Informação e prevenção não farmacológica da COVID-19 no território de uma unidade de saúde da família em Pernambuco / Information and non-pharmacological prevention of COVID-19 in the territory of a family health unit in Pernambuco / Información y prevención no farmacológica del COVID-19 en el territorio de una unidad de salud de la familia en Pernambuco

Introdução: O conhecimento da magnitude em que a população implementa medidas de proteção emitidas pelas autoridades de saúde pública é essencial na prevenção da doença do novo coronavírus (COVID-19). A eficácia de medidas não farmacológicas de prevenção e das políticas públicas destinadas a reduzir o contágio pela COVID-19 depende de quão bem os indivíduos são informados sobre as consequências da infecção e as medidas que devem adotar para reduzir sua propagação. O entendimento, as atitudes e as práticas das pessoas em relação à COVID-19 e sua prevenção são basilares para a compreensão da dinâmica epidemiológica, demandando a realização de pesquisas sobre o cumprimento de medidas não farmacológicas de prevenção do contágio em diversos territórios. Para isso, em 2020, medidas não farmacológicas contra a COVID-19 foram divulgadas por fontes diversas, estatais e privadas, para a maior parte da população brasileira, com a finalidade de orientar comportamentos para conter a crise sanitária. As equipes da Estratégia Saúde da Família têm um papel fundamental neste processo de educação em saúde, pois compreendem elementos socioculturais das suas comunidades, alcançando-as tanto em capilaridade quanto em adequação local da informação técnico-científica. Este artigo abrange uma pesquisa de campo, parte de um projeto multicêntrico nacional. Objetivo: Avaliar se a população do território de uma unidade da Estratégia Saúde da Família da cidade de Condado-PE entende e aplica as informações que recebeu sobre medidas não farmacológicas de prevenção em suas práticas de proteção contra a COVID-19. Mais especificamente, a pesquisa visou determinar que informações foram recebidas pelos respondentes, quais as suas fontes, o grau de confiabilidade atribuído a estas, além da adesão deles às medidas não farmacológicas e sua relação com variáveis sociodemográficas. Métodos: O modelo do estudo foi observacional e descritivo, com abordagem quantitativa, a partir da coleta de dados primários com 70 usuários por entrevista presencial com questionário estruturado. Resultados: Os resultados mostraram que a população recebeu vasta informação sobre prevenção da doença. Conclusão: Com níveis variados de confiabilidade das fontes, atribuindo importância relevante às medidas de prevenção e adotou a maioria delas, com exceção do isolamento social total.

Introduction: Knowledge of the magnitude to which the population implements protective measures issued by public health authorities is essential in preventing coronavirus disease 2019 (COVID-19). The effectiveness of non-pharmacological prevention measures (NPM) and public policies aimed at reducing the spread of COVID-19 depends on how well individuals are informed about the consequences of the infection and the measures they must adopt to reduce its spread. The understanding, attitudes, and practices of people in relation to COVID-19 and its prevention are fundamental for understanding the epidemiological dynamics, demanding research on compliance with NPM to prevent contagion in different territories. To this end, in 2020, NPM against COVID-19 were released by various sources, state and private, for most of the Brazilian population, with the aim of guiding behaviors to contain the health crisis. The Family Health Strategy (FHS) teams play a key role in this health education process, as they comprise sociocultural elements of their communities, reaching them both in capillarity and in local adequacy of technical-scientific information. This article covers field research, part of a national multicenter project. Objective: To evaluate whether the population of the territory of an FHS unit in the city of Condado, Pernambuco, understands and applies the information it received about NPM prevention in their practices to protect against COVID-19. More specifically, the research aimed to determine what information was received by the respondents, what are their sources, the degree of reliability attributed to these, in addition to their adherence to the NPM and their relationship with sociodemographic variables. Methods: The study model was observational and descriptive, with a quantitative approach, based on the collection of primary data with 70 users through face-to-face interviews with a structured questionnaire. Results: The results showed that the population received extensive information on disease prevention. Conclusion: With varying levels of reliability of the sources, attributing relevant importance to prevention measures and adopted most of them, with the exception of total social isolation.

El conocimiento de la magnitud con la que la población implementa las medidas de protección emitidas por las autoridades de salud pública es fundamental en la prevención de la enfermedad por coronavirus 2019 (COVID-19). La efectividad de las medidas de prevención no farmacológicas (MFN) y de las políticas públicas dirigidas a reducir la propagación de la COVID-19 depende de qué tan bien se informe a las personas sobre las consecuencias de la infección y las medidas que deben adoptar para reducir su propagación. La comprensión, actitudes y prácticas de las personas con relación al COVID-19 y su prevención son fundamentales para comprender la dinámica epidemiológica, exigiendo investigaciones sobre el cumplimiento de las MNF para prevenir el contagio en diferentes territorios. Con ese fin, en 2020, MNF contra el COVID-19 fueron divulgados por diversas fuentes, estatales y privadas, para la mayoría de la población brasileña, con el objetivo de orientar comportamientos para contener la crisis sanitaria. Los equipos de la Estrategia de Salud de la Familia (ESF) juegan un papel fundamental en este proceso de educación en salud, ya que integran elementos socioculturales de sus comunidades, alcanzándolas tanto en la capilaridad como en la adecuación local de la información técnico-científica. Este artículo aborda una investigación de campo, parte de un proyecto multicéntrico nacional, con el objetivo de evaluar si la población del territorio de una unidad de la ESF en la ciudad de Condado-PE comprende y aplica la información recibida sobre la prevención de MNF en sus prácticas de protección contra el COVID -19. Más específicamente, la investigación tuvo como objetivo determinar qué información recibieron los encuestados, cuáles son sus fuentes, el grado de confiabilidad atribuido a estas, además de su adherencia al MNF y su relación con variables sociodemográficas. El modelo de estudio fue observacional y descriptivo, con enfoque cuantitativo, basado en la recolección de datos primarios con 70 usuarios a través de entrevistas cara a cara con un cuestionario estructurado. Los resultados mostraron que la población recibió amplia información sobre prevención de la enfermedad, con diversos niveles de confiabilidad de las fuentes, atribuyendo importancia relevante a las medidas de prevención y adoptando la mayoría de ellas, con excepción del aislamiento social total.

