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Abstract

Contact tracing is a cornerstone in public health practice, providing an effective response to infectious disease outbreaks. Beginning in April 2020, as the COVID-19 pandemic spread quickly in the United States, public health departments increasingly relied on contact tracers to control disease spread and reduce the impact on the community. The Florida Department of Health (DOH) employed hundreds of public health students to pursue transmission control statewide as contact tracers. This study employed a qualitative thematic approach to capture 11 graduate-level public health students’ experiences, motivations, challenges, and recommendations on contact tracing procedures as DOH contract tracers. In-depth interview questions focused on students’ interest in public health, experiences as a contact tracer, patient/case interactions, and personal outlook on the COVID-19 pandemic. The COVID-19 pandemic brought new experiences and challenges for public health students employed by local health departments as contact tracers. Three categories and subthemes emerged from interviews: (1) motivations to work as a contact tracer, (2) challenges faced throughout employment, and (3) overall assessment of the contact tracing process. Identifying and understanding the work of contact tracers from the system-level perspective is vital as they contribute to improving training and working relationships with management and ultimately extend to the community. Lessons learned during the early months of the COVID-19 pandemic should help inform public health practice, especially when considering recruitment, curricula, training, and retention of the public health workforce in the face of current and emerging public health emergencies.

Keywords

contact tracers public health training workforce students COVID-19

Introduction

Since its inception in the early 20th century, contact tracing has become a cornerstone of public health practice, given its success in reducing disease transmission and infection.^1,2 The speed at which COVID-19 transmission unfolded in the United States during the Spring of 2020 called for immediate public health response, resulting in the recruitment of almost 70,000 contact tracers nationwide.³ In the early days of the pandemic, the Florida Department of Health responded by contacting public health schools across the state, resulting in thousands of public health students becoming contact tracers to assist in slowing the spread of COVID-19.^4
-9 By May 2020, Florida employed over 2,000 contact tracers who were critical in responding to the public health emergency.^9,10 However, Florida was understaffed by about 4,000 contact tracers.¹⁰

COVID-19 emergency responders were motivated by various reasons, including the desire to help their community and gain public health experience.⁸ Through their work, public health students in Arizona observed that the lack of proper management during the early days of the pandemic led to issues in recruiting contact tracing volunteers.⁵ Pennsylvania students identified three significant challenges to contact tracing procedures: the inadequacy of existing state testing protocols, lack of organization, and cultural and language barriers.⁶ Across the nation, COVID-19 responders noted a lack of standardized training and limited participation from community members as barriers to case investigation.^7,11

While health departments across the United States recruited large numbers of contact tracers, physicians, nurses, and other frontline workers received increased attention during the pandemic.^12,13 However, little consideration was given to contact tracers, though they played a significant role in controlling population contamination during this critical period.¹⁴ Considering the expected 30% growth in the public health field by 2031 and the importance of contact tracing in controlling transmission during the initial stages of an epidemic, it is imperative to identify and discuss views on contact tracing and suggestions to improve it made by student contact tracers during the COVID-19 pandemic. Hence, this study aimed to explore the experiences and perceptions of contact tracers during the early days of the pandemic.

Methods

This study employed a qualitative approach to explore the involvement of public health students in controlling COVID-19 transmission during the early days of the pandemic. Through open-ended interviews, 11 students shared their contact tracing experiences. Three questions were posited for investigation: (1) What motivated you to work as a COVID-19 contact tracer; (2) What is your overall experience as a contact tracer; and (3) What are your suggestions to improve the contact tracing process?

Study Design

The study design consisted of two stages: (1) an initial observation period of the contact tracing process and (2) interviews conducted with contact tracers. Field observations began while recruiting interview participants. During the first stage of the research, casual and formal observations of the contact tracing process were conducted by members of the research team to identify strengths and weaknesses as the process unfolded in the field. Steps in the contact tracing process are summarized in Figure 1. The second stage consisted of in-depth interviews with contact tracers employed by the state health department (HD).

Figure 1.

Steps in contact tracing process at the health department.

Study Participants

Participants worked as contact tracers and case investigators beginning in April 2020 and were recruited through purposive sampling. Research team members recruited former and current state HD employees. Inclusion criteria for participation included those: (1) enrolled or recently graduated from a graduate-level public health program, (2) employed as a contact tracer between April and December 2020, and (3) fluent in English. Florida International University’s Institutional Review Board approved the study protocol (#IRB-21-0115). All participants received study information and provided verbal informed consent before the interview.

