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Muñoz Bohorquez J, Channell Doig A, Goldring S, Campos E, Burton K, Delacey JL, McCoy LH, Sorenson C, Crist G, Terhune C, Kim J. Access Barriers, Trusted Channels, and Misconceptions About the COVID-19 Vaccine Among Rural Immigrant Farmworkers. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153241262050. [PMID: 38881300 DOI: 10.1177/15404153241262050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background: Although COVID-19 has disproportionately impacted immigrant agricultural workers, vaccination efforts have been challenging. Barriers to immunization include language, visa status, and access to medical care. Additionally, vaccine hesitancy, mistrust, and misinformation contributed to low uptake. Methods: A community needs assessment was conducted with immigrant agricultural workers (n = 9) and community stakeholders (n = 15) in rural areas of Maryland and Delaware. In-depth interviews were recorded, transcribed verbatim, and analyzed using template analysis. Results: The participants named trusted and untrusted sources, sources of misinformation, and barriers to accessing information and physical locations to receive the vaccine as reasons for not getting the vaccine. Trusted sources included known community leaders and television programs. Some barriers mentioned were fear of deportation, lack of paid time off, language barriers, and difficulty navigating the U.S. healthcare system. Discussion: There is a need for culturally-tailored programs that address misinformation and barriers and use community-based programming.
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Affiliation(s)
- Juliana Muñoz Bohorquez
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Amara Channell Doig
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Sarah Goldring
- Cooperative Extension, University of Delaware, Newark, Delaware, USA
| | - Esmeralda Campos
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland, USA
| | - Kiarra Burton
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Jennifer Lynne Delacey
- Department of Health Policy and Management, University of Maryland, College Park, Maryland, USA
| | - Lisa H McCoy
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Catherine Sorenson
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Gina Crist
- Cooperative Extension, University of Delaware, Newark, Delaware, USA
| | - Crystal Terhune
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
| | - Jinhee Kim
- University of Maryland Extension, University of Maryland, College Park, Maryland, USA
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LePrevost CE, Cofie LE, Nieuwsma J, Harwell EL, Rivera ND, Acevedo PA, Lee JGL. Community health worker outreach to farmworkers in rural North Carolina: Learning from adaptations to the SARS-CoV-2 pandemic. Health Expect 2024; 27:e14047. [PMID: 38613767 PMCID: PMC11015864 DOI: 10.1111/hex.14047] [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: 01/12/2024] [Revised: 03/18/2024] [Accepted: 04/03/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Community health workers represent a critical part of the health outreach and services for migrant and seasonal farmworkers ('farmworkers') in rural areas of the United States. PURPOSE We sought to identify adaptations to farmworker patient engagement and health outreach made by community health workers during the first 18 months of the COVID-19 pandemic. METHODS In this qualitative study, we used semi-structured interviews with community health workers from August 2020 to February 2022 (n = 21). Two coders used thematic analysis to identify three themes related to the experiences of community health workers in conducting health education and outreach to farmworkers prior to and following the onset of the pandemic. FINDINGS We found themes related to pre-pandemic outreach efforts to provide health education resource sharing with farmworkers and pandemic-related outreach efforts that included adoption of porch drops and distanced delivery of health education, adaptation of modes of health education and communication through technology and the internet, and taking on new roles related to COVID-19. Finally, we identified changes that reverted after the pandemic or will continue as adaptations. CONCLUSIONS Community health workers created practice-based innovations in outreach in response to the COVID-19 pandemic. These innovations included new COVID-19 related roles and new modes of health education and outreach, including the use of digital resources. The changes developed for emergency use in COVID-19, particularly related to internet and technology, have likely altered how community health workers conduct outreach in North Carolina going forward. Funders, community health worker training programs, and researchers should take note of these innovations. PATIENT OR PUBLIC CONTRIBUTION Community health workers who typically come from patient populations and provide critical navigation and connection with the health care system advised on the design and creation of this research project, including serving on an advisory board. Two authors have experience working as community health workers.
