In-depth Phone Interviews Research Articles

Precarious Work and Housing for Michigan Farmworkers During the COVID-19 Pandemic and Beyond

ABSTRACT Objectives Farmworkers in Michigan face precarious and exploitative labor conditions that affect their access to affordable, fair, and quality housing, which are key social determinants of health. We sought to assess the health, working conditions, and housing access, affordability, and quality of farmworkers living in and outside of employer-provided housing during the COVID-19 pandemic. Methods We conducted a mixed methods cross-sectional study in collaboration with community partners from the Michigan Farmworker Project and the Michigan Department of Civil Rights. We assessed housing, labor conditions, and general health through in-depth phone interviews with seasonal, migrant, and H-2A farmworkers (n = 63) during the height of the COVID-19 pandemic (2020–2021) in Michigan. Descriptive analyses of these data included comparisons by type of farmworker and type of housing (employer-provided or other). Results The majority of farmworkers interviewed were women and seasonal farmworkers and spoke primarily Spanish. A significant share of farmworker participants reported living in poverty (38.3%) and had low or very low food security (27.0%). Nearly half of farmworkers (47.6%) rated their health as “fair” or “poor” during the year prior to the interview, and more than a third reported 3 or more chronic conditions (39.6%) and lack of health insurance coverage (38.7%). Among the 43 workers tested, 25.6% reported testing positive for COVID-19. Farmworkers reported experiences of objectification and dehumanization. Three-quarters of workers reported feeling that they were treated as less than human by supervisors and one-third reported verbal abuse. Farmworkers also experienced challenges exacerbated by their social vulnerability that impeded them from finding affordable, quality housing. Regarding housing quality, the majority of workers (80.6%) reported one or more environmental hazards around their residence, and about a third reported not having air conditioning (33.%) and lacking a functioning washing machine (33.9%). Concerns about the quality of drinking water accessible to workers and exposure to chemicals were shared by participants. Conclusion This study adds valuable knowledge to the understanding of the systemic barriers to housing and work conditions for female and male seasonal, migrant, and H-2A farmworkers in Michigan. Shortcomings in the regulatory and policy environment result in precarious housing and work conditions, including exploitative labor practices. These conditions negate equality, fairness, and health equity, important tenants for public health.

Understanding the Perspectives and Needs of Latinx Caregivers of Persons with Alzheimer's Disease in the Appalachians: An Interpretive Phenomenological Approach.

Alzheimer's disease and related dementias (ADRD) disproportionately impact Latinx and other communities of color in the United States. The challenges for patients with ADRD and their informal caretakers can be attributed, in part, to the gaps that exist within health care services and systems. To understand the perspectives of barriers, beliefs, knowledge, and needs for the Latinx informal caregivers that take care of relatives with ADRD in the Upstate of South Carolina, region of Appalachia. This study was approved by the GHS-Prisma Health and Clemson University IRB, Study #Pro00086707. In-depth phone interviews were conducted with a sample of Latinx informal caregivers. A descriptive and interpretive phenomenological approach was used for analysis. Participants were recruited through community partnerships with local organizations. Salient themes identified in this study included the relevance of caregiver's degree of awareness about the disease and a perspective of Alzheimer's disease as a progressive and degenerative disease. Critical moments identified encompassed challenges related to patient engagement with the outside world, their attitudes, and behaviors, as well as caregiver-related challenges with access to culturally and linguistically relevant resources needed to provide proper care. Caregivers identified several culturally relevant coping strategies used and motivators in providing care for their relatives with ADRD. Linguistically and culturally sensitive programs and resources that account for knowledge, assets, and needs of Latinx informal caregivers of ADRD patients are needed to improve the quality of care and decrease disparities in health outcomes for Latinx older adults.