Data Collection

Field observations were conducted from May to July 2020, followed by interviews via Zoom in April and May 2021. Members of the research team spent days in the HD working alongside the students and making notes on the processes occurring during the beginning of the pandemic. The investigators then developed the interview guide consisting of open-ended questions on participants’ public health interests, contact tracing experiences, interactions with cases and coworkers, and personal views of the COVID-19 pandemic. Before the interviews, all participants completed a brief demographic questionnaire. Interviews lasted 30 to 90 minutes and were digitally recorded and transcribed verbatim. Researchers reviewed the interview transcripts for accuracy and then transferred them into NVivo for coding and analysis.

Data Analysis

Data analysis followed an inductive thematic approach.^15,16 Investigators transcribed and read the transcripts several times to familiarize themselves with the data. Initial codes were developed and defined as they emerged. Data were organized for analysis using the NVivo software and further examined to (1) identify emergent codes and themes, (2) expand existing themes, and (3) refine the codes as appropriate until a final set of codes was used to develop a codebook. The research team discussed and agreed on the final themes.

Results

Participants

Eleven contact tracers participated in the study. Table 1 highlights participants’ demographics and socioeconomic characteristics. The mean age of the contact tracers was 26.5 (SD = 3.3) years, and 82% were women. Most participants (73%) were non-Hispanic Black, and approximately one-third studied epidemiology. Nearly half of the participants were enrolled in a Master of Public Health (MPH) program at the time of the interview.

Table 1.

Demographic Characteristics of Study Participants.

Demographics and characteristics	n (%)
Age (years)
23-27	8 (72.7)
28-33	3 (27.3)
Gender
Female	9 (81.8)
Male	2 (18.2)
Race/ethnicity
Black or African American	8 (72.7)
Hispanic or Latino	2 (18.2)
Asian or Asian American	1 (9.1)
Education classification
Current master’s student	5 (45.4)
Current doctoral student	4 (36.4)
Recent graduate	2 (18.2)
Public health concentration
Epidemiology	4 (36.4)
Health promotion and disease prevention	3 (27.3)
Social and behavioral sciences	1 (9.1)
Health policy and management	1 (9.1)
Environmental health sciences	1 (9.1)
General	1 (9.1)

Findings

The experiences of public health students while employed as contact tracers are organized into three categories and subthemes (Table 2): (1) participants’ motivations to work as contact tracers, (2) participants’ challenges experienced while employed, and (3) participants’ overall views on the contact tracing process.

Table 2.

Emergent Themes From Interview Questions With Current and Former Public Health Students Contact Tracers.

