication (ERC) to protect public health, including the difficulty in tackling the spread of inaccurate information. This study aimed to understand those challenges and potential solutions by interviewing leading government spokespersons and their advisors from around the world with experience during large scale emergencies. Interviews were conducted with 27 individuals representing governments from 19 countries across five continents. Thematic analysis, using both a deductive and inductive approach, organized and identified salient themes and patterns that emerged from the interview data. RESULTS The thematic analysis of the interviews' data led to the identification of 9 principles of communication: 1) Timeliness, 2) Transparency, 3) Coordination, 4) Accuracy and Consistency, 5) Accountability and Integrity, 6) Independence from politics, 7) Responsiveness, 8) Equity, 9) Trust and Empathy. We also developed 36 recommendations actionable by government agencies to enhance the practice of the 9 principles. Examples include the need for: proactive communication strategies, permanent communication task forces integrated into preparedness and response efforts, robust processes to enhance open discussion of controversial topics within government agencies, clarification of how various branches of government coordinate to oversee specific aspects of the overall communication, and development of relationships across public and private entities ahead of a crisis. CONCLUSIONS Our findings suggest key practical recommendations for leaders of government agencies to enhance ERC capabilities going forward. Before a crisis, they must constantly review internal processes and integrate ERC functions into overall communication planning efforts. During a crisis, they must coordinate roles and responsibilities across branches of governments, strive to communicate to a range of populations to uphold equity, maintain transparency by avoiding information voids on controversial issues and build trust by building relationships with a variety of community leaders. After a crisis, government agencies should continue the practice of social listening to hear more about the public's informational needs, strengthen civic participation processes, and understand how an always evolving information environment can best be leveraged during future crises.
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Affiliation(s)
- Elena Savoia
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Emergency Preparedness Research Evaluation and Practice (EPREP) Program, Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Rachael Piltch-Loeb
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
- Emergency Preparedness Research Evaluation and Practice (EPREP) Program, Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Eva H Stanton
- Emergency Preparedness Research Evaluation and Practice (EPREP) Program, Division of Policy Translation and Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Howard K Koh
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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9
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James PB, Gatwiri K, Mwanri L, Wardle J. Impacts of COVID-19 on African Migrants' Wellbeing, and Their Coping Strategies in Urban and Regional New South Wales, Australia: a Qualitative Study. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01806-z. [PMID: 37768537 DOI: 10.1007/s40615-023-01806-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
AIM As the COVID-19 pandemic response continues to evolve, the need to protect more vulnerable populations in society becomes more apparent. Studies are still emerging on how different population groups have been impacted by the COVID-19 pandemic. Our study explored the impact of COVID-19 for African migrants in New South Wales, Australia, and their coping strategies. METHODS We employed inductive, exploratory qualitative interpretive research design using individual semi-structured in-depth interviews with 21 African migrants. RESULTS COVID-19 lockdowns disrupted the African sense of community. Social isolation, financial insecurity due to joblessness, or reduced working hours led to stress, frustration, anxiety, sadness, loneliness, and depression. On the other hand, COVID-19 lockdowns allowed for more family time, reflecting, and appreciating the gift of life and personal intellectual growth. Despite such challenges, there was much community support, especially from religious organisations. Support from government agencies was available, but access was hampered by misinformation, digital literacy, and immigration status. Holding on to religion and faith was a key coping mechanism, followed by indulging in self-care practices such as healthy eating, exercise, Yoga, meditation, sleep, and limited interaction with social media. CONCLUSION The COVID-19 lockdown disrupted the collectivist culture of African migrants and had untoward socioeconomic impacts that affected their wellbeing, many of which reflect an exacerbation of pre-existing inequities. To ensure that African migrant COVID-19-related health and wellbeing needs are met, the African migrant community must be actively involved in every facet of the NSW COVID-19 and other future outbreak response efforts.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Kathomi Gatwiri
- Centre for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Lillian Mwanri
- Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, 5000, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia
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Abdi I, Bolsewicz K, Bullivant B, Marques MD, Steffens MS. Understanding the factors that influence communication about COVID-19 vaccines with patients: Perspectives of Australian immunisation providers. Vaccine X 2023; 14:100304. [PMID: 37091729 PMCID: PMC10108559 DOI: 10.1016/j.jvacx.2023.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
Background COVID-19 immunisation providers have been at the forefront of the pandemic, and their ability to communicate effectively with patients is key to encouraging COVID-19 vaccine acceptance and uptake. This study explored providers' perspectives on the factors influencing communication with patients about COVID-19 vaccines. Methods We used an explanatory-sequential mixed-methods approach to conduct the study between December 2021 and March 2022. Phase I involved a cross-sectional survey with immunisation providers in New South Wales (n = 341; 189 general practitioners, 118 nurses and 34 pharmacists), followed by Phase II: semi-structured, in-depth qualitative interviews (n = 19; 10 nurses, 9 pharmacists). We generated descriptive results for the survey. We analysed the qualitative data thematically using an inductive approach. Results Almost half of survey participants reported communicating often with people who were hesitant about COVID-19 vaccines (49 %; 166/341), however, 21 % (71/341) reported inadequate time to address concerns during consultations. Interview participants reported communication challenges, including time constraints, difficulties addressing and eliciting patient concerns, and keeping up to date with changing information. Conversely, interview participants reported that easy access to government information resources, time to learn about COVID-19 vaccines proactively, knowing about and being able to use tailored strategies to support Aboriginal and Torres Strait Islander and CALD patients were helpful when communicating with patients. Conclusions Immunisation providers play an important role in patient vaccine acceptance and uptake. Our findings indicate that whilst providers were largely confident in their interactions with patients, further communication support would strengthen providers' skills in communicating with patients who have questions and concerns about COVID-19 vaccines.
