Public Health Residents Research Articles

The New to Public Health Residency Program Supports Transition to Public Health Practice.

Training and retaining a competent public health workforce are challenging. Residency programs for new and transitioning professionals are effective in other fields but rare in governmental public health. The New to Public Health Residency Program is a residency program for professionals entering public health practice. On the basis of the Foundational Public Health Services model, the program was designed using adult learning principles and best practices from nurse residency programs. Content created by public health experts is delivered over 12 months through online course sessions that include interactive learning activities. Additional program components include monthly synchronous online discussions and support from a mentor. Residents apply their learning through implementation of an evidence-based practice project at their workplace. The program is accredited for continuing professional development contact hours. Agencies with limited resources to support new public health employees may find the New to Public Health Residency Program a vital training resource.

How Does Public Health Investment Affect Subjective Well-Being? Empirical Evidence from China.

Maximizing or improving residents’ subjective well-being is one of the basic purposes of public expenditure. As an important component of public expenditure, the impact of public health investment on residents’ subjective well-being receives considerable attention. Regarding the empirical evidence, this paper measures residents’ subjective well-being from the perspectives of overall cognitive happiness, life satisfaction, positive emotions and negative emotions, on the basis of a multi-level structural model of subjective well-being. Factor analysis is used to estimate the subjective well-being of residents at the province level in China, based on the China Family Panel Studies of 2018. In addition, structural equation modeling is employed to explore the impact of public health investment and its regional disparity on the subjective well-being of residents. The empirical results show that public health investment has a significant positive effect on residents’ subjective well-being. Moreover, there is an inverted U-shaped relationship between the regional disparity of public health investment and residents’ subjective well-being. Further study illustrates that the effects of public health investment and its regional disparity on residents’ subjective well-being are heterogeneous by group. Public health investment has a greater impact on the well-being of low- and middle-income, eastern and urban residents than high-income, midwest and rural residents.

Racial and oral health equity in dental school curricula.

ObjectivesThe objective of this study was to assess the current efforts to move dental school curriculum beyond diversity and inclusion toward an anti‐racism approach to racial equity.MethodsIn this cross‐sectional study, an electronic Qualtrics survey was sent to 67 Dental School Associate Deans/Deans of Academic Affairs and 15 Dental Public Health (DPH) Residency Program Directors. Survey topics included oral health equity, Critical Race Theory (CRT), racism and the physiologic impacts of racism on oral health. Descriptive statistics were used to demonstrate frequencies.ResultsOverall response rate was 31.7% (DPH = 6, predoctoral Dental = 20). The majority of respondents that answered the question stated that the educational program offered instruction in oral health equity (96.2%), racism (75%), and the physiologic impacts of racism on oral health (83.3%). Only 17.4% of the respondents stated that the educational program offered instruction in CRT. The main barriers to providing the instruction was limited faculty trained in the topics to offer the instruction or there was limited time to offer additional content in the curriculum.ConclusionsFindings demonstrate that oral health equity, racism and the physiologic impacts of racism are being discussed in dental education to some extent, but there is limited instruction in CRT. More robust efforts are needed to ensure dental students and DPH residents are competent in providing anti‐racist and unbiased health care; there should be an incorporation of anti‐racism standards in the Commission on Dental Accreditation (CODA)'s predoctoral and Advanced Education Program standards.

Public health nurses fostering self-help health promotion groups for older people.

Public health nurses foster self-help groups that are intended to solve health problems and improve the health of older people. This study aims to clarify how public health nurses foster such self-help groups. This is a qualitative study that utilizes one-to-one semi-structured interviews. The participants comprised 11 full-time public health nurses who had experience in fostering self-help groups and had at least 5 years of experience as public health nurses. Interview transcripts were created, and a qualitative analysis was performed inductively. In total, 33 themes, 14 theme clusters, and four categories were extracted. The categories were as follows: coordinating with relevant occupations and residents to collect community information and solve health problems, organizing classes from health promotion to member-centered group activities, ensuring group development support and establishing a support system, and supporting leaders behind the scenes. Public health nurses begin by gathering information about a given community and sharing local health problems with public health authorities and residents. The nurses build trusting partnerships with members and assign appropriate roles to them to better address their problems. Additionally, the nurses provide indirect group support by encouraging leaders as needed.