Você está pensando, refletindo, analisando o que você vê e o que você faz o tempo todo: percepção de residentes de Medicina de Família e Comunidade sobre vídeo feedback / You are thinking, reflecting, analysing what you see and what you do all the time: perception of General Practice trainees about video feedback / Estás pensando, reflexionando, analizando lo que ves y lo que haces todo el tiempo: percepción de los residentes de Medicina Familiar y Comunitaria sobre vídeo feedback

Introdução: A comunicação é reconhecida como uma habilidade central por vários órgãos reguladores internacionais da educação médica. O ensino específico de habilidades de comunicação é fundamental para melhorar a comunicação dos médicos. As técnicas experienciais mostraram superioridade em comparação com os modelos tradicionais. A utilização de consultas reais ajuda os estudantes a visualizar melhor as suas competências de entrevista e a refletir sobre elas. Com os avanços da tecnologia, o uso de consultas médicas gravadas em vídeo tornou-se a abordagem padrão para o ensino da comunicação. No entanto, a eficácia dessa técnica depende do envolvimento ativo dos estudantes. As suas contribuições e comentários dos pares sobre a consulta gravada são essenciais para a aprendizagem. Contudo, a perspectiva do estudante sobre a utilidade dessa abordagem educativa recebeu pouca atenção. Objetivos: Compreender a percepção da aprendizagem dos residentes de medicina de família e comunidade resultante da atividade de vídeo feedback na sua formação profissional. Métodos: Estudo exploratório, qualitativo, realizado com residentes do primeiro ano de medicina de família e comunidade de um programa de residência estabelecido em São Paulo, Brasil. Os participantes foram entrevistados após as sessões educativas, que foram analisadas por meio de análise temática reflexiva. Resultados: A autopercepção de sua prática, o aprendizado de habilidades de comunicação e os ganhos afetivos foram identificados pelos participantes como pontos de aprendizado derivados da atividade de vídeo feedback. Além disso, sobre o aprendizado de habilidades específicas de comunicação, eles mencionaram comunicação não-verbal e verbal, conexões entre teoria e prática, estrutura de consulta e oportunidades para cristalizar conhecimentos. Os ganhos afetivos incluíram sentir-se parte de um grupo, melhora da autoestima, superação de inseguranças, percepção de consultas mais efetivas, reforço do gosto pelo trabalho e reconhecer a necessidade de mais aprendizado. Conclusões: Os ganhos de aprendizagem identificados em nosso estudo levaram a uma experiência de humanidade compartilhada, que permite aos participantes serem mais efetivos técnica e afetivamente com seus pacientes. Além disso, identificamos que a atividade educativa de vídeo feedback pode ser utilizada para outros possíveis fins educacionais além do ensino da comunicação.

Introduction: Communication is recognized as a central skill by various international medical education regulatory bodies. Specific teaching on communication skills is important to enhance doctors' communication. Experiential techniques appear to be superior compared to traditional models. Real-life consultation helps trainees visualize their interview skills and reflect on them. Upgraded by technology, the use of video-recorded medical visits became the standard approach for communication teaching. However, the effectiveness pf this technique relies on trainees' active involvement. Their inputs and peer feedback on the recorded consultation are essential to learning. Despite its importance, their perspective on the usefulness of video feedback in medical education has received limited attention. Objective: To understand the perception of learning among general practice trainees as a result of the video feedback activity in their vocational training. Methods: An exploratory, qualitative study, conducted with first-year general practice trainees from an established training program in São Paulo, Brazil. Participants were interviewed after educational session, which were analyzed using reflexive thematic analysis. Results: Self-perception of their practice, communication skills learning, and affective gains were identified by participants as learning points derived from the video feedback activity. Furthermore, for specific communication skills learning, they mentioned nonverbal and verbal communication, theory and practice connections, consultation structure and opportunities for crystallizing knowledge. Affective gains included feeling part of a group, improving self-esteem, overcoming insecurities, perception of more effective consultations, reinforcing fondness for their work, and need for more learning. Conclusions: The learning gains identified in our study led to an experience of common humanity, which allowed participants to be more technically and affectively effective with their patients. Also, we identified that the video feedback educational activity can be used for other possible educational purposes, beyond the teaching of communication.

