Public Outreach Efforts Research Articles

Web-Based Perspectives of Deemed Consent Organ Donation Legislation in Nova Scotia: Thematic Analysis of Commentary in Facebook Groups.

The Canadian province of Nova Scotia recently became the first jurisdiction in North America to implement deemed consent organ donation legislation. Changing the consent models constituted one aspect of a larger provincial program to increase organ and tissue donation and transplantation rates. Deemed consent legislation can be controversial among the public, and public participation is integral to the successful implementation of the program. Social media constitutes key spaces where people express opinions and discuss topics, and social media discourse can influence public perceptions. This project aimed to examine how the public in Nova Scotia responded to legislative changes in Facebook groups. Using Facebook's search engine, we searched for posts in public Facebook groups using the terms "deemed consent," "presumed consent," "opt out," or "organ donation" and "Nova Scotia," appearing from January 1, 2020, to May 1, 2021. The finalized data set included 2337 comments on 26 relevant posts in 12 different public Nova Scotia-based Facebook groups. We conducted thematic and content analyses of the comments to determine how the public responded to the legislative changes and how the participants interacted with one another in the discussions. Our thematic analysis revealed principal themes that supported and critiqued the legislation, raised specific issues, and reflected on the topic from a neutral perspective. Subthemes showed individuals presenting perspectives through a variety of themes, including compassion, anger, frustration, mistrust, and a range of argumentative tactics. The comments included personal narratives, beliefs about the government, altruism, autonomy, misinformation, and reflections on religion and death. Content analysis revealed that Facebook users reacted to popular comments with "likes" more than other reactions. Comments with the most reactions included both negative and positive perspectives about the legislation. Personal donation and transplantation success stories, as well as attempts to correct misinformation, were some of the most "liked" positive comments. The findings provide key insights into perspectives of individuals from Nova Scotia on deemed consent legislation, as well as organ donation and transplantation broadly. The insights derived from this analysis can contribute to public understanding, policy creation, and public outreach efforts that might occur in other jurisdictions considering the enactment of similar legislation.

A Method to Increase and Document the Impact of Astrobiology Education and Public Outreach.

Astrobiology education and public outreach (E/PO) efforts vary widely in terms of audience, content focus, duration, intensity, and numerous other characteristics. To identify best practices and gauge impact, an evaluation model is needed that functions across a variety of activities. In 2013, the NASA Astrobiology Institute (NAI) convened 19 astrobiology E/PO specialists for 2 days in Phoenix, AZ, with a professional evaluator to develop an evaluation model. The resulting model, termed the impact analysis method (IAM), is a series of evaluation-based practices that are tied to each phase in the "life cycle" of an E/PO project: beginning with needs assessment, which leads to the articulation of clear measurable objectives, from which design criteria for the project are developed, followed by examining the fidelity of the implementation and measuring the impacts. Data from those measurements were then used by astrobiology E/PO specialists to refine future implementation, collect evidence of impact, and support subsequent program decisions. A rubric was developed to show increasing levels of rigor of the evaluation practices in each phase of the project. Eleven astrobiology E/PO specialists who used the IAM reported increases in their understanding of evaluation and improvements in their programs.

Case-control study to identify risk factors for SARS-CoV-2 infection among university students in the northeastern USA.