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Affiliation(s)
- Catherine E. LePrevost
- Department of Applied Ecology, College of Agriculture and Life SciencesNC State UniversityRaleighNorth CarolinaUSA
| | - Leslie E. Cofie
- Department of Health Education and Promotion, College of Health and Human PerformanceEast Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Julianna Nieuwsma
- Department of Applied Ecology, College of Agriculture and Life SciencesNC State UniversityRaleighNorth CarolinaUSA
| | - Emery L. Harwell
- Department of Applied Ecology, College of Agriculture and Life SciencesNC State UniversityRaleighNorth CarolinaUSA
| | - Natalie D. Rivera
- NC Farmworker Health Program, Office of Rural HealthNC Department of Health and Human ServicesRaleighNorth CarolinaUSA
| | - Paula A. Acevedo
- Department of Health Education and Promotion, College of Health and Human PerformanceEast Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Joseph G. L. Lee
- Department of Health Education and Promotion, College of Health and Human PerformanceEast Carolina UniversityGreenvilleNorth CarolinaUSA
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3
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Cofie LE, Rivera ND, Santillán-Deras JR, Knox G, Lee JGL. Digital Inclusion for Farmworkers in a Pandemic: The North Carolina Farmworker Health Program Internet Connectivity Project, 2020‒2021. Am J Public Health 2022; 112:1551-1555. [PMID: 36223575 PMCID: PMC9558178 DOI: 10.2105/ajph.2022.307017] [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] [Accepted: 06/28/2022] [Indexed: 09/03/2023]
Abstract
The North Carolina Farmworker Health Program (NCFHP) implemented an emergency program in response to North Carolina migrant and seasonal farmworkers' urgent need for Internet access for health information, family connections, and telehealth services during COVID-19 isolation and quarantine. This article describes the NCFHP Internet Connectivity Project implementation and evaluation from June 2020 to December 2021. The project placed 448 devices across the state and provided Internet access to more than 3184 farmworkers during the 2021 peak farming season. (Am J Public Health. 2022;112(11):1551-1555. https://doi.org/10.2105/AJPH.2022.307017).
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Affiliation(s)
- Leslie E Cofie
- Leslie E. Cofie and Joseph G. L. Lee are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC. At the time of the project, Natalie D. Rivera was with the North Carolina Farmworker Health Program, Office of Rural Health, North Carolina Department of Health and Human Services, Raleigh. At the time of the project, Jocelyn R. Santillán-Deras was with Manos Unidas and North Carolina Farmworkers Project, Whiteville. Glenn Knox is with the Broadband Infrastructure Office, North Carolina Department of Information Technology, Raleigh
| | - Natalie D Rivera
- Leslie E. Cofie and Joseph G. L. Lee are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC. At the time of the project, Natalie D. Rivera was with the North Carolina Farmworker Health Program, Office of Rural Health, North Carolina Department of Health and Human Services, Raleigh. At the time of the project, Jocelyn R. Santillán-Deras was with Manos Unidas and North Carolina Farmworkers Project, Whiteville. Glenn Knox is with the Broadband Infrastructure Office, North Carolina Department of Information Technology, Raleigh
| | - Jocelyn R Santillán-Deras
- Leslie E. Cofie and Joseph G. L. Lee are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC. At the time of the project, Natalie D. Rivera was with the North Carolina Farmworker Health Program, Office of Rural Health, North Carolina Department of Health and Human Services, Raleigh. At the time of the project, Jocelyn R. Santillán-Deras was with Manos Unidas and North Carolina Farmworkers Project, Whiteville. Glenn Knox is with the Broadband Infrastructure Office, North Carolina Department of Information Technology, Raleigh
| | - Glenn Knox
- Leslie E. Cofie and Joseph G. L. Lee are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC. At the time of the project, Natalie D. Rivera was with the North Carolina Farmworker Health Program, Office of Rural Health, North Carolina Department of Health and Human Services, Raleigh. At the time of the project, Jocelyn R. Santillán-Deras was with Manos Unidas and North Carolina Farmworkers Project, Whiteville. Glenn Knox is with the Broadband Infrastructure Office, North Carolina Department of Information Technology, Raleigh
| | - Joseph G L Lee
- Leslie E. Cofie and Joseph G. L. Lee are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC. At the time of the project, Natalie D. Rivera was with the North Carolina Farmworker Health Program, Office of Rural Health, North Carolina Department of Health and Human Services, Raleigh. At the time of the project, Jocelyn R. Santillán-Deras was with Manos Unidas and North Carolina Farmworkers Project, Whiteville. Glenn Knox is with the Broadband Infrastructure Office, North Carolina Department of Information Technology, Raleigh
