Public health measures to reduce COVID-19 transmission include masking in public places, physical distancing, staying home when ill, avoiding high-risk locations, using a contact tracing app, and being willing to take a COVID-19 vaccine. However, adoption of these measures varies greatly. We aimed to improve health messaging to increase adherence to public health behaviours to reduce COVID-19 transmission by: 1) determining attitudes towards public health measures and current behaviours; 2) identifying barriers to following public health measures; and, 3) identifying public health communication strategies. We recruited participants from a random panel of 3000 phone numbers across Alberta to fill a predetermined quota: age (18–29; 30–59; 60+ years), geographic location (urban; rural), and whether they had school-age children. Two researchers coded and themed all transcripts. We performed content analysis and in-depth thematic analysis. Nine focus groups were conducted with 2–8 participants/group in August-September, 2020. Several themes were identified: 1) importance of public health measures; 2) compliance with public health measures; 3) critiques of public health messaging; and 4) suggestions for improving public health messaging. Physical distancing and masking were seen as more important than using a contact tracing app. There were mixed views around willingness to take COVID-19 vaccine. Current public health messaging was perceived as conflicting. Participants felt that consistent messaging and using social media to reach younger people would be helpful. In conclusion, these findings provide insights that can be used to inform targeted (e.g., by age, current behaviour) public health communications to encourage behaviors that reduce COVID-19 transmission.

Background Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine. Methods A cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations. Results Of the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine. Conclusion These results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake.

ObjectivesThere remains concern regarding the use of survey data to assess aspects of healthcare quality. The relationship between patient experience and adverse events as documented by patient safety indicators (PSIs) is a timely research topic. The objectives were to document the association of PSIs and patient experience scores, and to determine risk-adjusted odds of high experience scores versus PSI presence.Setting and participantsFrom April 2011 to March 2014, 25 098 patients completed a telephone survey following discharge from 93 inpatient hospitals in Alberta, Canada.Research designA modified version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was used. Surveys were linked to inpatient records and PSI presence was documented using a validated algorithm.MeasuresThree questions about overall hospital, physician and nurse ratings were scored on an 11-point Likert scale from 0 (worst) to 10 (best). Experience was classified as high (9 or 10) versus low (0–8). Demographic/clinical differences between respondents with/without a PSI were assessed. Logistic regression examined the relationship between factors including PSI and experience ratings.ResultsOverall, physician and nurse care was rated high by 61.9%, 73.7% and 66.2% of respondents. 1085 patients (4.3%) had a documented PSI. Most frequent PSIs were haemorrhagic events (n=502; 2.0% of sample), events relating to obstetrics (n=373; 1.5%) and surgical-related events (n=248; 1.0%). Risk-adjusted models showed patients with PSIs had decreased odds of having high overall (OR=0.86; 95% CI 0.75 to 0.97), physician (OR=0.76; 95% CI 0.66 to 0.87) and nurse (OR=0.83; 95% CI 0.73 to 0.94) ratings.ConclusionsThere is clear evidence that inpatient experience ratings are associated with PSIs, one element of quality of care. Future research, examining individual PSIs and patient experience questions, is warranted, as this may inform targeted quality improvement initiatives.

Objective To identify factors associated with patients’ overall rating of inpatient hospital care. Data Sources Two years of patient interview data (April 1, 2011 to March 31, 2013), linked to inpatient administrative records. Study Design Patients rated their overall health on a scale of 0 (worst care) to 10 (best care) using the HCAHPS instrument administered via telephone, up to 42 days postdischarge. Logistic regression was used to generate odds ratios for each independent predictor. Data Extraction HCAHPS data were linked to inpatient records based on health care numbers and dates of service. The outcome (overall health experience) was collapsed into two groups (10 vs. 0–9). Principal Findings Overall hospital experience of 0–9 was associated with younger age, male gender, higher level of education, being born in Canada, urgent admission, not having a family practitioner as the most responsible provider service, and not being discharged home. A length of stay of less than 3 days was protective. The c‐statistic for the multivariate model was 0.635. Conclusions Our results are novel in the Canadian population. Several questions for future research have been generated, in addition to opportunities for quality improvement within our own organization.

Objective:To determine which individual patient experience questions and domains were most correlated with overall inpatient hospital experience.Methods:Within 42 days of discharge, 27 639 patients completed a telephone survey based upon the Hospital-Consumer Assessment of Healthcare Systems and Processes instrument. Patients rated their overall experience on a scale of 0 (worst care) to 10 (best care). Correlation coefficients were calculated to assess the relationships between individual survey questions and domains with overall experience.Results:Questions on provider coordination and nursing care were most correlated with overall experience. Hospital cleanliness, quietness, and discharge information questions showed poor correlation. Correlation with overall experience was strongest for the “communication with nurses” domain.Conclusions:Our individual question results are novel, while the domain-based findings replicate those of US-based providers, results which had not yet been reported in the Canadian context—one with universal health care coverage. Our results suggest that our large health care organization may attain initial inpatient experience improvements by focusing upon personnel-based initiatives, rather than physical attributes of our hospitals.