Assessing COVID-19-related depression, anxiety and stress among European public health residents

BackgroundIn Europe, Public Health Residents (PHR) have participated in the response against COVID-19.The pandemic has had a profound mental health (MH) impact on healthcare workers, but little evidence has been accrued about the Public Health (PH) workforce.The current study aims at assessing prevalence and risk factors for pandemic-related depression (D), anxiety (A) and stress (S).MethodsBetween March 22 and April 11, 2021 we administered an online survey to PHR from France, Italy, Portugal and Spain, recruited through the national associations of PHR.We collected socio-demographic data and assessed changes in the working conditions due to COVID-19.We used the Depression Anxiety Stress Scales-21.Cut-off scores for D, A and S were: 9, 7, and 14.Multivariable logistic regression models were applied to determine risk factors for pandemic-related MH outcomes.Data analysis was performed with SPSS version 27.Results443 out of approximately 2000 PHR completed the survey, response rate: 22.15%. Most responders (n = 226; 51%) were from Italy, 87 (19.6%) from Portugal, 74 (16.47%) from Spain and 56 (12.6%) from France. Median age: 29 years (IQR 25 - 33). Female/male ratio: 1.6. PHR above the cut-offs for D, A and S were: 60.5%, 43.1%, 61.2%.DASS-21 scores were 13.3 (± 10.27), 8.13 (± 7.79), 19.06 (± 9.71), respectively.Across the multivariable logistic regression models, the main identified predictors were: for D - the COVID-19 impact on PH training (OR 1.78, 95% CI [1.12-2.80], p = 0.014); for A - the loss of research opportunities (OR 1.94, 95% CI [1.28-2.93], p = 0.002) and for psychological S - the year of residency (last year vs other years of residency: OR 2.3, 95% CI [1.20-4.38], p = 0.012).ConclusionsOur sample featured mild-to-moderate levels of prevalent D, A and moderate levels of psychological stress.Overall, the main risk factors associated with negative psychometric outcomes were training challenges, loss of research opportunities and residency seniority.Key messages During the pandemic it is vital to increase knowledge and awareness about the impact of the health emergency on mental health in the Public Health workforce.It is important to deploy concrete efforts into building healthy work environments, guarantee adequate training and research opportunities for Public Health Residents.

3.G. Round table: How to prepare the public health workforce for a digital health future?

Digital health is a crucial field for healthcare sustainability and adequate response to emerging health challenges. It has potential to increase efficiency in public health areas, such as surveillance, communication, data analysis and visualization, planning and collaboration. While the COVID-19 pandemic has accelerated the digitalisation of healthcare, a structured and planned approach is needed to ensure its sustainable and equitable integration in healthcare. Capacity building in digital literacy plays a key role to ensure an adequate implementation of digital public health. Moreover, the application of digital health solutions in public health services requires a proper training for students, young professionals, and public health experts. To fulfil this, education on digital health should be fully integrated in medical and public health curricula. Our workshop aims to discuss the potential of digital health technologies for public health services and identify proposals for a renewed digital public health curriculum. In this workshop, we will present a summary of potential uses of digital health in public health, focusing advances developed during COVID-19 pandemic. This introduction will provide a background for participants to be aware of digital health solutions, from basic digital services to innovations, that are applicable in public health practice. Panellists will share both local and national experiences. Although there are some examples of digital health updated curricula, a more comprehensive and structured approach to public health training is needed. Digital public health education should include specific topics, such as capacity building, opportunities for youth, and an ethics-driven approach. However, it should be tailored for public health students and professionals needs, which are certainly different. A short presentation will provide a guiding framework for participants to discuss the topic. Following, during small group discussions, workshop participants will share perspectives and suggestions for an updated digital public health curricula, including different approaches for both undergraduate students, public health residents and public health experts. In this round table discussion, one panelist will present a summary of potential uses of digital health in public health (10 minutes). The following presentation will cover main concerns that digital public health education should consider, particularly for young professionals (10 minutes). Following, participants will be asked to discuss in 3 to 6 small groups which topics should be included in curricula and training opportunities in medical schools, public health schools and public health services (20 minutes). Finally, each group will briefly present their conclusions (15 minutes), which will be highlighted in a wrap-up conclusion (5 minutes). We intend to keep in touch with all participants, in order to develop a concrete proposal for digital health education curricula.Key messages Digital health has potential to increase efficiency in multiple public health areas and digital health education is a key step to ensure its implementation in public health schools and services.COVID-19 accelerated the digitalization in public health, but a planned approach is needed to guarantee adequate training for students and professionals.

