Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent–Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists ( M Age = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families ( M ChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.
SARS-CoV-2 vaccine distribution is at risk of further propagating the inequities of COVID-19, which in the United States (US) has disproportionately impacted the elderly, people of color, and the medically vulnerable. We identify vaccine deserts - US Census tracts with localized, geographic barriers to vaccine-associated herd immunity - using a comprehensive supply database (VaccineFinder) and an empirically parameterized model of spatial access to essential resources. Incorporating high-resolution COVID-19 burden and time-willing-to-travel for vaccination, we show that early (February - March 2021) vaccine allocation disadvantaged rural and medically vulnerable populations. Data-driven vaccine distribution to vaccine deserts may improve immunization in the hesitant and control SARS-CoV-2.
In February, 2020, during the initial phase of the COVID-19 pandemic, the US Centers for Disease Control and Prevention (CDC) made recommendations to clean and disinfect frequently-handled objects, which triggered nationwide panic buying of disinfectant products such as Clorox and Lysol. Numerous regu latory agencies and public health organisations (eg, CDC, US Food and Drug Administration, US Consumer Product Safety Commission, and the American Association of Poison Control Centers [AAPCC]) have repeatedly advised against ingestion and other off-label use of disinfectants and cleaning products. However, during a White House press briefing on April 23, 2020, President Trump implied that the White House Coronavirus Task Force should investigate injections of disinfectant as a potential treatment for COVID-19. 1 Health communication research shows that ideological and political affiliations can widen the divide between acquired knowledge and an individual's beliefs regarding public health behaviours and outcomes. 2 Political leaders, especially the president of the USA, can command media attention and direct public health policy. 3 During public health emergencies, imprecise communication of emerging research by government leadership can cast doubt on reputable sources of scientific information. 2,3 Additionally, as the so-called Spiral of Silence theory purports, those in positions of authority can influence social dynamics and public opinion on controversial issues. 4 Government leaders who openly question scien tific consensus on an important issue can increase anxiety and perceptions of threat among the public, undermining the effect of accurate information and encouraging risky behaviours. 3 Rapidly evolving information related to the pandemic has led to confusion regarding appropriate public health measures and behaviours for stopping the spread of COVID-19. People tend to use motivated reasoning, such that new information consistent with their opinions is considered stronger than information inconsistent with previous beliefs (ie, confirmation bias) regardless of its objective accuracy, and individuals have little incentive to spend excessive time and effort in seeking and processing technical information. 3 During
Background COVID-19 vaccine distribution is at risk of further propagating the inequities of COVID-19, which in the United States (US) has disproportionately impacted the elderly, people of color, and the medically vulnerable. We sought to measure if the disparities seen in the geographic distribution of other COVID-19 healthcare resources were also present during the initial rollout of the COVID-19 vaccine. Methods Using a comprehensive COVID-19 vaccine database (VaccineFinder), we built an empirically parameterized spatial model of access to essential resources that incorporated vaccine supply, time-willing-to-travel for vaccination, and previous vaccination across the US. We then identified vaccine deserts—US Census tracts with localized, geographic barriers to vaccine-associated herd immunity. We link our model results with Census data and two high-resolution surveys to understand the distribution and determinates of spatially accessibility to the COVID-19 vaccine. Results We find that in early 2021, vaccine deserts were home to over 30 million people, >10% of the US population. Vaccine deserts were concentrated in rural locations and communities with a higher percentage of medically vulnerable populations. We also find that in locations of similar urbanicity, early vaccination distribution disadvantaged neighborhoods with more people of color and older aged residents. Conclusion Given sufficient vaccine supply, data-driven vaccine distribution to vaccine deserts may improve immunization rates and help control COVID-19.
Background Throughout the COVID-19 pandemic, US Centers for Disease Control and Prevention policies on face mask use fluctuated. Understanding how public health communications evolve around key policy decisions may inform future decisions on preventative measures by aiding the design of communication strategies (eg, wording, timing, and channel) that ensure rapid dissemination and maximize both widespread adoption and sustained adherence. Objective We aimed to assess how sentiment on masks evolved surrounding 2 changes to mask guidelines: (1) the recommendation for mask use on April 3, 2020, and (2) the relaxation of mask use on May 13, 2021. Methods We applied an interrupted time series method to US Twitter data surrounding each guideline change. Outcomes were changes in the (1) proportion of positive, negative, and neutral tweets and (2) number of words within a tweet tagged with a given emotion (eg, trust). Results were compared to COVID-19 Twitter data without mask keywords for the same period. Results There were fewer neutral mask-related tweets in 2020 (β=–3.94 percentage points, 95% CI –4.68 to –3.21; P<.001) and 2021 (β=–8.74, 95% CI –9.31 to –8.17; P<.001). Following the April 3 recommendation (β=.51, 95% CI .43-.59; P<.001) and May 13 relaxation (β=3.43, 95% CI 1.61-5.26; P<.001), the percent of negative mask-related tweets increased. The quantity of trust-related terms decreased following the policy change on April 3 (β=–.004, 95% CI –.004 to –.003; P<.001) and May 13 (β=–.001, 95% CI –.002 to 0; P=.008). Conclusions The US Twitter population responded negatively and with less trust following guideline shifts related to masking, regardless of whether the guidelines recommended or relaxed mask usage. Federal agencies should ensure that changes in public health recommendations are communicated concisely and rapidly.
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