Service delivery and programing adaptations for individuals with disabilities by municipalities and non-profit organizations during the COVID pandemic.

Municipalities and nonprofit organizations play a major role in administrating services that support individuals with disabilities. The purpose of this study was to explore how these organizations responded to the COVID-19 pandemic in regards to service delivery and programming for people with disabilities. This qualitative interpretative description study used semi-structured individual interviews for data collection. Recordings of the interviews were transcribed. Then the transcripts were analyzed qualitatively for themes following an inductive approach. Twenty-six individuals working for nonprofit organization or municipalities participated in the study. Six themes were identified: doing more with less; adapting rather than creating new services; ongoing consultation with stakeholders; feeling successful at adapting the services; being innovative with fundraising and embracing radical change. Flexibility and iterative user-centered approach appeared to be common coping strategies. Remote services were privileged to adapt service delivery during the COVID-19 pandemic.

Being a Parent of Children with Disabilities during the COVID-19 Pandemic: Multi-Method Study of Health, Social Life, and Occupational Situation.

Parents of children with disabilities face challenges in their daily lives, but little is known about their experience of the COVID-19 pandemic. The objective of the study was to explore the experiences of parents of children with disabilities during the COVID-19 pandemic in Quebec, Canada. Forty parents of children with disabilities from Quebec, Canada (mean [SD] age: 41.2 [6.7]; 93% women) were selected from the Ma Vie et la pandémie (MAVIPAN) study. All 40 parents completed the MAVIPAN online questionnaires including the Depression, Anxiety and Stress Scale (DASS-21), Warwick-Edinburgh Mental Wellbeing short 7-item scale (WEMWBS), Social Provisions Scale-10 item (SPS-10), and the UCLA Loneliness Scale (UCLA-LS). A multi-method analysis was used to summarize questionnaires and thematically explore parents' experiences. Parents reported deterioration in their mental (50.0%) and physical (27.5%) health, with moderate levels of depression, stress, and anxiety, yet moderately positive well-being. Additional experiences included reduction in available supports (71.4%) and feelings of social isolation (51.4%). Our results highlighted reduced mental and physical health, limited and modified access to certain services, and reduction of social supports for some parents of children with disabilities. Health professionals, policymakers, and governments should be mindful of these challenges experienced by parents of children with disabilities.

Exploring the Experiences of People with Disabilities during the First Year of COVID-19 Restrictions in the Province of Quebec, Canada

During the COVID-19 pandemic, the province of Quebec, Canada implemented stringent measures to mitigate virus transmission, which considerably affected the life of people with disabilities (PWD). The objective of this study was to explore the experiences of PWD during the first year of COVID-19 restrictions across the province. Participants who self-identified as having a disability in the Ma Vie et la pandámie study (MAVIPAN) were invited to participate in a semi-structured interview between December 2020 and May 2021. A mixed inductive and deductive approach was used to conduct a thematic analysis using NVivo 12. Forty PWD from Quebec, Canada participated in the interviews (mean [SD] age, 55.4 [15.5] years, 50% women). A deterioration in mental health and a reduction in social contact with loved ones were reported. PWD experienced delays and cessation of health services and reported feeling at risk of contracting severe strains of COVID-19 because of their health condition. Enhanced difficulties experienced by PWD and the lack of consideration specific to PWD by public authorities during COVID-19 was particularly concerning for participants in this study. Future studies should explore the value of implementing social programs specifically targeting PWD to enhance support as the pandemic continues.

Providing community services for persons with disabilities during the COVID-19 pandemic: A scoping review.

Community organisations and municipalities support people with disabilities by providing resources and services that are essential for their engagement in the community. Their services were particularly impacted by restrictions related to the COVID-19 pandemic. The aim of the study is to identify scientific literature that examines how community organisations and municipalities adapted services and resources provided to people with disabilities as a result of the COVID-19 pandemic. A scoping review was conducted by searching the databases Medline, Embase, CINAHL, PsycINFO and Web of Science Core Collection in January 2021. Fifteen studies were included from the initial search strategy of 7651 individual studies. Most of the studies were quantitative studies (73.3%; n = 11) and aimed at describing the adaptations put in place during the COVID-19 pandemic (66.7%; n = 10). Most services and resources involved some form of preventive healthcare (66.7%; n = 10). The adaptation of modalities for delivering resources and services varied widely across organisations (e.g. online or a combination of online and in-person) but mostly led to an improvement of the studied outcome (e.g. social skills, quality of life). Barriers (e.g. need for a reliable internet connection, lack of technology literacy from the member) and facilitators (e.g. flexibility and planning from the organisations) for these adaptations have been identified, but there is little information surrounding their cost. The results highlight that the delivery of online services has increased since the inception of the COVID-19 pandemic with valuable outcomes. However, further research is needed to better identify the barriers, facilitators and outcomes of remote services to better face future large-scale disasters like the COVID-19 pandemic and to better support individuals who cannot reach in-person services.