Introducción: La comunicación es reconocida como una habilidad fundamental por varios organismos reguladores internacionales de educación médica. La enseñanza específica de habilidades de comunicación es importante para mejorar la comunicación de los médicos. Las técnicas experienciales parecen ser superiores a los modelos tradicionales. El uso de consultas reales ayuda a los estudiantes a visualizar y reflexionar mejor sobre sus habilidades de entrevista. Actualizado por la tecnología, el uso de consultas médicas grabadas en video se ha convertido en el enfoque estándar para la enseñanza de la comunicación. Sin embargo, para que la técnica funcione, la participación de los estudiantes es crucial. Sus contribuciones y comentarios de los compañeros sobre la consulta grabada son esenciales para el aprendizaje. Sin embargo, la perspectiva de los estudiantes sobre la utilidad de este enfoque educativo ha recibido poca atención. Objetivos: Comprender la percepción del aprendizaje por parte de los residentes de medicina de familia y comunitaria como resultado de la actividad de vídeo feedback en su formación profesional. Métodos: Estudio cualitativo exploratorio realizado con residentes de primer año de medicina familiar y comunitaria de un programa de residencia establecido en São Paulo, Brasil. Los participantes fueron entrevistados después de una sesión educativa, que fueron analizados mediante análisis temático reflexivo. Resultados: La autopercepción de su práctica, el aprendizaje de habilidades comunicativas y las ganancias afectivas fueron identificadas por los participantes como puntos de aprendizaje derivados de la actividad de vídeo feedback. Además, sobre el aprendizaje de habilidades comunicativas específicas, mencionaron la comunicación verbal y no verbal, las conexiones entre la teoría y la práctica, la estructura de consulta y las oportunidades para cristalizar conocimientos. En cuanto a las ganancias afectivas, relataron sentirse parte de un grupo, mejora de la autoestima, superación de las inseguridades, percepción de consultas más efectivas, refuerzo del gusto por el trabajo y necesidad de más aprendizaje. Conclusión: Los logros de aprendizaje identificados en nuestro estudio llevaron a una experiencia de humanidad compartida, que permite a los participantes ser técnica y afectivamente más efectivos con sus pacientes. Además, identificamos que la actividad educativa de vídeo feedback puede ser utilizada para otros posibles fines educativos, además de la enseñanza de la comunicación.

Vaccine communication strategies among healthcare workers as a reflection of the Israeli Ministry of Health's communication strategies before and after the COVID-19 pandemic.

Background: Healthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers' hesitancy and doubts about getting the flu vaccine themselves. However, few studies have dealt with how they perceive their role in communicating information regarding vaccines, especially following the COVID-19 pandemic. Objectives: (1) To identify the communication strategies used by the Israeli Ministry of Health regarding vaccines during epidemic crises (before and after the COVID-19 pandemic); (2) To identify the communication strategies used by healthcare workers regarding vaccines before and after the COVID-19 pandemic. Methods: A qualitative study based on in-depth interviews was conducted among healthcare workers and used a semi-structured protocol as a research tool. A total of 18 healthcare workers were sampled using purposeful and snowball sampling. Results: Despite healthcare workers' perception that there has been a decrease in trust in the Israeli Ministry of Health among the public following the COVID-19 outbreak, they still rely on the Israeli Ministry of Health as their primary source of information and use the same communication strategies (such as fear appeals and correcting information) as of the Israeli Ministry of Health to communicate with the public, healthcare providers, and other relevant stakeholders. Conclusion: Healthcare workers have been shaped by the professional socialization processes within the health system, leading to a predominant reliance on established communication strategies and informational channels. This reliance underscores the importance of evolving these methods to better engage with the public. To address this, there is a compelling need to innovate and adopt new communication techniques that emphasize effective dialogue and transparent interactions. By doing so, healthcare professionals can ensure that their outreach is not only informative but also responsive to the diverse needs and preferences of the community.

The feasibility and usability of a personal health record for patients with multiple sclerosis: a 2-year evaluation study.

Background: Multiple sclerosis (MS) is a persistent inflammatory condition impacting the brain and spinal cord, affecting globally approximately 2.8 million individuals. Effective self-management plays a crucial role in the treatment of chronic diseases, including MS, significantly influencing health outcomes. A personal health record (PHR) is a promising tool to support self-management, potentially empowering patients and enhancing their engagement in treatment and health. Despite these promising aspects, challenges in implementation persist and PHRs are still a relatively new concept undergoing rapid development. Objective: This study aimed to assess the feasibility and usability of the PHR. Secondary objectives included evaluating implementation determinants, and exploring preliminary effects on quality of care for both patients and healthcare professionals (HCPs), self-management, self-efficacy for patients, job satisfaction, efficiency, and demand for HCPs, and preliminary effects on costs and health-related quality of life. Methods: This study had a mixed-methods design. Quantitative data of patients (n = 80) and HCPs (n = 12) were collected via self-reported questionnaires at baseline (T0), after one year (T1), and after two years (T2). One focus group interview was conducted at T2 with patients (n = 7), and another one with HCPs (n = 4), to get a more in-depth understanding of the feasibility and usability of the PHR via the Unified Theory of Acceptance and Use of Technology framework, and to further explore the secondary objectives in-depth. Results: Most patients never logged in during the first year and logged in a couple of times per year during the second year, averaging around 15 min per log-in session. The HCPs mainly logged in a couple of times per year over the two years with an average use of six minutes per session. Patient usability and satisfaction scores were below average and moderate, respectively: with SUS-scores of 59.9 (SD = 14.2, n = 33) at T1 and 59.0 (SD = 16.3, n = 37) at T2, and CSQ-8 scores of 21.4 (SD = 5.0, n = 34) at T1, and 22.1 (SD = 5.0, n = 39) at T2. HCPs had similar usability and satisfaction scores. Multiple facilitators and barriers were identified by both patients and HCPs, such as (in)sufficient knowledge of how to use the PHR, lack of staff capacity and ICT obstacles. No significant differences were found in the preliminary effects. Qualitative data showed, among others, that both patients and HCPs saw the benefit of the PHR in terms of performance expectancy, by gaining more insight into health and health data, but challenges remained regarding effort expectancy, such as log-in issues and experiencing difficulties with information retrieval. Conclusion: The feasibility and usability were considered moderate by patients and HCPs; however, potential regarding the performance of the PHR was observed. Implementation challenges, such as the complexity of usage, lowered the adoption of the PHR. The evolving nature of PHRs requires ongoing evaluation and adaptation to optimize their potential benefits. Utilizing a participatory design approach and a dedicated implementation team could help in achieving this optimization, ultimately enhancing their adoption.

