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Jo S, Han SY, Howe N. Factors Associated with Handwashing Behaviors During the COVID-19 Pandemic: An Analysis of the Community Health Survey in Korea. SAGE Open Nurs 2023; 9:23779608231172364. [PMID: 37139169 PMCID: PMC10150421 DOI: 10.1177/23779608231172364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Handwashing is the most effective preventive behavior for coronavirus disease-19 (COVID-19) infection. However, research has shown the lower handwashing behaviors among Korean adults. Objectives This study aims to analyze factors associated with handwashing as a preventive behavior for COVID-19 infection based on the health belief model (HBM) and the theory of planned behavior (TPB) behavioral theories. Methods This secondary data analysis utilized the Community Health Survey developed by Disease Control and Prevention Agency conducted in 2020. Sampling method was stratified and targeted 900 people living in the territory of each community public health center. In total, 228,344 cases were used in the analysis. Handwashing behavior, perceived susceptibility, perceived severity, subjective norm, and influenza vaccine uptake were used in the analysis. Regression analysis using weighing strategy by stratification and domain analysis was used. Results Less washing hand was associated with older age (B = 0.01, p < .001), males (B = 0.42, p < .001), not receiving an influenza vaccine (B = 0.09, p < .001), perceived susceptibility (B = 0.12, p < .001), subjective norm (B = 0.05, p < .001), and perceived severity (B = -0.04, p < .001). Conclusion While perceived susceptibility and social norm had positive association, perceived severity had a negative association with handwashing. Considering the Korean culture, creating a shared norm for frequent handwashing could be beneficial to promote handwashing rather than emphasizing the disease and its consequences.
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Affiliation(s)
- Soojung Jo
- School of Nursing, Purdue University, West Lafayette, IN, USA
| | - Soo-Yeon Han
- Department of Nursing, Bucheon University, Bucheon, South Korea
- Soo-Yeon Han, Department of Nursing, Bucheon
University, Bucheon, South Korea.
| | - Nancy Howe
- Edson College of Nursing and Health Innovation,
Arizona State University, Phoenix, AZ, USA
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Mudenda S, Ngalande N, Mukosha M, Hikaambo CN, Daka V, Matafwali SK, Banda M, Mfune RL, Mayoka G, Witika BA. Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia. Front Public Health 2022; 10:1028312. [PMID: 36530704 PMCID: PMC9748439 DOI: 10.3389/fpubh.2022.1028312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Background The COVID-19 pandemic led to the disruption of physical classes for university students globally, as large gatherings fuelled the transmission of the virus. In the efforts to mitigate its transmission and return to normality, prevention measures, including vaccination, have been encouraged. Therefore, it is critical to understand the knowledge and practices of students regarding COVID-19. This study assessed the knowledge and practices toward COVID-19 among healthcare students at the University of Zambia. Materials and methods This questionnaire-based cross-sectional study was carried out from August 2021 to October 2021 among 478 healthcare students (pharmacy, physiotherapy, nursing, biomedical, medicine, and radiography). We used a previously validated questionnaire to measure knowledge and practice. The predictors of knowledge and practices were assessed using logistic regression with robust estimation of standard errors. Statistical analysis was conducted using Stata/BE version 17.0. Results Of the 478 respondents, 243 (50.8%) were females. A larger proportion, 175 (36.6%) were in Pharmacy training, and 156 (32.6%) were in their fifth year of study. The overall mean knowledge score of the participants was 87.9 (SD = 16.1), being higher at 89.6 (SD = 14.3) among medical students and the lowest at 86.7 (SD = 17.1) among Pharmacy students, although this was statistically non-significant (p = 0.488). The overall mean practice score was 60.0 (SD = 24.7), being significantly higher at 63.5 (23.4) among nursing, physiotherapy and environmental students compared to other students (p = 0.048). In multivariable analysis, the participant training program was non-significantly associated with knowledge and practice toward COVID-19. However, increased age (AOR = 1.09, 95% CI: 1.01-1.117) and residing in urban areas (AOR = 1.79, 95% CI: 1.07-3.01) than in rural areas were associated with higher odds of good practice toward COVID-19. Conclusion The healthcare students generally showed good knowledge levels and poor practices toward COVID-19. Further, there was no evidence of a difference in knowledge of COVID-19 among healthcare students. These findings suggest the need for implementation strategies to be centered on improving the practices of students toward COVID-19.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Nelly Ngalande
