ABSTRACT
Purpose Coronavirus has accentuated the cracks within the fragile UK food system. Empty shelves and empty stomachs, the damaging consequences of coronavirus have led to an unprecedented increase in food insecurity and food access. The purpose of this paper is to provide in-depth insight into varied and innovative rural localised responses to food access during the pandemic. Design/methodology/approach This study draws on multiple perspectives of those working to combat food insecurity, inequality and inaccessibility in Gwynedd, exploring food access initiatives and their responses to the pandemic, innovative food distribution collaborations and the role of maintaining already fragile rural communities. Findings This study concludes that the need for transformative place-making to build stronger, more resilient communities has never been more pressing, with support from public sector funding to help alleviate some of the hardships and pressure with the rise in poverty and austerity, coronavirus imposed or not. Originality/value This study focuses on a single local authority area in North Wales, Gwynedd, an area where little food research has been published to date. The coronavirus pandemic also places the timely research within the scope of food access and distribution during hardship. This study discusses the impacts exposed by the pandemic and lessons that can be drawn and reflected on for future benefit.
ABSTRACT
Statement of purposePreventing opioid misuse and opioid use disorder (OUD) is necessary given the opioid epidemic. Prevention programs for adolescents/young adults are needed to alter risk trajectories. We developed interventions using telemedicine (synchronous video conference) and a patient portal-like messaging system to address risk factors for opioid misuse/OUD among young Emergency Department (ED) patients. Our presentation describes these promising interventions and their feasibility and acceptability.Methods/ApproachIn Spring 2020, N = 40 ED patients ages 16–30 who were at risk for opioid misuse/OUD enrolled in a pilot trial involving screening/baseline assessments, motivational interviewing-based remote interventions (baseline telemedicine brief intervention [BI], 1-month of portal messaging), and a 1-month follow-up. Before COVID-19, N = 10 enrolled in the ED (in-person cohort: IPC);during COVID-19, N = 30 recent ED patients enrolled via phone recruitment (remote cohort: RC). Feasibility data are presented by cohort;acceptability data are combined.ResultsAmong the N=40, the sample had a mean age of 22.9 years. Gender was: 70% female, 5% non-conforming, 25% male. Race was: 75% White, 15% Black/African American, and 10% other racial identities;17.5% were Hispanic/Latinx. Regarding feasibility, eligibility rates were similar (IPC: 17%, RC: 15%);consenting rates differed (IPC: 100%, RC: 56%), likely due to the RC’s telephone approach. Portal engagement increased from the IPC (60%) to the RC (93%), possibly due to addressing technical difficulties and IPC user feedback. BI and portal satisfaction were high (M = 9.3 on a 1–10 scale and M = 8.5, respectively). Interventions exceeded motivational interviewing fidelity thresholds (adapted for portal messaging). Follow-up rates were high (IPC: 80%, RC: 93%).SignificancePreventing opioid misuse is critical to avoiding escalation of opioid use and overdoses, and emergency department patients are at increased risk. This study demonstrates the feasibility and acceptability of these intervention approaches via telemedicine for preventing future injuries.