Factors contributing to the sharing of COVID-19 health information amongst refugee communities in a regional area of Australia: a qualitative study.

BACKGROUND: The COVID-19 pandemic has had a disproportionate impact on culturally and linguistically diverse (CALD) groups worldwide. Newly emerging CALD populations formed by recently arrived refugees are predisposed to even greater health disadvantages due to complexities of the refugee experience. The aim of this study was to explore how culture, refugee experiences and existing relationships shaped what COVID-19 messages were listened to and shared during the early-mid phases of the pandemic. The work focused on three newly emerging refugee groups in the Hunter New England region, Australia: Afghan, Congolese and Syrian communities. METHODS: Qualitative, semi-structured interviews were conducted to explore the experiences and stories of 15 adult community members, nine influential members and six service providers. All community members arrived in Australia on or after January 2014. Interpreter-assisted interviews were conducted with small groups or individuals, audio-recorded and transcribed verbatim in English. Three levels of thematic data analysis were employed to uncover the important issues and experiences of the participants. RESULTS: Three key themes and several subthemes were identified. The themes were: 1) Experience as a refugee uniquely influences COVID-19 message communication; 2) Refugee groups use diverse practices when accessing and sharing COVID-19 messages; and 3) Official government messages could be improved by listening and tailoring to community needs. CONCLUSIONS: Effective health messaging relies on reaching communities in a culturally acceptable and meaningful way. Official COVID-19 messages can be tailored to engage newly emerging communities by improving the quality of the content, delivery and format whilst working collaboratively with communities and trusted service providers. Further mutual research is needed to understand emerging communities' viewpoints. The use of culturally informed approaches is recommended.

Ezidi voices: The communication of COVID-19 information amongst a refugee community in rural Australia- a qualitative study.

BACKGROUND: There is growing evidence that government health information related to COVID-19 has failed to adequately reach culturally and linguistically diverse (CALD) populations in Australia. Refugees are a unique sub-set of the CALD communities and are subject to numerous barriers preventing adequate health care, both pre- and post-migration. The barriers are accentuated during emergencies, such as a pandemic, as a result of an intersection of various social and economic inequalities. The recently resettled Ezidi refugee community in a regional area of Australia is an example of a community sitting at the intersection of various inequities and thus at greater risk from COVID-19. The purpose of this study is to describe the experiences of the Ezidi in a regional area with COVID-19 information and how this has been communicated to and shared within this group; what barriers the community may experience in accessing COVID-19 information; and how the government-led COVID-19 information communication could be improved. METHODS: This qualitative study was designed to explore the perceptions and views of the Ezidi and service providers regarding COVID-19 messaging. Multicultural and Refugee Health staff facilitated interviews with four local service providers and ten Ezidi community members, including seven influential leaders. Thematic analysis was employed across individual, pair and group data analysis. Similar categories were grouped into themes. RESULTS: The main findings of the study are: the refugee experience influences the communication of COVID-19 messages; cultural, social and gender norms influence responses to COVID-19; trusted individuals and service providers are key in communities' uptake of COVID-19 messages; currently available governmental COVID-19 information resources and sharing strategies were found unhelpful and inappropriate; COVID-19 communiqués and message delivery for this regional minority refugee community can be improved. CONCLUSION: The recently resettled Ezidi community, and likely other similar communities, would benefit from tailored engagement by government organisations, as well as settlement services to improve the communication of COVID-19 health information and reduce related inequities.

Use of a public park for physical activity in the Caribbean: evidence from a mixed methods study in Jamaica.

