Back Onside: A Qualitative Study to Understand Experiences of Involvement in a Physical Activity Programme in Adults Who are Unemployed or At-Risk of Unemployment

Unemployment or being at-risk of unemployment is a health risk factor. Back Onside is a physical activity programme run in Bradford (UK) by the Bradford Bulls Foundation. It is aimed at improving the mental and physical health and wellbeing of adults who are unemployed or at-risk of unemployment. The programme is delivered in a relaxed and sociable environment to help build a positive mindset towards physical activity. We conducted semistructured interviews with participants on the programme (n = 5) and external stakeholders (n = 6) between 24 June and 12 July, 2021. Data analysis was completed using the context-mechanism-outcome (CMO) framework of realist evaluation. Four CMOs were identified: (1) resocialisation following COVID-19 lockdown restrictions;(2) congruence between the programme and participants' goals;(3) engaging people in enjoyable activities;and (4) inclusive environments. We recommend future programmes to take an inclusive and relaxed approach to physical activity and be congruent with participants' goals and values to ensure participants' feel supported and adhere to the programmes.

COVID-19 and Latinx alcohol use: The role of health insurance

Latinx people have been disproportionately impacted by COVID-19 evidenced by high rates of exposure, hospitalization, and death. The COVID-19 pandemic has seen an increase in alcohol use across numerous communities but minimal work, thus far, has examined potential underlying mechanisms among Latinxs. Social determinants of health, such as lack of health insurance, can function as systemic barriers to necessary resources to manage COVID-19 placing individuals at greater risk for negative outcomes. The present study sought to examine the ability of emotional distress and physical health problems to mediate the relationship between COVID-19 exposure and alcohol use, which is conditional on having health insurance. An online survey study of 388 Latinx adults found that emotional distress, but not physical health problems, mediated the relationship between COVID-19 exposure and alcohol use. This indirect effect was stronger among uninsured Latinx participants. These findings highlight the role of social determinants in exacerbating the negative consequences associated with the COVID-19 pandemic for Latinx adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Abstract (Spanish) Las personas latinas han sido afectadas de manera desproporcionada por la COVID-19 segun lo demuestran las grandes tasas de exposicion, hospitalizacion y decesos. La pandemia de COVID-19 ha marcado un aumento en el consumo de alcohol a traves de numerosas comunidades, sin embargo, hasta el momento, pocos trabajos de investigacion han examinado los posibles mecanismos subyacentes entre los latinos. Los factores sociales determinantes de los decesos, tales como falta de seguro de salud, pueden funcionar como impedimentos sistemicos para acceder a los recursos necesarios para tratar la COVID-19, dejando a las personas en mayor riesgo de obtener resultados desfavorables. El presente estudio busco examinar la capacidad de la angustia emocional y de los problemas de salud fisica de intervenir en la relacion entre la exposicion a la COVID-19 y el consumo de alcohol, todo lo cual esta condicionado a poseer seguro de salud. Una encuesta en linea de un estudio de 388 adultos latinos descubrio que la angustia emocional, pero no los problemas de salud fisica, mediaron en la relacion entre la exposicion a la COVID-19 y el consumo de alcohol. Este efecto indirecto fue mas fuerte entre los participantes latinos sin seguro. Estos hallazgos resaltan la funcion de los factores sociales determinantes que exacerban las consecuencias negativas relacionadas con la pandemia de COVID-19 para los adultos latinos. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The present study sought to explore variables that may have explanatory roles between COVID-19 exposure and alcohol use among Latinx people. Results supported that both individual factors (emotional distress) and systemic factors (health insurance status) contribute to how COVID-19 exposure is related to alcohol use among Latinx people. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 and Latinx alcohol use: The role of health insurance

