Public Health Academic Alliance for COVID-19 Response: The Role of a National Medical Task Force in Puerto Rico

Ensuring Community Engagement in Disease Surveillance: The Municipal Case Investigation and Contact Tracing System for COVID-19 in Puerto Rico

Objectives. To describe the implementation of a novel disease surveillance model in Puerto Rico, the Municipal Case Investigation and Contact Tracing System for COVID-19, established during the pandemic as the primary response. Methods. We analyzed data from July 2020 to June 2021, including all COVID-19 cases reported by public and private laboratories in Puerto Rico to describe the accomplishments and limitations of the surveillance. Results. During the first year, the system was successfully implemented in all Puerto Rican municipalities, collecting data on more than 132 000 confirmed COVID-19 cases. It improved case investigation coverage, reduced laboratory reporting times, and facilitated community engagement for ongoing response enhancements. Conclusions. Surveillance systems of this scale were new to Puerto Rico's Health System, and there was a steep learning and improvement curve. This approach enabled tailored health education, equitable distribution of testing and treatments, and surveillance by educational institutions. Public Health Implications. Near-real-time epidemiological data publication promoted trust, education, and evidence-based policymaking. (Am J Public Health. 2024;114(S1):S96-S102. https://doi.org/10.2105/AJPH.2023.307493).

AÇÕES DE PROMOÇÃO DA SAÚDE NAS UNIVERSIDADES EM FACE DA PANDEMIA DO COVID-19: SCOPING REVIEW

RESUMO Objetivo: mapear na literatura as ações e estratégias de promoção da saúde das universidades no contexto da pandemia do novo coronavírus (COVID-19). Metodo: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Com base nestas perspectivas, ficou estabelecida a pergunta norteadora: quais ações e estratégias de promoção da saúde foram realizadas em universidades com a comunidade interna e seu entorno na pandemia do COVID-19? As buscas foram realizadas em março de 2021 nas bases de dados de portais de informação públicos, restritos e de literatura cinzenta. Resultados: foram selecionados 38 estudos e com base nesses foram construídas três categorias: 1) Ações e estratégias de enfrentamento do COVID-19 nas universidades 2) Ações e estratégias inclusivas e de Proteção social a grupos vulneráveis ao COVID-19 nas universidades 3) Ações e estratégias de Educação em saúde e bem-estar em face do COVID-19 nas universidades. Conclusões: o estudo evidenciou que ações e estratégias de promoção da saúde nas Universidades acontecem quando a proposta encontra apoio institucional, mobilização inter e transdisciplinar, integração com setores governamentais e iniciativa privada, além do engajamento da população acadêmica. Observaram-se diversas ações em diferentes cenários, demonstrando comprometimento social e posicionamento crítico em face do COVID-19, visando uma sociedade mais justa e sustentável pela via do conhecimento.

HEALTH PROMOTION ACTIONS IN UNIVERSITIES IN THE FACE OF THE COVID-19 PANDEMIC: A SCOPING REVIEW

ABSTRACT Objective: to map in the literature the universities' health promotion actions and strategies in the context of the new coronavirus (COVID-19) pandemic. Method: a Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. Based on these perspectives, the following guiding question was established: which health promotion actions and strategies were implemented in universities with the internal community and its surroundings in the COVID-19 pandemic? The searches were carried out in March 2021 in the databases of public, restricted and gray literature information portals. Results: a total of 38 studies were selected and three categories were elaborated based on them, namely: 1) Actions and strategies for coping with COVID-19 in universities; 2) Inclusive and Social protection actions and strategies for groups vulnerable to COVID-19 in universities; and 3) Health and Well-being Education actions and strategies in the face of COVID-19 in universities. Conclusions: the study evidenced that health promotion actions and strategies in universities become a reality when the proposals find institutional support, inter- and transdisciplinary mobilization and integration with governmental sectors and private initiative, in addition to engagement of the academic population. Several actions were observed in different scenarios, showing social commitment and a critical stance in the face of COVID-19, aiming at a fairer and more sustainable society through knowledge.