Question:	Themes	Select quotes from contact tracers
What led you to work as a contact tracer?	Desire to help the community	• “I definitely wanted to get my hands in . . . I wanted to be a part of helping the community with decreasing the transmission.” (Former Student, Female, age 31) • “I felt like I could help. I feel like I had skills that could help with the pandemic.” (Current Student, Male, age 33)
	Opportunity for more public health experience	• “If you’re not actively trying to get a job in public health, it’s really hard to get a job in public health because they want you to have experience. But we need the job to get experience. And that’s when I saw that opportunity; I was like, ‘Oh, this is great.’” (Current Student, Female, age 26)
	Increase professional development	• “The idea of a job opportunity within the field of public health, sometimes . . . it’s not easy to get a job right out. So, I think having the opportunity really built my resume . . . so I think it was very great for career development as well.” (Current Student, Female, age 23) • “It added more to my skill set of what I’m already learning. There’s another skill set for me to learn, and I’m really appreciative of that.” (Current Student, Female, age 29)
What challenges did you face during employment as a contact tracer?	Navigating relationships with supervisors and management	• “I felt like management was not the best. . . there are some [team leaders] that just didn’t know what to do. Some of them were a little bit unprofessional . . . I got a little turned off.” (Current Student, Male, age 27) • “There was a shift in management that happened, the management style changed where . . . the environment just was tense all the time.” (Former Student, Female, age 31) • “It comes to communication, how management speak to [you], even though we’re students. . . the same level of respect you give to a 20-year veteran is the same respect you should give us as students and employees.” (Current Student, Female, age 27)
	Interactions with members of the community with COVID-19	• “[The case] was trying to get his test results, but he’s being very rude because I guess he had been waiting for a very long time, and he was extremely rude and just calling me all sorts of names and . . . I cried, he hurt my feelings.” (Current Student, Female, age 26) • “When someone dies, their death certificate gets faxed over immediately to the health department . . . it was a little tough to see familiar names of family members who you’ve spoken with.” (Current Student, Female, age 23)
	Balancing work, school, and social life	• “During that time, I was in school doing summer school, and we worked from 8 to 5 at one point. Then it became 8 to 6 . . . The challenge was just to keep the energy to still do my work for school at the end of the day.” (Current Student, Female, age 26) • “It came to a point where literally my whole life was eat, a little bit of sleep, and then work. I didn’t really have time for anything else, so I definitely think it took a huge toll on my mental health.” (Current Student, Female, age 23)
What is your assessment of the contact tracing process?	Importance of contact tracing	• “When people get positive with COVID. . . they’ve been around 20-30 people, and sometimes they’re not going to share that information with those 20-30 people. Sometimes it’s up to the contact tracer to link it. . . it’s up to us to do the research.” (Current Student, Female, age 27) • “A lot of people need a lot of information about what to do, what not to do, where they can get access to care, and where they can find a test. . .the public needs that information, and they need someone to talk to, and contact tracers are the perfect person.” (Current Student, Male, age 33)
	Flaws identified in the contact tracing process	• “During those spikes . . . we had to cut the interviews short because we had so many people and not enough contact tracers. So, we didn’t necessarily trace everyone they had been around, didn’t necessarily ask every question that we probably should have because we just had so many people, we had to get to that we didn’t have enough manpower to really do effective contact tracing.” (Current Student, Male, age 33) • “We were also employing a lot of people outside of the public health field. And it was just a job for them.” (Former Student, Female, age 24)
	Improvements needed to aid contact tracing	• “I think the first thing needed is better training. . . in all aspects in terms of how to deal with certain situations.” (Current Student, Female, age 26) • “Figuring out a way to where we can educate the public about contact tracing or some basis of public health would be very beneficial.” (Current Student, Female, age 23)

Themes and Subthemes

Motivations to work as a contact tracer

Participants were positively motivated to join the health department as COVID-19 contact tracers. They found the COVID-19 pandemic to be “a once-in-a-lifetime outbreak” and “a great time for public health,” making them eager to help. Most students shared their desire to help their community in these “exciting but scary times.” Since COVID-19 was a newly emerging disease in 2020, public health students took the contact tracing job as an opportunity to apply their classroom-learned skills to help their community.

Students who did not work in a professional setting before their time as case investigators spoke on the positive impact that working with the HD had on their professional development. For example, students observed that contact tracing helped them build and expand their resumes for future opportunities. All participants agreed that working during the COVID-19 pandemic allowed them to build on their coursework and gain hands-on experience. As 1 student indicated, “Now I can view the world through the public health lens, which did not often occur in the classroom.”

Employment challenges

Study participants unanimously expressed that they endured challenges during their employment; foremost were the difficulties adjusting to working under new management. During a COVID-19 spike, over 100 students worked as contact tracers, increasing the strain on HD management. The contact tracers found navigating “workplace politics” demanding and challenging. Some students indicated that management made their experience at the HD less than ideal and even turned them away from choosing this field of work in the future. Several participants stressed the importance of communication in emergencies like the COVID-19 pandemic and suggested employers increase collaboration with employees and become more forthcoming. One student indicated facing hardships because she was viewed only as a student instead of an HD employee.

Multiple contact tracers shared difficulties relating to community members who tested positive for COVID-19. Some community members who called the HD were unfriendly, while others mistrusted the workers and the public health system. As contact tracers, participants relayed COVID-19 diagnoses to community members, and students had trouble communicating the unpleasant news. Others conveyed the challenge of handling the stress of losing cases to the SARS-CoV-2 virus, especially the ones they grew fond of during their weekly check-ins.

Most study respondents shared the difficulty of balancing long work hours with school and social activities. Since the state HD reached out to public health students and recent graduates, most contact tracers were juggling a full course load and working, sometimes over 60 hours a week. Others recalled feeling “burnout” as contact tracers and claimed the job started harming their mental health.

