Has the COVID-19 Pandemic Led to Changes in the Tasks of the Primary Care Workforce? An International Survey among General Practices in 38 Countries (PRICOV-19).

The COVID-19 pandemic has had a large and varying impact on primary care. This paper studies changes in the tasks of general practitioners (GPs) and associated staff during the COVID-19 pandemic. Data from the PRICOV-19 study of 5093 GPs in 38 countries were used. We constructed a scale for task changes and performed multilevel analyses. The scale was reliable at both GP and country level. Clustering of task changes at country level was considerable (25%). During the pandemic, staff members were more involved in giving information and recommendations to patients contacting the practice by phone, and they were more involved in triage. GPs took on additional responsibilities and were more involved in reaching out to patients. Problems due to staff absence, when dealt with internally, were related to more task changes. Task changes were larger in practices employing a wider range of professional groups. Whilst GPs were happy with the task changes in practices with more changes, they also felt the need for further training. A higher-than-average proportion of elderly people and people with a chronic condition in the practice were related to task changes. The number of infections in a country during the first wave of the pandemic was related to task changes. Other characteristics at country level were not associated with task changes. Future research on the sustainability of task changes after the pandemic is needed.

Factors influencing the adoption and participation rate of nursing homes staff in a saliva testing screening programme for COVID-19.

Testing strategies are crucial to prevent and control the spread of covid-19 but suffer from a lack of investment in understanding the human factors that influence their implementation. The aim of this study was to understand the factors that encourage participation and the level of engagement of nursing homes staff in a routine saliva testing programme for COVID-19 In December 2020, nursing homes (n = 571) in Wallonia (Belgium) were invited to participate in a saliva testing programme for their staff. The directors were questioned by telephone at the end of a 3-week pilot phase. 445 nursing homes took part in the evaluation questionnaire, of which 36(8%) answered that they chose not to participate in the testing programme. The average participation rate of nursing staff was 49(±25)%. Perception of the justification of the efforts required for testing and perception of practicability of the procedure were significantly associated with the adoption of the system by the nursing homes directors (OR(95%CI): 5.96(1.97-18.0), p = 0.0016); OR(95%CI): 5.64(1.94-16.4), p = 0.0015 respectively). Staff support, incentives and meetings increased the level of engagement in testing (p<0.05). While the adoption of the programme confirmed the acceptability of salivary testing as a means of screening, the participation rate confirmed the need for studies to understand the factors that encourage health care staff to take part. The results suggested rethinking strategies to consider staff engagement from a health promotion perspective.

Acceptability of Community Saliva Testing in Controlling the COVID-19 Pandemic: Lessons Learned from Two Case Studies in Nursing Homes and Schools.

Current public health debate centers on COVID-19 testing methods and strategies. In some communities, high transmission risk may justify routine testing, and this requires test methods that are safe and efficient for both patients and the administrative or health-care workers administering them. Saliva testing appears to satisfy those criteria. There is, however, little documentation on the acceptability of this method among beneficiaries. This article presents the lessons learned from a pilot study on the use of saliva testing for routine screening of nursing home and secondary school personnel in Wallonia (the French-speaking part of Belgium), conducted in December 2020 to April 2021, respectively. Administrators at the facilities in question seemed to think highly of saliva testing and wished to continue it after the pilot study was over. This result reinforces the criteria (the noninvasive aspect, in particular) supporting a key role for saliva testing in monitoring community spread of the virus. Nevertheless, wider-scale deployment of this particular method will only be possible if the testing strategy as a whole takes a health promotion approach.

Learnings from Health Behavioural Survey Practices in France and Belgium During the First COVID-19 Stay-at-Home Order.

The COVID-19 pandemic has compelled public authorities to establish preventive measures involving individual behaviour modification strategies (mask-wearing, social distancing, etc.) with a view to community protection. In this context, documenting people's behaviour changes, the impact of public health measures, and individuals' knowledge, motivations, and beliefs - even their perception of how the crisis is being managed - is essential for understanding the experience of the population and adapting the management approach accordingly. This article presents findings and lessons on how to monitor a population's behaviour during a crisis, obtained by reviewing forty-five surveys conducted in Belgium and France during the first Covid-19 stay-at-home order, from April to May 2020. The central message is to argue that the citizens' role in this type of survey - and in managing the crisis, more generally - should be reconsidered by thinking of them as true health partners and members of a community that could be mobilised to help.

COVID-19: An emergency educational model

The current health crisis reminds us of the importance of communicating prevention messages and ensuring that they are understood by the population. If messages on barrier gestures were designed to be easily understood, the fact remains that the transition from information processing to the implementation of health behaviour represents a real challenge. In order to bring about changes in health behaviour to cope with the epidemic, it is imperative to provide "crisis education", coupled with an information strategy, particularly to help the most vulnerable and needy. In this context, the Health Education and Practices Laboratory (LEPSUR3412) of the Sorbonne Paris Nord University has designed a brief educational intervention for people affected by COVID-19. This intervention (30 min to 1 h) is based on three fields of practice: discharge education (ETP-SH), health literacy and identity-housing. The different phases of this intervention are similar to those of the ETP-SH: an educational diagnosis followed by the negotiation of possible applications with the person, a phase of interactive exchanges, the permanent verification of the person's understanding and the planning of a telephone session scheduled at a distance. (PsycInfo Database Record (c) 2020 APA, all rights reserved) Abstract (French) La crise sanitaire actuelle rappelle tout l'enjeu de la communication des messages de prevention et de leur comprehension par la population. Si les messages sur les gestes barrieres ont ete concus pour etre facilement compris, il n'en reste pas moins que le passage du traitement de l'information a la mise en oeuvre d'un comportement de sante represente un veritable defi. Pour obtenir des changements de comportements de sante face a l'epidemie, il est imperatif de proposer une << education d'urgence , couplee a une strategie d'information, en particulier pour aider les personnes les plus vulnerables et demunies. Dans ce contexte, le Laboratoire Educations et Pratiques de Sante (LEPSUR3412) de l'Universite Sorbonne Paris Nord a concu une intervention educative breve pour les personnes concernees par le COVID-19. Cette intervention (30 min a 1 h) s'adosse a trois champs de pratiques : l'education therapeutique de sortie d'hopital dite ETPSH, la litteratie en sante et l'identite-logement. Les differentes phases de cette intervention sont proches de celles de celles de l'ETP-SH : un diagnostic educatif suivi de la negociation des applications possibles avec la personne, une phase d'echanges interactifs, la verification permanente de la comprehension par la personne et la planification d'une seance telephonique planifiee a distance. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

CEdRIC: Strategy for Patient Education During COVID-19 Triage.

The current coronavirus disease 2019 (COVID-19) pandemic is forcing healthcare systems around the word to organise care differently than before. Prompt detection and effective triage and isolation of potentially infected and infectious patients are essential to preventing unnecessary community exposure. Since there are as yet no medications to treat or vaccines to prevent COVID-19, prevention focuses on self-management strategies, creating patient education challenges for physicians doing triage and testing. This article describes a five-step process for effectively educating, at discharge, patients who are suspected of being infectious and instructed to self-isolate at home. We are proposing the CEdRIC strategy as a practical, straightforward protocol that meets patient education and health psychology science requirements. The main goal of the CEdRIC process is to give patients self-management strategies aimed at preventing complications and disease transmission. The COVID-19 pandemic is challenging clinicians to rapidly teach their patients self-management strategies while managing the inherent pressures of this emergency situation. The CEdRIC strategy is designed to deliver key information to patients and standardize the discharge process. CEdRIC is currently being tested at triage centres in Belgium. Formal assessment of its implementation is still needed.