Co-designing multidisciplinary telehealth education for online learning

Purpose>There are growing expectations that students graduating from health courses and current health professionals have some proficiency in using telehealth. However, there is limited accessibility to multidisciplinary-based material to meet this need. This paper describes the development of an online telehealth education resource using a co-design approach and the strengths and challenges of embedding authentic learning principles in an open-access online course with a broad target audience.Design/methodology/approach>The authors first describe the co-design process of the course and discuss the pedagogy underpinning the course design. Then learner enrolment data is discussed to evidence uptake across key characteristics. Finally, the authors assess the efficacy of the co-design approach by analysing feedback collected from learners at the end of the course.Findings>The course is structured across four modules and comprises interactive content, reflective tasks, case studies and purposefully developed digital material. Responses from the working group and from learner feedback indicate that the course is an authentic and relevant introduction to telehealth practice for both health students and current health professionals, despite some limitations.Originality/value>This case study demonstrates the value of a co-design process and key learning design choices in online course development to meet the educational needs of learners from broad disciplinary backgrounds, in various stages of learning/understanding of telehealth and/or requiring a practice-based resource in the context of a rapidly changing policy environment.

The impact of COVID-19 on the eating habits of families engaged in a healthy eating pilot trial: a thematic analysis.

BACKGROUND: The eating habits of children and adults have been impacted by the COVID-19 pandemic, with evidence of increases in snacking and emotional eating, including eating to relieve boredom. We explored the experiences of families with children aged 4-8 years who had recently participated in a healthy eating pilot trial when the first national lockdown began in England. METHODS: Eleven mothers were interviewed in April and May 2020. Interview questions were developed based on the COM-B model of behaviour. Four main themes were constructed using inductive thematic analysis. RESULTS: The first theme related to an initial panic phase, in which having enough food was the primary concern. The second related to ongoing challenges during the lockdown, with sub-themes including difficulties accessing food, managing children's food requests and balancing home and work responsibilities. The perception that energy-dense foods met families' needs during this time led to increased purchasing of (and thus exposure to) energy-dense foods. In the third theme, families described a turning point, with a desire to eat a healthier diet than they had in the early stages of the lockdown. Finally, in the fourth theme, families reported a number of strategies for adapting and encouraging a balanced diet with their children. CONCLUSIONS: Our results suggest that even if parents have the capability (e.g. knowledge) and motivation to provide a healthy diet for their family, opportunity challenges (e.g. time, access to resources, environmental stressors) mean this is not always practical. Healthy eating interventions should not assume parents lack motivation and should be sensitive to the context within which parents make feeding decisions.

Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review.

BACKGROUND AND OBJECTIVES: Ambulatory (outpatient) health care organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to provide a continuity of care for both COVID-19 and non-COVID-19 patients. The purpose of this study is to systematically identify the facilitators and barriers experienced by outpatient health care organizations in an effort to maintain effective and efficient patient throughput during the pandemic. MATERIALS AND METHODS: This study systematically reviewed articles focused on initiatives taken by ambulatory care organizations to maintain optimal outpatient throughput levels while balancing pandemic precautions, published during 2020. RESULTS: Among the 30 articles that met the inclusion criteria, three initiatives healthcare organizations have taken to maintain throughput were identified: the use (and enhanced use) of telehealth, protocol development, and health care provider training. The research team also identified three barriers to patient throughput: lack of telehealth, lack of resources, and overall lack of knowledge. CONCLUSIONS: To maintain patient throughput during the COVID-19 pandemic, healthcare organizations need to develop strategies such as the use of virtual consultation and follow-up, new guidelines to move patients along the care delivery value-chain, and ongoing training of providers. Additionally, the availability of required technology for telehealth, availability of resources, and adequate knowledge are vital for continuous patient throughput to ensure continuity of care during a pandemic.

COVID-19 Impact on Acute Ischemic Stroke Treatment at 9 Comprehensive Stroke Centers across Los Angeles.

