Patient flow time data of COVID-19 vaccination clinics in 23 sites, United States, April and May 2021.

INTRODUCTION: Public health department (PHD) led COVID-19 vaccination clinics can be a critical component of pandemic response as they facilitate high volume of vaccination. However, few patient-time analyses examining patient throughput at mass vaccination clinics with unique COVID-19 vaccination challenges have been published. METHODS: During April and May of 2021, 521 patients in 23 COVID-19 vaccination sites counties of 6 states were followed to measure the time spent from entry to vaccination. The total time was summarized and tabulated by clinic characteristics. A multivariate linear regression analysis was conducted to evaluate the association between vaccination clinic settings and patient waiting times in the clinic. RESULTS: The average time a patient spent in the clinic from entry to vaccination was 9 min 5 s (range: 02:00-23:39). Longer patient flow times were observed in clinics with higher numbers of doses administered, 6 or fewer vaccinators, walk-in patients accepted, dedicated services for people with disabilities, and drive-through clinics. The multivariate linear regression showed that longer patient waiting times were significantly associated with the number of vaccine doses administered, dedicated services for people with disabilities, the availability of more than one brand of vaccine, and rurality. CONCLUSIONS: Given the standardized procedures outlined by immunization guidelines, reducing the wait time is critical in lowering the patient flow time by relieving the bottleneck effect in the clinic. Our study suggests enhancing the efficiency of PHD-led vaccination clinics by preparing vaccinators to provide vaccines with proper and timely support such as training or delivering necessary supplies and paperwork to the vaccinators. In addition, patient wait time can be spent answering questions about vaccination or reviewing educational materials on other public health services.

Assessment of the Costs of Implementing COVID-19 Vaccination Clinics in 34 Sites, United States, March 2021.

OBJECTIVES: To estimate the costs to implement public health department (PHD)-run COVID-19 vaccination clinics. DESIGN: Retrospectively reported data on COVID-19 vaccination clinic characteristics and resources used during a high-demand day in March 2021. These resources were combined with national average wages, supply costs, and facility costs to estimate the operational cost and start-up cost of clinics. SETTING: Thirty-four PHD-run COVID-19 vaccination clinics across 8 states and 1 metropolitan statistical area. PARTICIPANTS: Clinic managers at 34 PHD-run COVID-19 vaccination clinics. INTERVENTION: Large-scale COVID-19 vaccination clinics were implemented by public health agencies as part of the pandemic response. MAIN OUTCOMES MEASURED: Operational cost per day, operational cost per vaccination, start-up cost per clinic. RESULTS: Median operational cost per day for a clinic was $10 314 (range, $637-$95 163) and median cost per vaccination was $38 (range, $9-$206). There was a large range of operational costs across clinics. Clinics used an average of 99 total staff hours per 100 patients vaccinated. Median start-up cost per clinic was $15 348 (range, $1 409-$165 190). CONCLUSIONS: Results show that clinics require a large range of resources to meet the high throughput needs of the COVID-19 pandemic response. Estimating the costs of PHD-run vaccination clinics for the pandemic response is essential for ensuring that resources are available for clinic success. If clinics are not adequately supported, they may stop functioning, which would slow the pandemic response if no other setting or approach is possible.

Worker well-being in the United States: Finding variation across job categories.

Job categories shape the contexts that contribute to worker well-being, including their health, connectivity, and engagement. Using data from the 2014 Gallup Daily tracking survey, this study documented the distribution of worker well-being across 11 broad job categories among a national sample of employed adults in the United States. Well-being was measured by Gallup-Sharecare Well-Being 5™, a composite measure of five well-being dimensions (purpose, community, physical, financial, and social). Analysis of variance (ANOVA) was used to examine how well-being varied across job categories and the extent to which household income modified that relationship, controlling for demographic factors. Well-being varied significantly across job categories, even after adjusting for household income and demographic factors. Well-being was higher among business owners, professionals, managers, and farming/fishing workers and lower among clerical/office, service, manufacturing/production, and transportation workers. Purpose well-being (e.g., liking what you do and being motivated to achieve your goals) showed the greatest variability across job categories-there were small differences across income levels for business owners, professionals, managers, and farming/fishing workers, and statistically significant gaps between the high income group and the two lower income groups among clerical/office, service, manufacturing/production, and transportation workers. Physical well-being exhibited the smallest gaps across income groups within job categories. The findings suggest that job category is an important component of worker well-being that extends beyond the financial dimension to purpose well-being. Our results suggest well-being inequity across job categories, and highlight areas for future research, policy and practice, including targeted interventions to promote worker and workplace well-being.

Training Employers to Implement Health Promotion Programs: Results From the CDC Work@Health® Program.

PURPOSE: Centers for Disease Control and Prevention (CDC) initiated the Work@Health Program to teach employers how to improve worker health using evidence-based strategies. Program goals included (1) determining the best way(s) to deliver employer training, (2) increasing employers' knowledge of workplace health promotion (WHP), and (3) increasing the number of evidence-based WHP interventions at employers' worksites. This study is one of the few to examine the effectiveness of a program designed to train employers how to implement WHP programs. DESIGN: Pre- and posttest design. SETTING: Training via 1 of 3 formats hands-on, online, or blended. PARTICIPANTS: Two hundred six individual participants from 173 employers of all sizes. INTERVENTION: Eight-module training curriculum to guide participants through building an evidence-based WHP program, followed by 6 to 10 months of technical assistance. MEASURES: The CDC Worksite Health ScoreCard and knowledge, attitudes, and behavior survey. ANALYSIS: Descriptive statistics, paired t tests, and mixed linear models. RESULTS: Participants' posttraining mean knowledge scores were significantly greater than the pretraining scores (61.1 vs 53.2, P < .001). A year after training, employers had significantly increased the number of evidence-based interventions in place (47.7 vs 35.5, P < .001). Employers' improvements did not significantly differ among the 3 training delivery formats. CONCLUSION: The Work@Health Program provided employers with knowledge to implement WHP interventions. The training and technical assistance provided structure, practical guidance, and tools to assess needs and select, implement, and evaluate interventions.

Comparing 2 National Organization-Level Workplace Health Promotion and Improvement Tools, 2013-2015.

Creating healthy workplaces is becoming more common. Half of employers that have more than 50 employees offer some type of workplace health promotion program. Few employers implement comprehensive evidence-based interventions that reach all employees and achieve desired health and cost outcomes. A few organization-level assessment and benchmarking tools have emerged to help employers evaluate the comprehensiveness and rigor of their health promotion offerings. Even fewer tools exist that combine assessment with technical assistance and guidance to implement evidence-based practices. Our descriptive analysis compares 2 such tools, the Centers for Disease Control and Prevention's Worksite Health ScoreCard and Prevention Partners' WorkHealthy America, and presents data from both to describe workplace health promotion practices across the United States. These tools are reaching employers of all types (N = 1,797), and many employers are using a comprehensive approach (85% of those using WorkHealthy America and 45% of those using the ScoreCard), increasing program effectiveness and impact.

Appraising quantitative research in health education: guidelines for public health educators.

Many practicing health educators do not feel they possess the skills necessary to critically appraise quantitative research. This publication is designed to help provide practicing health educators with basic tools helpful to facilitate a better understanding of quantitative research. This article describes the major components- title, introduction, methods, analyses, results, and discussion sections-of quantitative research. Readers will be introduced to information on the various types of study designs and seven key questions health educators can use to facilitate the appraisal process. On reading, health educators will be in a better position to determine whether research studies are well designed and executed.