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Surveys can be a critical tool in monitoring public health during emergencies. Existing surveillance systems may provide timely reporting of cases and deaths associated with diseases. However, during COVID-19 they did not provide accurate information on the number of cases with virus-related symptoms, testing and treatment seeking. In fact, the surge of potentially infected individuals seeking diagnosis, testing and treatment represented a serious but largely unmeasured dimension of the crisis. This study aimed to evaluate the potential value of monitoring health, attitudinal, and behavioral dimensions that are not included in current U.S. disease surveillance systems during population health emergencies. Additionally, it seeks to demonstrate the feasibility of designing and implementing a low-cost, rapid-turnaround health and behavioral monitoring system when comparable data from existing surveillance systems are unavailable. From March through November 2020, we conducted national surveys with approximately 1,000 interviews each month with Census-balanced samples from a large national commercial panel. These surveys employed replicate national samples drawn from all 50 US states and the District of Columbia. A total of 9,200 interviews, averaging about 20 min in length, were completed over the course of the nine months of fielding. Nearly a quarter of respondents (22%) reported they had been sick for three days or longer since January with what might be COVID. Respondents were questioned about their symptoms, whether they had seen a doctor, had a confirmatory test for the COVID virus, and test results. Approximately one in ten respondents were currently experiencing COVID-like symptoms each month (95% CI: 10.7–12.0%). These numbers dwarf the 0.3% in April and 3.6% in November who had ever had a COVID positive test result. Moreover, 42% of these symptomatic adults sought medical care or testing, increasing strains on the health care system,. Although surveys may not be needed to estimate diagnosed cases, hospitalizations, or deaths, they can provide the missing data on symptomatic cases in the population, the proportion seeking medical care, ability to obtain a confirmatory test, and reasons for not seeking care or testing. This study demonstrates the ability of surveys to provide such information in a timely fashion, which could be replicated in other countries.

Despite relatively high rates of population spread, morbidity and mortality, the adoption of COVID-19 vaccines among the eligible populations was relatively slow. Some of the reasons for vaccination hesitancy and refusals have been attributed to unique aspects of this pandemic, including attitudes toward COVID-19 vaccines. However, little attention has been paid to the role of underlying vaccine beliefs in the likelihood of early vaccine adoption for COVID-19. This study provides a more comprehensive assessment of factors influencing willingness to get an early vaccination, and the relative contribution of general vaccine attitudes, compared to demographics, perceived threat and institutional trust. Monthly national surveys were conducted between June and November 2020 using a national consumer panel of U.S. adults (n = 6185). By late November, only 24% of respondents said they were very likely to get a Food and Drug Administration (FDA)-approved COVID-19 vaccine as soon as it became available. While COVID-19 risk perceptions, confidence and trust in key institutions and information sources, and some demographic variables, were predictive of early vaccination intent, general beliefs regarding vaccines played a significant role, even compared to demographics, perceived risk and institutional trust. This lesson from the COVID-19 experience could help inform public health communications in future epidemics.

Published surveys in the United States provide much evidence that COVID-19 vaccination is influenced by disease and vaccine-related risk perceptions. However, there has been little examination of whether individual’s general beliefs about vaccines are also related to COVID-19 vaccination, especially among unvaccinated adults. This study used an August 2021 national survey of 1000 U.S. adults to examine whether general beliefs about vaccines were associated with COVID-19 vaccination status. In addition, it used multivariate analyses to assess the relative contribution of individual vaccine beliefs to current vaccine status independently of COVID-19-specific attitudes and experiences, and demographics. The findings indicated that, collectively, general vaccine beliefs mattered more than demographics, COVID-19-specific risk perceptions, confidence in government, or trust in public health agencies in COVID-19 vaccination status. Overall, the findings affirm the importance of vaccine education and communication efforts that help people understand why vaccines are needed, how vaccine safety is established and monitored, and how vaccines provide protection from infectious diseases. To achieve success among vaccine-hesitant individuals, communication strategies should target vaccine beliefs that most influence vaccination outcomes.

Background Latinos enroll in Alzheimer's disease (AD) clinical trials at lower rates, yet it remains unclear whether their willingness differs from their non‐Hispanic White (NHW) counterparts. This study examined differences in trial willingness, along with barriers and motivators, among Latino and NHW adults in a nationally representative sample. Method A structured web panel survey was administered to 1,800 adults aged 50 and older with no self‐reported neurological disorders, including 600 NHW and 1,200 Latino participants across the U.S. Participants received a primer on AD and clinical trials before responding. Willingness to participate was assessed using Likert‐scale items on general and AD‐specific trial participation. Multinomial logistic regression examined willingness differences, adjusting for age, sex, education, income, and AD family history. Secondary analyses explored motivators and barriers. Result Among Latinos, 34.6% identified as Puerto Rican, 26.9% as Mexican, 14.4% as Central or South American, 8.5% as Cuban, 3.7% as Dominican, and 11.9% as other/mixed heritage. While overall trial willingness did not differ between NHW and Latinos, a trend in heritage‐specific differences emerged. Cuban (OR=2.30; 95% CI: 0.73–7.28) and Central American (OR=1.89; 95%CI: 0.45–7.93) participants showed a pattern of greater willingness compared to NHW, while Dominican (OR=0.60; 95% CI: 0.14–2.47) and Mexican participants (OR=0.78; 95%CI: 0.33–1.82) showed a trend toward lower willingness. Motivators also varied by heritage: Cubans prioritized health benefits (76.5%), research contributions (55.1%), and monetary incentives (40.9%), while Central Americans valued health benefits (68.2%), monetary incentives (50.6%), and physician recommendations (34.7%). Barriers also differed: Dominicans cited safety concerns (48.2%), visit burden (27.8%), and transportation (24.2%), while Mexicans noted visit burden (31.3%), safety concerns (29.3%), and time constraints (20.8%). More Latinos reported they would be “more willing” to participate in AD‐focused trials than NHW (42.6% vs. 36%, p = 0.0069). Conclusion Willingness is not universally a barrier for Latinos, but heritage‐specific trends underscore the need for culturally tailored recruitment strategies. Addressing logistical barriers, safety concerns, and emphasizing trust and societal benefits is key to improving Latino participation in AD trials.