‘If I don’t take care of me, then I can’t be there for others:’ a qualitative study of caregiving relationships among older women living with HIV

Objective The population of women ages 50 years and older living with HIV is increasing. Yet, little is known about the care networks that older women living with HIV (OWLH) use to manage their health. The goal of this study was to explore the caregiving and care receiving relationships among OWLH and how these relationships impact HIV management. Methods OWLH aged 50 years and older were recruited from clinics and community-based organizations across the U.S. We conducted semi-structured, in-depth phone interviews and performed content and thematic analysis on transcripts. Results Participants (N = 23) were on average 60 years old and had been living with HIV for an average of 23.7 years. Participants 1) relied on diverse care networks; 2) were caregivers for grandchildren and parents; 3) had pride and joy in being caregivers; and 4) were highly proactive in their own HIV management. Care networks promoted self-love and acceptance. However, concerns about aging with HIV were still highly prevalent. Conclusion Being a caregiver and care recipient are sources of meaning and strength to help OWLH manage HIV. Public health programs should consider engaging both OWLH and their care networks in healthcare discussions and educational efforts.

Protocol Analysis Data Collection Technique Implemented for Artificial Intelligence Design

This article suggests that artificial intelligence (AI) can automate protocol analysis, a form of data analysis in cognitive psychology for inferring the information processes used by individuals from their verbal behavior while solving a problem. We propose a framework to employ think-aloud protocols (TaP) and thematic analysis in qualitative accounting research. Specifically, we use the TaP methodology to explore the impact of legal conflict and the lack of international financial reporting standards (IFRS) knowledge on implementing these accounting standards in a developing country (i.e., Iraq). The article analyzes 32 semi-structured in-depth phone interviews with external auditors, preparers, the capital market, national professional accounting and auditing associations, and academics. The results indicate that the lack of an AI framework, IFRS knowledge, and legislation conflict may adversely interact with standard implementation. This article explores how protocol analysis can benefit from AI support and provide design features. Protocol analysis can provide opportunities for future article, design, and action.

EMPOWERING AND ADDRESSING AGE-RELATED CONCERNS AMONG OLDER WOMEN LIVING WITH HIV

Abstract There are currently over 100,000 older (ages 50+ years) women living with HIV/AIDs in the United States. Older women living with HIV (OWLH) face unique psychosocial challenges with HIV prevention and care, including intimate partner violence, gender discrimination, ageism, and caregiving responsibilities. These factors can impede self-care and contribute to increased mental, emotional, and physical burdens. Little is known about the resources OWLH draw upon to help manage psychosocial stressors and their perspectives of aging with HIV. This qualitative study identified sources of strength and self-care among OWLH, as well as their concerns about aging with HIV. We recruited participants through HIV clinics and community support groups. We conducted one-on-one, semi-structured in-depth phone interviews with OWLH. Interviews were recorded and transcribed verbatim. Following a Grounded Theory approach, two coders performed open coding then thematic coding. Participants (N = 23) were on average 60 years old (range 51 – 68) and had been living with HIV for an average of 23.7 years. We found that a desire to self-educate, community activism, and engagement with other OWLH reduced participants’ internalized stigma and were sources of empowerment. However, concerns about aging with HIV persists, including pervasive HIV stigma, comorbidities, shrinking caregiver networks, long-term effects of treatment, and lack of HIV research and programs focusing on older women. These findings suggest that while OWLH are empowered agents in their own HIV care journey, structural interventions (e.g., inclusion of older women in HIV trials) are still needed to address the unique concerns of this population.

Assessing acceptability and effectiveness of a pleasure-oriented sexual and reproductive health chatbot in Kenya: an exploratory mixed-methods study

Integrating pleasure may be a successful strategy for reaching young people with sexual and reproductive health and rights (SRHR) interventions. However, sexual pleasure-related programming and research remains sparse. We aimed to assess chatbot acceptability and describe changes in SRHR attitudes and behaviours among Kenyan young adults engaging with a pleasure-oriented SRHR chatbot. We used an exploratory mixed-methods study design. Between November 2021 and January 2022, participants completed a self-administered online questionnaire before and after chatbot engagement. In-depth phone interviews were conducted among a select group of participants after their initial chatbot engagement. Quantitative data were analysed using paired analyses and interviews were analysed using thematic content analysis. Of 301 baseline participants, 38% (115/301) completed the endline survey, with no measured baseline differences between participants who did and did not complete the endline survey. In-depth interviews were conducted among 41 participants. We observed higher satisfaction at endline vs. baseline on reported ability to exercise sexual rights (P ≤ 0.01), confidence discussing contraception (P ≤ 0.02) and sexual feelings/needs (P ≤ 0.001) with their sexual partner(s). Qualitative interviews indicated that most participants valued the chatbot as a confidential and free-of-judgment source of trustworthy “on-demand” SRHR information. Participants reported improvements in sex-positive communication with partners and safer sex practices due to new learnings from the chatbot. We observed increases in SRHR empowerment among young Kenyans after engagement with the chatbot. Integrating sexual pleasure into traditional SRHR content delivered through digital tools is a promising strategy to advance positive SRHR attitudes and practices among youth.

