Department of Nursing Instruction, College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.
Res Nurs Health. 2021 Oct;44(5):767-775. doi: 10.1002/nur.22167. Epub 2021 Jul 5.
The COVID-19 pandemic has had devastating effects on Black and rural populations with a mortality rate among Blacks three times that of Whites and both rural and Black populations experiencing limited access to COVID-19 resources. The primary purpose of this study was to explore the health, financial, and psychological impact of COVID-19 among rural White Appalachian and Black nonrural central Kentucky church congregants. Secondarily we sought to examine the association between sociodemographics and behaviors, attitudes, and beliefs regarding COVID-19 and intent to vaccinate. We used a cross sectional survey design developed with the constructs of the Health Belief and Theory of Planned Behavior models. The majority of the 942 respondents were ≥36 years. A total of 54% were from central Kentucky, while 47.5% were from Appalachia. Among all participants, the pandemic worsened anxiety and depression and delayed access to medical care. There were no associations between sociodemographics and practicing COVID-19 prevention behaviors. Appalachian region was associated with financial burden and delay in medical care (p = 0.03). Appalachian respondents had lower perceived benefit and attitude for COVID-19 prevention behaviors (p = 0.004 and <0.001, respectively). Among all respondents, the perceived risk of contracting COVID was high (54%), yet 33.2% indicated unlikeliness to receive the COVID-19 vaccine if offered. The COVID-19 pandemic had a differential impact on White rural and Black nonrural populations. Nurses and public health officials should assess knowledge and explore patient's attitudes regarding COVID-19 prevention behaviors, as well as advocate for public health resources to reduce the differential impact of COVID-19 on these at-risk populations.
COVID-19 大流行对黑人和农村人口造成了毁灭性的影响，黑人的死亡率是白人的三倍，农村和黑人人口获得 COVID-19 资源的机会有限。本研究的主要目的是探讨农村白人阿巴拉契亚人和黑人非农村肯塔基州中部教堂会众中 COVID-19 的健康、财务和心理影响。其次，我们试图研究社会人口统计学与行为、对 COVID-19 的态度和信念以及接种疫苗的意愿之间的关系。我们使用了横断面调查设计，该设计是基于健康信念和计划行为理论模型的结构制定的。在 942 名受访者中，大多数人年龄在 36 岁以上。共有 54%的人来自肯塔基州中部，而 47.5%的人来自阿巴拉契亚地区。在所有参与者中，大流行加剧了焦虑和抑郁，并延迟了获得医疗的机会。社会人口统计学与实践 COVID-19 预防行为之间没有关联。阿巴拉契亚地区与经济负担和医疗延迟有关（p=0.03）。阿巴拉契亚地区的受访者对 COVID-19 预防行为的感知益处和态度较低（p=0.004 和 <0.001）。在所有受访者中，感染 COVID 的风险很高（54%），但如果提供 COVID-19 疫苗，仍有 33.2%的人表示不太可能接种。COVID-19 大流行对白人农村和黑人非农村人口产生了不同的影响。护士和公共卫生官员应评估知识，并探讨患者对 COVID-19 预防行为的态度，以及倡导公共卫生资源，以减少 COVID-19 对这些高危人群的不同影响。