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | | | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Scott Kaba Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michelo Banda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Ruth Lindizyani Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Godfrey Mayoka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Bwalya Angel Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Gon G, Szekely A, Lowe H, Tosi M. Hand Hygiene Social Norms Among Healthcare Workers During Early COVID-19: Results of a Global Survey. Int J Public Health 2022; 67:1604981. [PMID: 36506712 PMCID: PMC9729248 DOI: 10.3389/ijph.2022.1604981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives: Poor hand hygiene among healthcare workers is an important driver of infectious disease transmission. Although social norms are considered a key determinant of hand hygiene behaviour, little is known about them among healthcare workers. This study describes hand hygiene social norms among health workers, assesses their predictors, and tests if social expectations increased during the early stages of COVID-19. Methods: We conducted a cross-sectional survey of healthcare workers from 77 countries (n = 1,233) from April to August 2020 assessing healthcare workers' hand hygiene social expectations, personal normative beliefs, punishment and reward, and demographic factors. Linear regressions and hierarchical linear modelling were used to analyse the responses. Results: We find high social expectations, personal beliefs, punishment, and rewards. Doctors tend to have lower social expectations than other occupation groups (e.g., nurses/midwives) and older respondents have higher social expectations. Social expectations increased during our survey, which may have been driven by COVID-19. Conclusion: Our findings suggest that hand hygiene social norms are strong among healthcare workers with variation across occupation and age; their strength increased during the COVID-19 pandemic. These have implications for behaviour change in healthcare environments that could leverage more norm-targeting interventions.
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Affiliation(s)
- Giorgia Gon
- London School Hygiene and Tropical Medicine, London, United Kingdom,*Correspondence: Giorgia Gon,
| | - Aron Szekely
- Collegio Carlo Alberto, Turin, Italy,Institute of Cognitive Sciences and Technologies, Italian National Research Council, Rome, Italy
| | - Hattie Lowe
- Institute for Global Health, University College London, London, United Kingdom
| | - Marco Tosi
- Department of Statistical Sciences, University of Padua, Padova, Italy
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Kim S, Capasso A, Ali SH, Headley T, DiClemente RJ, Tozan Y. What predicts people’s belief in COVID-19 misinformation? A retrospective study using a nationwide online survey among adults residing in the United States. BMC Public Health 2022; 22:2114. [PMCID: PMC9673212 DOI: 10.1186/s12889-022-14431-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
Tackling infodemics with flooding misinformation is key to managing the COVID-19 pandemic. Yet only a few studies have attempted to understand the characteristics of the people who believe in misinformation.
Methods
Data was used from an online survey that was administered in April 2020 to 6518 English-speaking adult participants in the United States. We created binary variables to represent four misinformation categories related to COVID-19: general COVID-19-related, vaccine/anti-vaccine, COVID-19 as an act of bioterrorism, and mode of transmission. Using binary logistic regression and the LASSO regularization, we then identified the important predictors of belief in each type of misinformation. Nested vector bootstrapping approach was used to estimate the standard error of the LASSO coefficients.
Results
About 30% of our sample reported believing in at least one type of COVID-19-related misinformation. Belief in one type of misinformation was not strongly associated with belief in other types. We also identified 58 demographic and socioeconomic factors that predicted people’s susceptibility to at least one type of COVID-19 misinformation. Different groups, characterized by distinct sets of predictors, were susceptible to different types of misinformation. There were 25 predictors for general COVID-19 misinformation, 42 for COVID-19 vaccine, 36 for COVID-19 as an act of bioterrorism, and 27 for mode of COVID-transmission.
Conclusion
Our findings confirm the existence of groups with unique characteristics that believe in different types of COVID-19 misinformation. Findings are readily applicable by policymakers to inform careful targeting of misinformation mitigation strategies.
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Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study. Vaccines (Basel) 2022; 10:vaccines10111847. [PMID: 36366356 PMCID: PMC9698425 DOI: 10.3390/vaccines10111847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term “lockdown”. In Italy, there were two lockdowns (9 March 2020−3 May 2020 and 3 November 2020−27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (−0.138−−0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013−0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013−0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (−0.050−−0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy.