Experiences of Social Participation for Canadian Wheelchair Users with Spinal Cord Injury during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic caused drastic life changes for people with spinal cord injury (SCI). The objective of the study is to explore the social participation of Canadian wheelchair users with SCI during the first wave of COVID-19. Methods: Fourteen participants from Quebec and British Columbia participated in a multi methods cross-sectional study. Three themes were identified, including (1) perceived participation restrictions for people with SCI and their loved ones, which revealed interruptions and changes in service provision during COVID-19, barriers and inconveniences to maintaining life habits and strategies developed during the pandemic to continue participating in meaningful activities;(2) There was no change in life habits (but some subjects found new ways to perform some activities), which highlights that life simply continued as usual and the participants developed new pastimes and interests;and (3) future hopes and concerns, which explained participants' concerns about changes in interpersonal relationships after the pandemic. This study highlights daily participation challenges for people with SCI during the pandemic. Even though the use of technologies, delivery services and social support seemed to facilitate engagement in meaningful activities, mental health challenges and concerns for future relationships persisted for some.

For a structured response to the psychosocial consequences of the restrictive measures imposed by the global COVID-19 health pandemic: the MAVIPAN longitudinal prospective cohort study protocol.

INTRODUCTION: The COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and social services to reorganise. This unprecedented crisis forces individuals to make considerable efforts to adapt and will have psychological and social consequences, mainly on vulnerable individuals, that will remain once the pandemic is contained and will most likely exacerbate existing social and gender health inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. The MAVIPAN (Ma vie et la pandémie/ My Life and the Pandemic) study aims to document how individuals, families, healthcare workers and health organisations are affected by the pandemic and how they adapt. METHODS AND ANALYSIS: MAVIPAN is a 5-year longitudinal prospective cohort study launched in April 2020 across the province of Quebec (Canada). Quantitative data will be collected through online questionnaires (4-6 times/year) according to the evolution of the pandemic. Qualitative data will be collected with individual and group interviews and will seek to deepen our understanding of coping strategies. Analysis will be conducted under a mixed-method umbrella, with both sequential and simultaneous analyses of quantitative and qualitative data. ETHICS AND DISSEMINATION: MAVIPAN aims to support the healthcare and social services system response by providing high-quality, real-time information needed to identify those who are most affected by the pandemic and by guiding public health authorities' decision making regarding intervention and resource allocation to mitigate these impacts. MAVIPAN was approved by the Ethics Committees of the Primary Care and Population Health Research Sector of CIUSSS de la Capitale-Nationale (Committee of record) and of the additional participating institutions. TRIAL REGISTRATION NUMBER: NCT04575571.

Can Technology Abate the Experience of Social Isolation for Those Affected by Dementia?

Background: The widespread social isolation measures recently utilized to mitigate the spread of COVID-19 to older adults may have exuded unexpected consequences. Social isolation among older adults is a risk factor for poor health outcomes. Innovative solutions to balancing public safety and health maintenance for those with dementia and their caregivers are needed. Methods: A sample of N = 82 dementia caregivers participated in a web-based survey to investigate their perceptions on (1) changes in personal mental health due to isolation from their loved one, and (2) the perceived need for use of smart mobile device app use in these situations. Results: The majority of our sample (87%) reported experiencing negative mental health outcomes beyond those experienced in typical situations. Furthermore, over 70% of caregivers were concerned with the care their loved on received during social isolation. Finally, 67% reported perceived need to use SMD apps in these times of social isolation. Conclusion: Our findings provide preliminary insight into troubling consequences occurring when individuals with dementia are socially isolated from their caregivers. An inverse relationship between SMD app use and poor mental health points to the potential for communication technology to lessen the negative impacts of social isolation, when it becomes necessary to public safety.

Accessibility of Online Resources for Associations Providing Services to People with Brain Injuries in Covid-19 Pandemic.

BACKGROUND: Since the Covid-19 pandemic, many community-based services for people with traumatic brain injury (TBI) have been moved online, which may have hindered their accessibility. The study aims to assess the accessibility of online information and resources dedicated to people with TBI. METHODS: The websites of 14 organizations offering information and resources to people with TBI in Quebec were evaluated. Two co-authors independently evaluated one page of each website and compared their results. Descriptive statistical analyses were performed. RESULTS: The average accessibility score of the 14 websites evaluated was 54% with a standard deviation of 16%. Website design and writing were the most accessible aspects (72.3%). Only two out of the 14 websites (14%) presented multimedia content. This category presented the most barriers to accessibility with a score of 42%. Regarding images, they reached an accessibility score of 46%. Their main shortcoming was the absence of a caption. CONCLUSION: This study highlights accessibility issues specific to people with TBI to access online resources and identifies specific areas of improvement. The results of this study provide community organizations with avenues of improvement to make their online resources more accessible to people with TBI and may therefore lead to improved community practices.

Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial.

BACKGROUND: Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. OBJECTIVE: This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. SETTING: The study will be implemented in a community setting in three Canadian cities. PARTICIPANTS: Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. INTERVENTION: Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75-150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants' training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. MEASUREMENTS: Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. IMPACT STATEMENT: We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review

Background: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. Objective: This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. Methods: A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework–Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. Results: A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. Conclusions: Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review.

BACKGROUND: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. OBJECTIVE: This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. METHODS: A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. RESULTS: A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. CONCLUSIONS: Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Impact of COVID-19 on people with physical disabilities: A rapid review.

BACKGROUND: The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic. OBJECTIVE: This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities. METHODS: A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language. RESULTS: Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted. CONCLUSIONS: Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.