Access to evidence-based care: a systematic review of trauma and surgical literature costs across resource settings.

Background: Evidence-based medicine has become the foundation for surgeons around the world to provide the most effective surgical care. However, the article processing charges (APCs) and subscription fees for surgical journals may be a barrier, particularly for those in low-income and middle-income countries (LMICs). Objectives: The objective of this study was to define the current options for producers and consumers of surgical literature, inclusive of trauma, across resource settings. Data sources: The Web of Science Core Collection database. Study appraisal and synthesis methods: A complete list of journals publishing surgical content between 2019 and 2020 was compiled. The most frequently indexed journals were reviewed using the individual journal websites to extract the type of access (ie, open, closed, hybrid), impact factors, publication languages, APCs, subscription pricing, and any discounts listed. Results: The literature search revealed 4759 unique journals. The 500 most frequently indexed were reviewed. The mean APC for a fully open access surgical journal was US$1574 and for a hybrid surgical journal was US$3338. The average costs for a 1-year subscription in a hybrid surgical journal were US$434 and US$1878 for an individual and institution, respectively. When considering purchasing power parity, APCs and subscription costs ranged from 2 to 15 times more expensive in LMICs when compared with those in the USA. Limitations: Primary search term was in English only, and only peer-reviewed journal articles were reviewed. Conclusions or implications of key findings: Although initiatives exist to support peer-reviewed journals in LMICs, there is an exorbitant cost for authors in these countries, as well as those in high-income countries that are not affiliated with a large institution, to either publish in, or access, a majority of surgical journals. Efforts to lower the overall cost of publishing must be made to provide greater access to medical literature. PROSPERO registration number: CRD4202140227. Level of evidence: Level IV.

Impact of COVID-19 pandemic and vaccine perceptions on HPV vaccine hesitancy.

OBJECTIVE: This study evaluated the impact of the COVID-19 pandemic and vaccine perceptions on Human Papillomavirus (HPV) vaccine hesitancy. Secondary endpoints included comparing COVID-19 and HPV vaccination trends regarding time, community of residence, and unmet social needs. METHODS: This was a survey-based, cross-sectional study that included 101 participants who were recruited through the Wyandotte County Public Health Department. Participants were eligible for inclusion in this study if they were a parent/guardian of one or more children aged 13 to 17; English- or Spanish-speaking. This study took place in Wyandotte County, Kansas. Descriptive statistics and chi-square analyses were utilized. RESULTS: There was no difference in completion of COVID-19 and HPV vaccines (p = 0.0975). Significantly more individuals started and did not finish the HPV vaccine series compared to the COVID-19 vaccine series (p = 0.0004). Most participants indicated their opinion on the HPV vaccine had not changed due to the pandemic (71.3 %). Participants who felt familiar with HPV had higher rates of HPV vaccine completion. While 77 % of participants felt extremely or moderately familiar with HPV, 61.4 % were unaware of its association with oropharyngeal cancer. CONCLUSION: There was minimal change in parents' perception of the HPV vaccine due to the COVID-19 pandemic despite decreased rates of vaccination during this time. HPV vaccine series completion was significantly lower than COVID-19 vaccine series completion, highlighting a need to improve HPV vaccine completion counseling. Additionally, patient education should address the knowledge gap discovered regarding the link between HPV infection and oropharyngeal cancer.

Development and evaluation of a COVID tracking system to support provision of social service in Wyandotte County, Kansas.

Background: In addition to the state-mandated case investigation and contact tracing, the Unified Government Public Health Department of Wyandotte County, Kansas implemented social support services for COVID-19 cases and contacts; however, did not have the systems in place to document the provision of these services. Our team worked with the health department to develop and implement the COVID Tracking System (CTS), an eHealth system that linked multiple involved teams. Here, we describe the development and evaluation of the CTS. The objective of this manuscript is to describe and evaluate the development and implementation process of the Covid Tracking System. Methods: Drawing from concepts of user-centered design, we took a 4-phase approach to development: understanding context, specifying needs, designing solutions, and evaluating. A mixed-methods evaluation of the development and implementation process using RE-AIM was conducted. Quantitative CTS data captured between February 1, 2021, and September 30, 2021 were exported. Descriptive statistics were calculated for categorical variables and means (SD, range) or median (IQR) for continuous variables. Qualitative discussions with key users supplemented the quantitative data. Results: There were 1,152 cases entered into the CTS, of whom 307 (26.6%) requested a letter be sent to their workplace to excuse them during their quarantine period, 817 (70.9%) requested and had food and cleaning supplies delivered, 21 (1.8%) requested guidance on applying for federal assistance, and 496 (43.1%) requested to be contacted by a community health worker. While a few technical glitches slowed down early implementation, these were quickly resolved and key users felt that the CTS streamlined client referral and simplified their workflow, allowing them to spend more time on patient care and follow up, rather than documentation. After study implementation ended, the Unified Government Public Health Department of Wyandotte County continued using the CTS for client tracing and follow up. Discussion: This project provides a roadmap of how user centered design can be applied to the development and evaluation of eHealth software to support program intervention implementation, even in situations where urgent action is needed.