BACKGROUND: Small island Caribbean countries such as Jamaica are now facing an epidemic of obesity and decreased physical activity (PA) levels. Public parks have been shown to be important resources for PA that also provide psychological and social benefits associated with increased PA. There are no studies that document PA in parks in the Caribbean. METHODS: This study utilized a mixed method approach by using the System for Observing Play and Recreation in Communities (SOPARC) to obtain baseline data on park usage patterns in Emancipation Park, a large urban public park in Jamaica. In addition, in-depth interviews were conducted to gain additional insights on the park's use for PA. RESULTS: The park was used mostly by females, in the evenings and by persons 18-64 years old. Females had significantly lower mean energy expenditure (EE) than males (0.078 versus 0.080 kcal/kg/min, p < 0.05). In-depth interviews revealed that safety, a central location within a business district, aesthetic appeal, a walking track and individual health benefits were key reasons for persons engaging in PA at the park. CONCLUSIONS: This is the first study to describe the usage of a public park for PA in Jamaica. The study elicited aspects of park use for PA in a major urban park in Jamaica from different vantage points by using direct systematic observation augmented with a qualitative approach. It revealed important differential park use for PA by sex, age group and EE levels, and provided insights into factors that motivate and hinder park usage for PA. This can be used by policymakers in Jamaica to inform PA interventions to reduce obesity, provide baseline data for comparisons with other parks in developing countries and to advocate for well-designed public parks.

Risk Factors Associated with Frequent Alcohol Binge Drinking among Jamaicans: Does Gender Matter?

Objective: Alcohol is one of the most commonly consumed substances in Jamaica, despite the many health problems associated with excessive alcohol use. The aim of this study was to identify potential risk factors for alcohol binge drinking among Jamaicans, and determine if there were significant gender differences in the associations between identified risk factors and frequent binge drinking. Methods: Data collected from the 2016 National Household Survey Jamaica were analysed. Descriptive and inferential statistics were computed using SPSS. Binary logistic regression analysis was used to determine factors associated with frequent binge drinking. Results: The total number of respondents was 4623. Females were 2,535 (54.8%) compared to males 2088 (45.2%). In bivariate analysis, there was a significant association between age and frequent binge drinking among males (X2 = 11.11, p =0.004), but not among females (X2 = 2.03, p = 0.36). Similarly, there was a significant association between employment and frequent binge drinking for males but not for females (X2= 12.85, p= 0.002; X2= 2.49, p= 0.29 respectively). In multivariate analysis, age 12- 17 years was significantly, inversely associated with frequent binge drinking in the crude logit model but not in the adjusted logit model (crude odds ratio [COR] 0.21, 95%CI= 0.6- 0.66; adjusted odds ratio [AOR] = 0.51, 95%CI= 0.12- 2.13 respectively). Employment was significantly, positively associated with frequent binge drinking in the adjusted logit model (employed: AOR= 3.63, 95% CI= 1.05- 12.59) among males. Among females, age showed no significant association with frequent binge drinking. Only having primary/ lower education was significantly, positively associated with frequent binge drinking among females (AOR= 5.17, 95%CI= 1.36- 19.65). Conclusion: Risk factors for frequent binge drinking differed by gender; being employed was a risk factor for males while having primary (or lower) education was a risk factor for females.

Investigating the Role of Alcohol in Behavioural Problems at School among Secondary School Students in Barbados

Background: The prevalence of alcohol use is quite high in the Caribbean region, and specifically, in Barbados. Alcohol use has been documented to negatively affect the way students behave within and outside school. This study set out to examine the role alcohol plays in students' behavioural problems at school. Methods: An analysis of crosssectional data collected during the National Secondary Schools Survey was done. Mean (and standard deviation), frequencies and percentages were computed, and differences in proportions among the groups were assessed using Pearson's Chi Square. Multivariate analysis using binary logistic regression was done to determine the association between explanatory variables and outcome variables. Results: In bivariate analysis, behavioural problems at school were significantly associated with age (p= 0.001), grade (p= 0.000), sense of belonging at school (p= 0.000), relationship with teachers (p= 0.000), and past month alcohol use (p= 0.007). In multivariate analysis, students' having frequent behavioural problems at school was significantly associated with neither past year nor past month alcohol use (AOR= 1.13, 95% CI= 0.91- 1.40, AOR= 1.02, 95% CI= 0.83- 1.24 respectively). Significant inverse associations were found between students' behavioural problems and age (11- 14 years: AOR= 0.53, 95% CI= 0.33- 0.84; AOR= 0.51, 95% CI= 0.32- 0.82 for models 1 and 2 respectively), and relationship with teachers (very good: AOR= 0.10, 95% CI= 0.07- 0.16; AOR= 0.13, 95% CI= 0.09- 0.20 for models 1 and 2 respectively). Conclusion: Neither past year nor past month alcohol consumption by students was associated with frequent behavioural problems at school. Students who were younger than 17 years, and who had a relationship with their teachers that was not very bad were significantly less likely to engage in frequent behavioural problems.