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Zhou Z, Jiang Y, Wu H, Jiang F, Yu Z. The Age of Mobility: Can Equalization of Public Health Services Alleviate the Poverty of Migrant Workers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013342. [PMID: 36293922 PMCID: PMC9603761 DOI: 10.3390/ijerph192013342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 05/26/2023]
Abstract
Migrants workers are important participants in and contributors to economic and social construction, but they still face the reality of being marginalized. Based on data from the China Migrants Dynamic Survey in 2018, this paper systematically investigated the impact of public health services on the multidimensional poverty of migrant workers. The research found that, first, the current mean of the multidimensional poverty deprivation value of migrant workers is 0.1806, which is one dimension of poverty that exists on average. In addition, migrant workers do not have high access to public health services. The proportions of migrant workers who have not established residents' health files and who have not received public health education are 74.22% and 29.92%, respectively. Second, public health services can significantly alleviate the multidimensional poverty of migrant workers. After mitigating the potential endogeneity problem by the IV-2SLS method and conducting robustness tests by the PSM method, the conclusion is still robust. Further research found that the impact of public health services on the multidimensional poverty alleviation of migrant workers is heterogeneous. The improvement of public health services has the greatest effect on the multidimensional poverty alleviation of the new generation of migrant female workers in the western region. The research in this paper helps to examine and clarify the policy significance of public health services for the multidimensional poverty alleviation of migrant workers and provides empirical evidence for the use of public health services to tackle the poverty problem.
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Affiliation(s)
- Ziming Zhou
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Yumeng Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Haitao Wu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Fan Jiang
- Institute of Agricultural Economics and Technology, Hubei Academy of Agricultural Science, Wuhan 430073, China
| | - Zhiming Yu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
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5
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Harwell EL, LePrevost CE, Cofie LE, Lee JGL. Community Health Workers' Role in Addressing Farmworker Health Disparities. J Agromedicine 2022; 27:391-401. [PMID: 35168470 PMCID: PMC9395548 DOI: 10.1080/1059924x.2022.2040069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Community health workers (CHWs) are uniquely positioned to connect migrant and seasonal farmworkers to health promotion and clinical services. However, research on CHWs' experiences, particularly related to their provision of health education to farmworkers, is limited. To explore CHWs' practices and challenges in conducting health education outreach, we conducted three focus group discussions with farmworker health CHWs (N = 28) in North Carolina in the spring of 2020. We analyzed the focus group transcripts, and we compared the code outputs, thematic code summaries, and memos maintained throughout the analytic process to examine the experiences of CHWs in acquiring and disseminating health information and resources, including use of technology. We identified three themes related to CHWs' experiences providing health information to farmworkers. First, CHWs described short-term preparation, immediately before providing health outreach, and long-term activities, devoted to maintaining and improving their capacity to provide relevant health information to farmworkers. Second, they described their use of health education delivery methods, including open-ended questions, participatory and interactive approaches, and non-verbal aids. Third, participants described their current use of technology and related challenges, as well as the technology needed to enhance health outreach, including internet access. Findings reveal opportunities to improve farmworker health education through professional development for CHWs, identification of preferred methods of health education delivery to farmworkers, and provision of technology to farmworker-serving organizations. Establishing rural internet access and equipping outreach organizations with technology would position CHWs to be maximally effective as they strive to reduce farmworkers' health inequities.Abbreviations: CHW: Community health worker; FGD: focus group discussion; NC: North Carolina.
