Addressing COVID-19 Vaccine Hesitancy With Community Distribution of Conversation Cards

To increase community conversations about COVID-19 vaccine hesitancy, we distributed vaccine cardholders and conversation cards to 6000 newly vaccinated adults at vaccination sites and encouraged them to talk with unvaccinated friends and family members. In 257 onsite exit interviews, we found that cardholders and conversation cards were well liked, and most recipients expected to use them. Follow-up surveys two weeks later showed that 51% of respondents used a card to start a conversation and 41% gave a card to an unvaccinated friend or family member. (Am J Public Health. 2024;114(S1):S87-S91. https://doi.org/10.2105/AJPH.2023.307481).

iHeard STL: Development and first year findings from a local surveillance and rapid response system for addressing COVID-19 and other health misinformation

BACKGROUND

The U.S. Surgeon General and others have emphasized a critical need to address COVID-19 misinformation to protect public health. In St. Louis, MO, we created iHeard STL, a community-level misinformation surveillance and response system. This paper reports methods and findings from its first year of operation.

METHODS

We assembled a panel of over 200 community members who answered brief, weekly mobile phone surveys to share information they heard in the last seven days. Based on their responses, we prioritized misinformation threats. Weekly surveillance data, misinformation priorities, and accurate responses to each misinformation threat were shared on a public dashboard and sent to community organizations in weekly alerts. We used logistic regression to estimate odds ratios (ORs) for associations between panel member characteristics and misinformation exposure and belief.

RESULTS

In the first year, 214 panel members were enrolled. Weekly survey response rates were high (mean = 88.3% ± 6%). Exposure to a sample of COVID-19 misinformation items did not differ significantly by panel member age category or gender; however, African American panel members had significantly higher reported odds of exposure and belief/uncertain belief in some misinformation items (ORs from 3.4 to 17.1) compared to white panel members.

CONCLUSIONS

Our first-year experience suggests that this systematic, community-based approach to assessing and addressing misinformation is feasible, sustainable, and a promising strategy for responding to the threat of health misinformation. In addition, further studies are needed to understand whether structural factors such as medical mistrust underly the observed racial differences in exposure and belief.

When do people increase COVID-19 protective behaviors? A longitudinal analysis of the impact of infections among close contacts and in the community

Studies examining individual-level changes in protective behaviors over time in association with community-level infection and self or close-contact infection with SARS-CoV-2 are limited. We analyzed overall and demographic specific week-to-week changes in COVID-19 protective behaviors and their association with COVID-19 infections (regional case counts and self or close contacts). Data were collected through 37 consecutive weekly surveys from 10/17/2021 - 6/26/2022. Our survey panel included 212 individuals living or working in St. Louis City and County, Missouri, U.S.A. Frequency of mask-wearing, handwashing, physical distancing, and avoiding large gatherings was self-reported (more/the same/less than the prior week). Close contact with COVID-19 was reported if the panel member, their household member, or their close contact tested positive, got sick, or was hospitalized for COVID-19 in the prior week. Regional weekly COVID-19 case counts were matched to the closest survey administration date. We used generalized linear mixed models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations. Evidence for effect modification was assessed using the likelihood ratio test. Increased protective behaviors were positively associated with COVID-19 case counts (OR_{highest vs. lowest case count category} = 4.39, 95% CI 3.35-5.74) and with participant-reported self or close contacts with COVID-19 (OR = 5.10, 95% CI 3.88-6.70). Stronger associations were found for White vs. Black panel members (p <.0001). Individuals modulated their protective behaviors in association with regional COVID-19 case counts and self or close contact infection. Rapid reporting and widespread public awareness of infectious disease rates may help reduce transmission during a pandemic by increasing protective behaviors.

1360. Investigating Transmission Dynamics Between Pets and Caretakers in Households of Children with Methicillin-resistant S. aureus Skin and Soft Tissue Infections

Background

Household pets are susceptible to Staphylococcus aureus (S. aureus) colonization. Our objective was to examine transmission of S. aureus between pets and their caretakers following a human household decolonization intervention.

Methods

From 2015-2021, a pragmatic randomized trial enrolled 196 households of children with community-associated methicillin-resistant S. aureus skin and soft tissue infection. Mouth and dorsal fur samples from indoor dogs and cats were cultured. Human nares, axillae, and inguinal fold samples were cultured. Samples were collected at enrollment and 1, 3, 6, and 9 months post-intervention. Participants were asked about pet daycare use, whether pets slept with caretakers, and pet skin conditions. Univariate and bivariate analyses, including McNemar tests, were conducted. Inclusion criteria were cat or dogs with at least one swab pre- and post-intervention.

Results

Our populations included 95 households with 161 pets; 35 households (39%) had ≥1 pet colonized with S. aureus. Within 2 weeks prior to enrollment, 3 (2%) pets had attended daycare, 70 (44%) slept with a caretaker, and 16 (10%) had skin conditions (see Table 1). 27 (17%) pets were colonized at enrollment. Of the 121 dogs, 20 (17%) were colonized at enrollment, 9 (7%) with MRSA. Of the 40 cats, 7 (18%) were colonized at enrollment, and 4 (10%) were colonized with MRSA. 72 (45%) pets had ≥1 caretakers who were colonized at enrollment; 18 (25%) of these pets were also colonized. Of the 137 caretakers, 48 (35%) were colonized at enrollment, and 16 (12%) were colonized with MRSA.

Whether a pet was colonized at enrollment was associated with colonization post-intervention (p< 0.001, see Table 2). All pets that were colonized at enrollment remained colonized post-intervention. Caretaker colonization at enrollment was associated with pet colonization post-intervention (p=0.04). Of the 72 pets whose caretakers were colonized at baseline, 36 (50%) pets were colonized post-intervention.

Conclusion

Both pet colonization and caretaker colonization at enrollment are significantly associated with pet colonization after human household member decolonization. This indicates that S. aureus may transmit from human caretakers to pets and human decolonization may not be fully protective against pet colonization.

Disclosures

Sara Malone, PhD, LCSW, AHRQ: Grant/Research Support|NIH: Grant/Research Support.

A Reasoned Action Approach to Depression Help-Seeking Messaging for College Students: Implications of Cognitive Biases in Depression

In this study we integrated insights from research on cognitive biases in depression with the reasoned action approach to predicting and changing behavior (RAA) with the goal of identifying implications for help-seeking messaging for college students with varying levels of depression. Findings from a sample of 374 U.S. college students support the ability of RAA to explain help-seeking intentions for non-depressed, mildly depressed students, and moderate to severely depressed students. More severe depression was associated with less favorable attitudes, perceived norms, perceived capacity, and intention; changes in the relative strength of attitudes, perceived norms, and perceived capacity in explaining help-seeking intentions; stronger expectations of negative outcomes of help-seeking and weaker expectations of positive outcomes; and to some extent, stronger expectations of negative outcomes for oneself than for others. These findings underscore that depressed students construe help-seeking differently than non-depressed students, and that depressed and non-depressed students need different help-seeking messages.