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Bamidele O, Greenley S, Ukoha-Kalu BO, Titus OF, Nanton V. A Scoping Review of Stigma Related to Prostate Cancer in Black Men. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02070-5. [PMID: 38980523 DOI: 10.1007/s40615-024-02070-5] [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: 12/18/2023] [Revised: 06/18/2024] [Accepted: 06/23/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Prostate cancer (CaP) disproportionately affects 1-in-4 Black men and is a stigmatised disease within their communities. Yet, Black men are underrepresented in CaP research concerning stigma, which necessitates a scoping review to map available evidence on this topic to inform future research. AIMS To map published literature on stigma related to CaP in Black men to understand their experiences and/or perceptions and identify directions for future research. METHODS A scoping review was conducted using the five-step framework by Arksey and O'Malley. Studies published in English addressing stigma related to CaP from the perspectives of Black men and/or their families were included. We searched six databases including Medline, Embase, PsycInfo, CINAHL, Web of Science Core Collection and Google Scholar, from inception to April 2023. Citation searches were also conducted. Two independent reviewers conducted screening and data extraction. Data was synthesised using descriptive content analysis. RESULTS Thirty-four eligible studies conducted in the USA, UK, Trinidad and Tobago, South Africa, Cameroon and Canada from 1995 to 2023 were included. A total of 1867 Black men with/without a CaP diagnosis and 145 adult partners were included. Review findings showed a complex intersection of self-stigma, public stigma and structural stigma impacted Black men's perceptions of their masculinity. While men's experiences/perceptions of stigma varied depending on their illness status, there were commonalities in their masculinity concerns (underpinned by stigma), which influenced their attitude towards digital rectal examination, post-treatment side effects and social interactions on CaP. These have implications for public health messaging on CaP within Black communities, as well as patient-provider interactions with the men. CONCLUSIONS This novel review highlights the need to pay attention to how CaP is presented to Black men and their communities using avenues and languages that are culturally acceptable and empower them to negotiate self-stigma, public stigma and structural stigma related to CaP. Directions for further research were also identified.
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Affiliation(s)
- Olufikayo Bamidele
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK.
| | - Sarah Greenley
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
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Biesty CP, Hemingway C, Woolgar J, Taylor K, Lawton MD, Waheed MW, Holford D, Taegtmeyer M. Community led health promotion to counter stigma and increase trust amongst priority populations: lessons from the 2022-2023 UK mpox outbreak. BMC Public Health 2024; 24:1638. [PMID: 38898512 PMCID: PMC11188168 DOI: 10.1186/s12889-024-19176-4] [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: 02/15/2024] [Accepted: 06/17/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Stigma, lack of trust in authorities, and poor knowledge can prevent health-seeking behaviour, worsen physical and mental health, and undermine efforts to control transmission during disease outbreaks. These factors are particularly salient with diseases such as mpox, for which 96% of cases in the 2022-2023 UK outbreak were identified among gay, bisexual, queer and men who have sex with men (MSM). This study explored stigma and health-seeking behaviour in Liverpool through the lens of the recent mpox outbreak. METHODS Primary sources of data were interviews with national and regional key informants involved in the mpox response, and participatory workshops with priority populations. Workshop recruitment targeted Grindr users (geosocial dating/hookup app) and at risk MSM; immigrant, black and ethnic minority MSM; and male sex workers in Liverpool. Data were analysed using a deductive framework approach, building on the Health Stigma and Discrimination Framework. RESULTS Key informant interviews (n = 11) and five workshops (n = 15) were conducted. There were prevalent reports of anticipated and experienced stigma due to mpox public health messaging alongside high demand and uptake of the mpox vaccine and regular attendance at sexual health clinics. Respondents believed the limited impact of stigma on health-seeking behaviour was due to actions by the LGBTQ + community, the third sector, and local sexual health clinics. Key informants from the LGBTQ + community and primary healthcare felt their collective action to tackle mpox was undermined by central public health authorities citing under-resourcing; a reliance on goodwill; poor communication; and tokenistic engagement. Mpox communication was further challenged by a lack of evidence on disease transmission and risk. This challenge was exacerbated by the impact of the COVID-19 pandemic on the scientific community, public perceptions of infectious disease, and trust in public health authorities. CONCLUSIONS The LGBTQ + community and local sexual health clinics took crucial actions to counter stigma and support health seeking behaviour during the 2022-2023 UK mpox outbreak. Lessons from rights based and inclusive community-led approaches during outbreaks should be heeded in the UK, working towards more meaningful and timely collaboration between affected communities, primary healthcare, and regional and national public health authorities.