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Kabantiyok D, Ninyio N, Shittu I, Meseko C, Emeto TI, Adegboye OA. Human Respiratory Infections in Nigeria: Influenza and the Emergence of SARS-CoV-2 Pandemic. Vaccines (Basel) 2022; 10:vaccines10091551. [PMID: 36146628 PMCID: PMC9506385 DOI: 10.3390/vaccines10091551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
The increasing outbreak of zoonotic diseases presents challenging times for nations and calls for a renewed effort to disrupt the chain of events that precede it. Nigeria's response to the 2006 bird flu provided a platform for outbreak response, yet it was not its first experience with Influenza. This study describes the impact of SARS-CoV-2 on Influenza surveillance and, conversely, while the 1918 Influenza pandemic remains the most devastating (500,000 deaths in 18 million population) in Nigeria, the emergence of SARS CoV-2 presented renewed opportunities for the development of vaccines with novel technology, co-infection studies outcome, and challenges globally. Although the public health Intervention and strategies left some positive outcomes for other viruses, Nigeria and Africa's preparation against the next pandemic may involve prioritizing a combination of technology, socioeconomic growth, and active surveillance in the spirit of One Health.
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Affiliation(s)
- Dennis Kabantiyok
- Laboratory Diagnostic Services Division, National Veterinary Research Institute, PMB 01, Vom 930001, Nigeria
| | - Nathaniel Ninyio
- School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Ismaila Shittu
- Department of Avian Influenza and Transboundary Animal Diseases, National Veterinary Research Institute, PMB 01, Vom 930010, Nigeria
| | - Clement Meseko
- Department of Avian Influenza and Transboundary Animal Diseases, National Veterinary Research Institute, PMB 01, Vom 930010, Nigeria
| | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, Department, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne, Neglected Tropical Diseases Department, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, Department, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne, Neglected Tropical Diseases Department, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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Joshi N, Lopus S, Hannah C, Ernst KC, Kilungo AP, Opiyo R, Ngayu M, Davies J, Evans T. COVID-19 lockdowns: Employment and business disruptions, water access and hygiene practices in Nairobi's informal settlements. Soc Sci Med 2022; 308:115191. [PMID: 35930847 PMCID: PMC9258418 DOI: 10.1016/j.socscimed.2022.115191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/25/2022] [Accepted: 06/30/2022] [Indexed: 12/05/2022]
Abstract
Host to one billion people around the world, informal settlements are especially vulnerable to COVID-19 lockdown measures as they already lack basic services such as water, toilets, and secure housing. Additionally, many residents work in informal labor markets that have been affected by the lockdowns, resulting in further reductions in access to resources, including clean water. This study uses a cross-sectional design (n = 532) to examine the vulnerabilities of households to employment and business disruptions, water access and hygiene practices during the COVID-19 lockdowns between April and June 2020 in three informal settlements in Nairobi, Kenya. We used survey questions from the Household Water Insecurity Experience Scale (HWISE) to investigate the relationship between employment and business disruptions, water access, and hygiene practices (i.e., hand washing, body washing, clothes washing, and being able to use or drink clean water). Of the sampled households, 96% were forced to reduce work hours during the lockdowns, and these households had 92% lower odds of being able to afford water than households who did not experience a work hour reduction (OR = 0.08, p < .001). Household challenges in affording water were likely due to a combination of reduced household income, increased water prices, and pre-existing poverty, and were ultimately associated with lower hygiene scores (Beta = 1.9, p < .001). Our results highlight a compounding tragedy of reduced water access in informal settlements that were already facing water insecurities at a time when water is a fundamental requirement for following hygiene guidelines to reduce disease burden during an ongoing pandemic. These outcomes emphasize the need for targeted investments in permanent water supply infrastructures and improved hygiene behaviors as a public health priority among households in informal settlements.