Hospital hand hygiene monitoring: internal audits and the role of public health residents

Abstract Background Healthcare workers (HCW) adherence to hand hygiene (HH) is the most effective infection prevention and control (IPC) measure to fight healthcare-associated infections (HAI) and is a crucial component for standard precautions, especially in a pandemic context. As suggested by the WHO and Joint Commission Network Project, evaluating adherence to HH is essential to identify deficiencies and promote improvement interventions. Methods San Raffaele Hospital in Milan, Italy, adopted internal audits to measure HCWs' adherence to HH according to WHO Guidelines. Public health (PH) residents were enrolled as auditors. They were trained with WHO technical manual for observers and handovers among residents. WHO observation form was used for collection. Process index was HH adherence, stratified by profession, unit, opportunity and indication. Results 8 PH medical residents carried out observations from January 2018 to December 2019. 434 HCWs were observed in 26 hospital units (191 nurses, 148 physicians, 83 healthcare assistants and 11 other professionals). Global adherence was 53%, calculated on 1,969 opportunities, and 2,221 indications observed, followed by 932 hands rubbing and 110 handwashing. Most observations involved nurses (adherence of 53%) and physicians (54%). Global adherence was generally higher in medicine, specialist surgery and intensive-care units while lower in general surgery and rehabilitation units. Indications with the highest adherence were “after body fluid exposure risk” (69%) and “after touching a patient” (64%). The lowest adherence (44%) was observed for “before clean/aseptic procedure” indication. The belief that gloves use may replace HH might partially explain the data. Conclusions Global HH adherence was in line with significant published data and was far better than 2016 data but slightly lower than observations in 2018 when the program started. We believe 2020 HH compliance could have changed due to HCW involvement in IPC against COVID-19. Key messages Hand hygiene (HH) audits represent a crucial tool of clinical governance and risk management: auditors’ training, monthly and annual reports, and feedbacks allowed to structure a virtuous process. If HH audits aim to improve practice we should understand when HH is most beneficial, assessing quality, improving performances through achievable targets using reproducible methods and technologies.

Design, implementation and assessment of a drive-through flu mass-vaccination program in Italy

ProblemThe SARS-CoV-2 pandemic has completely changed health systems around the world.As part of a mass immunization campaign with COVID-19 vaccines, it was necessary to study new methods to vaccinate a large number of people in a short time and in complete safety.Description of the problemTo ensure the requirements of speed, safety and low cost, we therefore designed an EBM model of drive-through flu-vaccination, built in the city of Rivalta di Torino (about 20,000 inhabitants), in Northern Italy, on two Saturdays in November 2020. The project was created by Public Health Residents with the collaboration of the Municipality, a team of Family Doctors and Civil Protection.ResultsWe measured driving time for each vehicle from the check-in station to the parking zone designed for the 15min post-vaccination follow-up. We calculated the mean length of stay time (LOS) and the mean time per person based on the number of individual vaccinations given per vehicle. In two days, 1539 vaccines were administered. Flows were only timed on the first day (417 vehicles and 672 vaccines). The highest percentage of cars (47%) received only one vaccination per vehicle, followed by 2 (45.8%), 3 (6.2%), and 4 (1%) vaccines per vehicle. The optimal number of vaccinations per vehicle to maximize efficiency was 4: the average LOS per vaccination decreased from 2.54 minutes per person (1 vehicle=1 person) to 0.34 seconds per person (1 vehicle=4 people). The mean LOS time was 3.06min (SD1.11).LessonsThis model appeared as a real possibility to start a rapid, effective, safe and low-cost mass-vaccination program in the Italian setting. It also seems to be appreciated by the population, not only in terms of novelty but also for the sense of security and speed of the process. For this reason, in April 2021, the same model was successfully applied in the same area for COVID-19 vaccination.Key messages The drive-through model appeared as a real possibility to start a rapid, effective, safe and low-cost mass-vaccination program in the Italian setting.The Pandemic has changed the needs and methods of carrying out common health practices: the drive-through model has proved to be a valuable resource for mass vaccination.

