American Journal of Health Studies

Geographic Coterminous of COVID-19 Case and Vaccination Centers in the Greater Accra Metropolitan Area, Ghana

Clement Kwang — 2023-12-31

Ghana was the first country globally to receive about 600,000 Oxford-AstraZeneca vaccine doses from the WHO-backed Covax program in February 2021. Ghana’s initial plan was to vaccinate about two-thirds of its adult population by the end of October 2021. This necessitated the selection of vaccination centers across the country. This study analyzed vaccination centers location against other factors, including COVID-19 cases, population density, and poverty level to assess the efficiency of each center's location in Greater Accra Metropolitan Area (GAMA). Our study applied spatial-analytical techniques to access the spatial coterminous distribution of COVID-19 cases with vaccination centers within GAMA. Hotspot analysis of cases was performed using kernel density tool and compared to hotspots of vaccination centers. Nearest neighbor analysis and error differential ellipse were performed to access the spatial pattern of the distribution of COVID-19 vaccination centers within the GAMA. This study revealed three local clusters of COVID-19 cases in Tema East municipality, Ayawaso Central, and Ablekuma West; three vaccination hotspots, found in Ashaiman, Madina, and Ayawaso
Central localities. COVID-19 case clusters are not coterminous with vaccination centers. The top three vaccination clusters were found in Ashiaman, Madina-La Nkwantanan, and Kpone-Katamanso which are inhabited by indigenous populations and also recorded the lowest COVID-19 cases. Tema East and Ayawaso East, which have the highest number of COVID-19 cases, recorded the lowest number of vaccination centers. We conclude that need-based allocation is lacking in the distribution of vaccination centers, which partly affects the equitable access and spatial distribution of COVID-19 vaccines.

Exploring Career Motivations and Concerns of Registered Nurses in New York State

Phoebe M. Massimino — 2023-12-31

Given the central role of nurses in our healthcare system for quality medical care, patient safety and ensuring optimal patient outcomes, it is important to understand their career motivations and work-related concerns. While the profession has been in existence for centuries, exploring current career motivations and work-related concerns is a key aspect of keeping the profession staffed and satisfied. A cross-sectional online survey was conducted with a convenience sample of 211 Registered Nurses (RNs) in New York State. This study sought to identify the motivation to pursue a career in nursing, including a career as an RN, as well as current work-related concerns in their primary nursing position. Personal motivators (predominantly the desire to help others) ranked as the principal reason for choosing the profession (63.8%) among respondents. Employment motivators (including job security, benefits and monetary reasons) ranked second (28.2%), and Lifestyle motivators (including hours and schedules) ranked third (8.0%). Statistical analysis examined the associations between variables of interest. Results revealed consistency across subgroups of RNs for both career motivations and current work concerns. Analyses were conducted to determine whether nurse career motivations and current work concerns differ by: demographics; education and training; licensure and employment. In consideration of the current and worsening nursing shortage, nurse attrition and retention strategies were explored within the context of nurse motivations and concerns. Understanding the career motivations and work concerns of RNs can advise both academia and healthcare employers regarding recruitment and retention strategies to ensure proper staffing for these essential healthcare workers.

Factors Associated with Condom Use among Community College Students

Danielle Colayco — 2023-12-31

The incidence and prevalence of sexually transmitted infections (STIs) have increased over the past decade, with half of all new diagnoses occurring in young people ages 15-24 years. Despite the risk, college students report low rates of condom use during sex. This study investigated factors associated with condom use in college students with the intent to inform health education strategies. In this cross-sectional study, a 40-item survey was administered to a random sample of classes at a community college in Central California. A total of 883 students participated. A multivariate logistic regression model identified factors associated with condom use, controlling for demographics, knowledge, and perceptions about sexually transmitted infections (STIs) and condoms.Hispanic/Latino respondents had higher rates of condom use compared to non-Hispanic/Latinos, as did non-White respondents compared to White respondents, non-females, and individuals who were not in a relationship. Regression results revealed that assertive negotiation (i.e., directly requesting to use condoms) was the most significant influencer of condom use. STI knowledge was not associated with condom use, nor was perceived seriousness or susceptibility to STIs.While traditional health promotion programs focus on knowledge and access to condoms, these results suggest that additional factors influence condom use, including the ability to directly request condom use with partners. In addition to topics such as STIs, contraception, and pregnancy, comprehensive sexual health education should also include communication and negotiation strategies between partners, through a lens that includes all sexualities and gender identities.

Symptom Screenings and Surveillance Testing for COVID-19 in University Athletes

Michelle Boyd — 2023-12-31

The Coronavirus disease (COVID-19) pandemic presented prevention, screening, and mitigation challenges for public and primary healthcare, including university athletics. During 2020-21, student-athletes at a medium-sized university were required to undergo a COVID-19 screening program [symptom screening/surveillance testing] as a condition of athletic participation.To determine the effectiveness of the screening program in identifying athletes in this population with a COVID-19 diagnosi, prior to every athletic encounter, all 334 student-athlete participants reported any COVID-19 symptoms to the athletic training staff, body temperature was measured, and participants from three teams were randomly selected for an additional anosmia screening. All participants were subject to COVID-19 surveillance testing. For each participant, results of each element of the screening and testing processes were recorded in their electronic medical record and cross-referenced with any positive COVID-19 medical diagnosis. From 2025 surveillance tests conducted, only 32 participants tested positive. Of those, 25 (78%) experienced and reported COVID-19 symptoms to the athletic trainer immediately before testing. Only
seven (.035%) were captured as pre-symptomatic positive tests. One hundred ten athletes who experienced symptoms, however, did not participate in an athletic encounter that day but instead self-admitted to the university health center for testing. All 110 tested positive at the health center. Experiencing and reporting COVID-19 symptoms appeared effective, and COVID-19 surveillance testing appeared ineffective, as detection measures in this study. Due to the extensive and costly resources needed, the decision to continue to implement these processes in the future will be difficult.