Exploring trauma and wellbeing of people who use drugs after witnessing overdose: A qualitative study

BackgroundThe national overdose crisis is often quantified by overdose deaths, but understanding the traumatic impact for those who witness and respond to overdoses can help elucidate mental health needs and opportunities for intervention for this population. Many who respond to overdoses are people who use drugs. This study adds to the literature on how people who use drugs qualitatively experience trauma resulting from witnessing and responding to overdose, through the lens of the Trauma-Informed Theory of Individual Health Behavior. MethodsWe conducted 60-min semi-structured, in-depth phone interviews. Participants were recruited from six states and Washington, DC in March–April 2022. Participants included 17 individuals who witnessed overdose(s) during the COVID-19 pandemic. The interview guide was shaped by theories of trauma. The codebook was developed using a priori codes from the interview guide; inductive codes were added during content analysis. Transcripts were coded using ATLAS.ti. ResultsA vast majority reported trauma from witnessing overdoses. Participants reported that the severity of trauma varied by contextual factors such as the closeness of the relationship to the person overdosing or whether the event was their first experience witnessing an overdose. Participants often described symptoms of trauma including rumination, guilt, and hypervigilance. Some reported normalization of witnessing overdoses due to how common overdoses were, while some acknowledged overdoses will never be “normal.” The impacts of witnessing overdose on drug use behaviors varied from riskier substance use to increased motivation for treatment and safer drug use practices. ConclusionRecognizing the traumatic impact of witnessed overdoses is key to effectively addressing the full range of sequelae of the overdose crisis. Trauma-informed approaches should be central for service providers when they approach this subject with clients, with awareness of how normalization can reduce help-seeking behaviors and the need for psychological aftercare. We found increased motivation for behavior change after witnessing, which presents opportunity for intervention.

Identifying the Information Needs and Format Preferences for Web-Based Content Among Adults With or Parents of Children With Attention-Deficit/Hyperactivity Disorder: Three-Stage Qualitative Analysis.

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood and adult behavioral disorder. Internet searches for ADHD information are rising, particularly for diagnosis and treatment. Despite effective ADHD treatments, research suggests that there are delays in seeking help for ADHD. Identifying ways to shorten delays is important for minimizing morbidity associated with ADHD. One way to shorten these delays is to improve internet health information resources. Research shows that parents of children with ADHD feel that much of the information available is technical and not tailored for their child's needs and verbal instructions given by health care providers were too pharmacologically focused with limited information about how to manage and support ADHD symptoms in daily living. A majority of parents search the internet for general and pharmacological information for ADHD and prefer web-based resources for learning about ADHD, but web-based resources may be inaccurate and of low quality. Ensuring accurate information through the internet is an important step in assisting parents and adults in making informed decisions about the diagnosis and treatment of ADHD. Although a great deal of information regarding ADHD is available on the internet, some information is not based on scientific evidence or is difficult for stakeholders to understand. Determining gaps in access to accurate ADHD information and stakeholder interest in the type of information desired is important in improving patient engagement with the health care system, but minimal research addresses these needs. This study aims to determine the information needs and formatting needs of web-based content for adults with ADHD and parents of children with ADHD in order to improve user experience and engagement. This was a 3-phase study consisting of in-depth phone interviews about experiences with ADHD and barriers searching for ADHD-related information, focus groups where participants were instructed to consider the pathways by which they made decisions using web-based resources, and observing participants interacting with a newly developed website tailored for adults with potential ADHD and caregivers of children who had or might have ADHD. Phase 1 individual interviews and phase 2 focus groups identified the needs of the ADHD stakeholders related to website content and format. Interview and focus group findings were used to develop a website. Phase 3 used think-aloud interviews to evaluate website usability to inform the tailoring of the website based on user feedback. Interviews and focus group findings revealed preferences for ADHD website information and content, website layout, and information sources. Themes included a preference for destigmatizing information about ADHD, information specific to patient demographics, and evidence-based information tailored to lay audiences. ADHD stakeholders are specifically seeking positive information about ADHD presented in a user-friendly format.

