Sister, Give Me Your Hand: a Qualitative Focus Group Study on Beliefs and Barriers to Mammography Screening in Black Women During the COVID-19 Era.

AIMS/PURPOSE: To evaluate current day challenges and beliefs about breast cancer screening for Black women in two diverse northeast communities in the midst of the COVID-19 pandemic. BACKGROUND: Breast cancer is the second leading cause of cancer-related death in women in the USA. Although Black women are less likely to be diagnosed with breast cancer, they suffer a higher mortality. Early detection of breast cancer can be accomplished through routine screening mammography, yet the effect of the COVID-19 pandemic on mammography screening barriers and perception in minority communities is uncertain. METHODS: Five focus group interviews were conducted as the first phase of a mixed method study across two heterogeneously diverse locations, Camden, New Jersey, and Brooklyn, New York. RESULTS: Thirty-three women participated in this study; sixteen women were recruited at the New Jersey location and seventeen at the New York location. Only two thirds of the women stated that they had received a mammogram within the last 2 years. The major themes were binary: I get screened or I do not get screened. Subthemes were categorized as patient related or system related. CONCLUSIONS: Our findings on factors that affect breast cancer screening decisions during the COVID-19 era include barriers that are related to poverty and insurance status, as well as those that are related to medical mistrust and negative healthcare experiences. Community outreach efforts should concentrate on building trust, providing equitable digital access, and skillfully addressing breast health perceptions.

Mental Health Problems among COVID-19 Frontline Healthcare Workers and the Other Country-Level Epidemics: The Case of Mexico.

COVID-19 frontline healthcare workers (FHCW) are struggling to cope with challenges that threaten their wellbeing. We examine the frequency and predictors of the most frequent mental health problems (MHP) among FHCW during the first COVID-19 peak in Mexico, one of the most severely affected countries in terms of FHCW's COVID-19 mortality. A cross-sectional survey was conducted between May 8 and August 18, 2020. A total of 47.5% of the sample (n = 2218) were FHCW. The most frequent MHP were insomnia, depression, posttraumatic stress symptoms, and health anxiety/somatization (whole sample: 45.7, 37.4, 33.9, and 21.3%; FHCW: 52.4, 43.4, 40.3 and 26.1, respectively). As compared to during the initial COVID-19 phase, depression and health anxiety/somatization symptoms as well as experiences of grieving due to COVID-19, personal COVID-19 status, and having relatives and close friends with COVID-19 were more frequent during the COVID-19 peak. Obesity, domestic violence, personal COVID-19 status, and grieving because of COVID-19 were included in regression models for main FHCW's MHP during the COVID-19 peak. In conclusion, measures to decrease other country-level epidemics contributing to the likelihood of COVID-19 complications (obesity) and MHP (domestic violence) as well as FHCW´s probability of COVID-19 infection could safeguard not only their physical but also mental health.

A qualitative assessment of psycho-educational videos for frontline COVID-19 healthcare workers in Mexico / Evaluación cualitativa de videos psicoeducativos para personal de salud de primera línea ante el COVID-19 en México

Abstract Introduction Frontline COVID-19 healthcare workers (FLHCWs) are at a high-risk of suffering occupational stress- and trauma-related mental health problems, including burnout and compassion fatigue (B&CF). Given the time limitations (due to their heavy workloads) and need to minimize face-to-face interventions (in order to avoid contagions), psychological interventions for FHCWs should be as brief and remote as possible. Objective To evaluate the usability and clarity of evidence-based psycho-educational videos to prevent B&CF, to deal with uncooperative, hostile, and anxious patients and relatives, and to use personal protective equipment (PPE), from the perspective of Mexican FLHCWs. Method Based on a convenience sampling by intensity approach, videos were distributed requesting feedback based on specific questions through WhatsApp to FLHCWs. Field notes were used to triangulate the information. Results Content analysis of feedback from a final sample of 24 participants ‒75% women, 42 ± 8.4 years old‒ yielded three general thematic categories and seven subthemes: 1. content evaluation, which included three subthemes: utility, pertinence, and practicality; 2. dissemination and other needs, with two subcategories: willingness to share and receive more videos (other needs); and 3. format aspects, also comprising two subthemes: attractiveness and duration. All participants found the videos content very beneficial, relevant, and applicable to the workplace and even in their everyday personal and family life, and were willing to share them and to receive more videos on other issues, including strategies to manage problems related to isolation. Discussion and conclusion Escalation of this remote preventive intervention to other COVID-19 centers and future similar epidemics is recommended.