Assessment of the contact tracing process

Working as contact tracers during the COVID-19 pandemic greatly expanded participants’ views on public health and contact tracing. For example, while working with cases, a female student realized that “this is public health; we are here for the people, and I would not have recognized what public health is, had I not worked as a contact tracer.” Most indicated that their views on public health expanded during the pandemic. Additionally, most students referred to their experience as an “awakening” necessary for their future careers.

Contact tracers at the HD performed various duties, referring to their time working as “wearing many different hats.” For example, they answered phone calls, relayed COVID-19 diagnoses, investigated cases’ history, and traced cases’ contacts. A key responsibility of all contact tracers was to minimize COVID-19 transmission throughout the community. One student believed contact tracing was vital because it gave the community access to information they otherwise would not have received through typical avenues.

Although participants identified strengths in contact tracing, they also recognized flaws. Among the most frequently cited was the hiring process, which was found inadequate to meet the increased demand for contact tracers. They found the hiring process stagnant and not adequately expedited to meet the hiring emergency. Hence, they indicated that the county health departments were severely short-staffed across the state, resulting in long working hours producing, in their view, lower-quality case investigation and tracing. In addition to the long work hours during the early months of the pandemic, the research team observed delays in accessing and delivering COVID-19 test results, adding to the delays in contact tracing throughout the HD.

Participants agreed that standardized training and guidance for recently hired contact tracers would have significantly improved the contact tracing process. All contact tracers reported receiving insufficient training, and most agreed that they were “thrown into the fire.” Respondents also stated that the overall process would benefit from streamlined guidance from supervisors and senior public health workers in the department. Several contact tracers emphasized the importance of collaboration between the health department and the public. This was especially the case during the early months of the pandemic when they found that educating community members about COVID-19 was of utmost importance to decrease the evident public mistrust. Recommendations made by COVID-19 contact tracers are summarized in Table 3.

Table 3.

Summary Table of Contact Tracers’ Recommendations.

Problem area	Recommendation
Hiring	– Expedite and streamline the hiring process – Target public health students and early public health professionals – Increase hiring threshold contact tracers and investigators – Standardize the interview process
Training	– All hires are to follow a nationally standardized contract tracing training – Promote interdepartmental collaboration in the form of guidance from HD supervisors and senior public health workers from STI and other infectious disease departments – Emphasize tracers’ communication and interpersonal skills during training – Mandate a 40-hour week of training for new hires
Community engagement	– Increase available resources to community members, including financial, nutrition, and social support – Market and advertise available resources via television, radio, and social media – Use the HD website and outreach programs to increase contact tracing awareness in the community – Engage the local media stations to promote the contact tracing process
Contact tracing procedures	– Include both phone and in-person case investigation – Include an HD caller ID on all phones used in contact tracing – Engage cases in the investigation and tracing – Separate responsibilities of each worker to decrease burnout – Increase case follow-up frequency – Expedite lab test results reporting – Decrease the time between a positive test result and case investigation initiation
Work-life balance	– Decrease work hours from 60 to 40 hours a week – Give current students assistance in school assignment – Increase paid time off availability – Provide mental health support to all hires

Discussion

This study detailed the observations and experiences of graduate-level public health students engaged in contact tracing throughout the early months of the COVID-19 pandemic. Participants in this study identified several motivations for working at the state HD. Foremost was the opportunity to serve the community by engaging in contact tracing. Though many students faced uncertainty and misgivings surrounding the COVID-19 pandemic, they explained that their motivation to help their community exceeded their fear. The literature notes that altruism and humanitarianism are typical of contact tracers and health caregivers.^17,18 Study participants revealed that helping community members and finding ways to improve the community’s conditions fulfilled them. However, the motivations to assist the HD were not entirely altruistic; the initial factors that attracted them to contact tracing included career development and compensation, suggesting personal growth remains a significant motivator for public health workers.