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Affiliation(s)
- Nupur Joshi
- School of Geography, Development and Environment, University of Arizona, United States.
| | - Sara Lopus
- Department of Social Sciences, California Polytechnic State University - San Luis Obispo, United States.
| | - Corrie Hannah
- Arizona Institutes for Resilient Environment and Societies (AIRES), University of Arizona, United States.
| | - Kacey C Ernst
- Epidemiology and Biostatistics Department, University of Arizona, United States.
| | - Aminata P Kilungo
- Community, Environment, and Policy Department, University of Arizona, United States.
| | - Romanus Opiyo
- Department of Urban and Regional Planning, University of Nairobi, Kenya.
| | - Margaret Ngayu
- Department of Urban and Regional Planning, University of Nairobi, Kenya.
| | - Julia Davies
- School of Geography, Development and Environment, University of Arizona, United States.
| | - Tom Evans
- School of Geography, Development and Environment, University of Arizona, United States.
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8
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Global survey on COVID-19 beliefs, behaviours and norms. Nat Hum Behav 2022; 6:1310-1317. [PMID: 35606513 DOI: 10.1038/s41562-022-01347-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/01/2022] [Indexed: 02/02/2023]
Abstract
Policy and communication responses to COVID-19 can benefit from better understanding of people's baseline and resulting beliefs, behaviours and norms. From July 2020 to March 2021, we fielded a global survey on these topics in 67 countries yielding over 2 million responses. This paper provides an overview of the motivation behind the survey design, details the sampling and weighting designed to make the results representative of populations of interest and presents some insights learned from the survey. Several studies have already used the survey data to analyse risk perception, attitudes towards mask wearing and other preventive behaviours, as well as trust in information sources across communities worldwide. This resource can open new areas of enquiry in public health, communication and economic policy by leveraging large-scale, rich survey datasets on beliefs, behaviours and norms during a global pandemic.
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Tibbels NJ, Dosso A, Kra KW, Gbeke KD, Coffi G, Ngoran AR, Niamke JL, Nana M, Benié W, Hendrickson ZM, Naugle DA. "In our culture, if you quarantine someone, you stigmatize them": Qualitative insights on barriers to observing COVID-19 prevention behaviors in Côte d'Ivoire. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000489. [PMID: 36962697 PMCID: PMC10022382 DOI: 10.1371/journal.pgph.0000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/13/2022] [Indexed: 11/19/2022]
Abstract
While vaccines are now authorized for use against the SARS-CoV2 virus, they remain inaccessible for much of the world and widespread hesitancy persists. Ending the COVID-19 pandemic depends on continued prevention behaviors such as mask wearing, distancing, hand hygiene, and limiting large gatherings. Research in low- and middle-income countries has focused on the prevalence of adherence and demographic determinants, but there is a need for a nuanced understanding of why people do or do not practice a given prevention behavior. The Breakthrough ACTION project led by Johns Hopkins Center for Communication Programs conducted a qualitative study in November 2020 in Côte d'Ivoire to explore people's experience with and perceptions of the COVID-19 pandemic. We conducted 24 focus group discussions and 29 in-depth interviews with members of the general population and health providers. This analysis explores barriers and facilitators to seven recommended prevention behaviors with a particular focus on response efficacy, self-efficacy, and social norms. We found these constructs to be salient for participants who generally felt that the behaviors were useful for preventing COVID-19 but were difficult to practice for a variety of reasons. The perception that COVID-19 prevention behaviors were anti-social emerged as a key theme. Behavior change interventions must reframe the recommended behaviors as pro-social, while making them very easy to practice by removing social and structural barriers such as the expense or inaccessibility of masks and hand sanitizer.
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Affiliation(s)
- Natalie Jean Tibbels
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Abdul Dosso
- Center for Communication Programs-Côte d'Ivoire, Johns Hopkins Bloomberg School of Public Health, Abidjan, Côte d'Ivoire
| | - Kouamé Walter Kra
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | | | - Gervais Coffi
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Alex Romeo Ngoran
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Jean Louis Niamke
- Department of Sociology, Université de Cocody, Abidjan, Côte d'Ivoire
| | - Marjorie Nana
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William Benié
- Center for Communication Programs-Côte d'Ivoire, Johns Hopkins Bloomberg School of Public Health, Abidjan, Côte d'Ivoire
| | - Zoé Mistrale Hendrickson
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Danielle Amani Naugle
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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