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Affiliation(s)
- Emery L Harwell
- Department of Applied Ecology, North Carolina State University, Raleigh, North Carolina, USA
| | - Catherine E LePrevost
- Department of Applied Ecology, North Carolina State University, Raleigh, North Carolina, USA
| | - Leslie E Cofie
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
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6
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Caxaj S, Tran M, Mayell S, Tew M, McLaughlin J, Rawal S, Vosko LF, Cole D. Migrant agricultural workers' deaths in Ontario from January 2020 to June 2021: a qualitative descriptive study. Int J Equity Health 2022; 21:98. [PMID: 35842656 PMCID: PMC9287708 DOI: 10.1186/s12939-022-01692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nine migrant agricultural workers died in Ontario, Canada, between January 2020 and June 2021. Methods To better understand the factors that contributed to the deaths of these migrant agricultural workers, we used a modified qualitative descriptive approach. A research team of clinical and academic experts reviewed coroner files of the nine deceased workers and undertook an accompanying media scan. A minimum of two reviewers read each file using a standardized data extraction tool. Results We identified four domains of risk, each of which encompassed various factors that likely exacerbated the risk of poor health outcomes: (1) recruitment and travel risks; (2) missed steps and substandard conditions of healthcare monitoring, quarantine, and isolation; (3) barriers to accessing healthcare; and (4) missing information and broader issues of concern. Conclusion Migrant agricultural workers have been disproportionately harmed by the COVID-19 pandemic. Greater attention to the unique needs of this population is required to avoid further preventable deaths.
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Affiliation(s)
| | | | | | - Michelle Tew
- Occupational Health Clinic for Ontario Workers, Hamilton, Canada
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7
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Parra-Lucares A, Segura P, Rojas V, Pumarino C, Saint-Pierre G, Toro L. Emergence of SARS-CoV-2 Variants in the World: How Could This Happen? Life (Basel) 2022; 12:194. [PMID: 35207482 PMCID: PMC8879166 DOI: 10.3390/life12020194] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has had a significant global impact, with more than 280,000,000 people infected and 5,400,000 deaths. The use of personal protective equipment and the anti-SARS-CoV-2 vaccination campaigns have reduced infection and death rates worldwide. However, a recent increase in infection rates has been observed associated with the appearance of SARS-CoV-2 variants, including the more recently described lineage B.1.617.2 (Delta variant) and lineage B.1.1.529/BA.1 (Omicron variant). These new variants put the effectiveness of international vaccination at risk, with the appearance of new outbreaks of COVID-19 throughout the world. This emergence of new variants has been due to multiple predisposing factors, including molecular characteristics of the virus, geographic and environmental conditions, and the impact of social determinants of health that favor the genetic diversification of SARS-CoV-2. We present a literature review on the most recent information available on the emergence of new variants of SARS-CoV-2 in the world. We analyzed the biological, geographical, and sociocultural factors that favor the development of these variants. Finally, we evaluate the surveillance strategies for the early detection of new variants and prevent their distribution outside these regions.
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Affiliation(s)
- Alfredo Parra-Lucares
- Division of Critical Care Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile; (A.P.-L.); (V.R.)
| | - Paula Segura
- Department of Anatomic Pathology, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile;
| | - Verónica Rojas
- Division of Critical Care Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile; (A.P.-L.); (V.R.)
- Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile
| | - Catalina Pumarino
- School of Medicine, Faculty of Medicine, Universidad de Chile, 8380456 Santiago, Chile;
| | - Gustavo Saint-Pierre
- Microbiology Unit, Clinical Laboratory, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile;
| | - Luis Toro
- Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile
- Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, 8380456 Santiago, Chile
- Critical Care Unit, Clínica Las Condes, 7591047 Santiago, Chile
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8
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Montesi M. Human information behavior during the Covid-19 health crisis. A literature review. LIBRARY & INFORMATION SCIENCE RESEARCH 2021; 43:101122. [PMID: 34642543 PMCID: PMC8498744 DOI: 10.1016/j.lisr.2021.101122] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 12/17/2022]
Abstract
The research carried out on human information behavior (HIB) during the Covid-19 health crisis was reviewed, with the premise that HIB and information practices allow humans to adapt to the changing circumstances of existence. A literature search was run on the LISTA and Google Scholar databases from middle March 2020 up to the end of March 2021. After filtering retrieved results, 52 studies were selected. Results are summarized into seven main themes, including the use of traditional and social media, infoveillance of search engines and social media activity, misinformation, disinformation and infodemics, and uncertainty and emotions. Results point to the need to carry out additional research in specific contexts and addressing vulnerable and marginalized groups. Further areas of inquiry include the interplay of emotions, knowledge and behaviors during the information seeking process, a better understanding of local knowledge and experiential knowledge, and the need to comprehend the limitations of ICT.
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Affiliation(s)
- Michela Montesi
- Facultad de Ciencias de la Documentación, Calle de Santísima Trinidad, 37, 28010 Madrid, Spain
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9
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Abstract
OBJECTIVE The increased reliance on digital technologies to deliver healthcare as a result of the COVID-19 pandemic has meant pre-existing disparities in digital access and utilisation of healthcare might be exacerbated in disadvantaged patient populations. The aim of this rapid review was to identify how this 'digital divide' was manifest during the first wave of the pandemic and highlight any areas which might be usefully addressed for the remainder of the pandemic and beyond. DESIGN Rapid review and narrative synthesis. DATA SOURCES The major medical databases including PubMed and Embase and Google Scholar were searched alongside a hand search of bibliographies. ELIGIBILITY CRITERIA Original research papers available in English which described studies conducted during wave 1 of the COVID pandemic and reported between 1 March 2020 and 31 July 2021. RESULTS The search was described using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and identified nine studies. The results are presented within a refined framework describing the three key domains of the digital divide: (1) digital access, within which one study described continuing issues with internet connectivity among vulnerable patients in the UK; (2) digital literacy, where seven studies described how ethnic minorities and the elderly were less likely to use digital technologies in accessing care; (3) digital assimilation, where one study described how video technologies can reduce feelings of isolation and another how elderly black males were the most likely group to share information about COVID-19 on social media platforms. CONCLUSIONS During the early phase of the pandemic in the developed world, familiar difficulties in utilisation of digital healthcare among the elderly and ethnic minorities continued to be observed. This is a further reminder that the digital divide is a persistent challenge that needs to be urgently addressed when considering the likelihood that in many instances these digital technologies are likely to remain at the centre of healthcare delivery.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - David Shukla
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- West Midlands Clinical Research Network, Birmingham, UK
- Eve Hill Medical Practice, Dudley, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
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Bloss JE, LePrevost CE, Zahra AG, Firnhaber GC, Cofie LE, Zepeda R, Lee JGL. Advancing the Health of Migrant and Seasonal Farmworkers in the United States: Identifying Gaps in the Existing Literature, 2021. Health Promot Pract 2021; 23:432-444. [PMID: 34549654 PMCID: PMC9096586 DOI: 10.1177/15248399211033308] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There are profound health inequities for agricultural workers. We sought to assess the literature on migrant and seasonal farmworker health with an eye toward health promotion interventions, special populations, use of community health workers (CHWs), and technology. We conducted a systematic mapping review by searching five databases in March 2021. Using quantitative content analysis after establishing interrater reliability, we coded titles and abstracts to assess 13 topics and six characteristics of the research such as its focus on health promotion, use of technology, and inclusion of CHWs. We identified 1,083 records. Just 8.2% of records described or evaluated a health promotion effort to intervene in farmworker well-being and even fewer (4.2%) examined unique populations of farmworkers such as indigenous farmworkers (n = 11) or sexual minority farmworkers (n = 1). A small body of literature focused on the role of CHWs or promotores most frequently described their role in implementing health interventions. The literature on farmworker health has gaps regarding health promotion interventions, special populations, and integration of CHWs into research projects. We offer suggestions to fill in identified gaps in the literature.