Curbing the coronavirus disease 2019 (COVID‐19) pandemic requires a thorough understanding of risk factors for transmission of SARS‐CoV‐2, the etiologic agent. Institutions of higher education present unique challenges for controlling disease spread because of features inherent to these settings. Our objective was to determine risk factors for SARS‐CoV‐2 infection among a university student population in the northeastern USA during the spring and fall 2021 semesters, using the case–control study design. Cases were defined as students with a newly diagnosed SARS‐CoV‐2 infection detected either through the robust PCR‐based surveillance testing program on campus or through healthcare testing if symptoms compatible with COVID‐19 were present. Controls were defined as students with negative SARS‐CoV‐2 status, based on consistently negative PCR results at the time of selection. A comprehensive questionnaire was administered to each student enrolled in the study, covering a broad range of campus life activities. A total of 446 cases and 1,185 controls were included in this study. Multivariable logistic regression analysis showed that recent party attendance (adjusted OR = 2.3, p < .0001), recently visiting a bar (aOR = 1.6, p = .007), living in a campus residence hall (aOR = 1.6, p = .001), fraternity/sorority membership (aOR = 1.8, p = .002), and recent travel (aOR = 1.3, p = .04) were associated with being a COVID‐19 case. Having an on‐campus job was negatively associated with being a COVID‐19 case (aOR = 0.6, p = .0003). Among cases, the most commonly reported symptoms were cough (43.9%), fatigue (38.1%) and sore throat (30.3%). These findings can be used to inform the development of COVID‐19 mitigation strategies and public health outreach efforts in university settings, thus reducing SARS‐CoV‐2 transmission among students and helping to preserve the vital education and research missions of these institutions.

Land Protection Partnership in the Montezuma Wetlands Complex, New York, USA

Conserving critical wildlife habitat at a regional scale can be challenging, especially when the region hosts a range of land uses, jurisdictions, and competing interests. Abundant opportunities exist for cooperation when vested conservation entities find common ground to use their unique strengths in a cooperative effort to protect and restore wetlands for wildlife and people. We present the Montezuma Wetlands Complex (MWC) Land Protection Partnership as a case study of regional conservation collaboration aimed at identifying areas in greatest need of wetland protection and restoration to support wetland wildlife and provide wildlife-based recreation. The MWC is among the most important wetland complexes in the Atlantic flyway of eastern North America for migratory birds because it provides critical migratory stopover habitat for millions of birds and regionally unique habitats for breeding birds and resident wildlife, including numerous endangered and threatened (E&amp;T) species. This case study demonstrates how state, federal, and nonprofit entities with differing goals and objectives can partner to protect and restore critical wetland habitat for wildlife. Partners optimized efforts by developing an online survey that included physical, land cover, biological, and people/use attributes which were ranked by each partner to determine common priorities and applied these into a spatial mapping, decision-support tool. Within attribute categories, land protection (physical), emergent marshes (land use), E&amp;T (biological), and recreational areas (people/use) were highest ranked by partners. The decision-support tool provided an objective method of ranking parcels of land for public outreach efforts by the partners to protect and restore wetland wildlife habitat.

Making Up for the Past

AbstractIn 2015, the Oregon Archaeological Society (OAS) presented statements to Oregon tribes and the Oregon Legislative Commission on Indian Services acknowledging the troubling history of OAS collecting activities and steps taken to transform the OAS, and sought guidance to address continuing tribal concerns. Tribes encouraged both the return of collections and increased public outreach efforts. Their guidance fueled increased effort by the Collection Recovery Committee (OASCRC), which has facilitated the return of five collections to tribal museums and university curation facilities and coordinated digital preservation of documents. The OAS may be the only avocational society in the United States actively engaged in such efforts, accomplished by a small group of volunteers. Case studies of collections, considerations involved in disposition, and the potential for repatriation and research are highlighted. The OAS seeks to halt dispersal and commodification of cultural objects and encourage academic research. Quick action can assure that the original collectors or descendants provide key site and location information. Educational opportunities can be rendered to the heritage community, and we are uniquely positioned to contribute to that service.

The Impact of Mediatization on EU Public Outreach Campaigns

This article addresses the mediatization of the European public sphere(s) and the issues it creates for the implementation of EU-wide public outreach efforts. As applied to the EU context, the concept of mediatization is understood as a relationship between the media and political institutions that causes societal transformation. In this sense, the public sphere is seen as a mediating infrastructure of debates of political legitimacy. In the context of mediatized politics, European public opinion is fragmented and bound to national public spheres. EU public outreach efforts are increasingly filtered and shaped by the media of its member countries. Due to multiple implementation issues, the EU has not been able to offer its members an attractive and unifying identity narrative promoting European values. This article offers some conceptual solutions to the problem.