[Factors that influence the use of sepsis-related competencies in health professionals and how they promote their patients' sepsis knowledge: Results of a mixed methods study with health professionals]. / Einflussfaktoren auf die eigene Anwendung der Sepsis-Kompetenz und ihre Förderung bei Patientinnen und Patienten: Ergebnisse einer Mixed-Methods-Studie mit Gesundheitsfachpersonen.

BACKGROUND: Sepsis is a life-threatening and relatively common emergency which is often recognized too late or not at all. Therefore, the "SepsisWissen" (SepsisKnowledge) project aimed to bring about changes in health care professionals' behavior in the area of sepsis prevention and early detection. It addressed the health care professionals themselves (e. g., their own vaccination, hygiene and early detection behavior) and their patient counseling behavior. To promote this behavior, the SepsisWissen campaign included offers such as trainings or print products. The subsequent core question is: From the health professionals' perspective, which barriers and facilitators affect their own application of sepsis competence and their promotion of their patients' sepsis competence? METHODS: This paper was based on a cross-sectional mixed-methods study part of "SepsisWissen" withPart a) was analyzed using qualitative oriented content analysis based on Mayring, part b) was analyzed descriptively. The interviewees included physicians, nurses, pharmacists, assistants to physicians and pharmacists and, additionally, one paramedic in the quantitative sample. Some of them had attended "SepsisWissen" trainings. RESULTS: The qualitative data analysis identified 41 conducive and hindering factors, which can be assigned to the following eight major topics: 1) syndrome sepsis; 2) predisposing factors for health professionals' own acquisition and application of sepsis competence; 3) enabling factors for health professionals themselves; 4) behavior and lifestyle of patients; 5) reinforcing factors for patients; 6) public health education; 7) political, administrative, and organizational context; 8) environmental factors. In the qualitative and quantitative surveys, the suggestion to improve the sepsis competence of the population and to reduce misinformation, respectively, through public education (e.g., via schools or the media). DISCUSSION: Sepsis training for health professionals was considered as a facilitating factor for taking potential sepsis symptoms and patients' respective statements more seriously. Future training formats should convey more explicitly how health professionals can better communicate their own sepsis knowledge to their patients. They request instruments to support their communication, such as checklists for lay persons. According to the interviews, health workers themselves need recurring external reminders for the topic of sepsis. Organizational and political conditions should be improved. From the health professionals' point of view, it is essential to offer better reimbursement for prevention and counseling services and to allocate adequate time resources for both. CONCLUSION: Health professionals could increase their potential to apply and promote sepsis competence if general conditions were optimized. From their perspective, it is most important to relieve them of some of their patient counselling burden by initiating more public education.

How do young women approaching screening age interpret the NHS cervical screening leaflet? A mixed methods study of identifying interpretation difficulties, barriers, facilitators, and leaflet interpretation, engagement and future screening behaviour.

BACKGROUND: Cervical cancer is a common cancer among young women aged 25-29 in England, and the NHS cervical screening leaflet is the first point of contact for those being invited for their first screening. This study aimed to explore how young women (18-24) understand and engage with the leaflet, as well as the barriers and facilitators associated with its interpretation, engagement, and screening intentions. METHODS: The study used a mixed-methods approach, including a survey (n = 120) to identify interpretation difficulties and how they were affected by different characteristics, and a follow-up interview (n = 10) to assess the utility of the leaflet, identify issues with its practicality, and determine the factors that influence screening intentions. RESULTS: The survey results showed that interpretation difficulties were common, particularly regarding HPV assessment, screening results, additional tests/treatment, and screening risks. Lower interpretation accuracy was associated with lower numeracy scores and non-white ethnicity. Despite these difficulties, participants had high confidence and motivation to engage with the leaflet. The interviews revealed knowledge gaps, issues with the leaflet's practicality, and a preference for digital information. Factors that were identified as barriers and facilitators of leaflet interpretation, engagement, and screening intentions included knowledge, social influence, beliefs about consequences, environmental context and resources, social role and identity, emotions and intentions. CONCLUSION: The current leaflet does not provide enough information for young women to make an informed decision about screening attendance. Implementing a digital invitation featuring simplified gist representation, targeted behaviour change techniques (BCTs), videos, and interactive tools can enhance education and promote screening behaviour. Future research should consider using digital tools and strategies to address existing barriers related to interpretation and engagement.

