Hand hygiene perceptions, preferences, and practices among hospital staff in the Dominican Republic in the context of COVID-19: a qualitative study.

Background: Proper hand hygiene (HH), which includes sanitizing with alcohol-based hand rub (ABHR) (or handwashing with soap and water if ABHR is unavailable), is key for preventing healthcare-associated infections (HCAI), including COVID-19. Understanding drivers of HH is key to improving adherence. Aim: This study aims to explore drivers and barriers to HH practice at two hospitals in the Dominican Republic in the context of the COVID-19 pandemic to inform development of HH behaviour change interventions. Methods: We conducted in-depth interviews with 20 hospital staff during September 2021. We used the COM-B (capability, opportunity, motivation, behaviour) model to explore HH experiences and preferences. Interviews were recorded, transcribed, coded, and analysed using a thematic approach. Results: A total of 11 parent codes and 27 sub-codes were identified, and 1145 coded segments were analysed. Use of handwashing with soap and water and/or sanitizing with ABHR was reported by all participants; handwashing was generally preferred. Participants expressed knowledge of proper HH methods (capability), but inconsistent supplies and lack of time presented HH challenges (opportunity). Interviewees described practicing HH to protect themselves and their families from COVID-19 and other infections (reflective motivation) or out of habit (automatic motivation). Discussion: By understanding and addressing underlying factors affecting HH, hospitals can decrease the risk of HCAIs. Our findings suggest that interventions implemented to improve HH in these hospitals should target motivation and opportunity. These findings informed a multimodal intervention to increase ABHR access and implement message-tested communications campaigns; end-point assessments will provide insights into the intervention's impact.

"Boiling Water but There's No Pop-Off Valve": Health Care Provider Perceptions of the Effects of COVID-19 on Intimate Partner Violence.

This study sought to understand the effects of COVID-19, including movement-related restrictions such as shelter-in-place, quarantine, and isolation orders, on intimate partner violence (IPV) from the perspective of health care providers (HCPs) working at a public hospital in Atlanta, Georgia. From November 2020 to May 2021, we conducted 12 interviews. Three themes emerged: (1) HCPs perceived that COVID-19 movement-related restrictions likely exacerbated IPV; (2) HCPs encountered many practice-oriented and community barriers in IPV care provision during COVID-19; and (3) HCPs suggested process and partnership improvements for IPV response. These findings can inform future pandemic preparedness including improved communication, improved IPV screening and follow-up, and strengthened hospital-community partnerships.

Domestic Violence in Atlanta, Georgia Before and During COVID-19.

Domestic violence is known to be one of the most prevalent forms of gender-based violence in emergency contexts and anecdotal data during the COVID-19 pandemic suggest that related restrictions on movement may exacerbate such violence. As such, the purpose of this study was to measure differences in domestic violence incident reports from police data in Atlanta, Georgia, before and during COVID-19. Thirty weeks of crime data were collected from the Atlanta Police Department (APD) in an effort to compare Part I offense trends 2018-2020. Compared with weeks 1-31 of 2018 and 2019, there was a growth in Part I domestic crimes during 2020 as reported to the APD. In addition, trendlines show that 2020 domestic crimes were occurring at a relatively similar pace as the counts observed in previous years leading up to the pandemic. A spike in domestic crimes was recorded after city and statewide shelter-in-place orders. The rise of cumulative counts of domestic crimes during the COVID-19 period of 2020 compared with the previous 2 years suggests increased occurrence of domestic violence. The co-occurring pandemics of COVID-19 and domestic violence come amidst a period of racial justice reckoning in the United States; both have a disproportionate impact on Black, Indigenous, and People of Color. As the country grapples with how to deal with health and safety concerns related to the pandemic, and the unacceptable harms being perpetrated by police, a public health approach is strongly warranted to address both universal health care and violence prevention.