A revised model of psychological hardiness suggests that transformational coping, positive health behaviors, and activistic social support may be qualitative indicators of hardiness and an expression of the synergistic presence of commitment, control, and challenge. Hardiness indicators correlate with health rather than illness, and have an indirect effect on the stress‐illness relationship through health. Stress and illness also correlate with health. A secondary qualitative analysis of the transcripts of eight women with paraplegia revealed three major themes related to spinal cord injury (SCI): physiological aspects of SCI, associated with the traumatic event and its consequences; psychological aspects of SCI, associated with problem‐solving, choices, and challenges; and social aspects of SCI, associated with personal and professional relationships.

Latinos enroll in Alzheimer's disease (AD) clinical trials at lower rates, yet it remains unclear whether their willingness differs from their non-Hispanic White (NHW) counterparts. This study examined differences in trial willingness, along with barriers and motivators, among Latino and NHW adults in a nationally representative sample. A structured web panel survey was administered to 1,800 adults aged 50 and older with no self-reported neurological disorders, including 600 NHW and 1,200 Latino participants across the U.S. Participants received a primer on AD and clinical trials before responding. Willingness to participate was assessed using Likert-scale items on general and AD-specific trial participation. Multinomial logistic regression examined willingness differences, adjusting for age, sex, education, income, and AD family history. Secondary analyses explored motivators and barriers. Among Latinos, 34.6% identified as Puerto Rican, 26.9% as Mexican, 14.4% as Central or South American, 8.5% as Cuban, 3.7% as Dominican, and 11.9% as other/mixed heritage. While overall trial willingness did not differ between NHW and Latinos, a trend in heritage-specific differences emerged. Cuban (OR=2.30; 95% CI: 0.73-7.28) and Central American (OR=1.89; 95%CI: 0.45-7.93) participants showed a pattern of greater willingness compared to NHW, while Dominican (OR=0.60; 95% CI: 0.14-2.47) and Mexican participants (OR=0.78; 95%CI: 0.33-1.82) showed a trend toward lower willingness. Motivators also varied by heritage: Cubans prioritized health benefits (76.5%), research contributions (55.1%), and monetary incentives (40.9%), while Central Americans valued health benefits (68.2%), monetary incentives (50.6%), and physician recommendations (34.7%). Barriers also differed: Dominicans cited safety concerns (48.2%), visit burden (27.8%), and transportation (24.2%), while Mexicans noted visit burden (31.3%), safety concerns (29.3%), and time constraints (20.8%). More Latinos reported they would be \"more willing\" to participate in AD-focused trials than NHW (42.6% vs. 36%, p = 0.0069). Willingness is not universally a barrier for Latinos, but heritage-specific trends underscore the need for culturally tailored recruitment strategies. Addressing logistical barriers, safety concerns, and emphasizing trust and societal benefits is key to improving Latino participation in AD trials.

Student activation is defined as a level of engagement in learning that a student has in reaching his or her academic goals. Students are activated when they have the necessary knowledge, skills, and confidence; take responsibility for their own learning; think critically; and implement strategies to be successful in their academic programs. With the current nursing shortage and a limited number of nursing student positions, it is critical that nursing programs have high retention and graduation rates, as well as high first-time NCLEX-RN pass rates. In order to identify nursing students who are at-risk for failure, an instrument to measure student activation was needed. The purpose of this dissertation was to validate an instrument that measures student activation and examine whether such an instrument can be used to identify stages of activation of nursing students. A 20-item Student Activation Measure was developed (alpha = .94) utilizing a multi-group, two-phase data collection design. A convenience sample (N=442) of bachelor of science and associate of science in nursing students was selected for this study. Principal components analysis supported that the SAM is a unidimensional measure with two highly correlated underlying factors that indicate level of activation: Taking Action and Having Knowledge and Confidence. Convergent validity was demonstrated by positive and significant relationships between student activation and measures of activation-related constructs, and a negative and significant relationship with psychological vulnerability. Discriminant validity was determined by nonsignificant relationships with measures of social desirability bias, strength of religious faith, and political stance. Significant differences in mean scores were found between Semester II (Medical-Surgical I) and Semester IV (High Acuity) for Taking Action . After controlling for age, marital status, number of hours worked and cumulative GPA, students in a baccalaureate nursing program continued to have significantly higher mean scores on Knowledge and Confidence than students in an associate nursing program. Thus, this new internally consistent and valid measure of student activation will facilitate identification of students who are less involved in their own learning and thereby at-risk for failure in their nursing program and on the NCLEX-RN