OBJECTIVE: To describe the impact of COVID-19 on acute cerebrovascular disease care across 9 comprehensive stroke centers throughout Los Angeles County (LAC). METHODS: Volume of emergency stroke code activations, patient characteristics, stroke severity, reperfusion rates, treatment times, and outcomes from February 1 to April 30, 2020, were compared against the same time period in 2019. Demographic data were provided by each participating institution. RESULTS: There was a 17.3% decrease in stroke code activations across LAC in 2020 compared to 2019 (1,786 vs. 2,159, respectively, χ2 goodness of fit test p < 0.0001) across 9 participating comprehensive stroke centers. Patients who did not receive any reperfusion therapy decreased by 16.6% in 2020 (1,527) compared to 2019 (1,832). Patients who received only intravenous thrombolytic (IVT) therapy decreased by 31.8% (107 vs. 157). Patients who received only mechanical thrombectomy (MT) increased by 3% (102 vs. 99). Patients who received both IVT and MT decreased by 31.8% (45 vs. 66). Recanalization treatment times in 2020 were comparable to 2019. CSCs serving a higher proportion of Latinx populations in the eastern parts of LAC experienced a higher incidence of MT in 2020 compared to 2019. Mild increase in stroke severity was seen in 2020 compared to 2019 (8.95 vs. 8.23, p = 0.046). A higher percentage of patients were discharged home in 2020 compared to 2019 (59.5 vs. 56.1%, p = 0.034), a lower percentage of patients were discharged to skilled nursing facility (16.1 vs. 20.7%, p = 0.0004), and a higher percentage of patients expired (8.6 vs. 6.3%, p = 0.008). CONCLUSION: LAC saw a decrease in overall stroke code activations in 2020 compared to 2019. Reperfusion treatment times remained comparable to prepandemic metrics. There has been an increase in severe stroke incidence and higher volume of thrombectomy treatments in Latinx communities within LAC during the pandemic of 2020. More patients were discharged home, less patients discharged to skilled nursing facilities, and more patients expired in 2020, compared to the same time frame in 2019.

Impact of COVID-19 Pandemic on Timing of Childhood Cancer Diagnoses.

The COVID-19 pandemic impacted the health care system in unprecedented ways. We reviewed the registry of new cancer patients who presented to the Children's of Mississippi Center for Cancer and Blood Disorders and showed the average number of new pediatric cancer diagnoses dropped during the initial COVID-19 months and rose significantly in June 2020. We must encourage families to seek health care when needed and keep scheduled appointments for routine vaccinations and health maintenance as we know the long-term sequela of delaying health maintenance far outweighs risks at present.

Forensic e-mental health: Review, research priorities, and policy directions

Forensic e-mental health is an area of psychology that is relatively underdeveloped considering technological advancements and the many mental health needs of justice-involved individuals. It includes the procurement, storage, sharing, and provision of forensic mental health information and services via electronic means and is associated with improved accessibility, efficiency, cost-savings, and safety. During the COVID-19 pandemic, clinics, hospitals, jails, prisons, and the courts rapidly adopted these modalities for service continuity out of necessity, rather than choice. In the absence of formal guidelines, practitioners, researchers, and policymakers were left searching for answers: what forensic e-mental health technologies are available, what was their research evidence, and what could the future hold? A "primer" covering the many aspects of technology-assisted forensic practice and research was overdue. To address this knowledge gap, we reviewed the e-mental health research base encompassing forensic evaluations and interventions. Considering stakeholders' needs, cost, and feasibility, we prioritized key topics that should rise to the top of the forensic e-mental health research agenda: the psychometric properties of forensic e-mental health assessments, impact of video recording evaluations, how to assess and treat diverse populations, restoration of competence to proceed, continuum of care, minimizing treatment attrition, and decreasing substance use. We report how to plan for and overcome logistical hurdles when implementing forensic e-mental health policy, utilize technology for training and education, and harness digitized data across the forensic realm. In conclusion, we find that there is ample opportunity for leveraging technology to improve forensic mental health practice, research, and policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved)