The Content of COVID-19 Information Searches and Vaccination Intention: An Implication for Risk Communication.

OBJECTIVE: The main objective of this study was to examine the association between COVID-19 information search activities and vaccination intention. METHODS: Cross-sectional data were collected using online surveys. Independent variables included COVID-19 information search on the (1) science of viral effects of COVID-19 on the body, (2) origin of COVID-19, (3) symptoms and outcomes, (4) transmission and prevention, (5) future outbreak, and (6) policies/procedures to follow. The outcome variable was vaccination intention. A multivariable regression analysis was conducted. RESULTS: Participants (N = 501) had a mean age of 32.44 ± 11.94 years, were 55.3% female, and 67.9% were white. Most COVID-19 information searches were on symptoms and outcomes (77.7%) and policies/procedures to follow (69.9%). Intention to vaccinate against COVID-19 was higher among participants who searched for information on the science of viral effects of COVID-19 on the body (ß = 0.23, 95% CI: 0.03-0.43; P = 0.03) and policies/procedures to follow (ß = 0.24, 95% CI: 0.03-0.41; P = 0.02). CONCLUSIONS: People who searched for information about (1) the science of viral effects of COVID-19 and (2) policies/procedures recommendations also reported higher vaccination intention. Risk communication seeking to increase vaccination should meet the consumers' information demand by prioritizing the scientific rationale for COVID-19 vaccination and by clarifying what policies/procedures are recommended.

An Assessment of Systemic Factors and COVID-19 Mortality in Africa.

Objectives: The objective of this study was to examine the association between several country-level systemic indices and the deaths from COVID-19 across African countries. Method: Regression analyses were conducted to test the association between selected indices and deaths from COVID-19 across African countries. All tests were run at the α = 0.05 level of significance. Result: We found a statistically significant correlation between total COVID-19 deaths per million and Stringency Index (p-value <0.001) and Human Development Index (p-value <0.001). Multiple regression analysis showed that Stringency Index was the only variable that remained significant when other factors are controlled for in the model. Conclusion: Countries in Africa with poorer governance, inadequate pandemic preparedness and lower levels of development have unexpectedly fared better with respect to COVID-19 deaths mainly because of having a younger population than the countries with better indices.

Digital Solutions for Community and Primary Health Workers: Lessons From Implementations in Africa.

The agenda for Universal Health Coverage has driven the exploration of various innovative approaches to expanding health services to the general population. As more African countries have adopted digital health tools as part of the strategic approach to expanding health services, there is a need for defining a standard framework for implementation across board. Therefore, there is a need to review and employ an evidence-based approach to inform managing challenges, adopting best approaches, and implement informed recommendations. We reviewed a variety of digital health tools applied to different health conditions in primary care settings and highlighted the challenges faced, approaches that worked and relevant recommendations. These include limited coverage and network connectivity, lack of technological competence, lack of power supply, limited mobile phone usage and application design challenges. Despite these challenges, this review suggests that mHealth solutions could attain effective usage when healthcare workers receive adequate onsite training, deploying applications designed in an intuitive and easy to understand approach in a manner that fits into the users existing workflows, and involvement of the stakeholders at all levels in the design, planning, and implementation stages of the interventions.

Importance of Community-Level Interventions During the COVID-19 Pandemic: Lessons from Sub-Saharan Africa.

Community-level strategies are important in ensuring adequate control of disease outbreaks especially in sub-Saharan African countries. Learning from public health responses to previous infectious disease outbreaks is important in shaping these responses to COVID-19. This study aims to highlight and summarize the evidence from community-level interventions during infectious disease outbreaks in sub-Saharan Africa (SSA). We conducted a scoping review of published literature on community-level interventions and strategies adopted in different infectious disease outbreaks in SSA. To obtain relevant studies, we searched EMBASE, CINAHL, MEDLINE, and Google Scholar in August 2020. Our search was based on the combination of keywords such as coronavirus, flu, Ebola, community, rural, strategies, impact, effectiveness, feasibility, Africa, developing countries, and SSA. Studies that met the inclusion criteria were selected and synthesized under the following distinct themes: health education, sensitization, and communications; surveillance; and service delivery. Our review highlights community-based strategies that have been tried and tested with varying outcomes for different outbreaks in different sub-Saharan African communities, we believe they will inform the selection of strategies to adopt in managing the COVID-19 pandemic at the community level. The important aspects of these strategies were highlighted, requirements for successful implementation and the possible challenges that might be encountered were also discussed. Achieving control of the COVID-19 pandemic in sub-Saharan African communities, will require concerted community-based and community-led strategies, which in turn rely on the availability of necessary socioeconomic resources, and the contextual adaption of these interventions.