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Affiliation(s)
- Ikram Abdi
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Katarzyna Bolsewicz
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Bianca Bullivant
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Maryke S Steffens
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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11
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Seale H, Harris-Roxas B, Mustafa K, McDermid P. Communication and engagement of community members from ethnic minorities during COVID-19: a scoping review. BMJ Open 2023; 13:e069552. [PMID: 37344110 DOI: 10.1136/bmjopen-2022-069552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES This review examined the factors influencing communication and engagement with ethnic and racial minority groups in Australia during the COVID-19 pandemic. It aimed to answer two main questions: (1) what communication problems people from these communities typically faced during the pandemic? and (2) what strategies and recommendations were suggested to enhance communication and engagement for ethnic and racial minorities during the current COVID-19 pandemic and any similar events in the future? DESIGN Scoping review. DATA SOURCES PubMed, EMBASE, Cochrane Library, PsychINFO and CINAHL. Grey literature was searched within organisations' websites and a Google search of key terms. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included original research, case studies, reports (including government and charity reports), systematic and scoping articles and literature reviews in English, published from January 2020 to August 2022. DATA EXTRACTION AND SYNTHESIS Two researchers independently assessed the literature for eligibility and extracted data from the included literature. The selected papers were analysed and summarised into themes relevant to the research questions. The final review included 38 studies combining published academic papers and grey literature. RESULTS Key themes relating to communication and engagement issues included a lack of trust in authority, a lack of access to information and ineffective communication channels and a lack of timely and culturally responsive materials. To reduce the issues, the papers spoke about the key role of community organisations to provide local support and community leaders as trusted spokespersons. Lastly, key recommendations to reduce inequity and strengthen future pandemic responses focused on the need for collaborations and consultations, increasing the number of bilingual workers and supporting community-led communication efforts. CONCLUSIONS The insights gained from the activities and experiences documented in this review during the COVID-19 pandemic should be incorporated into future decision-making and interventions to enhance communication and engagement strategies.
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Affiliation(s)
- Holly Seale
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kinza Mustafa
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Pippa McDermid
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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12
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Vernon-Wilson E, Tetui M, Nanyonjo A, Adil M, Bala A, Nelson D, Sayers E, Waite N, Grindrod K. Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada. BMC Public Health 2023; 23:932. [PMID: 37221519 DOI: 10.1186/s12889-023-15861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. METHODS Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. RESULTS Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. CONCLUSIONS Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.
