@Article{info:doi/10.2196/57798,
author="Zhang, Lingli
and Li, Xin
and Chen, Jiali
and Wang, Xiaoye
and Sun, Yuyang",
title="Public Preference and Priorities for Including Vaccines in China's National Immunization Program: Discrete Choice Experiment",
journal="JMIR Public Health Surveill",
year="2024",
month="Nov",
day="14",
volume="10",
pages="e57798",
keywords="discrete choice experiment",
keywords="national immunization program",
keywords="vaccines",
keywords="vaccination",
keywords="immunization",
keywords="public preferences",
keywords="China",
keywords="mixed logit model",
keywords="heterogeneity",
keywords="varicella",
keywords="public health",
keywords="infectious diseases",
abstract="Background: Several important vaccines, such as the Haemophilus influenzae type b vaccine, rotavirus vaccine, pneumococcal conjugate vaccine, and influenza vaccine, have not been included in China's National Immunization Program (NIP) due to a prolonged absence of updates and limited resources. Public engagement could identify concerns that require attention and foster trust to ensure continuous support for immunization. Objective: This study aimed to identify public preferences for vaccine inclusion in the NIP and to determine the desired vaccine funding priorities in the Chinese population. Methods: A dual-response discrete choice experiment was utilized to estimate the relative importance of 6 attributes, including incidence of vaccine-preventable diseases, mortality of vaccine-preventable diseases, vaccine effectiveness, vaccine cost, vaccinated group, and vaccine coverage. Participants were recruited through the Wenjuanxing platform using a census-based quota sample of the nationwide population aged 18 years and older. A mixed logit model was used to estimate the coefficient of attribute preferences and predict the selection probability. Subgroups and interaction effects were analyzed to examine the heterogeneity in preferences. Results: In total, 1258 participants completed the survey, of which 880 were involved in the main analysis and 1166 in the sensitivity analysis. The relative importance and model estimates of 2 attributes, vaccine cost and vaccination group, varied between the unforced- and forced-choice settings. All 6 vaccine attributes significantly influenced the preferences for vaccine inclusion, with vaccine effectiveness and coverage as the most important factors, followed by the vaccinated group and mortality of vaccine-preventable diseases in the unforced-choice settings. The top vaccines recommended for China's NIP included the varicella vaccine, Haemophilus influenzae type b vaccine, enterovirus 71 vaccine, and influenza vaccine for preschoolers and school-aged children. The current analysis also revealed distinct preference patterns among different subgroups, such as gender, age, education, and income. The interaction analysis indicated that the region and health status of participants contribute to preference heterogeneity. Conclusions: Public preferences for including vaccines in the NIP were primarily influenced by vaccine effectiveness and coverage. The varicella vaccine should be prioritized for inclusion in the NIP. The public preferences could provide valuable insights when incorporating new vaccines in the NIP. ",
doi="10.2196/57798",
url="https://publichealth.jmir.org/2024/1/e57798"
}



@Article{info:doi/10.2196/66452,
author="Nair, C. Satish",
title="Promoting Oral Health Literacy Among UAE Public Sector Employees",
journal="JMIR Public Health Surveill",
year="2024",
month="Nov",
day="12",
volume="10",
pages="e66452",
keywords="health literacy",
keywords="Gulf countries",
keywords="oral health literacy",
keywords="health promotion",
keywords="United Arab Emirates",
keywords="workplace",
doi="10.2196/66452",
url="https://publichealth.jmir.org/2024/1/e66452"
}