Improving compliance with physical distancing across religious cultures in Israel

BACKGROUND

Physical distancing contains the corona virus, but compliance with physical distancing across religious minorities in Israel has been shown to be relatively poorer than in the majority population. This study tests the power of messages as drivers of willingness to comply with physical distancing across religious minorities in Israel during the first wave of the COVID-19 from March till June 2020.

METHODS

896 Israeli Muslims, Druze, Bedouins, Jewish Orthodox, Christians, and Jewish Seculars participated in this conjoint-based experimental design. The size of the total sample and of the subgroups is consistent with the suggested size in conjoint analysis studies, particularly when aiming at stability of coefficients rather than stability of means. The dependent variable was 'willingness to comply'. Independent variables were known contributors to compliance: perceived risk, practices of physical distancing, ways to assure compliance, and the agent communicating the policy.

RESULTS

A regression analysis indicated minor differences in the power of messages across groups despite dramatic cultural differences amongst them. We identified three distinct mindsets that transcend religious cultures from the responses of the study subjects to various messages and named them "pandemic observers," "obedient followers," and "sensitive interpreters." Compliance of "Pandemic Observers" (n = 306) may be improved by messages such as, "Dangerous virus spreading wildly" and "Health experts suggest what to do but the government is reactive rather than proactive" (β = 14, p < .005). Compliance of "Obedient Followers" (n = 242) may be driven by the messages "Socialize and work only from home, using the internet, e.g. zoom/Skype" and "Everyone should stay 2 m. (6 ft.) apart" (β = 16, p < .0050). Compliance of "Sensitive Interpreters" (n = 249) may be improved by messages such as, "Only people who are 60 and over are to be allowed to buy groceries during first 2 h from opening" and by using the media to publicize the official health policy (β = 8; p < .005).

CONCLUSIONS

Mindset-assignment reflects how people think rather than their religious affiliation. A personal viewpoint identifier was developed to predict mindset-assignment and enable health authorities to enhance compliance through mindset-tailored messages for members of each mindset segment. We recommend that health authorities and policy makers consider these different personality types, which range across religious minorities and emphasize the messages that each type responds to in developing and implementing a communication plan to improve physical distancing as an important public health measure.

The voices of community pharmacists during the COVID-19 pandemic in Puerto Rico

Background

Community pharmacists have provided health care services uninterruptedly throughout the coronavirus disease 2019 (COVID-19) pandemic. However, their public health role is often overlooked.

Objectives

The purpose of this article is to discuss the roles and the coping mechanisms of community pharmacists working during the COVID-19 pandemic in Puerto Rico.

Methods

A cross-sectional study, using an electronic survey, was conducted to assess the community pharmacists’ response during the COVID-19 pandemic in Puerto Rico. Two open-ended questions explored community pharmacists’ opinions about the pharmacist’s role and coping mechanisms during the pandemic. The responses were analyzed following an inductive thematic analysis. Two major themes emerged from their responses: professional and personal experiences.

Results

Of the 302 participants who completed the survey, 77% of them answered 1 or both open-ended questions. The answers were diverse, and the respondents went beyond the specific topics asked. In professional experiences, important roles as educators and providing continuity of care and emotional support to their patients were highlighted. They also expressed concerns and frustrations on the profession’s shortcomings, feeling overworked yet with a lack of recognition. In personal experiences, most of the respondents were concerned about the impact of having to juggle work and home life. They also reported mental health concerns, expressing feeling stressed, overworked, and worried about the constant risk of exposure and fear of exposing their loved ones.

Conclusion

Community pharmacists in Puerto Rico ensured the continuation of care, provided education, and managed anxious and stressed patients. Most relied on family members to cope with the extra burden that the COVID-19 pandemic. The lack of recognition created resentfulness among participants. It is essential to listen to our community pharmacists’ voices to support and respond to their needs and learn from their experiences as frontline health care workers.

Impact of the early COVID-19 era on endometriosis patients: Symptoms, stress, and access to care

Introduction:

Monitoring the impact of natural disasters such as pandemics on health and wellbeing is a public health priority. Stress is proven to affect pain intensity and quality of life of endometriosis patients. A cross-sectional study was conducted to determine whether the measures implemented to mitigate COVID-19 infections had a substantial impact on risk behaviors, endometriosis symptoms, stress, and access to healthcare.