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Affiliation(s)
- Elizabeth Vernon-Wilson
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Maisha Adil
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Arthi Bala
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Emma Sayers
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, Lincolnshire, UK
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
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13
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Carlson SJ, Edwards G, Blyth CC, Nattabi B, Attwell K. 'Corona is coming': COVID-19 vaccination perspectives and experiences amongst Culturally and Linguistically Diverse West Australians. Health Expect 2022; 25:3062-3072. [PMID: 36262050 DOI: 10.1111/hex.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/17/2022] [Accepted: 09/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Culturally and Linguistically Diverse (CALD) groups within high-income countries are at risk of being left behind by the COVID-19 vaccination rollout. They face both access and attitudinal barriers, including low trust in government and health authorities. OBJECTIVE To explore perceptions and attitudes towards COVID-19 vaccination, as well as facilitators, barriers and strategies to promote uptake among CALD residents of Western Australia (WA), where there were almost no COVID-19 cases for 2 years. DESIGN AND PARTICIPANTS Perth, WA's capital, was chosen as the state's study site because most of the state's CALD population lives there. Eleven semistructured in-depth interviews and three focus groups (with 37 participants) were conducted with CALD residents between August and October 2021. Thematic analysis was conducted, informed by the 'Capability', 'Opportunity', 'Motivation', 'Behaviour' model. RESULTS CALD participants faced barriers including a lack of knowledge about COVID-19 and the vaccines, low self-rated English proficiency and education levels, misinformation, passive government communication strategies and limited access to vaccine clinics/providers. They were, however, motivated to vaccinate by the imminent opening of state and international borders, trust in government and healthcare authorities, travel intentions and the desire to protect themselves and others. CONCLUSIONS Despite high levels of trust and significant desire for vaccines among CALD communities in Perth, current strategies were not meeting their needs and the community remains at risk from COVID-19. Tailored intervention strategies are required to provide knowledge, address misinformation and facilitate access to ensure uptake of COVID-19 vaccines-including for additional doses-amongst CALD communities. Governments should work with trusted CALD community members to disseminate tailored COVID-19 vaccine information and adequately translated resources. PATIENT OR PUBLIC CONTRIBUTION The Wesfarmers Centre of Vaccines and Infectious Diseases Community Reference Group at Telethon Kids Institute consulted on this project in September 2020; Ishar Multicultural Women's Health Services consulted on and facilitated the focus groups.
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Affiliation(s)
- Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Gracie Edwards
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Barbara Nattabi
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Katie Attwell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
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14
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Ayre J, Muscat DM, Mac O, Batcup C, Cvejic E, Pickles K, Dolan H, Bonner C, Mouwad D, Zachariah D, Turalic U, Santalucia Y, Chen T, Vasic G, McCaffery KJ. Main COVID-19 information sources in a culturally and linguistically diverse community in Sydney, Australia: A cross-sectional survey. PATIENT EDUCATION AND COUNSELING 2022; 105:2793-2800. [PMID: 35369997 PMCID: PMC8966120 DOI: 10.1016/j.pec.2022.03.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Describe COVID-19 information-seeking experiences for culturally and linguistically diverse groups in Sydney, Australia. METHODS Cross-sectional survey, translated into 11 languages; participants recruited from March 21 to July 9, 2021. Regression models identified factors associated with difficulty finding easy-to-understand COVID-19 information. RESULTS Across 708 participants (88% born overseas, 31% poor English proficiency), difficulty finding easy-to-understand COVID-19 information was rated 4.13 for English (95%CI: 3.85-4.41) and 4.36 for non-English language materials (95%CI: 4.07-4.66) (1 easy to 10 hard). Participants who were older (p < 0.001), had inadequate health literacy (p < 0.001), or poor English proficiency (p < 0.001) found it harder to find easy-to-understand English-language COVID-19 information. Those who had greater difficulty finding easy-to-understand non-English COVID-19 information were younger (p = 0.004), had poor English proficiency (p < 0.001), were university-educated (p = 0.05), and had spent longer living in Australia (p = 0.001). They were more likely to rely on friends and family for COVID-19 information (p = 0.02). There was significant variation in information-seeking experiences across language groups (p's < 0.001). CONCLUSIONS Easy-to-understand and accessible COVID-19 information is needed to meet the needs of people in culturally and linguistically diverse communities. PRACTICE IMPLICATIONS COVID-19 communication efforts must involve working alongside these communities to leverage existing communication channels and tailor messages.
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Affiliation(s)
- J Ayre
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia.
| | - D M Muscat
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - O Mac
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - C Batcup
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - E Cvejic
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - K Pickles
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - H Dolan
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - C Bonner
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
| | - D Mouwad
- Western Sydney Local Health District, Westmead, Australia
| | - D Zachariah
- Western Sydney Local Health District, Westmead, Australia
| | - U Turalic
- Nepean Blue Mountains Local Health District, Kingswood, Australia
| | - Y Santalucia
- South Western Sydney Local Health District, Fairfield, Australia
| | - T Chen
- Western Sydney Local Health District, Westmead, Australia
| | - G Vasic
- Western Sydney Local Health District, Westmead, Australia
| | - K J McCaffery
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Sydney, Australia
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