Intensive care nurse managers' experiences during the first wave of the Covid-19 pandemic: Implications for future epidemiological crises.

Nurse managers play an important role in coordinating the multidisciplinary teamwork, which is specifically important in emergency and crises situations like the COVID-19 pandemic. The aim of this qualitative study is twofold: (1) to explore the experiences of the Intensive care units (ICU) nurse managers regarding their work during the first wave of the COVID-19 pandemic, and (2) to analyse what implications might be provided based on experiences of nurse managers for future possible epidemiological crises. In-depth phone interviews were conducted to explore the experiences of ward managers-nurses (n = 15) working in different hospitals across Poland. Interviews were taped and transcribed verbatim, and then qualitatively analysed. Three main categories were identified: (1) Challenge of working with the unknown, (2) Nurse managers' expectations, and (3) Methods of coping and received support. The COVID-19 pandemic strongly affected the work of ICU nurse managers and uncovered the malfunctioning of the healthcare system. It is important to improve the knowledge and competence of hospital management personnel through exercises and in-service training on how to handle emergencies in order to improve the management of healthcare facilities, increase the safety of patients and employees, and the quality of healthcare.

Experiences and Perceptions of Telehealth Visits in Diabetes Care During and After the COVID-19 Pandemic Among Adults With Type 2 Diabetes and Their Providers: Qualitative Study.

Since the COVID-19 pandemic, telehealth has been widely adopted in outpatient settings in the United States. Although telehealth visits are publicly accepted in different settings, little is known about the situation after the wide adoption of telehealth from the perspectives of adults with type 2 diabetes mellitus (T2D) and their providers. This study aims to identify barriers and facilitators of maintaining continuity of care using telehealth for patients with T2D in a diabetes specialty clinic. As the second phase of a multimethod study to understand missed appointments among adults with T2D, we conducted semistructured, individual, in-depth phone or Zoom interviews with 23 adults with T2D (14/23, 61% women; mean age 55.1, SD 14.4, range 35-77 years) and 10 providers from diabetes clinics in a tertiary academic medical center in Maryland. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis by the research team. Adults with T2D and their providers generally reported positive experiences with telehealth visits for diabetes care with some technical challenges resulting in the need for in-person visits. We identified the following 3 themes: (1) "perceived benefits of telehealth visits," such as convenience, time and financial efficiencies, and independence from caregivers, benefits shared by both patients and providers; (2) "perceived technological challenges of telehealth visits," such as disparities in digital health literacy, frustration caused by unstable internet connection, and difficulty sharing glucose data, challenges shared by both patients and providers; and (3) "impact of telehealth visits on the quality of diabetes care," including lack of diabetes quality measures and needs and preferences for in-person visits, shared mainly from providers' perspectives with some patient input. Telehealth is generally received positively in diabetes care with some persistent challenges that might compromise the quality of diabetes care. Telehealth technology and glucose data platforms must incorporate user experience and user-centered design to optimize telehealth use in diabetes care. Clinical practices need to consider new workflows for telehealth visits to facilitate easier follow-up scheduling and lab completion. Future research to investigate the ideal balance between in-person and telehealth visits in diabetes care is warranted to enhance the quality of diabetes care and to optimize diabetes outcomes. Policy flexibilities should also be considered to broaden access to diabetes care for all patients with T2D.

Identifying positive and negative deviants and factors associated with healthy dietary practices among young schoolchildren in Nepal: a mixed methods study

BackgroundSchool-based interventions have been implemented in resource-limited settings to promote healthy dietary habits, but their sustainability remains a challenge. This study identified positive deviants (PDs) and negative deviants (NDs) from the control and treatment groups in a nutrition-sensitive agricultural intervention in Nepal to identify factors associated with healthy dietary practices.MethodsThis is an explanatory mixed methods study. Quantitative data come from the endline survey of a cluster randomized controlled trial of a school and home garden intervention in Nepal. Data were analyzed from 332 and 317 schoolchildren (grades 4 and 5) in the control and treatment group, respectively. From the control group, PDs were identified as schoolchildren with a minimum dietary diversity score (DDS) ≥ 4 and coming from low wealth index households. From the treatment group, NDs were identified as schoolchildren with a DDS < 4 and coming from high wealth index households. Logistic regression analyses were conducted to identify factors associated with PDs and NDs. Qualitative data were collected through in-depth phone interviews with nine pairs of parents and schoolchildren in each PD and ND group. Qualitative data were analyzed thematically and integrated with quantitative data in the analysis.ResultsTwenty-three schoolchildren were identified as PDs, and 73 schoolchildren as NDs. Schoolchildren eating more frequently a day (AOR = 2.25; 95% CI:1.07–5.68) and whose parents had a higher agricultural knowledge level (AOR = 1.62; 95% CI:1.11–2.34) were more likely to be PDs. On the other hand, schoolchildren who consumed diverse types of vegetables (AOR = 0.56; 95% CI: 0.38–0.81), whose parents had higher vegetable preference (AOR = 0.72; 95% CI: 0.53–0.97) and bought food more often (AOR = 0.71; 95% CI: 0.56–0.88) were less likely to be NDs. Yet, schoolchildren from households with a grandmother (AOR = 1.98; 95% CI: 1.03–3.81) were more likely to be NDs. Integrated results identified four themes that influenced schoolchildren’s DDS: the availability of diverse food, the involvement of children in meal preparation, parental procedural knowledge, and the grandmother’s presence.ConclusionHealthy dietary habit can be promoted among schoolchildren in Nepal by encouraging parents to involve their children in meal preparation and increasing the awareness of family members.

Gendered Awareness of Pig and Poultry Farmers on the Potential of Black Soldier Fly (Hermetia illucens) Farming in Kenya

Given the need to boost food production while guaranteeing environmental sustainability, the black soldier fly (BSF) (Hermetia illucens (L.), Diptera: Stratiomyidae) is gaining traction worldwide as an alternative protein source. In Kenya, BSF production and its use as a feed component is an emerging business, but farmer awareness of the potential use of BSF in animal feed has received limited attention. This study examined the factors influencing farmer awareness of insect farming and its usefulness as ingredient in livestock feed from a gender perspective. The analysis employed a mixed-methods approach by combining binary logistic regression analysis using cross-sectional survey data from a sub-sample of 235 pig and poultry farmers and content analysis from in-depth phone interviews. The study was implemented in Kiambu County, Kenya. About 44% of the farmers were aware of the use of black soldier fly in the animal feed industry, of which 46.72% were female, and 41.59% were male. From the results, years of education, the number of chickens owned, and membership in agricultural groups significantly influenced male and female farmers’ awareness. In addition, age and the number of pigs owned significantly influenced female farmers’ awareness. The results suggest that these factors are important to consider when strategies are developed to create awareness of BSF farming. Lessons learned from this study will inform BSF dissemination strategies to better target potential men and women BSF producers, influence their decision-making ability and improve information flows between scientists and producers.

The Challenges of Building Sustainable Cities in Cameroon: Health Issues Associated with a Rapid Urban Population Increase in Buea Municipality.

Rapid urbanization compounded by urban poverty is one of the main challenges facing many Sub-Saharan African countries. The Buea municipality is the 10th largest city in Cameroon and equally faces such problems brought about by unplanned development in the past four decades. In 2020, the population growth rate in Buea rose to 42% compared to 5.6% in 2005, especially in the peri-urban areas. This resulted in direct and indirect pressures on available resources. Since 2019, Buea has been hosting close to 100,000 Internally Displaced Persons (IDPs) fleeing from the conflict between the defense and security forces and the separatist groups operating in the South West and North West Regions. Consequently, this expansion of urban agglomerations in Buea brings about challenges for the urbanites whose standard of living within the urban space is affected. This article seeks to qualitatively examine how this rapid urbanization has contributed to this recurrence of cholera outbreak since 2019 and the effects on the healthcare system and measures that are in place to mitigate this outbreak. In addressing these issues, the study administered in-depth phone Interviews with medical practitioners at Buea Regional Hospital, which is the main Cholera Treatment Centre in Buea. It also conducted in-depth phone interviews with public health experts at the South West Regional Delegation of Public Health and Buea Council personnel incharge of hygiene and sanitation. The study also made use of direct observation of the researcher on the field during sensitization campaigns in the affected communities in Buea. Base on the results the influx of IDPs have stress the already existing sanitation and shortage/rationing of water in the town. The study also found out that governance and cultural issues are equally associated to the problem of recurrence of the cholera disease in Buea Municipality.

