Community-Centered Assessment to Inform Pandemic Response in Georgia (US)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Survey Instrument Development
2.2. Sampling Plan
Sample Size and Precision of Estimates Considerations
- Characteristics of the survey respondents
- COVID-19 testing and/or vaccination behaviors
- COVID-19 knowledge
- Attitudes and behavior towards testing and vaccination
- Intent to vaccinate
- Level of trust towards personal, health/medical, state, and federal entities
2.3. Statistical Analyses
3. Results
3.1. Sample Characteristics
Participants’ Characteristics by Ethnicity/Race
3.2. COVID-19-Related Trusted Source of Information and Knowledge
3.2.1. Trusted Sources of Information
3.2.2. Trusted Sources by Ethnicity/Race
3.2.3. Predictors of COVID-19 Trusted Sources of Information
3.3. COVID-19 Related Knowledge
Predictors of COVID-19 Related Knowledge
3.4. COVID-19 Testing and Vaccination by Key Covariates
Knowledge and Trust Vis-a-Vis Testing and Vaccination
4. Discussion
4.1. COVID-19-Related Knowledge
4.2. Vaccination Predictors
4.3. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Hispanic, White (n = 528) | Non-Hispanic, Black (n = 744) | Hispanic, Black (n = 729) | Total (n = 2001) | p-Value |
---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | ||
Age-group | |||||
18–30 years | 292 (55.3) | 279 (37.5) | 414 (56.8) | 985 (49.2) | <0.001 |
31–40 years | 199 (37.7) | 293 (39.4) | 260 (35.7) | 752 (37.6) | |
Older than 40 years | 37 (7.0) | 172 (23.1) | 55 (7.5) | 264 (13.2) | |
Sex | |||||
Man | 330 (62.5) | 320 (43.0) | 493 (67.6) | 1143 (57.1) | <0.001 |
Woman | 198 (37.5) | 424 (57.0) | 236 (32.4) | 858 (42.9) | |
Education level | |||||
High school or less | 158 (29.9) | 162 (21.8) | 197 (27.0) | 517 (25.8) | 0.003 |
College or higher | 370 (70.1) | 582 (78.2) | 532 (73.0) | 1484 (74.2) | |
Employment status | |||||
Unemployed ¥ | 58 (11.0) | 112 (15.1) | 72 (9.9) | 242 (12.1) | 0.006 |
Employed | 470 (89.0) | 632 (85.0) | 657 (90.1) | 1759 (87.9) | |
Ever tested for COVID-19 | |||||
No | 49 (9.3) | 135 (18.2) | 72 (9.9) | 256 (12.8) | <0.001 |
Yes | 479 (90.7) | 609 (81.9) | 657 (90.1) | 1745 (87.2) | |
Vaccination status | |||||
No dose of vaccination | 100 (18.9) | 234 (31.5) | 312 (42.8) | 646 (32.3) | <0.001 |
Partially vaccinated | 105 (19.9) | 131 (17.6) | 169 (23.2) | 405 (20.2) | |
Fully vaccinated | 323 (61.2) | 379 (50.9) | 248 (34.0) | 950 (47.5) | |
Total household incomeǂ | |||||
Less than USD 35,000 | 153 (29.1) | 206 (27.7) | 192 (26.4) | 551 (27.6) | <0.001 |
USD 35,000–<USD 50,000 | 205 (39.1) | 179 (24.1) | 271 (37.2) | 655 (32.8) | |
USD 50,000–<USD 75,000 | 141 (26.9) | 224 (30.1) | 169 (23.2) | 534 (26.7) | |
≥USD 75,000 | 24 (4.6) | 114 (15.3) | 91 (12.5) | 229 (11.5) | |
Prefer not to answer | 2 (0.4) | 21 (2.8) | 5 (0.7) | 28 (1.4) | |
Perceived risk of getting COVID-19 ǂ | |||||
High risk | 37 (7.1) | 66 (8.9) | 56 (7.7) | 159 (8.0) | <0.001 |
Moderate risk | 162 (30.9) | 238 (32.0) | 177 (24.3) | 577 (28.9) | |
Low risk | 218 (41.5) | 304 (40.9) | 290 (39.8) | 812 (40.6) | |
No risk | 84 (16.0) | 58 (7.8) | 91 (12.5) | 233 (11.7) | |
Do not know /No opinion | 14 (2.7) | 47 (6.3) | 103 (14.1) | 164 (8.2) | |
Not applicable /Refused | 0 (0.0) | 14 (1.9) | 7 (1.0) | 21 (1.1) | |