Students employed as COVID-19 contact tracers faced many challenges.^5,6 The most significant obstacle identified was the “learning curve” of navigating relationships with management. For most participants, working in the HD was their first experience in a professional work setting. Public health workers’ job satisfaction heavily relies on positive working relationships with management.^19-21 The novelty of COVID-19 also posed a significant test regarding management. HD employees were pulled from their usual duties to join the COVID-19 workforce while public health students left the classrooms to enter the work field for the first time. Moreover, students described a tense workplace and long work hours, leading to worker burnout, fatigue, reduced motivation, and decreased interest in the job.²² Participants also cited exhaustion and poor mental health among their most frequent grievances throughout their employment. Study participants also struggled with balancing a full-time job at the health department—at times over 12 hours per shift, up to 6 days a week—with completing their schoolwork and maintaining a social life. This study suggests efforts should be focused on promoting mental well-being for contact tracers and other health professionals during pandemics and other public health emergencies.

Students at the forefront of the COVID-19 response developed a more direct viewpoint of public health in practice. Contact tracers were the go-between for the HD, public health officials, and the community. The system flaws they witnessed daily affected participants’ views of contact tracing immensely. During COVID-19 case spikes, participants received a more extensive caseload, which demanded longer work hours and shorter times to speak with each positive case. The limited number of contact tracers made it difficult for employees to investigate and trace cases proficiently. Participants’ observations confirm that only about half of assigned COVID-19 cases were interviewed within 24 hours of a positive test result and were even less so during case spikes.²³ In addition to the worker shortage, failures in contact tracing can occur before the case reaches the HD. Test results are often delayed, cases cannot always be reached for an interview, and community members do not always provide complete or correct details of their close contacts leading to detrimental delays in contact tracing.²⁴ Increased resources are needed in infectious disease emergencies such as COVID-19 to expedite the contact tracing process, allowing community members to be reached quickly, thus increasing the efficiency of time spent on the case.

As a result of the COVID-19 pandemic, more students have become interested in public health as a career. In the early months of the outbreak, public health school interest increased by 23%, and in 2021, President Biden called for the funding of 100,000 public health workers to conduct vaccine outreach and contact tracing.^25,26 Even with the influx of public health interest and the increased number of workers in the field, there is no current formal standardized federal training for contact tracers. Meaning contact tracing training can vary across cities, counties, and states.⁷ Students in the present study shared suggestions to improve contact tracing, including mandating a minimum 40-hour week of training before beginning contact tracing work. Beech and Woodard suggest training in health communication, cultural sensitivity, and active listening to ensure competent responses to ever-evolving health issues.⁷ Participants suggested standardizing the contact tracing training for public health workers to allow for a more streamlined investigation process, a broader community reach, and increased confidence for new public health workers.

Community engagement was an additional difficulty reported by study participants. Respondents indicated that case investigation would run smoother if enhanced collaboration between the community and the HD had existed. Additionally, respondents noted that the novelty of COVID-19 produced mistrust and hesitancy in the community, inhibiting efficient contact tracing. Other tracers faced a similar challenge in building trust with university students who tested positive. Cases often hesitated to talk about their private health information, withheld crucial information, and quickly ended the conversations with contact tracers.²⁷ More extensive collaboration can decrease mistrust while increasing the community’s contact tracing awareness. Respondents realized that COVID-19 dramatically increased the visibility of public health and suggested that working at the HD was imperative in building and maintaining the public’s trust in public health. In a previous study, about half of Americans stated being comfortable engaging with the key steps in contact tracing to control the spread of COVID-19. However, about 30% of American adults had little to no knowledge of contact tracing.²⁸ These responses support previous findings suggesting the public held mixed views about COVID-19 contact tracing.^28
-30 Hence, publicizing the valuable contributions of contact tracing in public health practice, maintaining community health and safety, and easing the community’s fear is necessary.¹⁷

This study has several limitations. First, given that this study was restricted to contact tracers employed by the state of Florida, it is not representative of the larger contact tracing workforce. Contact tracers in this study were also public health students; hence their experiences may differ from those not in school. Therefore, the results presented here may not be generalizable. The COVID-19 pandemic and the workforce generated by its emergence are ever-changing, with new variants, vaccinations, and testing options continuously evolving. Therefore, the opinions and experiences of study participants will continue to evolve. At the study’s completion, the COVID-19 pandemic was still occurring; thus, its findings reflect the views of contact tracers employed during the early months of the pandemic. As a new stage of the pandemic emerged after vaccinations became available to the public in early January 2021, the findings presented here are expected to contribute to the limited research on the experiences of public health students employed as contact tracers during the early stages of the COVID-19 pandemic.