@Article{info:doi/10.2196/64270,
author="O'Dwyer, Brynn
and Jaana, Mirou
and Hui, Charles
and Chreim, Samia
and Ellis, Jennifer",
title="Digital Contact Tracing Implementation Among Leaders and Health Care Workers in a Pediatric Hospital During the COVID-19 Pandemic: Qualitative Interview Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Nov",
day="5",
volume="10",
pages="e64270",
keywords="COVID-19",
keywords="surveillance",
keywords="technology",
keywords="digital contact tracing",
keywords="qualitative",
keywords="hospitals",
keywords="Reach, Effectiveness, Adoption, Implementation, and Maintenance framework",
keywords="RE-AIM",
abstract="Background: Health systems had to rapidly implement infection control strategies to sustain their workforces during the COVID-19 pandemic. Various outbreak response tools, such as digital contact tracing (DCT), have been developed to monitor exposures and symptoms of health care workers (HCWs). Limited research evidence exists on the experiences with these technologies and the impacts of DCT innovations from the perspective of stakeholders in health care environments. Objective: This study aims to identify the factors influencing the adoption of DCT, highlight variations in perspectives across 3 key stakeholder groups concerning the impact of DCT, and provide benchmarking evidence for future pandemic preparedness. Methods: Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we conducted an exploratory qualitative study to investigate the implementation and impact of DCT at the Children's Hospital of Eastern Ontario between December 2022 and April 2023. We conducted 21 semistructured interviews with key stakeholders, including health care administrators (6/21, 29\%), occupational health and safety specialists (8/21, 38\%), and HCWs (7/21, 33\%). Stakeholders were asked about the factors influencing engagement with the DCT tool, organizational-level uptake, the implementation process, long-term use and sustainability of DCT, and unintended consequences. Verbatim transcripts were subject to thematic analysis using NVivo (QSR International). Results: The implementation of DCT was viable and well received. End users indicated that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk assessment consequences and access concerns were reported as barriers (reach). Participants commonly agreed that the DCT technology had a positive influence on the hospital's capacity to meet the demands of COVID-19 (effectiveness). Implementors and occupational specialists referred to negative staffing impacts and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a DCT tool that was human-centered were crucial factors driving staff adoption of the technology. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs' standard practices, alongside the evolving perceived threat of COVID-19. Stakeholders collectively agreed on the viability of DCT and its applicability to infectious disease practices (maintenance). Conclusions: Hospital stakeholders were highly satisfied with DCT technology and it was perceived as feasible, efficient, and having a positive impact on organizational safety. Challenges related to the alignment and delivery of DCT, alongside the evolving perspectives on COVID-19, posed obstacles to continued adoption by HCWs. Our findings contribute to evidence-based practices and present benchmarks that can inform preparedness for future pandemics and infectious disease outbreaks and help other organizations implement similar technologies. ",
doi="10.2196/64270",
url="https://publichealth.jmir.org/2024/1/e64270"
}


@Article{info:doi/10.2196/59690,
author="Dougherty, Kylie
and Gebremariam, Abebe
and Biza, Heran
and Belew, Mulusew
and Benda, Natalie
and Tesfaye, Yihenew
and Cranmer, John
and Bakken, Suzanne",
title="Obstetric Emergency Supply Chain Dynamics and Information Flow Among Obstetric Emergency Supply Chain Employees: Key Informant Interview Study",
journal="JMIR Form Res",
year="2024",
month="Sep",
day="5",
volume="8",
pages="e59690",
keywords="basic emergency obstetric care needs",
keywords="BEmOC",
keywords="supply chain",
keywords="Ethiopia",
keywords="Sociotechnical Model",
abstract="Background: For the past several decades, the Ethiopian Ministry of Health has worked to decrease the maternal mortality ratio (MMR)---the number of pregnant women dying per 100,000 live births. However, with the most recently reported MMR of 267, Ethiopia still ranks high in the MMR globally and needs additional interventions to lower the MMR to achieve the sustainable development goal of 70. One factor contributing to the current MMR is the frequent stockouts of critical medications and supplies needed to treat obstetric emergencies. Objective: This study describes the obstetric emergency supply chain (OESC) dynamics and information flow in Amhara, Ethiopia, as a crucial first step in closing stockouts and gaps in supply availability. Methods: Applying qualitative descriptive methodology, the research team performed 17 semistructured interviews with employees of the OESC at the federal, regional, and facility level to describe and gain an understanding of the system in the region, communication flow, and current barriers and facilitators to consistent emergency supply availability. The team performed inductive and deductive analysis and used the ``Sociotechnical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems'' to guide the deductive portion. Results: The interviews identified several locations within the OESC where barriers could be addressed to improve overall facility-level readiness, such as gaps in communication about supply needs and availability in health care facilities and regional supply hubs and a lack of data transparency at the facility level. Ordering supplies through the integrated pharmaceutical logistics system was a well-established process and a frequently noted strength. Furthermore, having inventory data in one place was a benefit to pharmacists and supply managers who would need to use the data to determine their historic consumption. The greatest concern related to the workflow and communication of the OESC was an inability to accurately forecast future supply needs. This is a critical issue because inaccurate forecasting can lead to undersupplying and stockouts or oversupplying and waste of medication due to expiration. Conclusions: As a result of these interviews, we gained a nuanced understanding of the information needs for various levels of the health system to maintain a consistent supply of obstetric emergency resources and ultimately increase maternal survival. This study's findings will inform future work to create customized strategies that increase supply availability in facilities and the region overall, specifically the development of electronic dashboards to increase data availability at the regional and facility levels. Without comprehensive and timely data about the OESC, facilities will continue to remain in the dark about their true readiness to manage basic obstetric emergencies, and the central Ethiopian Pharmaceutical Supply Service and regional hubs will not have the necessary information to provide essential emergency supplies prospectively before stockouts and maternal deaths occur. ",
doi="10.2196/59690",
url="https://formative.jmir.org/2024/1/e59690",
url="http://www.ncbi.nlm.nih.gov/pubmed/39235860"
}