Minors' Experiences Accessing Confidential Contraception in Texas

PurposeTexas is one of 24 states that restricts minors' ability to obtain contraception without parental consent, unless they access confidential services at federally funded Title X clinics. This study explores Texas minors' reasons for and experiences seeking confidential contraception. MethodsBetween September 2020 and June 2021, we conducted in-depth phone interviews with 28 minors aged 15–17 years. Participants were recruited via the text line and Instagram account of an organization that helps young people navigate Texas' parental consent laws. Interview transcripts were coded and analyzed using inductive and deductive codes in our thematic analysis. ResultsParticipants wanted to be proactive about preventing pregnancy by using more effective contraceptive methods but faced resistance from adults when they initiated conversations about sex and contraception or tried to obtain consent. In the absence of adult support, they turned to online and social media resources for information about types of contraception but encountered challenges finding accurate information about where to obtain methods in Texas without a parent. Only 10 participants were able to attend an appointment for contraception. Parents' increased monitoring of minors' activities during the COVID-19 pandemic, combined with transportation and appointment-scheduling barriers, made it difficult for minors to attend in-person visits, particularly if clinics were farther away. DiscussionMinors in Texas faced a range of barriers to finding accurate information and obtaining confidential contraceptive services, which were exacerbated by the COVID-19 pandemic. Expanding options for accessible confidential contraception, along with repealing parental consent laws, would better support minors' reproductive autonomy.

Perceptions of public health nursing Team Leaders (TLs) and Team Supervisors (TSs) on nurse’s development in Fiji

BackgroundNurse team leaders are responsible for contributing to managing the quality of service delivery and facility output of their nurses to ensure there is a high quality of care delivered by the health system. This study aimed to explore the perceptions of public health nursing Team Leaders (TLs) and public health nursing Team Supervisors (TSs) on nurses’ development in Fiji.MethodsA qualitative study was used to gather information using in-depth phone interviews among TLs and TSs comprising Chief Midwifery Nursing Officer (CMNO), Director of Nursing (DON), Sub-divisional Nursing Managers (SDNMs), acting SDNMs and Nursing Manager (NM) at Central health division in Fiji. The data was collected through semi-structured open-ended questionnaires and were audio recorded. The data was analyzed using manual thematic analysis process.ResultsThe study comprised of 26 participants, which included 10 TSs and 16 TLs. Four themes were identified for the results amongst TSs and TLs: ethical development; professional development; psychological development; and recommendations. However, nine sub- themes were identified for TSs and eight sub-themes were identified for the result amongst TLs.ConclusionThis study highlighted that TLs and TSs elaborated on the need for the ethical, professional, psychological development, nursing development and also on the importance of policies and guidelines. Professional ethics should be integrated into the Continuous Profession Development (CPD) points that are used to renew yearly nursing licenses as well as exposing the need for having competencies on professional ethics in nurses’ logbooks. Further research is needed to determine the in-depth barriers.

Compliant citizens, defiant rebels or neither? Exploring change and complexity in COVID-19 vaccine attitudes and decisions in Bradford,UK: Findings from a follow-up qualitative study.