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Affiliation(s)
- Colette Pang Biesty
- Department of International Public Health, Liverpool University Hospitals NHS Foundation Trust/Liverpool School of Tropical Medicine, Liverpool, UK
| | - Charlotte Hemingway
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - James Woolgar
- Public Health Department, Liverpool City Council, Liverpool, UK
| | | | | | | | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Miriam Taegtmeyer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Facente SN, De Zuzuarregui M, Frank D, Gomez-Aladino S, Muñoz A, Williamson S, Wang E, Hunter LA, Packel L, Reingold A. Anticipated and Experienced Stigma After Testing Positive for SARS-CoV-2: A Qualitative Study. Health Promot Pract 2024; 25:235-243. [PMID: 35950699 PMCID: PMC10908201 DOI: 10.1177/15248399221115063] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Stigma has inhibited public health practitioners' influence during the COVID-19 pandemic. We explore the experienced and anticipated stigma of people affiliated with a large university in the United States, using the Health Stigma and Discrimination Framework. METHODS We conducted a qualitative secondary substudy of 20 people who tested SARS-CoV-2 positive and 10 who tested negative in the summer of 2020, selected from a study of 3,324 university students and employees. FINDINGS No participants reported anticipated stigmatization prior to testing positive. However, eight of 20 participants recounted stigma marking (being marked by COVID-19 diagnosis or membership in a "high-risk" group) or manifestations of stigma after testing positive, including feelings of guilt or shame, and concerns about being judged as selfish or irresponsible. Three described being denied services or social interactions as a result of having had COVID-19, long after their infectiousness ended. Participants noted that clear public health messaging must be paired with detailed scientific information, rather than leaving people to resort to non-experts to understand the science. DISCUSSION Public health messaging designed to mitigate spread of SARS-CoV-2 and protect the community may perpetuate stigma and exacerbate inequities. As a result, people may avoid testing or treatment, mistrust public health messaging, or even use risk-increasing behavior as coping mechanisms. IMPLICATIONS FOR PRACTICE Intentional use of language that promotes equity and deters discrimination must be high priority for any COVID-19-related public health messaging. Partnership with community leaders to co-create programs and disseminate messaging is a critical strategy for reducing stigma, especially for historically mistreated groups.
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Affiliation(s)
- Shelley N. Facente
- University of California, Berkeley, CA, USA
- Facente Consulting, Richmond, CA, USA
| | | | | | | | | | | | - Emily Wang
- University of California, Berkeley, CA, USA
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Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [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: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
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Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
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Nakireka S, Mukunya D, Tumuhaise C, Olum R, Namulema E, Napyo A, Serwanja Q, Ingabire PM, Muyinda A, Bongomin F, Musaba M, Mutaki V, Nantale R, Akunguru P, Ainembabazi R, Nomujuni D, Olwit W, Nakawunde A, Nyiramugisha S, Aol PM, Rujumba J, Munabi I, Kiguli S. "I thought I was going to die": Experiences of COVID-19 patients managed at home in Uganda. PLoS One 2023; 18:e0295113. [PMID: 38085728 PMCID: PMC10715664 DOI: 10.1371/journal.pone.0295113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND In Uganda, approximately 170,000 confirmed COVID-19 cases and 3,630 deaths have been reported as of January 2023. At the start of the second COVID-19 wave, the Ugandan health system was overwhelmed with a sudden increase in the number of COVID-19 patients who needed care, and the Ministry of Health resorted to home-based isolation and care for patients with mild to moderate disease. Before its rollout, the COVID-19 home-based care strategy had neither been piloted nor tested in Uganda. OBJECTIVE To explore the experiences of COVID-19 patients managed at home in Uganda. METHODS This was a qualitative study that was conducted to explore the lived experiences of COVID-19 patients managed at home. The study was carried out among patients who presented to three hospitals that were designated for treating COVID-19 patients in Uganda. COVID-19 patients diagnosed at these hospitals and managed at home were followed up and contacted for in-depth telephone interviews. The data were analysed using thematic content analysis with the aid of NVIVO 12.0.0 (QRS International, Cambridge, MA). RESULTS Participants experienced feelings of fear and anxiety: fear of death, fear of losing jobs, fear of infecting loved ones and fear of adverse events such as loss of libido. Participants also reported feelings of loneliness, hopelessness and depression on top of the debilitating and sometimes worsening symptoms. In addition to conventional medicines, participants took various kinds of home remedies and herbal concoctions to alleviate their symptoms. Furthermore, COVID-19 care resulted in a high economic burden, which persisted after the COVID-19 illness. Stigma was a major theme reported by participants. Participants recommended that COVID-19 care should include counselling before testing and during and after the illness to combat the fear and stigma associated with the diagnosis. Another recommendation was that health workers should carry out home visits to patients undergoing home-based care and that COVID-19 treatment should be free of charge. CONCLUSION COVID-19 home-based care was associated with fear, anxiety, loneliness, depression, economic loss and stigma. Policymakers should consider various home-based follow-up strategies and strengthen counselling of COVID-19 patients at all stages of care.