EuroNet MRPH: Networking Opportunities for Public Health Medical Residents

BackgroundThe European Network of Medical Residents in Public Health (EuroNet MRPH) is a non-profit, international, independent and non-governmental network of national associations of public health residents around Europe.ObjectivesTo describe the results accomplished by EuroNet MRPH and to show networking opportunities provided to medical residents in public health (MRPH) from 2011 to 2021.ResultsEuroNet's mission is to improve and facilitate connection between MRPH, to promote pan-European Research, and to facilitate international mobility. Digital and quarterly face-to-face meetings are used as a way of communication. Since 2011, 10 European MRPH associations and 4 individual members have joined the network, representing the UK, France, Spain, Italy, Portugal, Ireland, the Netherlands, Croatia, Slovenia, Turkey, Malta, Poland, Bosnia and Herzegovina, and Austria. In this period, 27 face-to-face meetings have been organised, promoting cooperation and exchanging of ideas between MRPH. Moreover, three working groups (WG) have been established, focusing on research, internships, and communication. Regarding research, studies about e-cigarettes, conflicts of interest, and the impact of COVID-19 on mental health of MRPH have been conducted. When it comes to internships, more than 20 possible destinations and an online form are available on our website, providing MRPH information and support. Finally, thanks to the communication WG, 20 newsletters have been published, sharing experiences and thoughts from members of the network. Moreover, EuroNet has an established presence in social media, with active accounts in Twitter, Instagram and Facebook, where public health information and opportunities for young professionals are promoted.ConclusionsIn the last ten years, EuroNet MRPH has actively promoted networking opportunities among European Medical Residents in Public Health.Key messages Enhancing international cooperation among young public health professionals is fundamental in order to face current and future public health challenges.EuroNet MRPH represents a useful tool to promote collaboration among young public health professionals.

Dental public health post-graduate trainees in the US: Experiences, challenges, and opportunities-A qualitative study.

The goal of this study was to explore challenges and opportunities that dental public health (DPH) residents and recent graduates experienced during and after their residency training programs in the US. In this qualitative study, to recruit participants, study invitations were distributed to 93 DPH postgraduate trainees via social media, email, and an online DPH nationwide course in 2019. Semi-structured in-depth interviews were conducted through Zoom audioconference. The interviews were conducted until thematic saturation was achieved. The audio-recorded interviews were transcribed and crosschecked to ensure accuracy. The interviews were coded using grounded theory. A qualitative analysis software (ATLAS.ti 8.0) was used to facilitate coding and organizing data extraction from transcripts. Eighteen DPH postgraduate trainees from 12 DPH residency programs participated and completed the interview. DPH trainees had experienced educational and financial challenges, difficulty finding DPH-related jobs after graduation, and a complex board examination preparation process. DPH postgraduate trainees and especially foreign-trained dentists experienced serious challenges during and after their postgraduate residency programs. Opportunities exist to enhance the strength of DPH programs to build a competent DPH workforce.

45Nigeria Centre for Disease Control Resident Doctors Internship Pilot: Translating Knowledge To Action In Epidemiology

45Nigeria Centre for Disease Control Resident Doctors Internship Pilot: Translating Knowledge To Action In Epidemiology

Implementing Lifestyle Medicine Education in a New Public Health and General Preventive Medicine Residency Program.

Mississippi ranks as the nation's least-healthy state. There is a shortage of trained preventive medicine (PM) physicians in the state. The Department of Preventive Medicine at The University of Mississippi Medical Center was reinstated in 2015 to address this need. Initial PM residency accreditation was awarded in November of 2017 with subsequent notification of 10-year accreditation status in April of 2020 allowing up to 4 PGY-2 and 4 PGY-3 resident positions per year. The residency experiences provided by the program are varied and unique due to the program being housed in both the School of Medicine and the School of Population Health. Preventive medicine residents have the opportunity to complete the American College of Lifestyle Medicine's Lifestyle Medicine Residency Curriculum. Through our diverse didactic and clinical experiences, we are optimistic that our program will continue to attract, train, and retain PM physicians for our state.