Resumen Introducción Los trabajadores de la salud de primera línea (TSPL) ante el COVID-19 presentan alto riesgo de desgaste profesional y fatiga por compasión (DP&FC). Tomando en cuenta sus limitaciones de tiempo y la necesidad de minimizar las intervenciones cara a cara, las intervenciones psicológicas para los TSPL deben ser tan breves y remotas como sea posible. Objetivo Evaluar la utilidad y claridad de videos psicoeducativos basados en evidencia para prevenir DP&FC, el manejo de pacientes y familiares no cooperativos, hostiles o ansiosos, y el uso de equipo de protección personal desde la perspectiva de los TSPL mexicanos. Método Los videos se distribuyeron a los TSPL por medio de WhatsApp, solicitándoles su opinión con base en preguntas específicas. Se utilizaron notas de campo para triangular esta información. Resultados El análisis de contenido de las retroalimentaciones recibidas por una muestra final de 24 participantes ‒75% mujeres, 42 ± 8.4 años‒ arrojó tres categorías temáticas y nueve subtemas: 1. evaluación de contenido, con tres subtemas: utilidad, pertinencia y practicidad, 2. difusión y otras necesidades, con dos subcategorías: disponibilidad tanto a compartir como a recibir más videos (otras necesidades), y 3. aspectos de forma, también con dos subtemas: atractivo y duración. La totalidad consideró los videos muy benéficos, relevantes y aplicables en el trabajo y su vida diaria personal y familiar; y reportó disposición a compartirlos y a recibir más material de este tipo. Discusión y conclusión Se recomienda el escalamiento de esta medida preventiva y remota a otros centros COVID-19 y en futuras epidemias similares.

Relevant factors about the RT-PCR assay for the detection of SARS-CoV-2, virus that causes COVID-19

La disponibilidad de la secuencia de SARS-CoV-2 desde enero de 2020, permitió la implementación de ensayos de reacción en cadena de la polimerasa con transcripción inversa en tiempo real para la detección de este virus. Diversos tipos de muestra, reactivos y condiciones han sido estandarizados en diferentes países para utilizar este ensayo como prueba confirmativa de pacientes con COVID-19, siguiendo las indicaciones establecidas por la OMS en virtud de su alta sensibilidad y especificidad. Las condiciones generales para obtener resultados confiables de su aplicación implican detalles como la obtención de ácidos nucleicos en cantidad y pureza adecuadas de muestras que indiquen inequívocamente la presencia del virus en el paciente, incluso en etapas tempranas de la infección. El presente artículo presenta técnicas y procedimientos empleados por diferentes protocolos disponibles para la detección de SARS-CoV-2 mediante ensayos RT-PCR, efectuando comparaciones de parámetros de desempeño que permiten reconocer estrategias que pueden ser utilizadas en la mejora de este tipo de pruebas diagnósticas The availability of the SARS-CoV-2 sequence since January 2020, allowed the implementation of real-time reverse transcription polymerase chain reaction assays for the detection of this virus. Various types of samples, reagents and conditions have been standardized in different countries to use this assay as a confirmatory test for patients with COVID-19, following the indications established by the WHO due to its high sensitivity and specificity. The general conditions for obtaining reliable results from its application involve details such as obtaining nucleic acids in adequate quantity and purity from samples that unequivocally indicate the presence of the virus in the patient, even in the early stages of infection. This article presents techniques and procedures used by different protocols available for the detection of SARS-CoV-2 by means of RT-PCR tests, making comparisons of performance parameters that allow to recognize strategies that can be used in the improvement of this type of diagnostic tests

Mental health problems among healthcare workers involved with the COVID-19 outbreak.

OBJECTIVE: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. METHODS: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. RESULTS: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). CONCLUSION: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.