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Affiliation(s)
| | - Catherine E LePrevost
- North Carolina State University, Raleigh, NC, USA.,North Carolina Agromedicine Institute, Greenville, NC, USA
| | | | | | | | - Ramón Zepeda
- Student Action with Farmworkers, Durham, NC, USA
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11
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Hayward SE, Deal A, Cheng C, Crawshaw A, Orcutt M, Vandrevala TF, Norredam M, Carballo M, Ciftci Y, Requena-Méndez A, Greenaway C, Carter J, Knights F, Mehrotra A, Seedat F, Bozorgmehr K, Veizis A, Campos-Matos I, Wurie F, McKee M, Kumar B, Hargreaves S. Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review. J Migr Health 2021; 3:100041. [PMID: 33903857 PMCID: PMC8061095 DOI: 10.1016/j.jmh.2021.100041] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. METHODS We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. RESULTS 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. CONCLUSIONS Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
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Affiliation(s)
- Sally E Hayward
- Institute for Infection and Immunity, St George's University of London, London, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anna Deal
- Institute for Infection and Immunity, St George's University of London, London, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Cherie Cheng
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Alison Crawshaw
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | | | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen; Department of Infectious Diseases at Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Manuel Carballo
- International Centre for Migration, Health, and Development, Geneva, Switzerland
| | | | - Ana Requena-Méndez
- Department of Medicine, Karolinska Insitutet, Solna, Sweden; and Barcelona Insitute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
| | | | - Jessica Carter
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Felicity Knights
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Anushka Mehrotra
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Kayvan Bozorgmehr
- Department of Population Medicine and Health and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ines Campos-Matos
- Public Health England; and UCL Collaborative Centre for Inclusion Health, London, UK
| | - Fatima Wurie
- Public Health England; and UCL Research Department of Epidemiology and Public Health, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - on behalf of the ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
- Institute for Infection and Immunity, St George's University of London, London, UK
- Institute for Global Health, University College London, London, UK
- Faculty of Business and Social Sciences, Kingston University, London, UK
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen; Department of Infectious Diseases at Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- International Centre for Migration, Health, and Development, Geneva, Switzerland
- Doctors of the World UK, London, UK
- Department of Medicine, Karolinska Insitutet, Solna, Sweden; and Barcelona Insitute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
- Department of Medicine, McGill University, Montreal, Canada
- Department of Population Medicine and Health and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany
- Medecins Sans Frontieres Greece, Athens, Greece
- Public Health England, London, UK
- Public Health England; and UCL Collaborative Centre for Inclusion Health, London, UK
- Public Health England; and UCL Research Department of Epidemiology and Public Health, London, UK
- Norwegian Institute of Public Health, Oslo, Norway
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Abstract
Telehealth services have slowly yet steadily increased over the past few decades as new technologies emerge. However, social distancing mandates, state shutdowns, and an overburdened healthcare system during the COVID-19 pandemic forced a dramatic surge forward in telehealth use and policy. While many of these emergency measures are temporary, the successes, failures and lessons learned during this period will change the way telehealth is administered, moving forward. This column will review recent changes to telehealth and telemedicine services during the pandemic and their impact on healthcare systems.
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Affiliation(s)
- Tariq Rahaman
- Tampa Bay Regional Campus Library, Nova Southeastern University, Clearwater, Florida, USA
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