COVID-19 vaccines have been the central pillar of the public health response to the pandemic, intended to enable us to 'live with Covid'. It is important to understand change and complexity of COVID-19 vaccines attitudes and decisions to maximize uptake through an empathetic lens. To explore the factors that influenced people's COVID-19 vaccines decisions and how their complex attitudes towards the vaccines had changed in an eventful year. This is a follow-up study that took place in Bradford, UK between October 2021 and January 2022, 1 year after the original study. In-depth phone interviews were conducted with 12 (of the 20 originally interviewed) people from different ethnic groups and areas of Bradford. Reflexive thematic analysis was conducted. Eleven of the 12 participants interviewed had received both doses of the COVID-19 vaccine and most intended to have a booster dose. Participants described a variety of reasons why they had decided to have the vaccines, including the following: feeling at increased risk at work; protecting family and others in their communities; unrestricted traveland being influenced by the vaccine decisions of family, friends and colleagues. All participants discussed ongoing interaction with COVID-19 misinformation and for some, this meant they were uneasy about their decision to have the vaccine. They described feeling overloaded by and disengaged from COVID-19 information, which they often found contradictory and some felt mistrustful of the UK Government's motives and decisions during the pandemic. The majority of participants had managed to navigate an overwhelming amount of circulating COVID-19 misinformation and chosen to have two or more COVID-19 vaccines, even if they had been previously said they were unsure. However, these decisions were complicated, demonstrating the continuum of vaccine hesitancy and acceptance. This follow-up study underlines that vaccine attitudes are changeable and contextual. The original study was developed through a rapid community and stakeholder engagement process in 2020. Discussion with the Bradford Council Public Health team and the public through the Bradford COVID-19 Community Insights Group was undertaken in 2021 to identify important priorities for this follow-up study.

P052“I feel like i had the best team”: Patients’ experiences with telehealth abortion in primary care

Objectives To explore patients’ experiences with telehealth abortion with medication delivery offered at a large Massachusetts safety-net primary care (PC) network. Methods This PC network cares for medically-underserved communities and was among the first to integrate telehealth abortion with medication delivery. We conducted semi-structured in-depth phone interviews from March to May 2022 with English-, Spanish-, or Portuguese-speaking patients who received telehealth abortion with medication delivery between July 28, 2020 and December 31, 2021 (n=55). Interviewers asked participants to walk through their experience of learning about the pregnancy, seeking and receiving care, and follow-up. The team employed frequent reflexivity, wrote memos post-interviews, and met frequently to discuss emergent patterns and themes. We employed inductive thematic analysis. Results We interviewed 14 participants (11 English, 1 Spanish, 2 Portuguese). Overall, participants reflected positively on their telehealth abortion experience within their PC network. They valued remote care access, familiarity and trust of the PC system and providers, privacy, and ease of scheduling and medication delivery. Telehealth empowered patients: They appreciated the ability to choose where to have the visit and described feeling reduced abortion-related stigma. Respondents described telehealth as a care modality that mitigated the provider-patient power dynamic and minimized in-clinic discomfort. Participants described feeling cared for, being treated with respect, and appreciation for receiving care from their established healthcare team within the context of ongoing social and medical health concerns. Conclusions Participants who receive telehealth abortion in their PC network with medication delivery report care as person-centered and empowering. Telehealth abortion is an acceptable alternative to in-clinic medication abortion. To explore patients’ experiences with telehealth abortion with medication delivery offered at a large Massachusetts safety-net primary care (PC) network. This PC network cares for medically-underserved communities and was among the first to integrate telehealth abortion with medication delivery. We conducted semi-structured in-depth phone interviews from March to May 2022 with English-, Spanish-, or Portuguese-speaking patients who received telehealth abortion with medication delivery between July 28, 2020 and December 31, 2021 (n=55). Interviewers asked participants to walk through their experience of learning about the pregnancy, seeking and receiving care, and follow-up. The team employed frequent reflexivity, wrote memos post-interviews, and met frequently to discuss emergent patterns and themes. We employed inductive thematic analysis. We interviewed 14 participants (11 English, 1 Spanish, 2 Portuguese). Overall, participants reflected positively on their telehealth abortion experience within their PC network. They valued remote care access, familiarity and trust of the PC system and providers, privacy, and ease of scheduling and medication delivery. Telehealth empowered patients: They appreciated the ability to choose where to have the visit and described feeling reduced abortion-related stigma. Respondents described telehealth as a care modality that mitigated the provider-patient power dynamic and minimized in-clinic discomfort. Participants described feeling cared for, being treated with respect, and appreciation for receiving care from their established healthcare team within the context of ongoing social and medical health concerns. Participants who receive telehealth abortion in their PC network with medication delivery report care as person-centered and empowering. Telehealth abortion is an acceptable alternative to in-clinic medication abortion.