The hidden landscape: Maritime cultural heritage of the Salas y Gómez and Nazca ridges with implications for conservation on the high seas

The human history of the waters surrounding the Salas y Gómez and Nazca ridges is rich and culturally diverse. This ranges from indigenous cultures who first ventured to this remote region close to a thousand years ago to the period of European colonial exploration, as well as the rise of the modern global economy. Voyaging, fishing, and the transportation of commodities across these remote waters left signs of the human history of exploration and exploitation. A deep understanding of this rich history is critical to effectively managing its marine resources, since natural and cultural resources are intrinsically intertwined in many cultures. While most of the Salas y Gómez and Nazca ridges are located in areas beyond national jurisdiction, there has been recent interest to protect this remote region by governments, intergovernmental organizations, and the scientific community. This study provides a synthesis of the maritime heritage and cultural resources of the Salas y Gómez and Nazca ridges in order to guide future conservation, management, scientific, and public outreach efforts in this region. While uninhabited, several communities have profound connections to these remote waters, particularly communities on the islands of Rapa Nui, Juan Fernández, as well as the Peruvian and Chilean continental coasts. These communities in particular should be appropriately engaged during all development phases of the proposed protected area, as these relationships are critical to not only building interest and support, but also to developing conservation strategies that are socially responsible and equitable. While this review summarizes what we know about the maritime heritage and cultural resources of the Salas y Gómez and Nazca ridges, several knowledge gaps remain. Activities addressing those knowledge gaps should be incorporated in the design and eventual management of the proposed protected area, including research, education and outreach aimed at better understanding and appreciating the cultural significance of the region. The Salas y Gómez and Nazca ridges provide a rare opportunity to protect and study a globally significant area on the high seas, while also providing a window into the profound relationships between people and the sea.

U.S. National Park visitor perceptions of bats and white-nose syndrome

Stakeholder perceptions are essential to creating effective conservation plans, especially when these efforts focus on taxa that have historically negative preconceptions, such as bats. In the U.S., one organization that has contributed to changing people's perceptions of bats is the National Park Service (NPS). The NPS offers a variety of educational programming on bats, including written educational material and ranger interpretive programs. These educational efforts about bats have increased with the discovery of white-nose syndrome (WNS), an invasive fungus that has killed millions of bats in North America. However, despite the NPS's efforts to educate the public and conserve bats, managers lack information on visitor perceptions and knowledge of bats and WNS. This study examined U.S. National Park visitors' attitudes towards bats, knowledge of bat ecology and human health risks, and knowledge of WNS to determine how these factors influenced their support of bat conservation efforts. In 2019, we collected 1365 surveys from visitors in eight NPS units with cave resources. Our results show visitors' support for bat conservation in national parks was influenced by their positive attitudes towards bats, perceptions of ecosystem services, and recognition of WNS. However, park differences in WNS recognition suggested that there are gaps in public outreach and educational efforts. As threats to bats motivate management changes over the coming decade, understanding visitor perceptions of bats and integrating this information into cave management plans will be critical for the NPS to achieve its management goals of enhancing recreation and conservation in environments shared by humans and bats.

Acceptance of COVID-19 Vaccine in Pakistan: A Nationwide Cross-Sectional Study.