The impact of social cohesion and risk communication on excess mortality due to COVID-19 in 213 countries: a retrospective analysis.

BACKGROUND: Tools for assessing a country's capacity in the face of public health emergencies must be reviewed, as they were not predictive of the COVID-19 pandemic. Social cohesion and risk communication, which are related to trust in government and trust in others, may have influenced adherence to government measures and mortality rates due to COVID-19. OBJECTIVE: To analyse the association between indicators of social cohesion and risk communication and COVID-19 outcomes in 213 countries. RESULTS: Social cohesion and risk communication, in their dimensions (public trust in politicians, trust in others, social safety nets, and equal distribution of resources index), were associated with lower excess mortality due to COVID-19. The number of COVID-19-related disorder events and government transparency were associated with higher excess mortality due to COVID-19. The lower the percentage of unemployed people, the higher the excess mortality due to COVID-19. Most of the social cohesion and risk communication variables were associated with better vaccination indicators, except for social capital and engaged society, which had no statistically significant association. The greater the gender equality, the better the vaccination indicators, such as the number of people who received all doses. CONCLUSION: Public trust in politicians, trust in others, equal distribution of resources and government that cares about the most vulnerable, starting with the implementation of programs, such as cash transfers and combating food insecurity, were factors that reduced the excess mortality due to COVID-19. Countries, especially those with limited resources and marked by social, economic, and health inequalities, must invest in strengthening social cohesion and risk communication, which are robust strategies to better cope with future pandemics.

The Emerging Landscape of Social Media Influencers in Public Health Collaborations: A Scoping Review.

Social media content creators or "influencers" are an increasingly influential voice in the public discourse generally, including global perceptions and practices related to health. In response, public health entities are increasingly embracing social media influencers (SMIs) as potential health promotion collaborators. Despite burgeoning interest in the potential of these partnerships, research evaluating this strategy remains limited. To address this gap, we conducted a scoping review to characterize and describe the current landscape of health promotion collaborations with SMIs with a focus on current practices. A search of six electronic databases (PubMed, SCOPUS, Communication & Mass Media Complete, CINAHL Plus, Web of Science, and APA PsycINFO) revealed wide-ranging and inconsistent approaches to these partnerships, including their optimal practices, data reported, and their evaluation criteria. Among the 658 articles initially identified, 15 publications met our inclusion criteria, spanning 7 countries, 8 social media platforms, 11 distinct health topics, and 21 different outcome measures. Basic information necessary for comparing across interventions was often lacking. We noted a lack of consensus on what constitutes an SMI with 53% of included studies lacking any definition or criteria. Although SMIs offer substantial promise as an emerging opportunity for health promotion, particularly for populations that may be otherwise difficult to identify or reach, this review highlights how the current lack of standardized methodologies and metrics prevents meaningful comparisons between collaborations and evaluations of their effectiveness. Based on these findings, we propose four key criteria to aid practitioners in the implementation and evaluation of SMI collaborations.

Participatory design of bodysymptoms.org: An interactive web resource to explain multisystem functional somatic symptoms.

OBJECTIVE: There is a lack of trustworthy information about Functional Somatic Symptoms (FSS) on the internet. This means integrative bio-psycho-social explanations of FSS and related health advice are not readily available to the public. To explore and address this problem, we carried out the bodysymptoms project, with the aim to build a website which presents current widely accepted explanations for FSS and shows how different explanations are inter-connected. METHODS: Bodysymptoms was set up as a research-in-action project with a diverse range of international stakeholder-participants, combining approaches from patient and public involvement in healthcare with participatory design. 7 participants with lived experience of multi-system functional symptoms took part in the project and measures of meaningful engagement throughout the project were rated highly. This manuscript describes the methodology by which the website was developed. RESULTS: Through iterative cycles we determined the requirements for an interactive explanatory model and co-created a novel online health interactive resource with integrated actionable health advice. The target end user are young adults with persistent physical symptoms, maintained by functional mechanisms. The overall aim is to empower people at risk of developing functional disorders to seek better health outcomes. The website is intended to be used prior to or alongside engagement with healthcare. CONCLUSION: Bringing lived experience and multi-disciplinary perspectives into dialogue through participatory design can harness the power of research to create immediate shared value. This project has resulted in a usable open access website, bodysymptoms.org, which provides education about FSS for patients, healthcare professionals and members of the public looking to understand FSS.

Exploring meningococcal serogroup B vaccination conversations under shared clinical decision-making in the US.

