Individual and area-level socioeconomic correlates of hypertension prevalence, awareness, treatment, and control in uMgungundlovu, KwaZulu-Natal, South Africa

Hypertension is the second leading risk factor for death in South Africa, and rates have steadily increased since the end of Apartheid. Research on the determinants of hypertension in South Africa has received considerable attention due to South Africa’s rapid urbanization and epidemiological transition. However, scant work has been conducted to investigate how various segments of the Black South African population experience this transition. Identifying the correlates of hypertension in this population is critical to the development of policies and targeted interventions to strengthen equitable public health efforts. This analysis explores the relationship between individual and area-level socioeconomic status and hypertension prevalence, awareness, treatment, and control within a sample of 7,303 Black South Africans in three municipalities of the uMgungundlovu district in KwaZulu-Natal province: the Msunduzi, uMshwathi, and Mkhambathini. Cross-sectional data were collected on participants from February 2017 to February 2018

Exploring the association between misinformation endorsement, opinions on the government response, risk perception, and COVID-19 vaccine hesitancy in the US, Canada, and Italy

The COVID-19 pandemic has highlighted the adverse consequences created by an infodemic, specifically bringing attention to compliance with public health guidance and vaccine uptake. COVID-19 vaccine hesitancy is a complex construct that is related to health beliefs, misinformation exposure, and perceptions of governmental institutions. This study draws on theoretical models and current data on the COVID-19 infodemic to explore the association between the perceived risk of COVID-19, level of misinformation endorsement, and opinions about the government response on vaccine uptake. We surveyed a sample of 2697 respondents from the US, Canada, and Italy using a mobile platform between 21-28 May 2021. Using multivariate regression, we found that country of residence, risk perception of contracting and spreading COVID-19, perception of government response and transparency, and misinformation endorsement were associated with the odds of vaccine hesitancy. Higher perceived risk was associated with lower odds of hesitancy, while lower perceptions of government response and higher misinformation endorsement were associated with higher hesitancy

The Use of a Scenario-Based Nominal Group Technique to Assess P/CVE Programs: Development and Pilot Testing of a Toolkit

Preventing and countering violent extremism (P/CVE) requires coordination among multiple agencies, stakeholders and systems. The complexity of this task (compounded by the variety of P/CVE programming around the world) creates a  challenge for those hoping to develop these initiatives. The purpose of this project was to develop a replicable process and corresponding toolkit to engage multiple stakeholders in consensus building around the efficacy and improvement of nascent, developing or mature systems-level P/CVE programs. As a method, we adapted the process of nominal group technique (NGT), a structured-brainstorming tool that provides an orderly procedure for obtaining qualitative and ranked information from heterogenous participant pools. The technique we developed is based on a case-study approach (“scenario”) which we then tested in three countries (USA, Sweden, and North Macedonia) with existing P/CVE initiatives at different stages of development. We conducted scenario-based NGT sessions in each location and then systematically analyzed the results using iterative qualitative coding based on a common framework. Results were analyzed to achieve consensus on the most common system-level challenges and system-level functions, necessary to overcome those challenges, in each location. Practitioners in each local jurisdiction were then able to utilize the results derived from the NGT for their own purposes, such as advocacy to policy makers, strategic regional P/CVE planning, and ongoing stakeholder engagement. Acknowledgments: This project was funded by the NATO Science for Peace and Security Programme under the award entitled "Evaluation Support for CVE at the Local Level" SPS.MYPG5556, the Swedish Contingency Agency (MSB), and the U.S. Department of Homeland Security (DHS), Science and Technology Directorate (Cooperative Agreement Number: 2015-ST-108-FRG005). The content of this manuscript as well as the views and discussions expressed are solely those of the authors and do not necessarily represent the official views of any of the above institutions, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government

Exploring the Association between Negative Emotions and COVID-19 Vaccine Acceptance: A Cross-Sectional Analysis of Unvaccinated Adults in Sweden