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Affiliation(s)
- Susan Nakireka
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
- Department of Internal Medicine, Uganda Christian University, School of Medicine, Mukono, Uganda
| | - David Mukunya
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Department of Research, Nikao Medical Center, Kampala, Uganda
| | - Crescent Tumuhaise
- Department of Medicine, Our Lady Health of the Sick, Nkozi Hospital, Mpigi, Uganda
| | - Ronald Olum
- Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda
- School of Public Health, Makerere University, Kampala, Uganda
| | - Edith Namulema
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
- Department of Internal Medicine, Uganda Christian University, School of Medicine, Mukono, Uganda
| | - Agnes Napyo
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Department of Public Health, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | | | | | - Asad Muyinda
- Department of Medicine, Jinja Regional Referral Hospital, Jinja, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Milton Musaba
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Vivian Mutaki
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Ritah Nantale
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | | | | | | | - William Olwit
- Department of Radiology, Uganda Cancer Institute, Kampala, Uganda
| | - Aisha Nakawunde
- Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda
| | | | | | - Joseph Rujumba
- Department of Pediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda
| | - Ian Munabi
- Department of Anatomy, School of Medicine, Makerere University, Kampala, Uganda
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda
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Udeagu CCN, Pitiranggon M, Misra K, Huang J, Terilli T, Ramos Y, Alexander M, Kim C, Lee D, Blaney K, Keeley C, Long T, Vora NM. Outcomes of a Community Engagement and Information Gathering Program to Support Telephone-Based COVID-19 Contact Tracing: Descriptive Analysis. JMIR Public Health Surveill 2022; 8:e40977. [PMID: 36240019 PMCID: PMC9668330 DOI: 10.2196/40977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/27/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Chi-Chi N Udeagu
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Masha Pitiranggon
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Kavita Misra
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Jamie Huang
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Thomas Terilli
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Yasmin Ramos
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Martha Alexander
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Christine Kim
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - David Lee
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Kathleen Blaney
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
| | - Chris Keeley
- New York City Test & Trace Corps, New York City Health + Hospitals, New York City, NY, United States
| | - Theodore Long
- New York City Test & Trace Corps, New York City Health + Hospitals, New York City, NY, United States
| | - Neil M Vora
- New York City Test & Trace Corps, New York City Department of Health & Mental Hygiene, Queens, NY, United States
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Paul AM, Lee C, Fesshaye B, Gur-Arie R, Zavala E, Singh P, Karron RA, Limaye RJ. Conceptualizing the COVID-19 Pandemic: Perspectives of Pregnant and Lactating Women, Male Community Members, and Health Workers in Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10784. [PMID: 36078503 PMCID: PMC9518350 DOI: 10.3390/ijerph191710784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Pregnant women are at greater risk of adverse outcomes from SARS-CoV-2 infection. There are several factors which can influence the ways in which pregnant women perceive COVID-19 disease and behaviorally respond to the pandemic. This study seeks to understand how three key audiences-pregnant and lactating women (PLW), male community members, and health workers-in Kenya conceptualize COVID-19 to better understand determinants of COVID-19 related behaviors. This study used qualitative methods to conduct 84 in-depth interviews in three counties in Kenya. Data were analyzed using a grounded theory approach. Emerging themes were organized based on common behavioral constructs thought to influence COVID-19 related behaviors and included myths, risk perception, economic implications, stigma, and self-efficacy. Results suggest that risk perception and behavioral attitudes substantially influence the experiences of PLW, male community members, and health workers in Kenya during the COVID-19 pandemic. Public health prevention and communication responses targeting these groups should address potential barriers to preventive health behaviors, such as the spread of misinformation, financial constraints, and fear of social ostracization.