IntroductionThe coronavirus disease 2019 (COVID-19) vaccine is available across various countries worldwide, with public-private partnerships ensuring all individuals are vaccinated through a phased approach. Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have stemmed, ultimately limiting the national administration of vaccines and rollouts. This study assessed the acceptance of the COVID-19 vaccine among the general public in Pakistan.MethodsA pre-validated questionnaire was administered from January 2021 to February 2021 to assess the public attitude and acceptance of the COVID-19 vaccine. Logistic regression analyses were run to identify factors associated with the acceptance among the population.ResultsA total of 936 responses were elicited, where 15% perceived their risk of being infected at 20-30% with an overall 70% agreeing to be vaccinated if recommended. Multivariate analysis identified higher acceptance in the male gender, healthcare workers, and students. Of all, 66% respondents chose healthcare workers and public officials, whereas 15.6% chose scientific literature, and 12.9% chose social media as the most reliable source of COVID-19 information.ConclusionGiven the relatively greater trust in healthcare providers for information regarding COVID-19, healthcare workers ought to be on the frontline for vaccine campaigns and public outreach efforts, with governmental efforts in addition to the promotion of scientific materials for population-level understanding.

Our Wastewater Footprint

Collaboration among scientists and stakeholders is increasingly valued in research to coproduce knowledge and research products that better inform decision making and enact meaningful change. We present an example of effective coproduction of knowledge to protect water quality along the Mississippi–Alabama coast using a comprehensive approach that tracked progress from initial research through product assessment. We coproduced an education and decision support tool known as “Our Wastewater Footprint” and engaged communities through a variety of public outreach efforts, adapting the product to meet the needs of individual end users. We assessed the effectiveness of our efforts by tracking attendance at outreach activities, measuring website traffic, and collecting survey data from end users after product use. Data from &amp;gt;9,900 users indicated that presentations at community events and print and social media posts most efficiently reached large audiences using limited resources, and social media posts were most effective in promoting changes in behavior and attitudes on a social level. This case study exemplifies how involving stakeholders in research and product development can increase community engagement in stewardship and prompt change to enhance water quality. Our results tangibly demonstrate that meaningful assessment of the administrative and social impacts of coproduced knowledge is feasible and can be accomplished in a short period of time.

Pacific Islanders in the Era of COVID-19: an Overlooked Community in Need

BackgroundPacific Islanders (PIs), an indigenous, diverse population in the USA, have endured generational burdens of Western colonization and institutional racism that placed this population at socioeconomic and health disadvantages, such as in poverty, chronic disease, and now COVID-19. However, little is known about the impact of COVID-19 on this historically disadvantaged population. This study assessed the extent US PIs have been adversely affected by COVID-19 across the 50 states.MethodsUsing state-level national data as of September 9th, 2020, we conducted a secondary-data analysis of COVID-19 cases and deaths in PIs relative to their population representation and other racial groups, case odds ratios, and age-adjusted standard mortality ratios.Key ResultsOnly 46% of states reported PI cases and 36% of states reported PI deaths. Of 23 states with available data on PIs, PIs were overrepresented in COVID-19 cases and deaths relative to their population representation in 21 and 14 states, respectively. The proportion of COVID-19 cases and deaths to the PI population was highest among all racial groups in 15 and 9 states, respectively. PIs had higher odds of exposure to COVID-19 than Whites in 21 of 23 states, and higher number of observed deaths than expected in 6 of 7 states with available PI data.ConclusionsEngaging PI community-based and faith-based organizations in medical and public health outreach efforts, health workforce employment and training programs, along with granular data collection and reporting, are vital to mitigate the disproportionate effects of COVID-19 on this population.

Predicting Age Groups of Reddit Users Based on Posting Behavior and Metadata: Classification Model Development and Validation.