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on individuals’ mental health. This study aimed to investigate how negative emotions toward the COVID-19 pandemic, including feeling anxious, depressed, upset, and stressed, were associated with COVID-19 vaccine acceptance in Sweden. The study is a cross-sectional online survey conducted between 21–28 May 2021, using three nested hierarchical logistic regression models to assess the association. The study included 965 unvaccinated individuals, 51.2% (n = 494) of whom reported their intention to get vaccinated. We observed graded positive associations between reported negative emotions and vaccine acceptance. Individuals who experienced economic stress had lower odds of vaccine acceptance while having a positive opinion of the government’s response to COVID-19 was associated with higher odds of being vaccine-acceptant. In conclusion, unvaccinated individuals experiencing negative emotions about the pandemic were more willing to get the vaccine. On the contrary, those with a negative opinion about the government’s response, and those that had experienced economic stress were less likely to accept the immunization

Essential Workers’ COVID-19 Vaccine Hesitancy, Misinformation, and Informational Needs in the Republic of North Macedonia

The COVID-19 pandemic has resulted in over 5.2 million deaths. Vaccine hesitancy remains a public health challenge, especially in Eastern Europe. Our study used a sample of essential workers living in the Republic of North Macedonia to: (1) Describe rates of vaccine hesitancy and risk perception of COVID-19; (2) Explore predictors of vaccine hesitancy; and (3) Describe the informational needs of hesitant and non-hesitant workers. A phone survey was administered in North Macedonia from 4–16 May 2021. Logistic regression explored associations of COVID-19 vaccine hesitancy with sociodemographic characteristics, non-COVID-19 vaccine hesitancy, previous diagnosis of COVID-19, and individual risk perception of contracting COVID-19. Chi-squared analyses compared differences in informational needs by hesitancy status. Of 1003 individuals, 44% were very likely to get the vaccine, and 56% reported some level of hesitancy. Older age, Albanian ethnicity, increased education, previous COVID-19 diagnosis, acceptance of other vaccines, and increased risk perception of COVID-19 infection were negatively associated with vaccine hesitancy. Results indicated significant differences in top informational needs by hesitancy status. The top informational needs of the hesitant were the freedom to choose to be vaccinated without consequences (57% vs. 42%, p p < 0.01)

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes treatment (n = 769).

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes treatment (n = 769).</p

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes prevalence (n = 3,685).

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes prevalence (n = 3,685).</p

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes awareness (n = 830).

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes awareness (n = 830).</p

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes control (n = 629).

Prevalence Ratios (PR) and Standard Errors (SE) for diabetes control (n = 629).</p

Healthrise diabetes dataset noPII.

South Africa is experiencing a rapidly growing diabetes epidemic that threatens its healthcare system. Research on the determinants of diabetes in South Africa receives considerable attention due to the lifestyle changes accompanying South Africa’s rapid urbanization since the fall of Apartheid. However, few studies have investigated how segments of the Black South African population, who continue to endure Apartheid’s institutional discriminatory legacy, experience this transition. This paper explores the association between individual and area-level socioeconomic status and diabetes prevalence, awareness, treatment, and control within a sample of Black South Africans aged 45 years or older in three municipalities in KwaZulu-Natal. Cross-sectional data were collected on 3,685 participants from February 2017 to February 2018. Individual-level socioeconomic status was assessed with employment status and educational attainment. Area-level deprivation was measured using the most recent South African Multidimensional Poverty Index scores. Covariates included age, sex, BMI, and hypertension diagnosis. The prevalence of diabetes was 23% (n = 830). Of those, 769 were aware of their diagnosis, 629 were receiving treatment, and 404 had their diabetes controlled. Compared to those with no formal education, Black South Africans with some high school education had increased diabetes prevalence, and those who had completed high school had lower prevalence of treatment receipt. Employment status was negatively associated with diabetes prevalence. Black South Africans living in more deprived wards had lower diabetes prevalence, and those residing in wards that became more deprived from 2001 to 2011 had a higher prevalence diabetes, as well as diabetic control. Results from this study can assist policymakers and practitioners in identifying modifiable risk factors for diabetes among Black South Africans to intervene on. Potential community-based interventions include those focused on patient empowerment and linkages to care. Such interventions should act in concert with policy changes, such as expanding the existing sugar-sweetened beverage tax.</div