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Affiliation(s)
- Alicia M. Paul
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Clarice Lee
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Berhaun Fesshaye
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rachel Gur-Arie
- Berman Institute of Bioethics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Eleonor Zavala
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Prachi Singh
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Ruth A. Karron
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rupali J. Limaye
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Mlouki I, Zammit N, Ghammem R, Ben Fredj S, Bannour R, El Echi A, Ladhari H, Haddedi A, Ghodhbani MM, Maatoug J, Ghannem H. Validity and reliability of a modified short version of a stigma scale for use among Tunisian COVID-19 patients after quarantine: A cross-sectional study. Health Sci Rep 2022; 5:e520. [PMID: 35224221 PMCID: PMC8855630 DOI: 10.1002/hsr2.520] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND AIM The COVID-19 is a stigmatizing infectious disease even after healing. Until now, no COVID-19 stigma scale validated in Tunisian Arabic language among the general population is available. Developing such tools is necessary to detect COVID-19 stigma and reduce it effectively. Indeed, stigmatization of COVID-19 patients could increase the spread of this disease and its related mental health issues. We aimed at testing the validity of a translated and modified version of the 12-item HIV stigma scale among Tunisian COVID-19 patients. METHODS A cross-sectional study was conducted between November and December 2020 among a representative sample of COVID-19 patients in the governorate of Sousse, Tunisia, after quarantine. The 12-item HIV stigma scale was translated in Tunisian Arabic and then modified to be adapted to the Tunisian context. The preliminary modified version was administrated to the participants by pretrained medical doctors during phone calls. It consisted on 20 items covering the four stigma dimensions (personalized stigma, disclosure concerns, concerns with public attitudes, and negative self-image). The psychometric evaluation of this version included internal consistency as well as principal component analysis (PCA). RESULTS The responses of 346 COVID-19 patients were obtained. Their median age was 40 years (interquartile range: 30-54.5). Females represented 60.4% of them. The PCA resulted in a three factor solution with 14 items. This 14-item scale demonstrated good internal consistency with a global Cronbach's α of 0.91 and values of 0.94, 0.93, and 0.98 for social stigma, negative self-image, and disclosure concerns, respectively. CONCLUSION This study provides a reliable and valid instrument for stigma measuring among Tunisian COVID-19 patients. The use of this scale would contribute in reducing the spread of this new infectious disease and its related mental health issues.
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Affiliation(s)
- Imen Mlouki
- Department of EpidemiologyFarhat Hached University HospitalSousseTunisia
| | - Nawel Zammit
- Department of Epidemiology (LR19SP03)Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of SousseSousseTunisia
| | - Rim Ghammem
- Department of Epidemiology (LR19SP03)Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of SousseSousseTunisia
| | - Sihem Ben Fredj
- Department of Epidemiology (LR19SP03)Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of SousseSousseTunisia
| | - Rania Bannour
- Department of EpidemiologyFarhat Hached University HospitalSousseTunisia
| | - Ansar El Echi
- Department of EpidemiologyFarhat Hached University HospitalSousseTunisia
| | | | | | | | - Jihene Maatoug
- Department of Epidemiology (LR19SP03)Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of SousseSousseTunisia
| | - Hassen Ghannem
- Department of Epidemiology (LR19SP03)Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of SousseSousseTunisia
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Shoib S, Ullah I, Ori D, Saleem SM, Hashmi N, Islam SMS. COVID-19, Stigma and Mental Health: Roots and Solutions. REVISTA COLOMBIANA DE PSIQUIATRIA 2021; 52:S0034-7450(21)00167-0. [PMID: 34776544 PMCID: PMC8576097 DOI: 10.1016/j.rcp.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Sheikh Mohd Saleem
- Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Nida Hashmi
- Karachi Medical and Dental College, Karachi, Pakistan
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10
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Meltzer GY, Chang VW, Lieff SA, Grivel MM, Yang LH, Des Jarlais DC. Behavioral Correlates of COVID-19 Worry: Stigma, Knowledge, and News Source. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11436. [PMID: 34769952 PMCID: PMC8583421 DOI: 10.3390/ijerph182111436] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022]
Abstract
Non-adherence to COVID-19 guidelines may be attributable to low levels of worry. This study assessed whether endorsing COVID-19-stigmatizing restrictions, COVID-19 knowledge, and preferred news source were associated with being 'very worried' versus 'not at all' or 'somewhat' worried about contracting COVID-19. Survey data were collected in July-August 2020 from N = 547 New York State (NYS) and N = 504 national Amazon MTurk workers. Respondents who endorsed COVID-19 stigmatizing restrictions (NYS OR 1.96; 95% CI 1.31, 2.92; national OR 1.80; 95% CI 1.06, 3.08) and consumed commercial news (NYS OR 1.89; 95% CI 1.21, 2.96; national OR 1.93; 95% CI 1.24, 3.00) were more likely to be very worried. National respondents who consumed The New York Times (OR 1.52; 95% CI 1.00, 2.29) were more likely to be very worried, while those with little knowledge (OR 0.24; 95% CI 0.13, 0.43) were less likely to be very worried. NYS (OR 2.66; 95% CI 1.77, 4.00) and national (OR 3.17; 95% CI 1.95, 5.16) respondents with probable depression were also more likely to be very worried. These characteristics can help identify those requiring intervention to maximize perceived threat to COVID-19 and encourage uptake of protective behaviors while protecting psychological wellbeing.