Patient-centered mobile health technology intervention to improve self-care in patients with chronic heart failure: Protocol for a feasibility randomized controlled trial.

This randomized controlled trial aims to determine the feasibility and preliminary efficacy of a patient-centered, mobile health technology intervention (iCardia4HF) in patients with chronic Heart Failure (HF). Participants (n = 92) are recruited and randomized 1:1 to the intervention or control group. The intervention group receives a commercial HF self-care app (Heart Failure Storylines), three connected health devices that interface with the app (Withings weight scale and blood pressure monitor, and Fitbit activity tracker), and a program of individually tailored text-messages targeting health beliefs, self-care self-efficacy, HF-knowledge, and physical activity. The control group receives the same connected health devices, but without the HF self-care app and text messages. Follow-up assessments occur at 30 days and 12 weeks. The main outcome of interest is adherence to HF self-care assessed objectively through time-stamped data from the electronic devices and also via patient self-reports. Primary measures of HF self-care include medication adherence and adherence to daily weight monitoring. Secondary measures of HF self-care include adherence to daily self-monitoring of HF symptoms and blood pressure, adherence to low-sodium diet, and engagement in physical activity. Self-reported HF self-care and health-related quality of life are assessed with the Self-care Heart Failure Index and the Kansas City Cardiomyopathy Questionnaire, respectively. Hospitalizations and emergency room visits are tracked in both groups over 12 weeks as part of our safety protocol. This study represents an important step in testing a scalable mHealth solution that has the potential to bring about a new paradigm in self-management of HF.

Mobile health approaches to disease surveillance in Africa; Wellvis COVID triage tool.

COVID-19 has rapidly spread across the globe and was declared a pandemic by the World Health Organization (WHO). The COVID-19 infection continues to spread across Africa. In Africa, mobile phone applications have been used for the surveillance and reporting of infectious diseases such as malaria, measles, polio, and other notifiable diseases as mandated by the WHO. A good example is the early warning alert and response system. We developed an eight-question triage tool using the Nigerian Centre for Disease Control surveillance case definitions for new coronavirus disease. Based on the assessed risk level we offered advice and guidance on the next steps. A user-administered tool such as this is vital to COVID19 control. It is also significant in relieving the burden on health systems, providing information on national health guidelines for prevention and control, fostering the participation of citizens, and giving them the next steps, pandemic control efforts become more effective.

Social approaches to COVID-19 pandemic response: effectiveness and practicality in sub-Saharan Africa.

INTRODUCTION: the threat of the coronavirus disease 2019 (COVID-19) pandemic to health systems and communities in sub-Saharan Africa (SSA) is enormous. Social approaches such as distancing measures are essential components of the public health response to respiratory-related infectious disease outbreaks. Due to socio-economic and broader peculiarities of SSA countries, social approaches that were effective elsewhere may have limited practicality in these contexts, and if practical; may yield different or even adverse results. We highlighted the effectiveness of these social approaches and their practicality in SSA. METHODS: we conducted a comprehensive literature search through multiple databases, to identify articles relevant to social distancing. Findings were thematically summarized. RESULTS: our review found emerging and varying empirical evidence on the effectiveness of social approaches in the control and mitigation of the COVID-19 pandemic; thus, limiting its applicability in SSA contexts. Nonetheless, our review demonstrates that the effectiveness and practicality of social approaches in SSA contexts will depend on available resources; timing, duration, and intensity of the intervention; and compliance. Weak political coordination, anti-science sentiments, distrust of political leaders and limited implementation of legal frameworks can also affect practicality. CONCLUSION: to overcome these challenges, tailoring and adaptation of these measures to different but unique contexts for maximum effectiveness, and investment in social insurance mechanisms, are vital.