A Faculty-Informed Framework for Responsible and Equitable Academic Travel

Introduction Academic medical faculty, who devote their lives to improving human health, are often frequent travelers. Given the significant contribution of transportation and travel activities to local and global environmental degradation, faculty must grapple with the impact of their work on patients and the public. During the COVID-19 pandemic, academicians were forced to develop innovative communication and business strategies, which also spawned new perspectives on the role of travel in academic life. We sought to learn more about these adaptations and perspectives, and to consider whether insights gained might inform a more deliberate and conscientious culture of academic travel. Materials and Methods We conducted faculty focus groups with participants from different academic levels and four different health graduate programs at an academic medical center, and inquired about motivations for and perspectives on past, present and future travel practices. Results Faculty provided extensive observations about their travel histories and how, in the middle of the COVID-19 pandemic, they were responding to abrupt challenges to their personal and professional responsibilities. They addressed the cognitive dissonance generated by flying frequently during a time of global warming, and they offered multiple recommendations for changes to the status quo. Conclusion Building on the rich qualitative data gathered during our focus groups, we propose a unique framework for academicians to advance the culture of travel in the 21st century. This framework proposes specific steps to mitigate planetary degradation and its associated inequities, and it suggests creative mechanisms for simultaneously enhancing the personal and professional quality of faculty life.

Pediatric Primary Care Perspectives of Mental Health Services Delivery during the COVID-19 Pandemic.

Due to a national shortage of child and adolescent psychiatrists, pediatric primary care providers (PCPs) are often responsible for the screening, evaluation, and treatment of mental health disorders. COVID-19 pandemic stay-at-home orders decreased access to mental health care and increased behavioral and emotional difficulties in children and adolescents. Despite increased demand upon clinicians, little is known about mental health care delivery in the pediatric primary care setting during the pandemic. This focus group study explored the experiences of pediatric PCPs and clinical staff delivering mental health care during the pandemic. Transcripts from nine focus groups with San Francisco Bay Area primary care practices between April and August 2020 were analyzed using a thematic analysis approach. Providers expressed challenges at the patient-, provider-, and system-levels. Many providers reported increased patient mental health symptomatology during the pandemic, which was often intertwined with patients' social determinants of health. Clinicians discussed the burden of the pandemic their own wellness, and how the rapid shift to telehealth primary care and mental health services seemed to hinder the availability and effectiveness of many resources. The findings from this study can inform the creation of new supports for PCPs and clinical staff providing mental health care.