Increasing Access to a Diverse Mental Health Workforce through Emergency Reciprocity Licensure

New Jersey's COVID-19 Temporary Emergency Reciprocity Licensure Program provided temporary licenses to more than 31000 out-of-state healthcare practitioners, over a quarter of whom were mental health providers. As the need for mental health care accelerated during the pandemic, especially among health disparity populations, expanding mental health provider pools may be a critical tool to increase access to care. In January 2021, we surveyed New Jersey's temporary licensees. We analyzed over 4500 mental health provider responses to examine the impact of the temporary licensure program on access to mental health care overall and on enhancing a diverse mental health workforce. Over 3700 respondents used their temporary license to provide mental health care to New Jersey patients. About 7% of respondents self-identified as Hispanic, 12% Black, 6% Asian, 1% American Indian or Alaska Native, and 0% (more than 5) Native Hawaiian or other Pacific Islander. They treated about 30100 New Jersey patients, 40% of whom were new to the provider, and 81% delivered care exclusively using telehealth. Respondents conversed with patients in at least 13 languages. About 53% served at least one patient from an underserved racial/ethnic minority group. Our findings suggest that temporary out-of-state mental health providers helped enhance mental health care continuity and access. Copyright 2023 Federation of State Medical Boards. All Rights Reserved.

How COVID-19 Emergency Practitioner Licensure Impacted Access to Care: Perceptions of Local and National Stakeholders

The COVID-19 public health emergency required US states to respond rapidly on regulatory issues, including the process for licensing healthcare practitioners. At least 45 states enacted some form of a licensure waiver, enabling practitioners to temporarily work across state lines. We conducted 22 interviews with national and local (New Jersey) licensure stakeholders in September and October 2021 to capture perceptions of how emergency licensure impacted access to care. Five themes emerged: (1) Emergency licensing helped shift the nation's healthcare workforce supply into regions and specialties of high need;(2) Expanded telehealth capacities complemented emergency licensure programs;(3) Concerns about care quality were mitigated by the urgency of the pandemic, credentialing processes, and investigative authorities;(4) Relocation packages and the need to replace staff could lead to higher costs of care;and (5) Views on licensure reciprocity and interstate compacts were favorable, but smaller provider organizations need to be protected. Overall, stakeholders perceived emergency licensure as successful in expanding access to care during the pandemic. Findings suggest that stakeholders view interstate licensure compacts more favorably now than pre-COVID. While stakeholders may be in favor of licensure reciprocity, they raised concerns about its feasibility, cost, and quality. Copyright 2022 Federation of State Medical Boards. All Rights Reserved.

Intention to Adopt E-Grocery Shopping Service in Vietnam During Covid-19 Pandemic

The purpose of this study is to determine the factors that influence the intention to adopt e-grocery shopping service of Vietnamese consumers during Covid-19 Pandemic. The sample size includes 235 responses collected from e-grocery shoppers in Vietnam. The research methodology includes Cronbach's Alpha analysis, EFA analysis and multiple regression analysis. Data is analysed in SPSS 20 software. The results have identified four factors that directly affect the intention to adopt e-grocery shopping service which are social influence, perceived ease of use, brand image and perceived usefulness. Social influence is the most significant factor that impacting the intention to adopt e-grocery shopping service among consumers during Covid-19 Pandemic in Vietnam. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

REDUCTIONS IN CANCER SERVICES IN AUSTRALIA DUE TO THE PANDEMIC: IMPLICATIONS FOR THE CANCER CARE WORKFORCE

Introduction To investigate immediate and longer-term impacts of the COVID-19 pandemic on cancer care in Australia and to provide context for consideration of system-level and oncology workforce challenges, we examined provision of a range of cancer services during 2020. Methods As a marker of cancer control activity, we examined sentinel diagnostic and therapeutic procedures relating to 14 cancer types using claims data for the Medicare Benefits Schedule, a listing of medical services subsidised by the Australian Government. Results Impacts of COVID-19 on cancer-related services were observed early in the pandemic with observed number of quarterly services notably lower than expected for most cancer types nationally. Some recovery of services through to March 2021 followed with modest increases in quarterly services above that expected for some cancer types. However, sustained impacts overall for 2020 were observed for many services with 8% (163,595) fewer diagnostic and 9% (14,600) fewer therapeutic procedures observed nationally in 2020 than were expected from historical data.1 Conclusions Recovery of service numbers may indicate workload increases for an already over-burdened oncology workforce and may contribute to physical and psychological fatigue in service providers.2 Potential implications of sustained impact on services include later stage at diagnosis, increased treatment complexity and poorer outcomes. Understanding of ongoing impacts on care delivery can inform cancer control planning beyond the pandemic.

Transitions to virtual administration of CBT-I: Strengths and barriers

Introduction: In March 2020, the University of Arkansas Psychological Clinic began social distancing resulting in a CBT-I group (four patients, 3 trainee co-leaders) transitioning from in-person meetings to telehealth via Webex. Two co-leaders led the group while the third disseminated electronic materials and scored the patients' online sleep diaries. Virtual administration of CBT-I had benefits and challenges. Report of case(s): Firstly, many of the patients were familiar with teleconferencing as their jobs also transitioned to virtual meetings and could identify environments with limited interruptions. Telehealth group etiquette such as muting audio, timely diary submission, and peer support were easily mastered. However, one patient had poor internet connection, which necessitated switching between their laptop and phone to connect and seemed to negatively impact engagement with the group. Furthermore, the clinicians were confronted with the difficult decision to continue helping troubleshoot technical issues or continue with the session. During in-person visits, co-leaders could address difficulties with sleep prescription or questions about the material;however, balancing technical issues, answering questions, and facilitating support amongst the patients via telehealth was often distracting and inefficient. From a clinician perspective, it was difficult to co-lead the group due to patients respectfully muting their mics, resulting in less contributions to discussion. Additionally, many of the administrative tasks typically completed with clinic staff after an in-person session were completed during session, making it challenging to maintain confidentiality. Presentation of visual aids was difficult as patient using cellphones to connect could not view and download files while connected to session. Finally, basic clinical techniques were impacted using the virtual platform. For instance, 'sitting in silence' was less effective while maintaining eye contact with the entire group was facilitated by looking directly at the camera. Unfortunately, reading facial expressions and non-verbals was often more difficult and clinicians relied on more direct questions rather than open-ended questions. Conclusion: These challenges provide opportunities to learn how to make CBT-I via telehealth more effective. Despite the challenges of transitioning to telepsychology, the CBT-I group was effective as evidenced by high satisfaction ratings from patients, reductions in PHQ-9 and ISI scores, SOL, WASO, and increases in sleep efficiency.