How parents share and limit their child's access to information about COVID-19: A mixed methods online survey study.

This study aimed to understand the role that parents play in sharing or limiting their child's access to information about coronavirus disease 2019 (COVID-19). A subset of data from an international mixed methods online survey study was analysed to elucidate the findings from Brazil. An online survey, conducted between April and June 2020, gathered closed and open text views from parents of children aged 7-12 years old. Quantitative data were analysed using descriptive statistics. Qualitative open text data were analysed using the three stages of the Bardin content analysis framework: pre-analysis (data organisation and initial full-content reading); exploration of the material (thematic coding to identify major motifs and develop thematic categories) and interpretation (treating the data as significant and valid). The sample consisted of 112 (89%) mothers and 14 (11%) fathers. The analysis of the parents open text resulted in two categories: 'How parents share information with their children about COVID-19' and 'How parents limit information to their children about COVID-19'. Some parents reported adopting an honest and open approach on how they shared information with their children, whilst some parents chose to minimise their child's access to information about the pandemic over concerns of the mortality related to COVID-19.

Using Creative Approaches and Facilitating Remote Online Focus Groups With Children and Young People: Reflections, Recommendations and Practical Guidance

The importance of engaging and involving children and young people (CYP) in research is widely recognised, especially for educational research exploring CYP's perceptions and experiences of school processes. Historically, working with CYP to collect qualitative data has involved face-to-face interactions, however the social distancing requirement during the COVID-19 pandemic meant there was a need to move ‘online' and work ‘remotely'. In this paper we share our experiences of undertaking remote online synchronous focus groups with CYP and discuss how we overcame the challenges associated with conducting qualitative research with CYP ‘from a distance'. We used remote online synchronous focus groups to explore CYP's perspectives on how education settings can support social, emotional, and mental wellbeing. We reflect on approaches used to uphold rigour and quality, and work ethically and sensitively. We have organised this into five topics reflecting distinct parts of the planning, design and practice: 1) working with CYP as research advisors to shape the design, feasibility and suitability of the methods and approach;2) developing creative approaches within the online focus groups to increase engagement and inclusion;3) considering logistical and technical practice;4) considering ethical practice underpinning online group data collection with CYP;and 5) valuing participation and disseminate findings when working from a distance with participants. We present reflections and guidance for other researchers considering the use of remote online synchronous focus groups with CYP, as a feasible and valuable means for collecting data in both a time- and cost-effective manner.

Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review.

There have been numerous reports of patients initially misdiagnosed in the 2009 H1N1 influenza and coronavirus disease 2019 (COVID-19) pandemics within the literature. A systematic review was undertaken to collate misdiagnoses during the H1N1 and COVID-19 pandemics and identify which cognitive biases may contribute to this. MEDLINE, Embase, Cochrane and MedRxiv databases were searched for misdiagnoses or cognitive biases resulting in misdiagnosis, occurring during the H1N1 or COVID-19 virus pandemics. Eligible studies were assessed for quality using JBI criteria; primary outcome was the final diagnosis. Sixty-nine studies involving 2551 participants were included. We identified 686 cases of misdiagnosis, categorized as viral respiratory infection, other respiratory infection, non-respiratory infection, and non-infective. Misdiagnoses are listed and relevant investigations are offered. No article described prospective assessment of decision making in the pandemic setting or debiasing diagnostic thinking. Further research is required to understand why misdiagnoses occur and harm arises and how clinicians can be assisted in their decision making in a pandemic context.

Children’s pictures of COVID-19 and measures to mitigate its spread: An international qualitative study

Objectives:To gain insight into children?s health-related knowledge and understanding of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) and COVID-19, and measures adopted to mitigate transmission.Design:A child-centred qualitative creative element embedded in an online mixed-methods survey of children aged 7?12?years.Setting:Children participated in the study in six countries ? the UK, Australia, Sweden, Brazil, Spain and Canada.Method:A qualitative creative component, embedded in an online survey, prompted children to draw and label a picture. Children were recruited via their parents using the researchers? professional social media accounts, through known contacts, media and websites from health organisations within each country. Analysis of the form and content of the children?s pictures took place.Results:A total of 128 children (mean age 9.2?years) submitted either a hand-drawn (n = 111) or digitally created (n = 17) picture. Four main themes were identified which related to children?s health-related knowledge of (1) COVID-19 and how it is transmitted;(2) measures and actions to mitigate transmission;(3) places of safety during the pandemic;and (4) children?s role in mitigating COVID-19 transmission.Conclusion:Children?s pictures indicated a good understanding of the virus, how it spreads and how to mitigate transmission. Children depicted their actions during the pandemic as protecting themselves, their families and wider society.

"People play it down and tell me it can't kill people, but I know people are dying each day". Children's health literacy relating to a global pandemic (COVID-19); an international cross sectional study.

The aim of this study was to examine aspects of children's health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The surveys included demographic questions and both closed and open questions focussing on access to and understanding of COVID-19 information. Descriptive statistics and qualitative content analysis procedures were conducted. The findings show that parents are the main source of information for children during the pandemic in most countries (89%, n = 347), except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child's access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children's health literacy needs during a pandemic.