Background While many healthcare providers (HCPs) have navigated patients’ vaccine concerns and questions prior to the rollout of the COVID-19 vaccines, sentiments surrounding the COVID-19 vaccines have presented new and distinct challenges. Objective To understand the provider experience of counseling patients about COVID-19 vaccinations, aspects of the pandemic environment that impacted vaccine trust, and communication strategies providers found supportive of patient vaccine education. Methods 7 focus groups of healthcare providers were conducted and recorded during December 2021 and January 2022, at the height of the Omicron wave in the United States. Recordings were transcribed, and iterative coding and analysis was applied. Results 44 focus group participants representing 24 US states with the majority (80%) fully vaccinated at the time of data collection. Most participants were doctors (34%) or physician’s assistants and nurse practitioners (34%). The negative impact of COVID-19 misinformation on patient-provider communication at both intrapersonal and interpersonal levels as well as barriers and facilitators to patient vaccine uptake are reported. People or sources that play a role in health communication (“messengers”) and persuasive messages that impact behavior or attitudes towards vaccination (“messages”) are described. Providers expressed frustration in the need to continuously address vaccine misinformation in clinical appointments among patients who remained unvaccinated. Many providers found value in resources that provided up-to-date and evidence-based information as COVID-19 guidelines continued to change. Additionally, providers indicated that patient-facing materials designed to support vaccination education were not frequently available, but they were the most valuable to providers in a changing information environment. Conclusions While vaccine decision-making is complex and hinges on diverse factors such as health care access (i.e., convenience, expense) and individual knowledge, providers can play a major role in navigating these factors with their patients. But to strengthen provider vaccine communication and promote vaccine uptake, a comprehensive communication infrastructure must be sustained to support the patient-provider dyad. The findings provide recommendations to maintain an environment that facilitates effective provider-patient communication at the community, organizational and policy levels. There is a need for a unified multisectoral response to reinforce the recommendations in patient settings.
Background Despite research on large urban areas in the context of COVID-19, evidence on how these settings impact migrants is still limited. Objective To explore exacerbating and mitigating factors of large urban areas on migrants’ vulnerabilities during the COVID-19 pandemic. Methods We conducted a systematic review of peer-reviewed studies published between 2020 and 2022, focused on migrants (foreign-born individuals who have not been naturalized in the host country, regardless of legal immigration status) in urban areas with a population >500 000. After screening 880 studies, 29 studies were included and categorized within the following thematic framework: (i) pre-existing inequities, (ii) governance strategies, (iii) urban design and (iv) engagement of civil society organizations (CSOs). Results Exacerbating factors include pre-existing inequities (e.g. unemployment, financial instability and barriers to healthcare access), exclusionary government responses (e.g. ineligibility for relief funds or unemployment benefits) and residential segregation. Mitigating community-level factors include the engagement of CSOs to fill institutional and governmental gaps through service provision and use of technology. Conclusions We recommend increased attention to pre-existing structural inequities faced by migrants, more inclusive governance strategies and partnerships between government and CSOs to improve the design and delivery of services to migrants in large urban areas. More research is needed on how urban design can be utilized to mitigate COVID-19 impacts on migrant communities. The factors identified in this systematic review should be considered as part of migrant-inclusive emergency preparedness strategies to address the disproportionate impact of health crises on migrant communities.
Background While many healthcare providers (HCPs) have navigated patients’ vaccine concerns and questions prior to the rollout of the COVID-19 vaccines, sentiments surrounding the COVID-19 vaccines have presented new and distinct challenges. Objective To understand the provider experience of counseling patients about COVID19 vaccinations, aspects of the pandemic environment that impacted vaccine trust and communication strategies providers found supportive of patient vaccine education. Methods 7 focus groups of healthcare providers were conducted and recorded during December 2021 and January 2022, at the height of the Omicron wave in the United States. Recordings were transcribed, and iterative coding and analysis was applied. Results 44 focus group participants representing 24 US states with the majority (80%) fully vaccinated at the time of data collection. Most participants were doctors (34%) or physician’s assistants and nurse practitioners (34%). The impact of COVID-19 misinformation on patient-provider communication at both intrapersonal and interpersonal levels as well as barriers and facilitators to patient vaccine uptake are reported; messengers and messages that promote or combat misinformation are described. Providers expressed frustration in addressing vaccine hesitancy among patients who remained unvaccinated. Many valued resources providing up-to-date and evidence-based information as COVID-19 guidelines continued to change. Additionally, providers indicated that patient-facing materials were the most helpful in navigating a changing information environment and underscored that these were not frequently available. Conclusions To strengthen provider vaccine communication and promote vaccine uptake, a supportive communication infrastructure must be sustained around the patient-provider dyad. The findings provide recommendations to sustain an environment that supports provider-patient communication at the community, organizational and policy levels. There is a need for a unified multisectoral response to reinforce the recommendations in patient settings.
Background Young people in the occupied Palestinian territory face challenges-including economic, political, and social challenges-that hinder their wellbeing. It is therefore pertinent to understand the needs of the youth and the factors that determine their well-being. This study explores the understanding and definition of well-being from the perspective of Palestinian youths, and their views of the factors that influence wellbeing. Methods A qualitative investigation of twelve focus group discussions was carried out in 2017. The participants were Palestinian youths (aged 18-32 years) residing in the West Bank, including East Jerusalem, and the Gaza Strip. Participants were selected using snowball sampling, with the help of various community organisations, and youths' personal contacts. A total of 123 youths participated in the discussions, which were recorded and transcribed verbatim. Research team members coded the transcripts and then organized codes into key dimensions of life (ie, economic, political, social, and personal), and into themes within these dimensions. Ethics approval was obtained from Birzeit University. Informed verbal consent was obtained from all participants.
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