OBJECTIVE: In 2019, the United States Advisory Committee on Immunization Practices (ACIP) updated their meningococcal serogroup B (MenB) vaccination recommendation for 16-|23-year-olds from individual to shared clinical decision-making (SCDM). SCDM recommendations are individually based and informed by a decision process between patients and healthcare providers (HCPs). MenB vaccination among 16-23-year-olds remains low. We examined recorded conversations in which MenB vaccine-related discussions between HCPs and patients/caregivers took place, and how these interactions changed following the updated SCDM recommendation. METHODS: An analysis of recordings where MenB vaccination was discussed between HCPs and patients (16-|23 years old)/caregivers was conducted using retrospective anonymized dialogue data (January 2015-October 2022). Shared decision-making strength was measured using a modified OPTION5 framework. RESULTS: Of 97 included recorded conversations, the average duration was 11.3 min. Within these conversations, MenB disease was discussed for 0.25 min (38.9% of words in total vaccine-preventable diseases discussion) and MenB vaccination was discussed for 1.36 min (60.9% of words in total vaccine discussion), on average. HCPs spoke 78.8% of MenB vaccine-related words and most (99.0%) initiated the MenB vaccination discussion. In 40.2% of recordings, HCPs acknowledged the MenB vaccine without providing a clear recommendation. HCP recommendations often favored MenB vaccination (87.0%) and recommendations were 21.4% stronger post-recommendation change to SCDM. As measured by the modified OPTION5 framework, most recordings did not reflect a high degree of shared decision-making between HCPs and patients/caregivers. CONCLUSIONS: MenB vaccination discussions were brief, and the degree of shared decision-making was low. Targeted education of HCPs and patients/caregivers may improve MenB vaccination awareness, SCDM implementation, and vaccine uptake.

Meningitis is a serious and sometimes deadly disease. In the United States (US), the Centers for Disease Control and Prevention (CDC) recommends that 16­23-year-olds get vaccinated against meningococcal serogroup B (MenB), which causes a specific type of meningitis called invasive meningococcal disease. As of 2019, the CDC recommends that healthcare providers and patients or their caregivers have a shared decision-making discussion about deciding to get vaccinated against MenB. Despite these recommendations, vaccination against MenB among 16­23-year-olds is very low. Only about 3 in 10 17-year-olds had received the MenB vaccine in 2022. We studied conversations between healthcare providers and patients or their caregivers that included discussions of MenB vaccination. These discussions were largely brief and led by the healthcare providers. We found that healthcare providers most often made recommendations that were in favor of their patients getting vaccinated against MenB. However, we also found that healthcare providers missed many opportunities to have these shared decision-making discussions about MenB vaccination with patients or their caregivers. Providing education and resources for patients, caregivers, and healthcare providers focused on increasing awareness about MenB vaccination and the role they can play in having shared decision-making discussions may lead to more adolescents and young adults getting vaccinated against MenB. More research is needed to find out how we can improve MenB vaccination coverage in the US.

Oncology patients' willingness to report their medication safety concerns from home: a qualitative study.

PURPOSE: Oncology patients often struggle to manage their medications and related adverse events during transitions of care. They are expected to take an active role in self-monitoring and timely reporting of their medication safety events or concerns to clinicians. The purpose of this study was to explore the factors influencing oncology patients' willingness to report adverse events or concerns related to their medication after their transitions back home. METHODS: A qualitative interview study was conducted with adult patients with breast, prostate, lung, or colorectal cancer who experienced care transitions within the previous year. A semi-structured interview guide was developed to understand patients' perceptions of reporting mediation-related safety events or concerns from home. All interviews were conducted via phone calls, recorded, and transcribed for thematic data analysis. RESULTS: A total of 41 individuals participated in the interviews. Three main themes and six subthemes emerged, including patients' perceived relationship with clinicians (the quality of communication and trust in clinicians), perceived severity of adverse medication events (perceived severe vs. non-severe events), and patient activation in self-management (self-efficacy in self-management and engagement in monitoring health outcomes). CONCLUSION: The patient-clinician relationship significantly affects patients' reporting behaviors, which can potentially interact with other factors, including the severity of adverse events. It is important to engage oncology patients in medication safety self-reporting from home by enhancing health communication, understanding patients' perceptions of severe events, and promoting patient activation. By addressing these efforts, healthcare providers should adopt a more patient-centered approach to enhance the overall quality and safety of oncological care.

Mental Health Impact of Pandemics and Other Public Health Emergencies in Children.

Pediatric health care providers can provide universal support to children and families to mitigate potential risk factors to adjustment while fostering protective factors to promote resiliency in children and families. They can educate caregivers about ways to enhance recovery of their children by modifying expectations and addressing the special emotional and social needs of their children. Most public health emergencies evolve through stages across an extended time period, often taxing the personal resources of health care providers. This underscores the need for pediatric health care providers to integrate self-care strategies in their personal and professional practice routines.

Shop Talk: A Qualitative Study to Understand Peer Health-related Communication Among Black Men at the Barbershop.

BACKGROUND: While successful health promotion efforts among Black men have been implemented at barbershops, the focus has largely been on outcomes as opposed to the processes by which outcomes are produced. An understanding of processes can be leveraged in the design and implementation of future efforts to improve the health of Black men. PURPOSE: The objectives of the present study were to: (i) understand peer-derived sources of health-related support at the barbershop and (ii) understand the role of the barbershop in promoting health among Black men. METHODS: Seven focus groups were conducted at barbershops used predominately by Black men. Each focus group lasted between 45 and 60 min. Using a thematic approach, each focus group was independently coded by two coders using a codebook derived from an inductive and deductive approach. The results were confirmed with members of the community advisory board. RESULTS: Three themes emerged: (i) dynamic and candid exchange of health-related support at the barbershop; (ii) tailored forms of health-related and judgment-free communication that provide encouragement and increase motivation; and (iii) characteristics of a supportive environment at the barbershop that facilitate health-related communication. CONCLUSIONS: The findings of the present study offer a potential pathway for public health efforts seeking to improve health among Black men. Those interested in designing and implementing these efforts can create tailored programs for Black men by recognizing and leveraging the unique dynamics of health-related conversations at the barbershop.