Public Health in the Public Eye: Experiences of Ohio's Public Health Workforce During COVID-19.

The COVID-19 pandemic was uniquely challenging for public health workers charged with enforcing recommendations. In the United States, media reports highlight frequent outbursts and threats from community members and elected officials regarding masking protocols, vaccine mandates, and other public health measures such as isolation/quarantining recommendations. Given this backdrop, the purpose of this study was to better understand the lived experiences of this critical workforce in the context of COVID-19. We conducted in-depth phone interviews with public health workers in Ohio (N = 11). Questions were designed to illicit workers' experiences and sense-making of the pandemic experience. We analyzed results using the techniques of interpretive phenomenological analysis. Five major themes focused on how workers experienced public perceptions of COVID-19 and the public health response. Three themes highlight the role of media and social media in polarizing public perceptions. These we note as: Dealing with Deadlock, Feeling Misunderstood and Misrepresented, and The Rollercoaster of Public Opinion. Getting on With the Work reveals strategies used to navigate public perceptions and misperceptions. This ranged from aggressive education and information sharing, to setting boundaries around the controversial or disputed aspects of the pandemic. Finally, After the Dust Settles comments on hopes for postpandemic transformations of public health and public perceptions thereof. These results can inform new pathways for public health. Paramount among these are effective strategies that address public knowledge, values, and worldviews. Such messaging must promote nuanced understanding and customized approaches for local realities, rather than relying on rigid dichotomies that further polarization and distrust.

Невозвратная учебная миграция сельского населения Республики Калмыкия: особенности и риски для региона

Non-return educational migration tends to become a topical problem of the Republic for it entails considerable risks, such as shortage of qualified manpower, decreased intellectual potential, losses of childbearing age groups, endangered ethnic culture and language, etc. Goals. The article aims to analyze results of in-depth interviews for characteristics of educational — and further labor — migration from rural Kalmykia to Moscow and St. Petersburg. Materials and methods. The qualitative study of non-return educational migration examines a total of 20 in-depth phone interviews. Results. In most cases, educational migrations to megalopolises turn into labor ones to be further aggravated with a home purchase and consummation of marriage. The youth migration threatens the preservation and transmission of ethnic culture, traditions and language both in the Republic and in places of actual residence of such migrants.

Willingness of Older Canadians with HIV to Participate in HIV Cure Research Near and After the End of Life: A Mixed-Method Study.

HIV cure research requires interrogating latent HIV reservoirs in deep tissues, which necessitates autopsies to avoid risks to participants. An HIV autopsy biobank would facilitate this research, but such research raises ethical issues and requires participant engagement. This study explores the willingness to participate in HIV cure research at the end of life. Participants include Canadians with HIV [people with HIV (PWHIV)] aged 55 years or older. Following a mixed-method study design, all participants completed a phone or online survey, and a subset of participants participated in in-depth phone or videoconference interviews. We produced descriptive statistics of quantitative data and a thematic analysis of qualitative data. Barriers and facilitators were categorized under domains of the Theoretical Domains Framework. From April 2020 to August 2021, 37 participants completed the survey (mean age = 69.9 years old; mean duration of HIV infection = 28.5 years), including 15 interviewed participants. About three quarters of participants indicated being willing to participate in hypothetical medical studies toward the end of life (n = 30; 81.1%), in HIV biobanking (n = 30; 81.1%), and in a research autopsy (n = 28; 75.7%) to advance HIV cure research, mainly for altruistic benefits. The main perceived risks had to do with physical pain and confidentiality. Barriers and facilitators were distributed across five domains: social/professional role and identity, environmental context and resources, social influences, beliefs about consequences, and capabilities. Participants wanted more information about study objectives and procedures, possible accommodations with their last will, and rationale for studies or financial interests funding studies. Our results indicate that older PWHIV would be willing to participate in HIV cure research toward the end of life, HIV biobanking, and research autopsy. However, a dialogue should be initiated to inform participants thoroughly about HIV cure studies, address concerns, and accommodate their needs and preferences. Additional work is required, likely through increased community engagement, to address educational needs.