Availability of Naloxone in 2 Underserved Urban Communities in Georgia.

In 2016, unintentional injuries became the third leading cause of death in the United States. In 2018, 54% of 103 672 unintentional injury deaths were due to drug overdoses among adults 19 to 64 years of age. In Georgia, opioid overdose deaths continued to increase, despite a 2014 state law for naloxone use to prevent deaths, and a 2017 amendment for more widespread community use without a prescription. Given these policies, naloxone availability in pharmacies in underserved communities remains unclear. Our objective is to explore naloxone availability in such communities. Three Public Health and Preventive Medicine residents during a social-cultural-behavioral longitudinal rotation conducted interviews of 9 community pharmacists. Several themes emerged: more education was needed, and naloxone was available only by prescription in certain pharmacies or in limited amounts. Additional assessments among community members and sectors can examine the extent to which policies to expand naloxone availability and accessibility are implemented, including reduced naloxone costs.

COVID-19 pandemic: an Italian single institution's experience and lessons learned by public health residents' workforce.

We hereby provide a systematic description of the response actions in which the public health residents' workforce was pivotal, in a large tertiary hospital. The Coronavirus Disease 2019 pandemic has posed incredible challenges to healthcare workers worldwide. The residents have been affected by an almost complete upheaval of the previous setting of activities, with a near total focus on service during the peak of the emergency. In our Institution, residents in public health were extensively involved in leading activities in the management of Coronavirus Disease 2019 pandemic. The key role played by residents in the response to Coronavirus Disease 2019 pandemic is highlighted by the diversity of contributions provided, from cooperation in the rearrangement of hospital paths for continuity of care, to establishing and running new services to support healthcare professionals. Overall, they constituted a workforce that turned essential in governing efficiently such a complex scenario. Despite the difficulties posed by the contingency and the sacrifice of many training activities, Coronavirus Disease 2019 pandemic turned out to be a unique opportunity of learning and measuring one's capabilities and limits in a context of absolute novelty and uncertainty.

Assessment of the healthcare managerial skills offered by the Italian post-graduate schools of public health.

The Italian National Health Service (Servizio Sanitario Nazionale, SSN) is facing relevant challenges due to decreased financing and increased healthcare costs (1). In this complex framework, most of the Italian Medical Doctors, after obtaining their Specialization degree in Public Health, develop their careers in organizational and managerial roles in public and private health organizations, i.e. hospitals, local health units, health districts or national and international agencies (1, 2). Public health technical competencies, in particular policy and management, are of crucial importance to develop, run and support healthcare services. However, some gaps exist between current public health needs and the extent to which Public Health Residents are trained in the above fields (3, 4). The study is a cross-sectional cognitive survey carried out through a questionnaire sent by e-mail to Residents and Directors of the Italian Schools of Public Health, from May to November 2018. The questionnaire was sent only to the accredited Schools which had all four years of the course running. The questionnaire investigated 35 managerial topics divided into 4 macro-areas. It was sent to both Directors of the SPHs and the Residents of 32 Schools. The latter were asked to provide a single collective answer per School. Respondents could assign a score from 1 (topic not addressed at all) to 4 (topic addressed extensively and linked to other related topics) to each item, also taking into account the skills acquired through internships, seminars, etc. that involved all the Residents. Answers were received from the Residents of 30/32 (93.8%) SPHs and from 15/32 (46.9%) of the Directors. Scores given by the Directors were higher than the ones of the Residents for every topic, and for 17 out of 35 items (48.6%) a statistically significant difference has been obtained. In the overall score of 3 macro-areas out of 4 (General issues, Managerial tools and macro-organisational Models) there are statistically significant differences. In Soft skills macro-area, the single scores of all topics are generally low for both Directors and Residents. The study shows that the Residents declare a strong need for training improvement in the field pf healthcare organization and management: the median score is equal to or greater than 3 (topic addressed extensively) in only a few answers. The comparison between Directors' and Residents' scores highlights a different perception of the training offered in these areas. The study results could be pivotal for the improvement of the managerial skills provided to the Residents in Public Health of the Country.

