Public Health Lessons for Non-Vaccine Influenza Interventions Looking Past COVID-19 (2022) / Chapter Skim
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4 Implementation of Non-Vaccine Control Measures
4 Implementation of Non-Vaccine Control Measures
Pages 97-124
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From page 97... ...
For example, the Ebola outbreaks highlighted the critical need for community engagement, clear and coordinated risk communications, and avoidance of contradictory messaging. But while countless reports were written about these experiences in the years following, those approaches were not immediately used when the COVID-19 pandemic began.
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From page 98... ...
how evidence-based communication strategies can promote population uptake of recommended measures, and (3) how a rapid, coordinated government response bolstered by strong and consistent leadership can catalyze a positive response to public health interventions.
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From page 99... ...
A study in the United States that used cell-phone location data to gauge adherence to physical distancing directives demonstrated the influence of belief in science on the adoption of COVID-19-containment measures; the researchers found that the proportion of people adhering to lockdown policies was significantly lower in areas with large proportions of climate change skeptics (Brzezinski et al., 2020)
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From page 100... ...
This research could focus on the interplay between epidemics and religious groups and their gatherings and the positive and negative influences of religion on a community's response to an epidemic and adherence to public health interventions. Social and Structural Determinants of Health Along with social and cultural values, strategies for successful implementation of non-vaccine control interventions should take into account the critical variables of community-specific social and structural determinants
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From page 101... ...
The pandemic has also exacerbated the confluence of factors driving health inequities that some communities -- typically defined by race, ethnicity, and socioeconomic status -- have experienced for generations. During the pandemic, this confluence of factors driving health inequities has heightened the risk of exposure to the virus due to occupational or living conditions and led to greater prevalence of noncommunicable diseases that increases the rates of severe disease and mortality due to COVID-19 in adversely affected groups (Maani et al., 2021)
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From page 102... ...
. Growing urbanization in countries such as Kenya, Tanzania, and Uganda and increases the number of people per household; it is estimated that in 57 percent of urban households, residents share a single room and thus are unable to practice physical distancing and other prevention measures implemented in other countries (Lirri, 2020; Wayomi et al., 2021)
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From page 103... ...
They also suggested potential strategies to address the factors, such as task shifting from clinicians to community health workers and community-based engagement to lessen the burden on the health sector. Numerous innovations developed in Africa, such as low-cost rapid test kits or locally manufactured ventilators, can be leveraged by putting them in the hands of the right workforce.
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From page 104... ...
BOX 4-2 Examples of Research and Programmatic Opportunities for Communication Approaches • Analyzing the positive and negative impacts of using mass media as a plat form for public health communication. • Gathering data on the public's understanding of, and adherence to, pub lic health guidance to formulate public health policies and communication strategies.
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From page 105... ...
. These findings suggest that the most effective strategies and channels of communication about public health measures vary according to a range of factors.
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From page 106... ...
Lastly, social and societal values and the population's trust in leadership and science, as discussed later in this chapter, can greatly impact uptake of preventive public health measures. Understanding Public Perceptions of Interventions A wealth of data is available from online sources that could be leveraged to better understand the public's perceptions about interventions in order to inform and refine communication strategies.
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From page 107... ...
Developing Community-Focused Communication Strategies The community should play an active -- rather than passive -- role in the response to an infectious disease outbreak or other public health emergency. Developing community-focused communication strategies can help foster community engagement and encourage adherence to non-vaccine control interventions.
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From page 108... ...
, they have not been fully optimized during the COVID-19 pandemic. A rapid review of evidence examined the use of community engagement in infection prevention and control during past epidemics, identifying five key functions: (1)
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From page 109... ...
In some cases, the new information may conflict with the previous findings and guidance, challenging the public's trust, but clear methods for communicating this have not been identified. Also lacking in research are the positive and negative impacts of using mass media as a platform for public health communications (Anwar et al., 2020)
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From page 110... ...
Both WHO's Independent Panel for Pandemic Preparedness and Response and the Lancet COVID-19 Commission Task Force for Public Health Measures to Suppress the Pandemic found that in successful countries, governments acted early and were proactive, whereas those that were unsuccessful were delayed in their response or denied the severity of COVID-19 (Lee et al., 2021; Sirleaf and Clark, 2021)
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From page 111... ...
. In addition to strong leadership, building public trust is crucial to ensuring compliance with non-vaccine control interventions.
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An example is using public health measures that require physical distancing despite adverse impacts on the local retail economy (Evans and Hagittai, 2020; Pagliaro et al., 2021)
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. It has been suggested that at the outset of an outbreak, the least restrictive and most effective public health measures should be implemented first, rather than restrictive measures that have an adverse effect on adherence and can undermine human rights (Georgieva et al., 2021)
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. In another cross-sectional study that surveyed adults in North America and Europe about barriers and facilitators of adherence to physical distancing measures, the most frequently stated barriers included (1)
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. The application of implementation science and frameworks could enhance the creation and uptake of non-vaccine control interventions and the management of the resource shortages that have hampered public health interventions worldwide during the COVID-19 pandemic.
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From page 116... ...
and national governments, including their local and state health agencies, should adopt policies that are tailored to each affected population, taking into account its social, economic, and cultural characteristics, needs and resources, and other contextual factors, including norms, values, and beliefs, in order to optimize the implementation of public health interventions, especially those that rely on individual behaviors.
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From page 117... ...
Recommendation 4-2: Governments, leaders of departments of health at local, state, and national levels, and elected and appointed govern ment leaders should: • Take the systemic factors, such as race and socioeconomic dis advantages that affect the health of affected populations, into consideration and leverage behavioral health research and mar keting tactics when developing and implementing public health interventions; • Demonstrate, in their behavior, adherence to non-vaccine mea sures to prevent influenza in order to promote public trust in, and uptake of, these measures; • Engage the community -- including grassroots organizations, spiritual leaders, teachers, and sports coaches -- in making and communicating decisions about public health measures; and • Choose words to convey communications positively (e.g., "physical distancing," "social solidarity," and "stay at home" rather than "social distancing," "individual isolation," and "lockdown")
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From page 118... ...
Recommendation 4-4: National governments -- as well as local, state, and global public health agencies -- should develop readily imple mentable intervention plans for outbreaks of influenza and other diseases. Such plans should specify how, from the beginning of an outbreak, the government will • Take into consideration the needs of the population affected, with special attention to the needs of marginalized groups; • Iteratively collect and use data about the implementation and effectiveness of non-vaccine control measures to adapt plans where needed; and • Use proven scientific frameworks to guide and improve such measures.
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From page 119... ...
2017. Public health and public trust: Survey evi dence from the Ebola Virus Disease epidemic in Liberia.
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2020. Public perceptions and attitudes to ward COVID-19 nonpharmaceutical interventions across six countries: A topic modeling analysis of Twitter data.
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From page 121... ...
2021. Institutional and behaviour-change interven tions to support COVID-19 public health measures: A review by the Lancet Commission Task Force on Public Health Measures to Suppress the Pandemic.
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2020. Leveraging media and health communication strategies to overcome the COVID-19 infodemic.
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2021. Addressing health and social care during and beyond COVID-19: The im portance of implementation science.
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International Journal for Environmental Research and Public Health 18(2)
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