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Facilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.

Primary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.

Building on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment.

During crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.

This study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.

This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized.

The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making.

The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers’ learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic.

The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics.

This study has explored learning during the COVID-19 pandemic and found a circular process, “the management learning wheel,” which supports management learning in prolonged crises.

This study aims to validate the English version of a WHO-adapted questionnaire: Zika infection awareness/knowledge questionnaire using a unique dual-approach validation model.

A cross-sectional pilot study of 30 adult respondents in Malaysia completed the self-administered questionnaire on knowledge and perception to Zika infection. Construct validity was assessed by exploratory factor analysis (EFA) of SPSS and Rasch partial credit. Reliability is tested using pKR20 and Cronbach’s alpha.

Knowledge construct was unidimensional, good model fit, easy to endorse and well discriminative. Five-rating Likert scale for perception domain was appropriate. Knowledge domain should be separated into 6 level of difficulties. Perception domain should remain as one construct. Knowledge domain was highly reliability (pKR20 = 0.96), perception domain was fairly reliable (Cronbach’s alpha = 0.641). Respondent's ability to answer knowledge domain and perception domain were separated into 3 and 4 levels.

Small sample size may affect factor analysis.

The questionnaire has good psychometric properties to measure the knowledge and perception of Zika infection among Malaysian community.

The questionnaire helped to gauge knowledge and perception of the general community in Malaysia to aid preparation of health education tool for Zika infection.

This paper validated questionnaire with two biostatistical software programs in bidirectional approach – items difficulty and respondents' ability – is the first field test of WHO questionnaire among general population in Southeast Asia.

The purpose of this study aimed to assess factors associated with the intention to take pre-exposure prophylaxis (PrEP) among Thai young men who have sex with men (YMSM) and transgender women (TGW) in Bangkok.

The study surveyed 350 sexually active Thai YMSM and TGW aged between 18 and 24 years registered with a nongovernmental organization (NGO) working with the MSM community. Data were collected using snowball sampling from four venues. Participants completed a self-administered questionnaire. Logistic regression was used to evaluate factors associated with the intention to take PrEP daily.

The results showed that of all those surveyed, n = 310 (88%) participated. The median age was 21 years. In all, 18% of participants had heard about PrEP, and 36% correctly identified that PrEP is used for prevention. After receiving information, 31% intended to take daily PrEP and the Voluntary Counseling and Testing (VCT) rate was 35.5%. Factors significantly associated with intention to take daily PrEP were history of HIV testing (adjusted odds ratio (AOR), 2.3, 95% CI, 1.3–4.1), and high perceived behavioral control of PrEP adherence scores (AOR 3.0, 95% CI, 1.8–5.2).

This study showed that intention to take and knowledge of daily PrEP among YMSM and TGW was low. Promoting health education to YMSM and TGW about PrEP and MSM-friendly VCT services are needed to effectively implement PrEP in HIV prevention programs.

This study aimed to determine the prevalence and risk factors of hepatitis B virus (HBV) infection among medical laboratory science students (MLSSs) in the University of Health and Allied Sciences (UHAS), Ghana.

A cross-sectional study design was employed to recruit a total of 178 students into the study. A self-administered questionnaire was used to gather relevant information on risk factors, and a hepatitis B diagnostic test kit was used to test for HBV infection. Descriptive, chi-square test, bivariate and multiple logistic regression statistical analysis were computed. Significance was observed at p < 0.05.

The prevalence of HBV infection among MLSSs was 6.7%. Torn gloves and splash of blood and body fluids contributed to 43.0% and 28.0% of all the risk factors of HBV infection, respectively. Also, 43.3% of students had received at least one dose of the hepatitis B vaccination. Sharp object-related injury and torn gloves increased the odds of HBV infection, while vaccination decreased the odds of HBV infection.

This study reveals the prevalence of HBV among MLSSs, who are recognized as being among the high-risk student populations aside from student nurses.

The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW).

It examined changes in condom use, lubricant use, HIV testing and counseling (HTC) uptake and sexually transmitted infection (STI) screening uptake, as well as how and why changes did or did not occur. The study applied mixed methods of both quantitative and qualitative approaches.

There were 16,539 MSM, and TGW reached at least three times in the program during October 2011‒September 2012. The program was found to affect changes in condom use with steady partners (p<0.000), condom use with casual partners (p<0.000), water-based lubricant use (p<0.000), HTC uptake (p<0.000) and STIs screening uptake (p<0.000). Age and province of outreach are associated with HTC uptake and STI screening (p<0.000), slightly as well as gender identity (p<0.1). Gender identity and province of outreach are associated with condom use with steady partners (p<0.000). Gender identity (p<0.000) and sex work (p<0.05) are associated with the use of lubricant. The qualitative results showed that the program had an immediate effect on HTC and STIs screening due to successful bond between the outreach workers and their clients, leading to trust and influencing behavior change.