Alcohol Consumption and Sexual Risk Behaviour among Jamaican Adolescents

Alcohol consumption has significant health, social and economic implications. Alcohol is the most prevalent psychoactive substance used by Jamaican adolescents. The aim of this study was to determine whether alcohol is associated with sexual risk behaviour among Jamaican adolescents. Methods: The data from National Secondary School Survey (NSS) conducted in 2013 was analysed. Descriptive statistics consisting of frequencies, percentages and Pearson's Chi square was done. Multivariate analysis was done using binary logistic regression. Result: The mean age of alcohol initiation among the participants was 12.3years [SD: 2.74]. There were significant associations between gender (X2= 14.56; p= 0.000), relationship with father/guardian (X2: 10.71; P= 0.03), relationship with mother (X2= 15.16; P= 0.004) and conversation with parents/ guardians about dangers of drug abuse (X2= 8.16; P=0.004). Adolescents who were males (AOR= 0.62, 95% CI= 0.43 - 0.88), in the 8th grade (AOR= 0.51, 95% CI= 0.26 - 0.98) or in the 10th grade (AOR: 0.52, 95% CI: 0.32 - 0.85) were less likely to engage in sexual risk behaviour. Lifetime alcohol consumption, past year alcohol consumption and past month alcohol consumption were not significantly associated with sexual risk behaviour (AOR= 0.35, 95% CI= 0.04 - 3.46; AOR= 1.75, 95% CI= 0.59 - 5.09, AOR= 0.78 95% CI= 0.56 - 1.11 respectively). Conclusion: Lifetime, past one year and past one month alcohol consumption among the students were not risk factors for sexual risk behavior (non-condom use) among Jamaican adolescents.

Does Risk Perception Affect Alcohol Consumption among Secondary School Students in Jamaica?

Background: Alcohol consumption among young people is a major public health problem world-wide and in Jamaica. A number of factors have been reported to affect alcohol use among high school students. The aim of this study was to investigate the influence of perception of the harmfulness of alcohol on alcohol use among secondary school students in Jamaica. Methods: Data collected from a nationally representative sample of 3,365 students were analyzed. Descriptive and inferential statistics were performed using SPSS. Results: Students' perception of risk of drinking alcohol frequently and getting drunk respectively had positive and significant associations with past month alcohol use (AOR= 1.44, 95% CI= 1.09- 1.88 and AOR= 1.38, 95% CI= 1.02- 1.86, respectively) compared to students who felt that drinking alcohol frequently and getting drunk were very harmful. Males, 12 years or younger were significantly less likely to use alcohol in the past month (AOR= 0.77, 95% CI=0.60- 0.97; AOR= 0.68, 95% CI= 0.53-0.97 respectively). Students with good relationship with their mothers were less likely to use alcohol in the past year and past month (AOR= 0.55, 95% CI= 0.35-0.87; AOR= 0.50, 95% CI= 0.32- 0.78). Conclusion: Risk perception of the harmfulness of alcohol significantly affects alcohol use among secondary school students in Jamaica. Males, 12 years or younger, who had good relationship with mothers, were significantly less likely to use alcohol in past month