BackgroundSocial media are important for monitoring perceptions of public health issues and for educating target audiences about health; however, limited information about the demographics of social media users makes it challenging to identify conversations among target audiences and limits how well social media can be used for public health surveillance and education outreach efforts. Certain social media platforms provide demographic information on followers of a user account, if given, but they are not always disclosed, and researchers have developed machine learning algorithms to predict social media users’ demographic characteristics, mainly for Twitter. To date, there has been limited research on predicting the demographic characteristics of Reddit users.ObjectiveWe aimed to develop a machine learning algorithm that predicts the age segment of Reddit users, as either adolescents or adults, based on publicly available data.MethodsThis study was conducted between January and September 2020 using publicly available Reddit posts as input data. We manually labeled Reddit users’ age by identifying and reviewing public posts in which Reddit users self-reported their age. We then collected sample posts, comments, and metadata for the labeled user accounts and created variables to capture linguistic patterns, posting behavior, and account details that would distinguish the adolescent age group (aged 13 to 20 years) from the adult age group (aged 21 to 54 years). We split the data into training (n=1660) and test sets (n=415) and performed 5-fold cross validation on the training set to select hyperparameters and perform feature selection. We ran multiple classification algorithms and tested the performance of the models (precision, recall, F1 score) in predicting the age segments of the users in the labeled data. To evaluate associations between each feature and the outcome, we calculated means and confidence intervals and compared the two age groups, with 2-sample t tests, for each transformed model feature.ResultsThe gradient boosted trees classifier performed the best, with an F1 score of 0.78. The test set precision and recall scores were 0.79 and 0.89, respectively, for the adolescent group (n=254) and 0.78 and 0.63, respectively, for the adult group (n=161). The most important feature in the model was the number of sentences per comment (permutation score: mean 0.100, SD 0.004). Members of the adolescent age group tended to have created accounts more recently, have higher proportions of submissions and comments in the r/teenagers subreddit, and post more in subreddits with higher subscriber counts than those in the adult group.ConclusionsWe created a Reddit age prediction algorithm with competitive accuracy using publicly available data, suggesting machine learning methods can help public health agencies identify age-related target audiences on Reddit. Our results also suggest that there are characteristics of Reddit users’ posting behavior, linguistic patterns, and account features that distinguish adolescents from adults.

Fury Road: Medical Physics Education Using Film

As part of a public education outreach effort, an introduction to the health effects of ionizing radiation and the field of medical physics was developed by a clinical medical physicist. The presentation was delivered to a broad public audience in 2019 (prior to COVID-19 safety concerns) through a community outreach science literacy program that pairs popular films with educational material. The program is a collaboration between a local science center and a community movie theater, and includes content developed by a keynote guest scientist and the screening of a popular film. The film chosen for the medical physics curriculum was “Mad Max: Fury Road” (Warner Bros. Pictures, Burbank, CA), which takes place in a fictional post-apocalyptic environment with widespread radiation contamination. The lecture introduced the audience to concepts of ionizing radiation, DNA damage from radiation, risk models, historical significance, ionizing radiation in the film, and ionizing radiation in our world (including therapeutic medical applications). A panel of clinical medical physicists answered audience questions following the film screening. Event attendance was high, with ticketed and lecturer seats occupying 98% of the theater’s seating capacity. Informal feedback from audience members indicated attendees had an increased interest of the field of medical physics following the program. The described education and outreach format may be used by educators interested in similar opportunities in their own communities, and also may be adapted as an entertaining and accessible installment of a physics club, seminar, or colloquium event in more formal educational settings. The electronic lecture slides are available for download as supplementary materials.

Accuracy and precision of citizen scientist animal counts from drone imagery.

Repeated counts of animal abundance can reveal changes in local ecosystem health and inform conservation strategies. Unmanned aircraft systems (UAS), also known as drones, are commonly used to photograph animals in remote locations; however, counting animals in images is a laborious task. Crowd-sourcing can reduce the time required to conduct these censuses considerably, but must first be validated against expert counts to measure sources of error. Our objectives were to assess the accuracy and precision of citizen science counts and make recommendations for future citizen science projects. We uploaded drone imagery from Año Nuevo Island (California, USA) to a curated Zooniverse website that instructed citizen scientists to count seals and sea lions. Across 212 days, over 1,500 volunteers counted animals in 90,000 photographs. We quantified the error associated with several descriptive statistics to extract a single citizen science count per photograph from the 15 repeat counts and then compared the resulting citizen science counts to expert counts. Although proportional error was relatively low (9% for sea lions and 5% for seals during the breeding seasons) and improved with repeat sampling, the 12+ volunteers required to reduce error was prohibitively slow, taking on average 6 weeks to estimate animals from a single drone flight covering 25 acres, despite strong public outreach efforts. The single best algorithm was ‘Median without the lowest two values’, demonstrating that citizen scientists tended to under-estimate the number of animals present. Citizen scientists accurately counted adult seals, but accuracy was lower when sea lions were present during the summer and could be confused for seals. We underscore the importance of validation efforts and careful project design for researchers hoping to combine citizen science with imagery from drones, occupied aircraft, and/or remote cameras.