HIV prevention by peer educators continues to be proved the most effective method, assuming its program consistency. TGW are more vulnerable to MSM to protect themselves, and they have steady partners. Future program for MSM can be replicated and scaled up, but more empowerment component and self-esteem building should be integrated to target TGW.

This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.

This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.

This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.

The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.

Awareness raising campaigns have been used to promote HIV prevention messages, including the expansion of HIV testing, but initiating such campaigns de novo can be costly. Both the Bronx, New York and Washington, DC have significant local HIV epidemics and a history of efforts to scale-up HIV testing. To build on prior HIV testing campaigns and create new messages based on consultation with diverse stakeholders, a partnership with a community-based clinical trial to enhance HIV testing and treatment was established. The purpose of this paper is to describe the history of HIV testing campaigns in the two jurisdictions, the awareness raising conducted in collaboration with the HIV Prevention Trials Network (HPTN) study (HPTN 065) and provide evidence of its effect in these two communities.

The foundation of prior campaigns allowed for expansion of social mobilization efforts to specific priority populations (gay men and other men who have sex with men), the most severely affected groups in both communities, and to expand the efforts to include clinical settings. New compelling and acceptable messages were shaped through engagement with community members and based on input from focus groups with target populations in each city.

By engaging the target population in the development of new messaging, HPTN 065 study successfully built on campaigns that were already underway in both jurisdictions and was able to use those messages and platforms to further normalize HIV testing.

Modifying and adapting existing messages saved time and resources, which can be important factors to consider in settings with limited resources or high media purchasing costs.

Efforts of this kind may ultimately help to decrease HIV transmission in large urban settings.

The purpose of this paper is to intelligibly demonstrate the effectiveness of face mask wearing as a means to prevent COVID-19 transmission. Through understanding the benefits of wearing masks, it is hoped to facilitate the change of societal behavior and more people are willing to wear face mask.

The paper investigates the 50 states in the United States of America (U.S.) and Washington, D.C. that implemented the mask mandates before September 30, 2020, which are divided into four groups: (1) those implemented the statewide mask mandates before June 5, 2020 when World Health Organization (WHO) recommended mask wearing; (2) those implemented statewide mask mandates after June 5, 2020; (3) those implemented partial mandates affecting 30 percent or more of the state’s population; and (4) those implemented partial mandates affecting less than 30 percent. Simple descriptive statistics are analyzed.

For the 50 U.S. states and Washington, D.C., the higher the mask wearing rate, the lower the number of COVID-19 cases (correlation coefficient: −0.69 (p<0.001)). For the 23 states with mobility reduction of less than 15 percent, the higher the proportion of population required to wear masks, the lower the number of cases. This can be seen from the difference in the number of cases among the four groups by ANOVA (p = 0.013).

The positive effect of wearing masks is shown based on simple descriptive statistics for intuitive and intelligible understanding, which may lead people to comprehend the importance of wearing masks, and break through their custom, culture, and norms, and wear masks.

Throughout history, pandemics have played a significant role in reshaping human civilizations through mortalities, morbidities, economic losses and other catastrophic consequences. The present COVID-19 pandemic has brought the world to its knees resulting in overstretched healthcare systems, increased health inequalities and disruptions to people’s right to health including life-saving routine immunization programs across the world.

This is a commentary paper.

Immunization remains one of the most successful, safe, cost-effective and proven fundamental disease prevention measures in the history of public health. However, the COVID-19 pandemic has effectively thrown the world's immunization practices out of gear, depriving approximately 80 million infants, in rich and poor countries alike, at risk of triggering a resurgence of vaccine-preventable diseases such as diphtheria, measles and polio. It is estimated that each COVID-19 death averted by suspending immunization sessions in Africa could lead to 29-347 future deaths due to other diseases including measles, yellow fever, polio, meningitis, pneumonia and diarrhoea.

The value of implementing robust immunization policies cannot be underestimated. Risks associated with postponing immunization services and the fact that COVID-19 is now an integral part of human civilization have resulted in several countries making special efforts to continue their immunization services. However, critical precautionary measures are warranted to prevent COVID-19 among healthcare service providers, facilitators, caregivers and children during the immunization sessions.