Policonsumo simultáneo de drogas en estudiantes de facultades de ciencias de la salud/ciencias médicas en siete universidades de cinco países de América Latina y un país del Caribe: implicaciones de género, legales y sociales / Simultaneous polydrug consuption among undergraduate students of health sciences of seven universities in five Latin American countries and one Caribean country: gender, legal and social implicacions / Policonsumo simultâneo de drogas entre estudantes de graduação de ciências da saúde de sete universidades em cinco países da América Latina e um país do Caribe: implicações de gênero, legal e sociais

El objetivo de este estudio fue comprender los patrones de policonsumo simultáneo de sustancias psicoactivas y sus implicaciones de género, legales y sociales, en estudiantes de primer y segundo año de las facultades de ciencias de la salud/ciencias médicas, en siete universidades de cinco países latinoamericanos, Colombia, Nicaragua, Chile, Brasil y El Salvador, y un país caribeño, Jamaica. El diseño fue un corte transversal. Las combinaciones de alcohol + tabaco y de alcohol + marihuana fueron las mas reportadas en todas las universidades, a excepción de alcohol + tabaco en Jamaica. Los factores asociados al policonsumo más referidos fueron "tener relaciones sexuales inesperada" en la universidad de Brasil, "tener relaciones sexuales sin protección" en las universidades de Chile, Colombia y Nicaragua, "tener problemas con su pareja sentimental" en la universidad de Jamaica, y "ausentarse de clases" en la universidad de El Salvador. Tres entornos se relacionaron, de manera positiva o negativa, con el policonsumo simultáneo de sustancias psicoactivas: estudiantil, familiar y de comportamiento sexual.

The objective of this study was to understand patterns of simultaneous polydrug use of psychoactive substances and its gender, legal and social implications, among first and second year undergraduate students in health sciences/medical sciences faculties from six universities in five Latin American countries, Colombia, Nicaragua, Chile, Brazil, and El Salvador, and one Caribbean country, Jamaica. The study design was cross-sectional. The combinations of alcohol + tobacco and alchol + cannabis were the most frequently reported in all universities, with the exception of alcohol + tabaco in Jamaica. The factors associated to polidrug use most frequently mentioned were "to have unexpected sexual relationships" in the Brazilian university, "to have unprotected sex" in the universities of Chile, Colombia and Nicaragua, "to have problems with his o her sentimental partner" in the Jamaican university, and "to skip classes" in the university of El Salvador. Three environments were related, positively or negatively, with simultaneous polydrug use of psychoactive substances: academic, familiar and sexual behavioral.

Estudo de corte transversal que teve por objetivo compreender os padrões de policonsumo simultâneo de substâncias psicoativas e suas implicações de gênero, direitos legais e sociais entre estudantes do primeiro e segundo ano de faculdades de ciencias da saúde/médicas, de sete universidades, em cinco países latinoamericanos e um do Caribe. Os resultados indicam que o uso de múltiplas drogas simultâneas como álcool + tabaco foi maior para as universidades na Colômbia, Nicarágua, Chile, Brasil e El Salvador, com exceção da Jamaica, seguido por policonsumo simultâneo de álcool + maconha. A consequencia mais comum entre os estudantes que usam mais de uma substância psicoativa é o "sexo eventual" na Universidade do Brasil; "ter relações sexuais sem proteção" nas Universidades do Chile, Colômbia e Nicarágua; "ter problemas com seu parceiro sentimental" na Universidade da Jamaica, e ausentar-se das aulas" para a Universidade de El Salvador. Conclui-se que os modelos representam a existência de três ambientes relacionados entre si, positiva ou negativamente, com o uso simultâneo de substâncias psicoativas: ou seja, estudante, família do aluno e comportamento sexual.

