Tackling barriers to COVID-19 vaccine uptake in London: a mixed-methods evaluation

BACKGROUND: In response to the COVID-19 pandemic, the first vaccine was administered in December 2020 in England. However, vaccination uptake has historically been lower in London than in other English regions. METHODS: Mixed-methods: This comprised an analysis of cumulative percentage uptake across London between 8 December 2020 and 6 June 2021 by vaccine priority cohorts and ethnicity. We also undertook thematic analyses of uptake barriers, interventions to tackle these and key learning from a qualitative survey of 27 London local authority representatives, vaccine plans from London's five Integrated Care Systems and interviews with 38 London system representatives. RESULTS: Vaccine uptake was lower in Black ethnic (57-65% uptake) compared with the White British group (90% uptake). Trust was a critical issue, including mistrust in the vaccine itself and in authorities administering or promoting it. The balance between putative costs and benefits of vaccination created uptake barriers for zero-hour and shift workers. Intensive, targeted and 'hyper-local' initiatives, which sustained community relationships and were not constrained by administrative boundaries, helped tackle these barriers. CONCLUSIONS: The success of the national vaccination programme depended on conceding local autonomy, investing in responsive and long-term partnerships to engender trust through in-depth understanding of communities' beliefs

Tackling barriers to COVID-19 vaccine uptake in London: a mixed-methods evaluation.

BACKGROUND: In response to the COVID-19 pandemic, the first vaccine was administered in December 2020 in England. However, vaccination uptake has historically been lower in London than in other English regions. METHODS: Mixed-methods: This comprised an analysis of cumulative percentage uptake across London between 8 December 2020 and 6 June 2021 by vaccine priority cohorts and ethnicity. We also undertook thematic analyses of uptake barriers, interventions to tackle these and key learning from a qualitative survey of 27 London local authority representatives, vaccine plans from London's five Integrated Care Systems and interviews with 38 London system representatives. RESULTS: Vaccine uptake was lower in Black ethnic (57-65% uptake) compared with the White British group (90% uptake). Trust was a critical issue, including mistrust in the vaccine itself and in authorities administering or promoting it. The balance between putative costs and benefits of vaccination created uptake barriers for zero-hour and shift workers. Intensive, targeted and 'hyper-local' initiatives, which sustained community relationships and were not constrained by administrative boundaries, helped tackle these barriers. CONCLUSIONS: The success of the national vaccination programme depended on conceding local autonomy, investing in responsive and long-term partnerships to engender trust through in-depth understanding of communities' beliefs

Knowledge about Stroke in Adults from Rural Communities

Fifty middle to low-income adult clients of a rural family care center were surveyed in a descriptive correlational study in order to determine their abilities to identify the signs and symptoms of a stroke and their knowledge of stroke risk. Additionally, Pearson’s Correlation Coefficient was used to ascertain whether the participants’ level of knowledge was related to their actual stroke risk, as identified by the American Heart Association’s Stroke Risk Tool Descriptive analysis of the item responses revealed that the percentage of the sample correctly identifying individual signs and symptoms ranged from 44 to 77%. When actual stroke risk was correlated with knowledge of stroke risk and knowledge of stroke signs and symptoms, no relationship was found. This sample’s knowledge regarding stroke, representing a personal factor in Pender’s (1996) Health Promotion Model, was low. Educational intervention is recommended to enhance overall health

Developing intersubjectivity and teamwork skills through learning circles on clinical placement: A mixed methods study

Aim: To determine the efficacy of learning circles on developing intersubjectivity and teamwork skills and determine barriers to and facilitators of, learning circles as a learning tool. Background: Teamwork skills are vital for safe, effective nursing care and are dependent on individual team members’ shared understandings or intersubjectivity. Work-based learning circles offer a potential pedagogic strategy to promote teamwork. Methods: In work-based learning circles conducted in 2018, students drew a concept map based on a clinical case and discussed an element of it with the group. Using a convergent parallel mixed methods design, a cross-sectional survey of students using a student clinical experience questionnaire and a qualitative descriptive approach for interviews with clinical facilitators was conducted. Results: Overall, 128 Bachelor of Nursing students (88.9% response) completed the survey and five facilitators (50%) attended group interviews. Students agreed that core teamwork skills were developed during their placement and clinical facilitators reported (1) student engagement in the learning circle processes; (2) learning much about students’ abilities; and (3) developing subtle teaching skills to enhance discussion. Sharing experiences from different wards and clinical experiences was a platform for developing intersubjectivity. Conclusions: To promote intra-professional teamwork skills, conducting learning circles with students from different disciplines may further enhance intersubjectivity and is an area for further research

Learning through structured peer discussion: An observational study

Background: Clinical experiences are an essential foundation of nursing education. While there have been many significant investigations into models of clinical education and student learning, how students ‘make sense’ of their experiences is less well investigated. Senior nursing staff in a tertiary health service partnered with nurse researchers to explore how students can learn more about practice through structured discussions with peers to promote shared understandings. Objectives: The study aimed to evaluate the contributions to student learning from structured peer discussions about patient care. Design: Exploratory observational study of the effects of learning circle discussions on individual understanding of patient care. Setting: A metropolitan health service in southeast Queensland, Australia. Participants: 72 Bachelor of Nursing students in Years 2 and 3. Methods: Students developed concept maps about patient care prior to peer discussions, and subsequently added further concepts (in another colour of text) after those discussions. Researchers' review of student generated concept maps and coded concepts indicated a five a priori ways of knowing categories: empirical, aesthetic, ethical, personal and socio-political. Descriptive analysis of categories was then conducted. Results: Empirical knowing was high in both groups, with more concepts included in Year 3 student maps. Aesthetic knowing was relatively high in both groups. Socio-political knowing was lower than anticipated overall. Personal and ethical forms of knowing were rarely included on the concept maps. Conclusions: While clinical placement is valued for developing empirical and aesthetic forms of knowing, the other forms of knowing have value for patient and family care and warrant strategies to improve their further development. Developing strategies to support student learning of ethical and personal forms of knowing deserves further investigation. © 2019 Elsevier Lt