Conclusion

This study expands the understanding of contact tracing experiences of public health students employed by the state HD during the early stages of the COVID-19 pandemic. The early response to the COVID-19 pandemic brought new challenges to public health students, such as navigating relationships with supervisors and community members. Many of the challenges identified by contact tracers in this study must be addressed from a system level. Lessons learned during the early days of the COVID-19 pandemic can help inform public health practice, especially concerning future recruitment, curricula, training, and retention of the public health workforce in the face of current and emerging epidemics. Results and lessons learned from this study can be used to inform future training programs for community and public health professionals working in local and state health departments to address community needs during emergencies. Finally, public health students’ experience with COVID-19, a lethal and highly contagious virus, highlights the need to provide access to mental health support to those public health professionals, including contact tracers, at the forefront of the fight against the spread of infectious diseases.

More information on the treatment of infectious diseases and accessibility to these services should be made available to those in the field and especially contact tracers who, on a daily basis, meet those who need it most. The findings presented here respond to the already noted sparse information on student involvement in contact tracing during the early days of the pandemic. Their experiences are essential to the design of future management and disease control strategies. Furthermore, investigating students’ views and recommendations on contact tracing should significantly improve the process, particularly when building successful tactics to slow the spread of current and future infectious diseases.

Footnotes

Acknowledgements

The authors thank the public health students who participated in this study. Support was provided by the National Heart, Lung, and Blood Institute through OT2HL158287/6793-02-S0005, “Florida Community-Engaged Research Alliance Against COVID-19 in Disproportionately Affected Communities.”

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Consent to Participate

Informed consent was obtained from all interviewed in this project.

Consent for Publication

All participants gave informed consent for their de-identified data to be published.

Ethical Approval

The study was approved by Florida International University’s Institutional Review Board (Protocol # IRB-21-0115).

ORCID iD

Tienna Fenton

References

Keeling

Hollingsworth

Read

JM.

Efficacy of contact tracing for the containment of the 2019 novel coronavirus (COVID-19). J Epidemiol Community Health. 2020;74(10): 861-866. doi:10.1136/jech-2020-214051

Morens

Taubenberger

Fauci

AS.

A centenary tale of two pandemics: the 1918 influenza pandemic and COVID-19, part II. Am J Public Health. 2021;111(7):1267-1272. doi:10.2105/AJPH.2021.306326

Simmons-Duffin

Why contact tracing couldn’t keep up with the U.S. COVID outbreak. National Public Radio. Published June 3, 2021. Accessed March 9, 2023. https://www.npr.org/sections/health-shots/2021/06/03/1002878557/why-contact-tracing-couldnt-keep-up-with-the-u-s-covid-outbreak

Burns

Strickland

Horney

JA.

Public health student response to COVID-19. J Community Health. 2021;46(2):298-303. doi:10.1007/s10900-020-00910-z

Koetter

Pelton

Gonzalo

, et al. Implementation and process of a COVID-19 contact tracing initiative: leveraging health professional students to extend the workforce during a pandemic. Am J Infect Control. 2020;48(12):1451-1456. doi:10.1016/j.ajic.2020.08.012

Pogreba Brown

Austhof

Rosa Hernández

, et al. Training and incorporating students in SARS-CoV-2 case investigations and contact tracing. Public Health Rep. 2021; 136(2):154-160. doi:10.1177/0033354920974664

Beech

Woodard

Contact tracing: a Clarion call for national training standards. Ethn Dis. 2020;30(3):437-440. doi:10.18865/ed.30.3.437

Chengane

Cheney

Garth

, et al. The COVID-19 response in Nebraska: how students answered the call. Prev Chronic Dis. 2020;17(E81). doi:10.5888/pcd17.200269

Rivkees

Roberson

The Florida Department of Health STEPS public health approach: the COVID-19 response plan and outcomes through May 31, 2020. Public Health Rep. 2020;135(5):560-564. doi:10.1177/0033354920946785

10.

Gonzalez

. What Florida contact tracing is like during the COVID-19 pandemic. WLRN. Published June 3, 2020. Accessed January 25, 2023. https://www.wlrn.org/news/2020-06-03/what-florida-contact-tracing-is-like-during-the-covid-19-pandemic

11.

Ruebush

Fraser

Poulin

, et al. COVID-19 case investigation and contact tracing: early lessons learned and future opportunities. J Public Health Manag Pract. 2021;27(1):S87-S97. doi:10.1097/PHH.0000000000001290

12.