Profile of simultaneous poly-substance users of undergraduate students at one university, Kingston - Jamaica / El perfile del policonsumo simultáneo de drogas entre estudiantes de pregrado de una universidad, Kingston - Jamaica / O perfil do policonsumo simultâneo de drogas entre estudantes de graduação de uma universidade, Kingston - Jamaica

This study is part of a multicentric research project involving seven universities in five Latin American countries and one Caribbean island (Jamaica). This cross-sectional study examines the profile of a sample of first and second year undergraduate students in the Medical/Health Science Department of one university in Kingston, Jamaica. The sample size was 295 students. Our results revealed that this pattern of drug use is occurring in this specific university. Alcohol was the most frequently reported substance 27.5%, followed by cannabis 6.1% and tobacco 4.7%. Report of polydrug consumption was low for all categories studied. Our findings may inform interventions at the university level.

Este estudio forma parte de una investigación multicentrica que involucra siete universidades en cinco países de América Latina y una isla caribeña (Jamaica). Estudio de corte transversal que examina el perfil de una muestra de estudiantes de pregrado del primer y segundo años del departamento de Ciencias de la Salud/Médicas de una universidad en Kingston, Jamaica. El tamaño de la muestra fue de 295 estudiantes. Nuestros resultados revelaron que este patrón de consumo de drogas se está produciendo en la universidad estudiada. Alcohol fue la droga mas reportada 27.5%, seguida por cannabis 6.1% y tabaco 4.7%. El reporte de poli-consumo simultaneo fue bajo. Nuestros hallazgos pueden contribuir a informar intervensiones a nivel universitario.

Este estudo é parte de uma investigação multicêntrica envolvendo sete universidades em cinco países da América Latina e uma ilha caribenha (Jamaica). Este estudo de corte transversal analisa o perfil de 295 estudantes do primeiro e segundo ano de graduação do departamento de ciências da medicina/saúde de uma Universidade em Kingston, Jamaica. Os resultados revelaram que o padrão de policonsumo simultâneo de drogas está ocorrendo na Universidade selecionada. O álcool foi a droga mais comumente relatada (27,5%), seguida pela maconha 6,1%, e tabaco 4,7%). O relatório de policonsumo simultâneo foi baixo. Nossas descobertas podem contribuir para as intervenções a nível universitário.

Nurses' use of the Internet in clinical ward settings.

BACKGROUND: The potential of the Internet as a fast and efficient way of accessing evidence to support nursing practice has been well recognized. In addition, nurses have highlighted the need for training in the use of information technology, information retrieval and critical appraisal as essential to their professional development. AIM: The aim of this paper is to present selected results of a longitudinal project that evaluated the impact of networked computers, with open access to the Internet, on four acute wards in a large UK teaching hospital. METHOD: Evaluation methods in the project included monitoring data from an Internet surveillance software package, a questionnaire survey with the nurses (n = 97) and in-depth interviews with a sample of nurses (n = 12). FINDINGS: A complex picture was revealed of the nature of Internet use and the factors that nurses perceived as influencing this. The majority used the networked computers and some frequent users emerged. Nurses were able to use the technology during quiet periods throughout the day and night. Patterns of use were mixed, with nurses accessing the Internet for a combination of work and non-work-related activities. They integrated use of Internet technology into their working days in ways that appropriately fitted patterns of clinical activity. Factors relating to the organization, workplace culture and training were identified influencing Internet use. CONCLUSIONS: Open access to the Internet in the workplace emerged as a useful but unrefined tool for encouraging the retrieval of information for practice. Future development of this technology in the workplace must include support and training for professional staff in order to enhance the skills required. Recommendations are made about what and how training may be useful in promoting nurses' use of Internet technology in clinical settings.

A multidisciplinary online educational database.

BACKGROUND: Before the introduction of the Trent online educational database there was no central resource that potential purchasers could use to access information on clinically relevant courses and programmes of professional development. The online database enables cancer centres, cancer units, and education and training confederations to identify current provision of cancer education and training courses in Trent. CONCLUSION: The electronic online evaluation identified that the majority of users felt the information they found was relevant and that they would recommend the database to colleagues. They also felt that it was easy to find the information they required and the information was presented in a useful and appropriate format.