I’ve previously tested positive for COVID-19 | 10 (1.9) | 17 (2.3) | 5 (0.7) | 32 (1.6) |
Trust Sources | Hispanic, White (n = 454) | Non-Hispanic, Black (n = 427) | Hispanic, Black (n = 560) | Total (n = 1441) | p-Value |
---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | ||
Doctor or health care provider | |||||
Not at all | 37 (8.2) | 32 (7.5) | 62 (11.1) | 131 (9.1) | 0.037 |
A little | 189 (41.6) | 154 (36.1) | 189 (33.8) | 532 (36.9) | |
A great deal | 228 (50.2) | 241 (56.4) | 309 (55.2) | 778 (54.0) | |
Faith leader (e.g., pastor/priest) | |||||
Not at all | 76 (16.7) | 74 (17.3) | 76 (13.6) | 226 (15.7) | 0.171 |
A little | 202 (44.5) | 174 (40.8) | 269 (48.0) | 645 (44.8) | |
A great deal | 176 (38.8) | 179 (41.9) | 215 (38.4) | 570 (39.6) | |
Close friends /family members | |||||
Not at all | 44 (9.7) | 50 (11.7) | 50 (8.9) | 144 (10.0) | <0.001 |
A little | 144 (31.7) | 192 (45.0) | 216 (38.6) | 552 (38.3) | |
A great deal | 266 (58.6) | 185 (43.3) | 294 (52.5) | 745 (51.7) | |
People you go to work/class with | |||||
Not at all | 54 (11.9) | 75 (17.6) | 62 (11.1) | 191 (13.3) | <0.001 |
A little | 180 (39.7) | 202 (47.3) | 305 (54.5) | 687 (47.7) | |
A great deal | 220 (48.5) | 150 (35.1) | 193 (34.5) | 563 (39.1) | |
News on radio /TV/online /newspapers | |||||
Not at all | 52 (11.5) | 69 (16.2) | 50 (8.9) | 171 (11.9) | <0.001 |
A little | 165 (36.3) | 200 (46.8) | 286 (51.1) | 651 (45.2) | |
A great deal | 237 (52.2) | 158 (37.0) | 224 (40.0) | 619 (43.0) | |
Contacts on social media | |||||
Not at all | 58 (12.8) | 117 (27.4) | 66 (11.8) | 241 (16.7) | <0.001 |
A little | 185 (40.8) | 180 (42.2) | 314 (56.1) | 679 (47.1) | |
A great deal | 211 (46.5) | 130 (30.4) | 180 (32.1) | 521 (36.2) | |
The U.S. Government | |||||
Not at all | 44 (9.7) | 61 (14.3) | 37 (6.6) | 142 (9.9) | <0.001 |
A little | 142 (31.3) | 210 (49.2) | 252 (45.0) | 604 (41.9) | |
A great deal | 268 (59.0) | 156 (36.5) | 271 (48.4) | 695 (48.2) | |
The U.S. Coronavirus Task Force | |||||
Not at all | 45 (9.9) | 44 (10.3) | 36 (6.4) | 125 (8.7) | <0.001 |
A little | 135 (29.7) | 153 (35.8) | 147 (26.3) | 435 (30.2) | |
A great deal | 274 (60.4) | 230 (53.9) | 377 (67.3) | 881 (61.1) |
Trust Questions | Covariate Predictors of Trust vs. the Reference Group | Odds Ratio (95% CI) of Bestowing Higher Level of Trust | p-Value for Testing Similarity of the OR to that of the Reference Group | Interpretation |
---|---|---|---|---|
How much do you trust your doctor/health provider | 18–30 y vs. 40+ 30–40 y vs. 40+ women vs. men | 0.3 (0.2, 0.5) 0.3 (0.2, 0.5) 0.2 (0.2, 0.4) | <0.000 <0.0001 0.0078 | Separately, younger and women respondents are 70–80% less likely to trust their doctor/health care |
How much do you trust your faith leader | College/higher vs. HS | 0.6 (0.5, 0.8) | 0.0008 | Responders with college degree or higher are 40% less likely to trust their faith leader |
How much do you trust your friends and family members | 18–30 y vs. 40+ Latinx/non-Latinx, Black vs. Latinx, White women vs. men | 1.8 (1.2,2.6) 0.4 (0.3,0.6) 0.4 (0.2,0.7) | 0.0038 <0.0001 <0.0001 | Younger respondents are 1.8-fold more likely to trust their friends, but women and AA/Blacks are each 60% less likely to trust their friends. |