Leadership in Public Health: an Italian learning experience

Abstract Background The “Public Health Leadership” Working Group of Italian Society of Public Health (S.It.I.) organized a two-days Workshop in Verona in January 2020. Leadership is linked to capacity of inspiring people to craft and achieve vision and goals, to provide mentoring, coaching and recognition and to encouragement empowerment, allowing other leaders to emerge and high quality of care. As in others country, in Italy investing in new generations is fundamental and far-sighted to create Leadership culture in tomorrow's professionals. Objectives The Workshop aim was to immerse Public Health residents into Health Leadership. Two types of practical/interactive experiences (Design thinking and Barometer strategy) and three speakers' interventions aroused curiosity, suggesting innovative ways to manage emerging local and global healthcare problems. Are residents interested in Leadership? Do they think Leadership could influence, motivate and enable to contribute to organization effectiveness? Results 100 residents (Male 52, Female 48), from 72% of Public Health Schools (26), attended Workshop: 46 of 1st, 23 of 2nd, 18 of 3rd and 13 of residency program last year. Satisfaction questionnaire was completed by 58 residents (7 points Likert scale from 1 [dissatisfied/not useful] to 7 [satisfied/useful]). 5.91 pts result in interventions satisfaction, increasing from 1st (5.84) to last year (6.00); interventions topics deepening results in 5.38 pts, decreasing from 1st (5.52) to last year (5.00). Overall satisfaction on practical/interactive activities was 5.89 and 5.83 pts results in these methodologies usefulness. Conclusions Health Leadership is a hot topic for residents; during residency program Leadership in not a main theme and residents want to improve non-technical skills to realise organization high quality of care. The practical/interactive activities were a winning choice to capture attention and cultivate mutual trust. This experience could be adapted in other countries. Key messages Teaching Leadership in Public Health is a main topic that needs to be strengthened in Public Health agenda. Italian Public Health residents are very interested in Health Leadership improvement during their trainings.

Global health challenges: Are future physicians prepared? The results of a 4 years training experience

Abstract Background Current health challenges are highlighting as Global Health (GH) is a discipline of growing importance for future physicians. Although its training is globally recommended, it has not universally entered the curricula of degree courses in Medicine and Surgery. A cycle of 6 seminars in global health has been promoted by researchers and public health residents of the Center for Research and Studies in GH of the Università Cattolica del Sacro Cuore (UCSC) in Rome, and offered for 4 consecutive years to medical students attending the UCSC. Objectives and Methods Main goal was increasing students knowledge and awareness in global health issues exploring their needs and perceptions about the impact of the topic on their future career. Two-hours frontal lessons held by experts and practical sessions (PBL) facilitated by promoters were planned on topics as determinants and inequalities in health, UHC, fragile and vulnerable population as migrants and victims of violence, SDGs, AIDS and emerging infectious diseases,international cooperation, maternal-child health. A pre-course, single event and post-course questionnaire was administered to participants. Results A mean of 48 students (± 15.7SD), 66.7% females, attending mainly the second(40.4%) and the third year (39%), joined each event. The analysis of the pre-course questionnaire has highlighted students' interest in healthcare inequalities, pandemics, migration, health in developing countries, healthcare systems. At the end, 92% of participants has considered the course interesting, 87% stated that the topic should be part of the degree course and 78% that it will influence their career. The methodology was considered adequate in 94% of cases underlining its strong incentive to work in team. Conclusions The strong interest of medical students in acquiring skills in global health seems to firmly encourage its inclusion and strengthening in study plans to prepare them properly to face the future challenges in health. Key messages Medical students consider the global health training relevant for their career encouraging its inclusion in the Medicine and Surgery curriculum. Practical sessions and team work could be useful tools to adequately train the future health workforce.