For many Black men, barbershops are more than just a place for a haircut. Barbershops are community hubs that have transformed into safe places for difficult conversations about health. The goal of our study was to understand how Black men communicate about health at the barbershop. To address this goal, we conducted focus groups among the true experts­Black men. We asked them: (i) how do Black men communicate about health at the barbershop? (ii) what do Black men communicate about health at the barbershop? and (iii) what about the barbershop facilitates these conversations? These men indicated that barbershops are a place where Black men can openly and dynamically provide health support to one another through role modeling, passing of wisdom, and passive testimonials. They said their conversations about health are often judgment-free and tailored to provide encouragement and motivation. Finally, they said that the supportive atmosphere of the barbershop facilitates these types of conversations. Although barbershops have been sources of health-related support for Black men for generations, the findings from this study can be used by those developing health promotion programs (in partnership with barbershops) to promote health among Black men.

How Do Healthcare Professionals Develop the Communication Process to Promote Patients' Health Literacy?

This study aimed to analyze the communication process of healthcare professionals for the promotion of health literacy. It is a qualitative study that utilized individual online interviews with 46 healthcare professionals working in Brazil. The thematic content analysis technique proposed by Bardin was employed, and Atlas Ti software assisted in the assessment and interpretation of the texts. Content categorization revealed 26 sub-themes, and the coding of these identified nine themes and three categories. The communication process in health literacy education was composed of a set of interdependent and interrelated variables termed emotions, professional preparedness, interprofessional collaboration, patient needs assessment, building rapport, family inclusion in the educational process, environmental aspects, strategies, and resources for teaching and learning. These data may support the analysis of health communication in healthcare services, the creation of data collection instruments, and the development of training programs to enhance skills within the context of the identified variables.

Barriers to Eye Care for Adults in the United States and Solutions for It: A Literature Review.

Vision loss and blindness is a significant public health concern that has had a profound impact on various communities in the United States. Both anticipated and unforeseen barriers have been linked to the rising rates of vision loss and blindness in the country. Extensive research has identified numerous barriers that put many Americans at a disadvantage when trying to seek high-quality eye care services. Not only do the barriers to eye care services create problems for eye health, but also create a poor quality of life. Therefore, understanding and identifying barriers to eye healthcare services is incredibly important. In addition to understanding and identifying barriers, it is also important to identify solutions to the problems created by these barriers. A systematic review of articles characterizing the barriers to eye care was completed which resulted in the identification of the major barriers that affect Americans. The review of previous research was also used to identify available solutions for problems associated with the barriers to eye care services. The major barriers identified were cost, insurance, transport and accessibility, eye health care literacy, and communication. Because of the identification of the major barriers, solutions were also identified. Health education and increased vision screenings were found to be the most used forms of solutions by healthcare professionals promoting good eye health. Telemedicine has also been cited as a possible solution to the growing problem of visual impairment and blindness within the American population.

Effect of a Theory-Based Narrative Video on Colorectal Cancer Screening Intention, Knowledge, and Psychosocial Variables Among a Predominantly Hispanic Population.

Colorectal cancer (CRC) remains the third leading cause of cancer death in the USA. Latinx adults are overrepresented in late-stage CRC diagnosis as CRC screening utilization remains low among Latinx-identifying individuals. This study aims to evaluate the effect of a theory-based narrative video following a culturally appropriate storyline on CRC screening intention, knowledge, and psychosocial variables along the U.S.-Mexico border. We designed and analyzed a non-randomized pre-posttest evaluation of a narrative, culturally tailored video embedded within a community program. The study is set in the U.S.-Mexico border community. Outreach provided a link or QR code to access the survey. In all, 458 participants started the survey, and 304 completed the survey. Participants were recruited through flyers distributed throughout various community events by the program's community health workers and via social media. The intervention evaluated changes in participant's knowledge, perceived barriers, perceived susceptibility, self-efficacy, and perceived benefits and intention to screen. Participants were a mean age of 39 and identified mainly as female (72.7%) and Hispanic/Latinx (88.49%). After viewing the narrative video, participants had significantly improved perceived susceptibility, self-efficacy, and benefits, while perceived barriers and sense of fatalism significantly decreased. Paradoxically, this was associated with a significant decrease in knowledge scores. Results from this intervention suggest that a theory-based narrative video following a culturally appropriate storyline effectively improves psychosocial variables and intention to carry out CRC screening in a predominantly Hispanic border population.

Changes in online marketing and sales practices among non-medical cannabis retailers in 5 US cities, 2022 to 2023.