How much do you trust News on the radio/TV/online | Latinx/non-Latinx, Black vs. Latinx, White College/higher vs. HS | 0.6 (0.4, 0.9) 0.7 (0.5, 0.9) | 0.0188 0.009 | Latinx/non-Latinx, Blacks and higher educated respondents are 30–40% less likely to trust news/media and internet news |
How much do you trust people you go to work or class with or other people you know | 18–30 y vs. 40+ 30–40 y vs. 40+ Latinx/non-Latinx, Black vs. Latinx, White Latinx, other race vs. Latinx, White College/higher vs. HS | 2.3 (1.6, 3.4) 2.1 (1.4, 3.0) 0.7 (0.4, 0.9) 0.3 (0.1, 0.9) 0.7 (0.5, 0.9) | <0.0001 0.0002 0.0247 0.0281 0.005 | While younger respondents are more than twice as likely to trust people at work/class, Latinx/non-Latinx, Blacks and higher educated respondents are between 70% and 30% less likely to bestow that trust |
How much do you trust your contacts in social media | 30–40 y vs. 40+ Latinx/non-Latinx, Black vs. Latinx, White women vs. men | 1.9 (1.3, 2.8) 0.6 (0.4, 0.8) 0.7 (0.6, 0.9) | 0.0006 0.0045 0.0136 | While younger respondents are 90% more likely to trust their contacts in social media, Latinx /non-Latinx, Blacks and women are between 30 and 40% less likely to trust them. |
How much do you trust the US government | Latinx/non-Latinx, Black vs. Latinx, White women vs. men College/higher vs. HS | 0.5 (0.4, 0.8) 0.7 (0.5, 0.8) 0.7 (0.5, 0.98) | 0.0007 0.0009 0.0337 | Separately, Latinx /non-Latinx, Blacks, women and higher educated respondents are between 50 and 30% less likely to trust the US government |
How much do you trust the US Coronavirus Task Force | women vs. men | 0.7 (0.6, 0.95) | 0.0197 | Women are 30% less likely to trust the US coronavirus Task |
Statements | Covariate/Predictors vs. the Reference Group | Odds Ratio (95% CI) of Knowing the Correct Answer | p-Value for Testing Similarity of the OR to that of the Reference Group | Interpretation |
---|---|---|---|---|
Getting a vaccine protects you and means you cannot get the disease if exposed to it in the future | Age: 18–30 y vs. 40+ 30–40 y vs. 40+ | 2.2 (1.4, 3.2) 2.8 (1.9, 4.1) | <0.0002 <0.0001 | Younger (vs. older) respondents are at least 2× more likely to give the correct answer |
Getting a vaccine for a disease means you might get sick from the vaccine itself | Latinx/non-Latinx, Black vs. Latinx, White College/higher vs. HS | 0.60 (0.4, 0.8) 0.7 (0.5, 0.96) | 0.003 0.0272 | Latinx/non-Latinx, Black (vs. Latinx, White) and highly educated responders are, respectively, 1.7 and 1.4-fold more likely to answer this question correctly |
Hydroxychloroquine is an effective treatment for COVID-19 | 18–30 y vs. 40+ 30–40 y vs. 40+ | 2.5 (1.6, 4.0) 2.7 (1.7, 4.1) | <0.0001 <0.0001 | Younger (vs. older) respondents are at least more than 2.5-fold more likely to give the correct answer |
Covariate/Predictor | Testing Odds Ratio (95% CI) p-Value | Interpretation | Vaccination Odds Ratio (95% CI) p-Value | Interpretation |
---|---|---|---|---|
COVID-19 spreads through coughing and sneezing (correct vs. not correct answer) | 1.4 (0.9, 2.1) 0.06 | Those who answered this question correctly were (marginally significant) 1.4× more likely to get tested (the sample is generally young and analysis adjusted for age, gender, employment, education, and race) | 1.3 (0.99, 1.6) 0.058 | Those who answered this question correctly were (marginally significant) 1.3× more likely to get vaccinated (the sample is generally young and analysis adjusted for age, gender employment, education, and race) |