Flu vaccination coverage among healthcare workers: a comparison between 2018 and 2019 campaigns

Abstract Background In Italy, recommended annual influenza vaccination is free to healthcare workers (HCWs) to prevent flu spread. No official data are available on HCWs' vaccination coverage (VC), which minimum target is set at 75%. Aim of this study is to compare 2019-20 and 2018-19 flu vaccination coverage in order to evaluate last year campaign effectiveness. Methods 2019-20 flu vaccination campaign efforts at Udine Hospital (Italy) were improved with the aid of public health residents to tackle HCWs convenience concerns. From October 29th to December 5th 2019, dedicated areas and days were increased, informative course about influenza vaccination (efficacy, benefits and safety) toward HCWs were conducted. Data about HCWs getting their flu shot within the hospital were traced and analyzed, grouping different categories. Results During 2019-20 flu season, vaccinated HCWs were 29.1% (1,169/4,012), while they were 22.7% (955/4,203) in 2018-19 (p < 0.0001). The 2019-20 campaign resulted to be effective among doctors (45.0% vs 38.4%; p = 0.0132), residents (52.4% vs 40.7%; p = 0.0003) and nurses (24.1% vs 17.3%; p < 0.0001). The less compliant category was midwives, who maintained the worse vaccination coverage in both seasons (20.4% and 24.1%; p = 0.6555). Regarding other HCWs in 2019-20, 18.6% were vaccinated (in 2018-19 14.0%, p = 0.002). Conclusions A significant improvement in vaccination coverage during 2019-20 flu season was reached by the specific vaccination campaign for all categories except midwives. Despite this, the global vaccination coverage is still far from the desired target and more must be done to fill this gap. Evidence of HCWs categories for which this intervention was more effective, could be useful in planning next flu vaccination strategies. Key messages Continuous efforts made by public health professionals in promoting flu vaccination show their effect on healthcare workers flu shot adherence. A planned vaccination agenda and educative course about influenza infection and benefits of vaccination, seem to be good strategies to improve vaccination coverage.

Gender Disparity in Academic Rank and Productivity Among Public Health Physician Faculty in North America.

BackgroundThe issue of gender disparity is particularly important in the domain of public health where the tone of its leadership is pivotal in bringing about impactful change to research, policies, and the wellbeing of our various populations. Our aim is to explore the gender disparity of author metrics and academic rankings of public health physician faculty through a cross-sectional study.MethodsData collection for this retrospective cross-sectional study took place during June and July of 2017. Public health and preventive medicine residency training programs in the United States and Canada were to compiled and all faculty members that met the inclusion criteria were recorded (n = 973). Variables of interest include gender, h-index, years of active research, and academic appointments. SCOPUS database (Elsevier, Amsterdam, the Netherlands) was used to generate author metrics, and all statistical tests were performed using Statistical Package for the Social Sciences (SPSS) software version 20 (IBM Corp., Armonk, NY).ResultsOverall, 31.14% (n = 303) of faculty members we studied were from Canada, and 68.86% (n = 670) were from the United States. In both countries, males made up the majority of all faculty members. Female faculty comprised most of the early career positions, and their proportions tapered off with higher academic rank, whereas male faculty trended in the opposite direction. Males generally were higher in all academic measures across all appointments. Conclusions Gender disparity exists within the North American public health and preventive medicine discipline. There are underlying factors preventing women from moving beyond early career positions or engaging in academic research.

Opinion, knowledge and attitude of public health residents towards the new mandatory vaccination law in Italy

AimDue to the introduction of the compulsory vaccination law in Italy, and the following intense debate, the aim of this study was to assess the opinion of Italian Public Health residents and their knowledge on this issue.Subjects and methodsData were collected using a previously developed and validated online questionnaire that was sent by email to Public Health Residents attending the 35 Post-Graduate Schools of Hygiene and Preventive Medicine in Italy. Multivariate stepwise logistic regression was performed for data analysis, and a 0.05 level of significance was chosen. Results are expressed as adjusted odds ratio (aOR) with 95% confidence intervals (CI).ResultsOut of 554 medical doctors, 359 filled in the questionnaire, of which 56.8% were female. Those who had a positive opinion about the Law also strongly agreed/agreed with the following statements: caregivers who do not comply with the mandatory vaccination law should be fined; the Law is the only way to prevent, contain and reduce public health risks; documentation of legally mandated vaccines should be required for children to attend preschools; mandatory vaccinations are necessary and the Decree Law should not be modified; the Law emphasises the importance of all the vaccinations provided by the National Immunisation Plan.ConclusionItalian Public Health residents agree with compulsory vaccination, considering it a useful and effective tool aimed at increasing the vaccination coverage rate.