Health experiences of the multiple sclerosis community during the second year of the COVID-19 pandemic, plans for future crises

Objectives & Aims: To investigate the health and healthcare experiences of persons with multiple sclerosis (MS) in the second year of the COVID-19 pandemic, including gathering community opinions to inform future crisis planning. Method(s): Second year data collection of a longitudinal consumer directed mixed-methods study. An online survey followed by semi structured interviews took place August-October 2021. Participants were Australian persons with MS, carers, MS-healthcare providers and MS advocates, most interviewed participants were returnees from the original 2020 interviews. The survey and interviews established health-related experiences in the second year of the pandemic and opinions on the needs of persons with MS for future crises. Qualitative data were analysed using a general inductive approach. Result(s): The study was completed by 34 persons (persons with MS:18, Carers:5, healthcare professionals:6, MS advocacy employees:5) from across Australia. Themes of healthy lifestyle, accessing healthcare and medication, accessing information, and plans of action were identified. Participants discussed and suggested helpful management strategies for the MS community during future crises including mental health services, increased accessibility to preventative measures, and healthcare and rehabilitation consistency through the crisis. Conclusion(s): The health and health-management implications of the COVID-19 pandemic are ongoing and represent one community crisis affecting Australians with MS. Consumer informed preparation models, such as those which include access to mental health services and consistency in healthcare and rehabilitation services are wanted by the MS community.

Children as innovators: harnessing the creative expertise of children to address practical and psychosocial challenges of the coronavirus disease 2019 (COVID-19) pandemic - COVISION study protocol

Background: We are currently in a period of transition, from the pre-COVID-19 (coronavirus disease 2019) era and the initial reactive lockdowns, to now the ongoing living with and potentially the after COVID-19 period. Each country is at its own individual stage of this transition, but many have gone through a period of feeling adrift;disconnected from normal lives, habits and routines, finding oneself betwixt and between stages, similar to that of liminality. Children and young people have been particularly affected. Aim: To increase the understanding of home and community-based strategies that contribute to children and young people's capacity to adjust to societal changes, both during and after pandemics. Moreover, to identify ways in which children's actions contribute to the capacity of others to adjust to the changes arising from the pandemic. The potential for these activities to influence and contribute to broader social mobilisation will be examined and promoted. Research design: To achieve the aim of this study, a participatory health research approach will be taken. The overarching theoretical framework of the COVISION study is that of liminality. The study design includes four work packages: two syntheses of literature (a rapid realist review and scoping review) to gain an overview of the emerging international context of evidence of psychosocial mitigations and community resilience in pandemics, and more specifically COVID-19;qualitative exploration of children and young people's perspective of COVID-19 via creative outlets and reflections;and participatory learning and action through co-production.

The effect of the Australian bushfires and the COVID-19 pandemic on health behaviours in people with multiple sclerosis.

BACKGROUND: Crises and disasters disproportionally impact people with chronic health conditions such as multiple sclerosis (MS). OBJECTIVE: To assess the impact of the COVID-19 pandemic and the Australian Black Summer Bushfires on health behaviours in people with MS. METHODS: People with MS, carers, healthcare and advocacy professionals were recruited online between May-July 2020 for an online survey and telephone interviews. RESULTS: Survey items relating to health behaviours were completed by 113 people with MS, and 18 people with MS, 4 MS advocates, 5 healthcare professionals, and 2 carers were interviewed. The bushfires affected 34.5% and the pandemic affected 74.3% of survey participants with MS. The pandemic and bushfires caused a decrease in physical activity in 53.8% and 55.3% of participants respectively, as well as increases in unhealthy eating (43.6% and 24.3% respectively) and alcohol consumption (35.4% and 10.5% respectively), and a decrease in typical sleeping patterns (40.5% and 39.5% respectively). Conversely, 27.5% of participants reported an increase in physical activity during the pandemic. Interview data detailed the circumstances and motivations for changes in health behaviours, as well as consequences, including reduced mobility, fitness, mood disturbances, and weight gain. CONCLUSION: There is a need to increase support and health promotion for people with MS to maintain or initiate positive health behaviours, especially in times of adversity.

The assist program

Background: Older adults (OA) disproportionately account for over 80 percent of mortality from the pandemic. Public Health safety recommendations for this vulnerable group includes social distancing and staying home, resulting in isolation and loneliness. UC Irvine Division of Geriatrics and School of Nursing developed the Assisting and Supporting Socially Isolated Seniors via Telephone or ASSIST Program to provide emotional support, community resources, and COVID-19 information by pairing OA with trained medical and nursing students for regular telephone check-ins during the pandemic. Methods: OA participants were recruited through health and community agencies including Meals on Wheels and low-income residential communities. Medical and nursing students were trained by UCI faculty/staff on COVID-19 guidelines, program procedures, and support services. Students called their paired OA and submitted Call Logs summarizing each conversation for faculty/staff review. Call Logs were analyzed to identify recurring themes. Staff conducted an OA participant satisfaction survey by phone. Students participated in an anonymous web-survey to identify learning experience and program satisfaction. Results: For 8 months during the pandemic, 43 OA participated in the program (living status-51% alone, 16% with others, 16% with family;70% female;63% aged 65-84). 45 students were paired to provide calls for about 30-minute weekly, averaging 9 calls per participant. An analysis of the combined 332 Call Logs identified frequent OA concerns: 'worries regarding health', 'family support and caregiving,' 'feelings of isolation,' 'COVID-19 education,' and 'needing community resources.' Satisfaction with the program was high with 95.2% of OA stating that ASSIST had been helpful;90.5% said that their student communicated effectively and provided helpful resources;and 95.2% said their student helped them feel less isolated during the pandemic. Mean student learning satisfaction was 4.3 of 5 (SD=0.43) with 94.7% reporting improved communication skills. Conclusion: The results from the project demonstrated satisfaction with the ASSIST program in vulnerable OA living in the community during the pandemic and positive geriatric education outcomes for healthcare students.

The impact of a covid-19 positive diagnosis on the risk of polypharmacy on community-dwelling adults aged 65 years and older

Background: Polypharmacy is known to increase with age and is a known risk factor for worsening geriatric syndromes. Emerging literature has shown post-COVID-19 infection complications involving pulmonary, cardiac, renal, dermatologic, thrombotic, and psychiatric disorders. It is expected that these would be treated with additional medications, which could increase an older adult's risk of polypharmacy, including an increase in total number of medications and high risk medications particularly, and, thus, worsening geriatric syndromes. Methods: This is an IRB-approved pilot study to evaluate if a long-term study of the assessment of polypharmacy risk in older adults after a positive COVID-19 diagnosis is warranted. This study will be conducted at the University of California, Irvine Senior Health Center, a primary care clinic for older adults with an interdiscinplinary healthcare team. Medication lists and changes to medications, diagnosis lists, and pertinent vitals and labs will be collected through chart review, along with treatment(s) used for COVID-19. These will be analyzed to determine if additional medications have been started after a COVID-19 diagnosis, and particularly, if these medications are high risk medications for older adults or could increase the individual's risk for worsening geriatric syndromes. Results: The data collection will occur through March 2021. Data will be analyzed on an on-going basis. Results are expected by March 2021. There will be data and results to present at the time of the meeting. Conclusions: Conclusions will be presented after results are obtained and analyzed. The results are expected to inform the feasibility of a continued, larger study to illustrate the long-term effects of a COVID-19 positive diagnosis the risk of polypharmacy in older adults.