An Evaluation of the Text Illness Monitoring (TIM) Platform for COVID-19: A Cross-Sectional Online Survey of Public Health Users

Determinants of Dutch public health professionals' intention to use digital contact tracing support tools: A cross-sectional online questionnaire study

Contact tracing (CT) can be a resource intensive task for public health services. To alleviate their workload and potentially accelerate the CT-process, public health professionals (PHPs) may transfer some tasks in the identification, notification, and monitoring of contacts to cases and their contacts themselves, using 'digital contact tracing support tools' (DCTS-tools). In this study, we aimed to identify determinants of PHPs' intention to use DCTS-tools. Between February and April 2022, we performed a cross-sectional online questionnaire study among PHPs involved in CT for COVID-19 in the Netherlands. We built three random forest models to identify determinants of PHPs' intention to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. The online questionnaire was completed by 641 PHPs. Most respondents had a positive intention towards using DCTS-tools for the identification (64.5%), notification (58%), and monitoring (55.2%) of contacts. Random forest models were able to correctly predict the intention of 81%, 80%, and 81% of respondents to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. Top-determinants of having a positive intention are the anticipated effect of DCTS-tools on the feasibility and efficiency of CT (speed, workload, difficulty), the degree to which PHPs anticipated that cases and contacts may find it pleasant and may be willing to participate in CT using DCTS-tools, and the degree to which PHPs anticipated that cases and contacts are sufficiently supported in CT when using DCTS-tools. Most PHPs have a positive intention to involve cases and their contacts in the identification, notification, and monitoring stages of the CT-process through DCTS-tools. The identified top-determinants should be prioritized in the (future) development and implementation of DCTS-tools in public health practice. Citizens' perspectives on the use of DCTS-tools should be investigated in future research.

Toward Sustaining Web-Based Senior Center Programming Accessibility With and for Older Adult Immigrants: Community-Based Participatory Research Cross-Sectional Study

BACKGROUND

During the COVID-19 pandemic, many community-based organizations serving Asian Americans pivoted to provide web-based care and social services. Asian American community leaders in the United States Pacific Northwest, including Asian Health & Service Center expressed that there are older immigrant adults who experienced backlash from discrimination, fear, and anxiety owing in part to anti-Asian hate and isolation, including from infection precautions. Pivoting supported staying safe from COVID-19 transmission and anti-Asian hate crimes.

OBJECTIVE

This study aims to examine the readiness of diverse groups of older Asian American immigrant adults (Chinese, Koreans, and Vietnamese) to use a web-based senior center, including technology access and telehealth use, and to identify the psychosocial health impacts that a web-based senior center could be positioned to meet.

METHODS

A community-based participatory research approach was used to conduct a cross-sectional survey study in an Asian-based health and service center in 2022. We selected surveys from the National Institutes of Health-supported PhenX Toolkit. Analyses were performed using R software.

RESULTS

There was an 88.2% (216/245) response rate. Overall, 39.8% (86/216) of participants were Chinese, 25% (54/216) were Korean, and 24.5% (53/216) were Vietnamese. There were significant group differences in mobile data plans (P=.0005). Most had an unlimited mobile data plan (38/86, 44% Chinese; 39/54, 72% Koreans; 25/53, 47% Vietnamese). Significant group differences existed regarding whether they started using a new electronic device to communicate with friends or family after the COVID-19 outbreak (P=.0005); most were Korean participants (31/54, 57%). For written text and audio or video apps, most Chinese participants used WeChat (65/85, 76%; 57/84, 68%, respectively), most Koreans used KakaoTalk (49/54, 91%; 49/54, 91%, respectively), and most Vietnamese used Facebook Messenger for written text (32/50, 64%) and Apple Face Time (33/50, 66%) or Facebook Messenger (31/50, 62%) for audio or video. Significant group differences existed regarding whether to try telehealth (P=.0005); most Vietnamese expressed that they would never consider it (41/53, 77%). Significant group differences existed regarding how well they were able to concentrate (χ22=44.7; P<.0001); Chinese participants reported a greater inability (median 5, IQR 4-6). With regard to difficulties in life experiences (χ22=51; P<.0001), the median was 6 (IQR 5-7) for the Vietnamese group. Significant group differences existed in having had a family/household member's salary, hours, and contracts reduced (P=.0005) and having had a family/household member or friend fallen physically ill (P=.0005)-most Vietnamese (15/53, 28%) and Korean participants (10/53, 19%).

CONCLUSIONS

To build an efficacious, web-based senior center with web-based care and social service options, more older adults need access to the internet and education about using technology-enabled communication devices. Addressing the unique psychosocial impacts of the COVID-19 pandemic on each group could improve health equity. The strength of the participating older adults was observed and honored.