Liebel

AM.

Contact tracers as knowledge-makers. J Commun Healthc. 2020;13(3):155-157. doi:10.1080/17538068.2020.1818417

13.

Hayter

Jackson

Pre-registration undergraduate nurses and the COVID-19 pandemic: students or workers?

J Clin Nurs. 2020;29(17-18):3115-3116. doi:10.1111/jocn.15317

14.

Bureau of Labor Statistics. Occupational outlook handbook. U.S. Bureau of Labor Statistics. Updated September 8, 2022. Accessed January 25, 2023. https://www.bls.gov/ooh/life-physical-and-social-science/epidemiologists.htm

15.

Zammit

Applying thematic analysis to education: a hybrid approach to interpreting data in practitioner research. Int J Qual Methods. 2020;19:1-9. doi:10.1177/1609406920918810

16.

Braun

Clarke

Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa

17.

Santella

Bosley

Carillo

, et al. “I wanted to be part of the solution”: motivations, preparation, and mental health of COVID-19 contact tracers in the New York metropolitan area. J Health Hum Serv Adm. 2020;44(3):219-244. doi:10.37808/jhhsa.44.3.2

18.

Akintola

What motivates people to volunteer? The case of volunteer AIDS caregivers in faith-based organizations in KwaZulu-Natal, South Africa. Health Policy Plan. 2011; 26(1):53-62. doi:10.1093/heapol/czq019

19.

Kitsios

Kamariotou

Job satisfaction behind motivation: an empirical study in public health workers. Heliyon. 2021;7(4):e06857. doi:10.1016/j.heliyon.2021.e06857

20.

Schön Persson

Nilsson Lindström

Pettersson

, et al. Relationships between healthcare employees and managers as a resource for well-being at work. Soc Health Vulnerability. 2018;9(1):1547035. doi:10.1080/20021518.2018.1547035

21.

Willis-Shattuck

Bidwell

Thomas

, et al. Motivation and retention of health workers in developing countries: a systematic review. BMC Health Serv Res. 2008;8(1):247. doi:10.1186/1472-6963-8-247

22.

Talaee

Varahram

Jamaati

, et al. Stress and burnout in health care workers during COVID-19 pandemic: validation of a questionnaire. J Public Health. 2022;30(3):531-536. doi:10.1007/s10389-020-01313-z

23.

Spencer

Chung

Stargel

, et al. COVID-19 case investigation and contact tracing efforts from health departments—United States, June 25-July 24, 2020. MMWR. 2021; 70(3):83-87.

24.

Lewis

Why many countries failed at COVID contact-tracing—but some got it right. Nature. 2020;588(7838):384-387. doi:10.1038/d41586-020-03518-4

25.

The White House. President Biden announces American rescue plan. The White House. Published January 20, 2021. Accessed February 8, 2023. https://www.whitehouse.gov/briefing-room/legislation/2021/01/20/president-biden-announces-american-rescue-plan/

26.

Warnick

Interest in public health degrees jumps in wake of pandemic: Applications rise. Nation’s Health. 2021;51(6): 1-12. Accessed February 8, 2023. https://www.thenationshealth.org/content/51/6/1.2

27.

Karosas

Challenges of contact tracing in college students during COVID-19 pandemic. J Am Coll Health. Published online June 3, 2022. doi:10.1080/07448481.2022.2082845

28.

McClain

Rainie

The challenges of contact tracing as U.S. battles COVID-19. Pew Research Center. Published October 30, 2020. Accessed May 19, 2021. https://www.pewresearch.org/internet/2020/10/30/the-challenges-of-contact-tracing-as-u-s-battles-covid-19/

29.

Barry

Anderson

Han

, et al. Change over time in public support for social distancing, mask wearing, and contact tracing to combat the COVID-19 pandemic among US adults, April to November 2020. Am J Public Health. 2021;111(5):937-948. doi:10.2105/AJPH.2020.306148

30.

Zhang

Kreps

McMurry

, et al. Americans’ perceptions of privacy and surveillance in the COVID-19 pandemic. PLoS One. 2020;15(12):e0242652. doi:10.1371/journal.pone.0242652

Lessons Learned From Contact Tracing During the COVID-19 Pandemic: Public Health Students’ Experiences in the Field