Ziolkowski Rebecca A, Balian Lara, Sridhar Shreya, Rodriguez Natalia M
Department of Public Health, Purdue University, West Lafayette, Indiana, USA.
Department of Public Health, Purdue University, West Lafayette, Indiana, USA
BMJ Open. 2024 Dec 10;14(12):e087134. doi: 10.1136/bmjopen-2024-087134.
Access to healthcare and accurate health information is a persistent issue for people experiencing homelessness (PEH), one heightened by the COVID-19 pandemic and exacerbated by issues of health literacy and mistrust. Strategies involving community health workers (CHWs) have the potential to improve education and service delivery for PEH. The objective of this study is to assess PEH knowledge, attitudes and barriers to COVID-19 testing and vaccination, and the impact of CHW-led education within a homeless shelter in Indiana.
DESIGN/SETTING: Between November 2021 and April 2022, 15 sessions were held at a homeless shelter that combined focus group discussions with COVID-19-related education. Pre-/post-tests measured knowledge gains and attitude shifts among PEH. Guided by the socioecological model, thematic analysis of focus group transcripts identified key motivators and barriers to COVID-19 vaccination and testing.
78 PEH (73% male, 74% white, mean age=48).
COVID-19-related knowledge gains and willingness to receive testing and vaccination among PEH.
Completion of an educational session was associated with a significant increase in knowledge scores (mean pre-test score=10.76/15, SD=2.16; mean post-test score=13.58/15, SD=1.72; p<0.001), with most participants (91%) improving by up to 10 points. The proportion of unvaccinated participants (42%) willing to be vaccinated increased from 21% to 39%. Participants willing to get tested for COVID-19 after a known exposure increased from 83% to 92%. Qualitative findings from the sessions provided insights into key knowledge gaps and revealed participant preferences towards health education format and topics.
CHW-led COVID-19 education increased knowledge gains and positively influenced attitudes towards vaccination and testing among PEH. Findings highlight the importance of tailored, community-driven interventions for pandemic response and emphasise the crucial role of education in building trust and promoting health literacy to improve health outcomes for vulnerable populations.
对于无家可归者而言，获得医疗保健服务和准确的健康信息一直是个问题，在新冠疫情期间这一问题更加突出，同时还因健康素养和不信任问题而加剧。涉及社区卫生工作者的策略有可能改善为无家可归者提供的教育和服务。本研究的目的是评估印第安纳州一家收容所内无家可归者对新冠病毒检测和疫苗接种的知识、态度和障碍，以及社区卫生工作者主导的教育所产生的影响。
设计/背景：2021年11月至2022年4月期间，在一家收容所举办了15场活动，将焦点小组讨论与新冠病毒相关教育相结合。通过前后测试来衡量无家可归者的知识增长和态度转变。在社会生态模型的指导下，对焦点小组记录进行主题分析，确定了新冠病毒疫苗接种和检测的关键动机和障碍。
78名无家可归者（73%为男性，74%为白人，平均年龄48岁）。
无家可归者的新冠病毒相关知识增长以及接受检测和接种疫苗的意愿。
完成一次教育活动与知识得分显著提高相关（测试前平均得分=10.76/15，标准差=；测试后平均得分=13.58/15，标准差=1.72；p < 0.001），大多数参与者（91%）提高了10分。未接种疫苗的参与者中愿意接种疫苗的比例从21%增至39%。在已知接触新冠病毒后愿意接受检测的参与者从增至92%。活动的定性结果提供了对关键知识差距的见解，并揭示了参与者对健康教育形式和主题的偏好。
社区卫生工作者主导的新冠病毒教育增加了知识增长，并对无家可归者对疫苗接种和检测的态度产生了积极影响。研究结果凸显了针对疫情应对的量身定制、社区驱动干预措施的重要性，并强调了教育在建立信任和提高健康素养以改善弱势群体健康结果方面的关键作用。 2.16
