Psychiatric illness confers significant risk for severe COVID-19 morbidity and mortality; identifying psychiatric risk factors for vaccine hesitancy is critical to mitigating risk in this population. This study examined the prevalence of vaccine hesitancy among those with psychiatric illness and the associations between psychiatric morbidity and vaccine hesitancy. Data came from electronic health records and a patient survey obtained from 14,365 patients at a group medical practice between February and May, 2021. Logistic regression was used to calculate odds for vaccine hesitancy adjusted for sociodemographic characteristics and physical comorbidity. Of 14,365 participants 1,761 (12.3%) participants reported vaccine hesitancy. Vaccine hesitancy was significantly more prevalent among participants with substance use (29.6%), attention deficit and hyperactivity (23.3%), posttraumatic stress (23.1%), bipolar (18.0%), generalized anxiety (16.5%), major depressive (16.1%), other anxiety (15.5%), and tobacco use disorders (18.6%), and those previously infected with COVID-19 (19.8%) compared to participants without these disorders. After adjusting for sociodemographic characteristics and physical comorbidities, substance use disorders and tobacco use were significantly associated with increased odds for vaccine hesitancy and bipolar disorder was significantly inversely associated with vaccine hesitancy. Interventions to improve uptake in these populations may be warranted.
A275was implemented. Tally sheets were used to categorize clinicians counter referral comments. Results: The study engaged 4 clinicians who made 132 counter-referral comments on referral slips delivered to them from CHWs. The comments were categorized into seven themes as indicated below. The theme "service provided and patient counter-referred to CHW" accounted for 40% (53/132); "continue with treatment" 16% (21/132);"medicine/treatment given" 15%(20/132); "patient advised to attend ANC, PNC and MCH/FP clinic" 12% (16/132); "patient recommended for further referral" 7%(9/132); "patient seen" 7% (9/132) and the theme " patient advised to come again" accounted for 3% (4/132.) ConClusions: Clinicians should take an active role in supporting and mentoring community health workers and ensuring that all members of households have access to healthcare. They need to recognize, appreciate and support their efforts. The referral and counter-referral comments made by both clinicians and CHWs acted as a perfect link between the two levels of healthcare.
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