Latinx people have been disproportionately impacted by COVID-19 evidenced by high rates of exposure, hospitalization, and death. The COVID-19 pandemic has seen an increase in alcohol use across numerous communities but minimal work, thus far, has examined potential underlying mechanisms among Latinxs. Social determinants of health, such as lack of health insurance, can function as systemic barriers to necessary resources to manage COVID-19 placing individuals at greater risk for negative outcomes. The present study sought to examine the ability of emotional distress and physical health problems to mediate the relationship between COVID-19 exposure and alcohol use, which is conditional on having health insurance. An online survey study of 388 Latinx adults found that emotional distress, but not physical health problems, mediated the relationship between COVID-19 exposure and alcohol use. This indirect effect was stronger among uninsured Latinx participants. These findings highlight the role of social determinants in exacerbating the negative consequences associated with the COVID-19 pandemic for Latinx adults.

Veterans' Use of Telehealth for Veterans Health Administration Community Care Urgent Care During the Early COVID-19 Pandemic.

BACKGROUND: Since the onset of the COVID-19 pandemic, telehealth has been an option for Veterans receiving urgent care through Veterans Health Administration Community Care (CC). OBJECTIVE: We assessed use, arrangements, Veteran decision-making, and experiences with CC urgent care delivered via telehealth. DESIGN: Convergent parallel mixed methods, combining multivariable regression analyses of claims data with semistructured Veteran interviews. SUBJECTS: Veterans residing in the Western United States and Hawaii, with CC urgent care claims March 1 to September 30, 2020. KEY RESULTS: In comparison to having in-person only visits, having a telehealth-only visit was more likely for Veterans who were non-Hispanic Black, were urban-dwelling, lived further from the clinic used, had a COVID-related visit, and did not require an in-person procedure. Predictors of having both telehealth and in-person (compared with in-person only) visits were other (non-White, non-Black) non-Hispanic race/ethnicity, urban-dwelling status, living further from the clinic used, and having had a COVID-related visit. Care arrangements varied widely; telephone-only care was common. Veteran decisions about using telehealth were driven by limitations in in-person care availability and COVID-related concerns. Veterans receiving care via telehealth generally reported high satisfaction. CONCLUSIONS: CC urgent care via telehealth played an important role in providing Veterans with care access early in the COVID-19 pandemic. Use of telehealth differed by Veteran characteristics; lack of in-person care availability was a driver. Future work should assess for changes in telehealth use with pandemic progression, geographic differences, and impact on care quality, care coordination, outcomes, and costs to ensure Veterans' optimal and equitable access to care.

Inpatient Telehealth Tools to Enhance Communication and Decrease Personal Protective Equipment Consumption during Disaster Situations: A Case Study during the COVID-19 Pandemic.

BACKGROUND: As the coronavirus disease 2019 pandemic exerts unprecedented stress on hospitals, health care systems have quickly deployed innovative technology solutions to decrease personal protective equipment (PPE) use and augment patient care capabilities. Telehealth technology use is established in the ambulatory setting, but not yet widely deployed at scale for inpatient care. OBJECTIVES: This article presents and describes our experience with evaluating and implementing inpatient telehealth technologies in a large health care system with the goals of reducing use of PPE while enhancing communication for health care workers and patients. METHODS: We discovered use cases for inpatient telehealth revealed as a result of an immense patient surge requiring large volumes of PPE. In response, we assessed various consumer products to address the use cases for our health system. RESULTS: We identified 13 use cases and eight device options. During device setup and implementation, challenges and solutions were identified in five areas: security/privacy, device availability and setup, device functionality, physical setup, and workflow and device usage. This enabled deployment of more than 1,800 devices for inpatient telehealth across seven hospitals with positive feedback from health care staff. CONCLUSION: Large-scale setup and distribution of consumer devices is feasible for inpatient telehealth use cases. Our experience highlights operational barriers and potential solutions for health systems looking to preserve PPE and enhance vital communication.

Outpatient services post-COVID-19: a paradigm drift or shift?

This commentary describes how the coronavirus crisis has altered working practices in NHS outpatient services in the UK, and examines the opportunities and challenges presented by this pandemic.