Lessons Relearned? H1N1, COVID-19, and Vaccination Planning.

Lessons Relearned? H1N1, COVID-19, and Vaccination Planning.

Propaganda and the Police: The Softer Side of State Control in China

Confronting a rising tide of police–society conflict, China’s Ministry of Public Security (MPS) is stepping up its propaganda campaigns. From television specials to social media accounts, this essay identifies the MPS’s public outreach efforts and tracks their prevalence and development. Using data from content analysis of policy documents and interviews with ministry officials, I argue that public relations campaigns have grown alongside the agency’s sometimes violent efforts to enforce law and order. Together with stability maintenance and the appearance of crime control, these tactics are part of a sophisticated and multipronged strategy to underpin regime legitimacy that extends far beyond brute force coercion.

Go big or go home: A model-based assessment of general strategies to slow the spread of forest pests via infested firewood.

Invasive pests, such as emerald ash borer or Asian longhorn beetle, have been responsible for unprecedented ecological and economic damage in eastern North America. These and other wood-boring invasive insects can spread to new areas through human transport of untreated firewood. Behaviour, such as transport of firewood, is affected not only by immediate material benefits and costs, but also by social forces. Potential approaches to reduce the spread of wood-boring pests through firewood include raising awareness of the problem and increasing the social costs of the damages incurred by transporting firewood. In order to evaluate the efficacy of these measures, we create a coupled social-ecological model of firewood transport, pest spread, and social dynamics, on a geographical network of camper travel between recreational destinations. We also evaluate interventions aimed to slow the spread of invasive pests with untreated firewood, such as inspections at checkpoints to stop the movement of transported firewood and quarantine of high-risk locations. We find that public information and awareness programs can be effective only if the rate of spread of the pest between and within forested areas is slow. Direct intervention via inspections at checkpoints can only be successful if a high proportion of the infested firewood is intercepted. Patch quarantine is only effective if sufficiently many locations can be included in the quarantine and if the quarantine begins early. Our results indicate that the current, relatively low levels of public outreach activities and lack of adequate funding are likely to render inspections, quarantine and public outreach efforts ineffective.

Cannabis Use and the Onset of Cigarette and E-cigarette Use: A Prospective, Longitudinal Study Among Youth in the United States.

Cigarette use is declining among youth in the United States, whereas cannabis use and e-cigarette use are increasing. Cannabis use has been linked with increased uptake and persistence of cigarette smoking among adults. The goal of this study was to examine whether cannabis use is associated with the prevalence and incidence of cigarette, e-cigarette, and dual product use among U.S. youth. Data included U.S. youth ages 12-17 from two waves of the Population Assessment of Tobacco and Health (PATH) Study (Wave 1 youth, n = 13 651; Wave 1 tobacco-naive youth, n = 10 081). Weighted logistic regression models were used to examine the association between Wave 1 cannabis use and (1) Wave 1 prevalence of cigarette/e-cigarette use among Wave 1 youth and (2) Wave 2 incidence of cigarette/e-cigarette use among Wave 1 tobacco-naive youth. Analyses were run unadjusted and adjusted for demographics and internalizing/externalizing problem symptoms. Wave 1 cigarette and e-cigarette use were significantly more common among youth who used versus did not use cannabis. Among Wave 1 tobacco-naive youth, Wave 1 cannabis use was associated with significantly increased incidence of cigarette and e-cigarette use by Wave 2. Youth who use cannabis are more likely to report cigarette and e-cigarette use, and cannabis use is associated with increased risk of initiation of cigarette and e-cigarette use over 1 year. Continued success in tobacco control-specifically toward reducing smoking among adolescents-may require focusing on cannabis, e-cigarette, and cigarette use in public health education, outreach, and intervention efforts. These data extend our knowledge of cigarette and e-cigarette use among youth by showing that cannabis use is associated with increased prevalence and incidence of cigarette and e-cigarette use among youth, relative to youth who do not use cannabis. The increasing popularity of cannabis use among youth and diminished perceptions of risk, coupled with the strong link between cannabis use and tobacco use, may have unintended consequences for cigarette control efforts among youth.

Seeing the “Unseeable,” A Student-Led Activity to Identify Metals in Drinking Water

Municipal drinking water, regulated by the Environmental Protection Agency via the Safe Drinking Water act, has long been assumed to be contaminant-free. However, crises related to drinking water have emerged, most notably the “Flint Water Crisis” in Flint, MI, where high levels of lead (Pb) were detected in the area’s water. Much of the water-sampling data collected in Flint was obtained by “Citizen Scientists” working closely with a team of researchers at Virginia Tech, who used the analytical technique of Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to quantify metal ions present in the water. Inspired by these efforts, we developed adaptable public water testing outreach efforts, led by students in Baltimore city (Middle School, High School, and College), to test the city’s drinking water. These “student-scientists” read news and scientific articles to understand the public health impact of lead in drinking water and the analytical approaches scientists use to detect metal ions in water. The students then developed a written “water collection protocol” and sought participation from colleagues (other students, faculty, and staff) who collected their home drinking water to be tested. The student scientists prepared and analyzed samples for lead (Pb) as well as copper (Cu), iron (Fe), and zinc (Zn) metal ions commonly found in drinking water, to be tested via ICP-MS. Data were then plotted onto a map of Baltimore City, with the metal levels indicated for each Zip code. This outreach event connects science to real-life news events while teaching analytical methodology and can be tailored to students at various stages of their education.

Non-pharmaceutical Interventions for Pandemic COVID-19: A Cross-Sectional Investigation of US General Public Beliefs, Attitudes, and Actions.

Non-pharmaceutical interventions (NPIs) represent the primary mitigation strategy for the COVID-19 pandemic. Despite this, many government agencies and members of the general public may be resistant to NPI adoption. We sought to understand public attitudes and beliefs regarding various NPIs and self-reported adoption of NPIs, and to explore associations between NPI performance and the baseline characteristics of respondents. We performed a cross-sectional age-, sex-, and race- stratified survey of the general US population. Of the 1,005 respondents, 37% (95% CI 34.0, 39.9) felt that NPIs were inconvenient, while only 0.9% (95% CI 0.3, 1.5) of respondents believed that NPIs would not reduce their personal risk of illness. Respondents were most uncertain regarding the efficacy of mask and eye protection use, with 30.6 and 22.1%, respectively, unsure whether their use would slow disease spread. On univariate logistic regression analyses, NPI adherence was associated with a belief that NPIs would reduce personal risk of developing COVID-19 [OR 3.06, 95% CI [1.25, 7.48], p = 0.014] and with a belief that NPIs were not difficult to perform [OR 1.79, 95% CI [1.38, 2.31], p < 0.0001]. Respondents were compliant with straightforward, familiar, and heavily-encouraged NPI recommendations such as hand-washing; more onerous approaches, such as avoiding face touching, disinfecting surfaces, and wearing masks or goggles, were performed less frequently. NPI non-adherence is associated with both outcome expectations (belief that NPIs are effective) and process expectations (belief that NPIs are not overly inconvenient); these findings have important implications for designing public health outreach efforts, where the feasibility, as well as the effectiveness, of NPIs should be stressed.