Background: A COVID-19 vaccination for children is positioned to be a critical resource in the pandemic-prevention effort. However, studies have shown hesitation towards COVID-19 vaccination uptake and a lack of trust in government agencies; putting children at risk for not receiving preventative medical care. The purpose of this study was to determine the association between trust in public health agencies and parental intention to vaccinate their children against COVID-19. Methods: Residents of a Midwestern state who reported being parent/guardian of one or more child, aged <18 living at home, were recruited to participate in a cross-sectional online survey conducted during September-October 2020 (n=238). Participants were asked their level of trust in both state and local public health departments and if they planned on vaccinating their children against COVID-19. Resident geography, rural, suburban, and urban, was categorized using definitions from the Health Resource Services Administration (HRSA) and matched to participant county of residence. Descriptive and binomial logistic regression analyses were conducted to predict probability of vaccine intent for children.Results:. Among participants, 132 (55.5%) reported intention to vaccinate their children against COVID-19. Factors that were found to significantly decrease probability of vaccinating child were being a rural resident and lower level of trust in both state and local public health agencies. Discussion: Results from this study highlight the importance of addressing public health agency mistrust among individuals, regardless of geography, to assure more equitable vaccine delivery. Further, special focus may be needed for those living in more isolated, less populated areas, where a higher level of trust may be needed before parents vaccinate their children.
BACKGROUND As the COVID‐19 pandemic spread, school district administrators in the United States were faced with difficult decisions regarding the implementation of virtual or in‐person learning to reduce risk of infection throughout student and staff populations. While a coordinated effort with surrounding districts would be most beneficial when encountering a highly infectious respiratory‐based infectious disease, the determinants of type of education delivery is unclear. METHODS Data from the Missouri Department of Elementary and Secondary Education assessing education delivery method at each school district across the state of Missouri (n = 514) from August 2020 were used. This cross‐sectional study, using results from a school district‐level survey, local COVID‐19 rates, and community‐level sociodemographic characteristics, conducted a spatially adjusted analysis of variance (ANOVA) to determine associations between education delivery type and geographic‐level sociogeographic characteristics. RESULTS Among Missouri school districts, 172 (33.4%) reported starting the 2020‐2021 academic year with an in‐person policy, 52 (10.1%) with a distant/virtual policy, 242 (47.1%) in‐person with a distance option, and 48 (9.3%) with a blended policy. This study found districts with lower household income levels were less likely to offer students any virtual learning options. Additionally, community COVID‐19 infection rates were not associated with the selection of virtual or in‐person education delivery. CONCLUSIONS These findings suggest the presence of a specific school policy was spatially random in regard to neighboring community policies, even when accounting for community characteristics. The efficacy of policy is likely to benefit upon application of a spatial framework when addressing a crisis fundamentally tied to location. Future planning that highlights and focuses on regional coordination for community resilience in the face of a pandemic should incorporate data sources that inform decisions made for families, students, and communities.
Background: While U.S. continues to face increasing rates of COVID-19, there is concern that voting behavior during the 2020 U.S. Presidential election may contribute to additional outbreaks and infections among communities. The purpose of the current study was to assess the impact of the spread of the COVID-19 infection and mask-wearing behavior on voting behaviors and political affiliation during the 2020 national election.Methods: During a two-week period from September into October 2020, YouGov, in association with Saint Louis University, conducted an online cross-sectional survey consisting of participants that were likely to vote in Missouri in the upcoming national election (n=931). The sample was stratified into two groups: those that reported always wearing a mask or face-covering in public spaces and those that did not. Individual socio-demographics and environmental factors were compared between these groups to identify significant differences according to mask-wearing patterns. Additionally, two adjusted multivariate models were constructed to determine probability of (1) reporting always wearing a mask and (2) planning on voting in-person on election day. Indicators in each model included reported political party affiliation, and urbanicity, presence of mask mandate, and recent COVID-19 rate, respective of reported Missouri county of residence. Results: The sample consisted of 931 participants across Missouri that were likely to vote during the 2020 Presidential election. Among this sample, 38.5% resided in counties with a mask mandate at the time of the survey.Individuals who resided in either suburban or urban counties were twice as likely to report always wearing a mask compared to rural residents. In addition, while individuals from counties with a mask mandate were over twice as likely to report always wearing a mask, county COVID-19 infection rates were not found to be a significant predictor of mask-wearing. Republicans and Independents were significantly less likely to report always wearing a mask. Compared to Democrats, Republicans were 4 times, and Independents were 2 times, more likely to vote in person on election day compared to Democratic party members. These results were significant even when adjusting urbanicity, residing in a county with a mask mandate, and county COVID-19 case-rate. While urbanicity and COVID-19 infection rate were determined to not add significantly to model performance, those that lived within a county with a mask mandate were nearly 50% less likely to vote in person on election date.Discussion: Overall, this study identified significant relationships that are likely to contribute to the spread of COVID-19. Individuals who identified as Republican and Independent party members were more likely to vote in-person on election day and less likely to always wear a mask in public spaces. The interaction between political party affiliation and mask wearing highlights the concerning dichotomy within political discourse and highlights an opportunity to develop novel interventions that reduce the current political division that exists within the U.S.
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