Mask Use During COVID-19: A Social-Ecological Analysis.

To limit the spread of coronavirus disease 2019 (COVID-19), the Centers for Disease Control and Prevention issued recommendations that individuals wear face masks in public. Despite these recommendations, the individual decision to adhere and wear a mask may not be a simple decision. In this article, we examine the decision to wear a mask from a social-ecological perspective. Through critical analysis of societal, interpersonal and community, and intrapersonal influences, it is clear that the decision to wear a mask is multifaceted and influenced by constructs including public health recommendations and government mandates, racism and cultural norms, geography, household income, age, and personal attitudes. Understanding the multifactorial influences on mask wearing during COVID-19 is crucial for informing the creation and distribution of inclusive public health messaging regarding mask wearing now in the midst of an unprecedented health crisis, and in future unforeseen public health emergencies.

Impact of the COVID-19 Pandemic on Medical Students' Perceptions of Health Care for Vulnerable Populations.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic highlighted the shortcomings of our health care delivery system for vulnerable populations and created a need to rethink health disparity education in medical training. We examined how the early COVID-19 pandemic impacted third-year medical students' attitudes, perceptions, and sense of responsibility regarding health care delivery for vulnerable populations. METHODS: Third-year family medicine clerkship students at a large, private medical school in Philadelphia, Pennsylvania responded to a reflection assignment prompt asking how the COVID-19 pandemic impacted their thoughts about health care delivery for vulnerable populations in mid-2020 (N=59). Using conventional content analysis, we identified three main themes across 24 codes. RESULTS: Students recognized homeless individuals and Black, indigenous, and persons of color (BIPOC) as vulnerable populations impacted by the pandemic. Students reported causes of vulnerability that focused heavily on social determinants of health, increased risk for contracting COVID-19 infections, and difficulty adhering to COVID-19 prevention guidelines. Notable action-oriented approaches to addressing these disparities included health care reform and community health intervention. CONCLUSIONS: Our findings describe an educational approach to care for vulnerable populations based on awareness, attitudes, and social action. Medical education must continue to teach students how to identify ways to mitigate disparities in order to achieve health equity.

Outpatient maternity care and telemedicine use perceptions in the COVID-19 pandemic: a 2020 CERA survey.

The COVID-19 pandemic resulted in rapid telemedicine implementation. This study aimed to identify mean differences in telehealth maternity care provided by perceived patient acceptability and clinician satisfaction, and to determine the association between acceptability, satisfaction, and perceived anticipation of long-term telehealth utilization in family medicine maternity care. Data from the 2020 Council of Academic Family Medicine Educational Research Alliance general membership survey of family medicine educators and practicing clinicians were analyzed. Respondents who reported providing maternity care in the 12 months preceding the survey were included (N = 290). Descriptive statistics were calculated. ANOVA was used to determine the mean difference in percent maternity care provided by reported clinician satisfaction and perceived patient acceptability. Logistic regression models were fit to determine associations between perceived telehealth satisfaction and acceptability with long-term use. The sample was 67 percent female, 85 percent white, mean age of 45 years (SE = .63). 51 percent reported total prenatal visits decreased since pandemic onset. Greater agreement with perceived patient telehealth acceptability (OR = 3.73 , 95 percent CI 1.09, 12.71) and clinician telehealth satisfaction (OR = 3.72 , 95 percent CI 1.40, 9.86) was significantly associated with anticipated long-term usage. Perceived patient telehealth acceptance and clinician satisfaction were significantly higher among clinicians providing more telehealth and positively associated with anticipated long-term use.

Menstrual Health: Taking Action Against Period Poverty

Many menstruators tend to conceal their menses out of fear or embarrassment, which yields conditioned self-silencing of their needs and further perpetuation of a generational and societal spiral of silence.9 This resounding stigma continually hinders both open discussion and policy engagement on menstrual experiences, management, and hygiene needs. [...]the purpose of this work is to combat this stigma by describing five actionable steps we can all take to begin addressing period poverty. Many who learn of this real and concerning phenomenon are surprised. [...]the definition of and concepts related to period poverty need to be openly discussed in public forums, such as town halls, city council meetings, and school board meetings-any place where social services and resource limitations are discussed. CONDUCT RESEARCH AND ENGAGE WITH THE COMMUNITY In-depth understanding and research on period poverty remain limited, and further research is needed to better conceptualize the full impact of period poverty in the community. [...]application of collaborative communitybased participatory research (CBPR) is necessary. CBPR places emphasis on community-researcher collaboration, which can uncover unique insights into the sociocultural composition of the community.9 This partnership-based approach can help to develop a more comprehensive understanding of public health concerns within a specific population, as well as potential solutions.9 CBPR may help facilitate and foster new evidence-based understanding of period poverty and can be used to ultimately address menstrual equity. [...]varied research methodologies should be considered and explored.

A qualitative analysis of third-year medical students' reflection essays regarding the impact of COVID-19 on their education.

BACKGROUND: The COVID-19 pandemic fundamentally changed every aspect of healthcare delivery and training. Few studies have reported on the impact of these changes on the experiences, skill development, and career expectations of medical students. METHOD: Using 59 responses to a short reflection essay prompt, 3rd year medical students in Philadelphia described how the COVID-19 pandemic affected their education in mid-2020. Using conventional content analysis, six main themes were identified across 14 codes. RESULTS: Students reported concerns regarding their decreased clinical skill training and specialty exposure on their career development due to the loss of in-person experience during their family medicine clerkship. A small number felt very let down and exploited by the continued high cost of tuition while missing clinical interactions. However, many students also expressed professional pride and derived meaning from limited patient and mentorship opportunities. Many students developed a new sense of purpose and a call to become stronger public health and patient advocates. CONCLUSIONS: The medical field will need to adapt to support medical students adversely impacted by the COVID-19 pandemic, from an educational and mental health standpoint. However, there are encouraging signs that this may also galvanize many students to engage in leadership roles in their communities, to become more empathetic and thoughtful physicians, and to redesign healthcare in the future to better meet the needs of their most vulnerable patients.