Wearing a face mask helps in mitigating the spread of COVID-19 (correct vs. not correct answer) | 1.7 (1.2, 2.5) 0.0078 | Those who answered this question correctly were 1.7× more likely to get tested | N.S. | N/A |
Wearing a face mask may be harmful to your health | 0.6 (0.5, 0.9) 0.0192 | Those who did not answer this question correctly were 40% less likely to get tested | N.S. | N/A |
Employed vs. not employed | 2.3 (1.5, 3.4) <0.0001 | Those who were employed were 2.3× more likely to get tested | 1.8 (2.3, 2.5) 0.0001 | Those who were employed were 1.8× more likely to get vaccinated |
College/higher vs. High school/lower | 1.9 (1.4, 2.7) 0.0002 | Those who have college/higher education were 1.9× more likely to get tested | 1.5 (1.1, 2.0) 0.00053 | Those who have college/higher education were 1.5× more likely to get vaccinated |
Latinx/non-Latinx, Black vs. Latinx, White | 0.5 (0.33, 0.84) <0.0001 | Latinx/non-Latinx, Blacks were 50% less likely to get tested | 0.6 (0.4, 0.8) 0.004 | Latinx/non-Latinx, Blacks compared to Latinx, Whites were 40% less likely to get vaccinated |
Hydroxychloroquine is an effective treatment for COVID-19 | 0.6 (0.4, 0.9) 0.0104 | Those who did not answer this question correctly were 40% less likely to get tested | 0.7 (0.5, 0.9) 0.0006 | Those who answered this question incorrectly were 30% less likely to get vaccinated |
In the U.S. COVID-19 has affected Black Hispanic/ Latino and Native American populations at a higher rate than White populations | 0.7 (0.5, 0.9) 0.0188 | Those who answered this question incorrectly were 30% less likely to get tested | 0.7 (0.6, 0.97) 0.002 | Those who answered this question incorrectly were 30% less likely to get vaccinated |
Perception of COVID-19 Risk (high vs. low) | N.S. | N/A | 2.3 (1.2, 4.4) 0.01 | Those who perceived the risk of COVID-19 as high (vs. those who perceived it as low) were 2.3× more likely to get vaccinated |
Health Insurance | 2.6 (1.7, 4) <0.0001 | Those who had health insurance (vs. those who did not) were 2.6× more likely to get tested | 2.8 (1.8, 4.3) <0.0001 | Those who had health insurance (vs. those who did not) were 2.8× more likely to get vaccinated |
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Henry Akintobi, T.; Quarells, R.C.; Bednarczyk, R.A.; Khizer, S.; Taylor, B.D.; Nwagwu, M.N.A.; Hill, M.; Ordóñez, C.E.; Sabben, G.; Spivey, S.; et al. Community-Centered Assessment to Inform Pandemic Response in Georgia (US). Int. J. Environ. Res. Public Health 2023, 20, 5741. https://doi.org/10.3390/ijerph20095741
Henry Akintobi T, Quarells RC, Bednarczyk RA, Khizer S, Taylor BD, Nwagwu MNA, Hill M, Ordóñez CE, Sabben G, Spivey S, et al. Community-Centered Assessment to Inform Pandemic Response in Georgia (US). International Journal of Environmental Research and Public Health. 2023; 20(9):5741. https://doi.org/10.3390/ijerph20095741
Chicago/Turabian StyleHenry Akintobi, Tabia, Rakale C. Quarells, Robert A. Bednarczyk, Saadia Khizer, Brittany D. Taylor, Michelle N. A. Nwagwu, Mekhi Hill, Claudia E. Ordóñez, Gaëlle Sabben, Sedessie Spivey, and et al. 2023. "Community-Centered Assessment to Inform Pandemic Response in Georgia (US)" International Journal of Environmental Research and Public Health 20, no. 9: 5741. https://doi.org/10.3390/ijerph20095741