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Affiliation(s)
- Gabriella Y. Meltzer
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; (V.W.C.); (S.A.L.); (M.M.G.); (L.H.Y.)
| | - Virginia W. Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; (V.W.C.); (S.A.L.); (M.M.G.); (L.H.Y.)
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10003, USA
| | - Sarah A. Lieff
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; (V.W.C.); (S.A.L.); (M.M.G.); (L.H.Y.)
| | - Margaux M. Grivel
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; (V.W.C.); (S.A.L.); (M.M.G.); (L.H.Y.)
| | - Lawrence H. Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY 10003, USA; (V.W.C.); (S.A.L.); (M.M.G.); (L.H.Y.)
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Don C. Des Jarlais
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY 10003, USA;
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11
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COVID-19 Stigma and Charismatic Social Relationship: A Legitimization Narrative of President Trump’s Status as a Charismatic Leader following a SARS-CoV-2 Infection Reported by the Portuguese Media. SOCIETIES 2021. [DOI: 10.3390/soc11040130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This concept paper aimed to understand how stigma, a concept usually associated with negative social relationships, in the context of a pandemic threat such as COVID-19 can, in some situations, structure a charismatic social relationship in a perceived positive association between stigma and a specific social characteristic. For this purpose, we used the example of the news selected and highlighted by several Portuguese media about the actions and messages developed by President Trump in the context of his infection with SARS-CoV-2 and the subsequent recovery process. These news reports gave visibility to a narrative that can be considered as reinforcing the legitimization of his condition as a charismatic leader in an electoral context marked by the pandemic threat. In conclusion, stigma associated with a pandemic health threat and generally linked to a negative social status can also reinforce admiration, trust, and belief in the charismatic leader by supporters and followers, as demonstrated with the plight of President Trump. Stigma can be a factor in social uplift in affirming an upward trajectory of social status and symbolic power for actors seen as ill, where stigma-motivated discrimination is experienced positively, unlike in most cases.
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12
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Hao F, Wang B, Tan W, Husain SF, McIntyre RS, Tang X, Zhang L, Han X, Jiang L, Chew NWS, Tan BYQ, Tran B, Zhang Z, Vu GL, Vu GT, Ho R, Ho CS, Sharma VK. Attitudes toward COVID-19 vaccination and willingness to pay: comparison of people with and without mental disorders in China. BJPsych Open 2021; 7:e146. [PMID: 34422295 PMCID: PMC8365102 DOI: 10.1192/bjo.2021.979] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Acceptance and willingness to pay for the COVID-19 vaccine are unknown. AIMS We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it. METHOD Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale. RESULTS Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls. CONCLUSIONS To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.
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Affiliation(s)
- Fengyi Hao
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, China; Mental Health Center, West China Hospital, Sichuan University, China; Translational Neuroscience Center, West China Hospital, Sichuan University, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China; and Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China
| | - Bokun Wang
- Modern Service Industry Bureau, Chongqing Liangjiang New Area Administration Committee, China
| | - Wanqiu Tan
- Department of Psychiatry, National University of Singapore (Chongqing) Research Institute, China
| | - Syeda Fabeha Husain
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Ontario, Canada
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, China; Mental Health Center, West China Hospital, Sichuan University, China; Translational Neuroscience Center, West China Hospital, Sichuan University, China; and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
| | - Ling Zhang
- Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China
| | - Xiaofan Han
- Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China
| | - Li Jiang
- Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China
| | | | | | - Bach Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam; and Bloomberg School of Public Health, Johns Hopkins University, Maryland, USA
| | - Zhisong Zhang
- Faculty of Education, Huaibei Normal University, China
| | - Gia Linh Vu
- Institute for Global Health Innovations and Faculty of Medicine, Duy Tan University, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Vietnam
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus S. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Vijay K. Sharma
- Division of Neurology, Department of Medicine, National University Health System, Singapore; and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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