Methods:

Electronic questionnaires that measured COVID-19 impact and peri-traumatic stress were disseminated through social media over June–September 2020 and completed by 82 adult patients with endometriosis living in Puerto Rico. Descriptive data analysis and correlations were done in quantitative data and systematic analysis of free text was done on qualitative responses.

Results:

Participants self-reported worsening of endometriosis symptoms and high levels of peri-traumatic stress, as well as changes in risk behaviors (exercise, nutrition, sedentarism, sleep) during the pandemic in comparison to the previous months. They also reported substantial barriers in access to medical appointments, scheduled procedures, and prescriptions. Electronic health modalities (telemedicine, mobile apps) were considered acceptable alternatives for gynecologic care during natural disasters.

Conclusion:

The COVID-19 pandemic negatively impacts the health and wellbeing of endometriosis patients while imposing substantial restrictions on access to health care. These timely insights will guide the development and implementation of plans to address barriers to health care and minimize long-term detrimental effects of natural disasters on the health of those living with stress-related disorders such as endometriosis.

Learning and Collaboration during Crisis: A Novel University-Community Partnership to Manufacture Medical Personal Protective Equipment

Research on crisis management focuses on pre-planning for disasters in order to understand potential barriers. However, one significant barrier to crisis response is that organizations may come together in unplanned configurations during crisis response. This means that significant opportunities exist for understanding the process by which individuals learn, collaborate, and create new systems during crises. In this case report, we present the case of face shield production by a university, academic medical center, and community partners during the supply chain collapse of the early COVID-19 pandemic with the aim of identifying the relationships that formed during the COVID-19 response, so that this case of relationship formation and participant experiences might inform similar disaster response challenges in the future. Thirteen participants responded to an in-depth questionnaire designed to simulate an asynchronous in-depth interview. Respondents reported on the activities of 80 individuals from 38 units/organizations, providing insight into communication challenges and resolutions. Responses were analyzed using thematic analysis, highlighting roles and relationships among participants. The findings grant insight into the experience of learning from crisis response efforts, responding to recent calls for social scientific work on COVID-19 responses.

Physical Activity and Daily Routine among Children Aged 0-12 during the COVID-19 Pandemic in Spain

The COVID-19 pandemic has impacted the lives of many people. Objective: The aim of the present study was to analyse the physical activity (PA) and daily routine among children (0–12 years) during lockdown and to establish the main relationships among the variables. Methods: A quantitative study with a descriptive–comparative and cross-sectional design carried out. The sample, selected for convenience, consisted of 837 Spanish children aged 0–12. The “Children and confinement” questionnaire was used, distributed electronically through Google Forms and social networks and activated for 45 days. The individuals participating in this study were mainly children (50.2%) who were in primary education (44.8%). Predominantly, the families of participants were biparental (87.9%), with established routines and schedules (85.7%). Results and conclusions: The use of digital screens is an important part of children’s daily routine. Their daily activities were practiced for more than three–six years, with more by girls. The time children devoted to sleep was directly proportional to the time they devoted to physical activity and indirectly proportional to the time they spent watching screens. The children who slept the most were those aged zero–three years, especially girls, who belonged to large families. The levels of physical activity in the sample were low, as were the times spent on activities such as music or games.

Containing COVID-19 by Matching Messages on Social Distancing to Emergent Mindsets-The Case of North America

Public compliance with social distancing is key to containing COVID-19, yet there is a lack of knowledge on which communication 'messages' drive compliance. Respondents (224 Canadians and Americans) rated combinations of messages about compliance, systematically varied by an experimental design. Independent variables were perceived risk; the agent communicating the policy; specific social distancing practices; and methods to enforce compliance. Response patterns to each message suggest three mindset segments in each country reflecting how a person thinks. Two mindsets, the same in Canada and the US, were 'tell me exactly what to do,' and 'pandemic onlookers.' The third was 'bow to authority' in Canada, and 'tell me how' in the US. Each mindset showed different messages strongly driving compliance. To effectively use messaging about compliance, policy makers may assign any person or group in the population to the appropriate mindset segment by using a Personal Viewpoint Identifier that we developed.