Objectives: Given the evolving cannabis marketplace (e.g., products, marketing strategies), this study examined online cannabis marketing practices over time. Methods: In 2022 and 2023, researchers assessed website content (e.g., age verification, sales, delivery, warnings, ad content, promotional strategies) among 175 randomly-selected cannabis retailers' websites across 5 US cities (Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles [LA], California, n=∼35/city). Analyses compared data from 2022 vs. 2023 and considered regulatory factors across cities. Results: Similar to 2022, in 2023, 76.6 % required age verification for site entry, 85.1 % used social media promotion, and 90.9 % offered online sales (82.4 % of which required age verification and 34.6 % offered delivery). There were significant (p < .05) decreases from 2022 to 2023 in the proportions indicating medical card requirements (27.4 % to 15.4 %), purchase limits (59.4 % to 47.4 %), health warnings (38.9 % to 29.7 %), health benefits (60 % to 47.4 %), and discounts/price promotions (92.6 % to 86.3 %). In 2023, proportions differed across cities in ways reflecting whether state/local law allowed online sales (>90 % in Denver, Las Vegas, LA), allowed discounts/price promotions (100 % in Denver and Las Vegas), or required health warnings (48-60 % in Seattle and LA vs. < 20 % elsewhere). Despite all sites prohibiting youth-oriented content and all but Denver and Las Vegas prohibiting health claims, 30.3 % posted content targeting youth/young adults (LA = 8.1 % to Denver = 74.2 %) and 47.4 % health claims (Seattle = 27.0 % to Denver = 71.0 %). Conclusions: Online cannabis retail presents risks for access and appeal to minors, emphasizes health benefits, and uses price promotions, regardless of restrictions, indicating need for greater regulatory efforts.

Explicit Training in Systematic Communication Strategies: A Pilot Study Exploring the Incorporation of Communication Tools by First-Year Residents in Simulation and in Clinical Practice.

OBJECTIVES: Educational approaches for training physicians in clinical communications vary, and whether physicians apply the communication skills they learn or find them useful in the clinic is not well known. The aim of this study was to determine how first-year residents who received explicit instruction in 7 communication strategies would apply them in a simulation exercise and in clinical practice. METHODS: First-year Internal Medicine residents at an urban teaching hospital received instruction in 7 systematic communication strategies: Ask-Tell-Ask, Teach-back, open-ended questioning, NURSE, open body language, pausing, and plain language. Residents were evaluated on their use of specific communication behaviors associated with the 7 strategies during a simulation exercise of disclosing a medical error to a standardized patient. Control group residents who did the simulation before attending the training program and training group residents who did the simulation after the training were compared. Residents were queried 6 months after the training program on their use of communication strategies during clinical practice. RESULTS: A total of 27 residents participated (n = 13 control group; n = 14 training group). The training group performed behaviors for "establishing patient understanding" significantly more often than the control group. Both groups used non-verbal communication and behaviors for addressing patient emotions at similar levels. Of the 24 residents who responded to the 6-month follow-up questionnaire, 24 (100%) reported using Ask-Tell-Ask, open-ended questioning, and Teach-back, and 22 (92%) reported using NURSE statements and non-verbal communication. Most respondents reported using the strategies in clinical practice often or very often (79%) and found the strategies useful or very useful (96%). CONCLUSION: Providing explicit instruction in systematic communication strategies, particularly those focused on establishing patient understanding, may be an efficient approach for helping early career physicians develop effective communication skills that can be readily implemented during clinical training and practice.

Disseminating a health information website to teens using a three-pronged approach with social media outreach.

Objective: To disseminate iuveo.org, a new health information website, primarily to teens in the United States using a three-pronged approach of social media, in-person, and emails. Methods: Dissemination methods included a combination of in-person, email, and social media campaigns starting in August 2022 to reach teens and stakeholders focused on teen health. Following the Social Marketing Theory framework, a social media campaign was implemented utilizing Instagram and X (formerly Twitter). Website analytics, including monthly usage of iuveo, was measured utilizing Google Analytics. The intrinsic analytics from X and Instagram were also tracked. Results: From August 2022-July 2023, iuveo attracted 1338 unique users to the website. In the same time frame, 1085 accounts were reached on Instagram, and 14,367 impressions were received on X. Most website users (84.8%) were classified as 'direct' acquisition, meaning that they directly typed in the URL or clicked on a link, and 7.3% of users visited iuveo from a social media platform. Conclusion: A three-pronged dissemination strategy is beneficial when disseminating a new health information website. Innovation: Utilizing a three-pronged approach with a social media campaign based on Social Marketing Theory, a health information website was disseminated to youth in the United States.

Reframing the experience of childbirth: Black doula communication strategies and client responses during delivery hospitalization.

Doulas, or birth coaches, are said to be "changing the world, one birth at a time." Black doulas have been suggested to mitigate against lack of representation in obstetric care, limited identity acknowledgement and accommodation, and obstetric racism. However, scientific inquiry into the specific communication strategies and messages used by Black doulas to advocate for clients was non-existent in extant literature. Guided by the Agency-Identity Model, we analyzed 20 diary-interviews of nine Black doulas who recently served Black clients. Specifically, we explored Black doulas' communication strategies and whether these strategies had an impact on client agency. We found that Black doulas prepare their clients for patient-provider interactions, including conversations about certain medical treatments and procedures and the risks for Black women and birthing people, the importance of informed consent, how to be heard, and how to resist neglect or abuse. We found that, in turn, most Black clients were able to enact agentic responses. We describe the specific doula messages, and contextualize our findings, considering how these collective interpersonal communication strategies of Black doulas, and their clients' agentic transformations, may index a sociopolitical movement to reframe the experience of childbirth in America.