ABSTRACT
Background: During the COVID-19 pandemic, many oncology practices began offering virtual visits via video and/or telephone. How such visits are perceived by Black adults receiving cancer care, a category of patients often facing access barriers and poorer outcomes, is not known. We elicited Black patients' perceptions of oncology virtual visits. Method(s): We conducted in-depth, semi-structured telephone interviews with Black adults aged >=21 years who received oncology care between 6/1/19 - 3/20/21 for head & neck cancer, prostate cancer, and multiple myeloma within two US-based academic health systems. The interview guide elicited perceptions within predefined themes (e.g., ease of use, usefulness, communication quality, appropriateness). Interviews were audio-recorded, transcribed verbatim, and coded for a priori themes and new ones identified during data immersion. One trained research assistant coded all transcripts, using Atlas.ti for data management. Result(s): Forty-nine Black adults diagnosed with cancer completed an interview between 9/2021 and 2/2022 (n = 16 head & neck, n = 16 prostate, n = 17 multiple myeloma);mean age 62 years (range: 26-79), 55% male, and 59% reported ever having a virtual visit (n = 21 experienced video virtual visit(s), n = 8 telephone only). Perceptions of virtual visits varied. Some expressed a desire for continued use and noted advantages, including factors associated with the comfort and convenience of being home and not needing to travel (e.g., not needing to get up and dressed;reduced time and gas/parking costs). Others emphatically indicated preferring in-person visits due to the face-to-face/one-on-one/person-to-person interaction. Those with positive perceptions endorsed similarities between information exchanges, communication, and physician knowledge in in-person compared to virtual visits, but often noted insurance coverage, working technology and the need for clinical appropriateness (e.g., it was just a follow up visit;I didn't need any labs) as foundational. Those expressing concerns discussed the inability for vital signs assessment/ physical exams/laboratory testing, and raised concerns regarding interpersonal communication, including the inability to be physically present with one another and assess each other's body language. For some respondents this led to concerns about trust/honesty and physicians being distracted and/or missing something during the visit. Technology-related obstacles (e.g., confidence and connectivity) when experienced were reported as overcome with assistance or via switching to telephone. Conclusion(s): We found Black adults with cancer generally receptive to virtual visits and that telephoneonly options increased access. Virtual visit acceptability among Black adults may be enhanced by improved interpersonal connectedness during visits, technology support, and patient-centered scheduling options.
ABSTRACT
Almost as soon as the NCAA announced the cancelation its 2020 "March Madness" basketball tournament, college administrators began moving to cut sports from their schools' portfolios. This study explores the effects of the COVID-19 pandemic on college athletics. It examines the historical and sociological context surrounding the decisions to eliminate athletic programs (affecting nearly 2,500 athletes at the time of writing) at universities across the country. Drawing on research surrounding the implementation of Title IX, the authors examine how college athletics' most recent crisis caused university leaders to once again cut sports in the name of gender equity.
ABSTRACT
Study Objectives: To determine the levels of burnout and empathy amongst EM residents during a time of pandemic as compared to the previous year. Methods: In June of 2020, three months into the COVID-19 pandemic and nearing the end of the academic year, EM residents in a suburban 4-year program were surveyed utilizing the Maslach Burnout Inventory (MBI) and the Jefferson Scale of Empathy (JSE). Surveys were presented online utilizing the Qualtrics® online platform. Anonymity was assured. At the time of this survey over 6000 patients had tested positive for COVID-19 in the hospital network. In one of the two hospitals, EM residents manage the care of the patients on the Intensive Care (ICU) service. Many participants had been required to work extra shifts and additional ICU months to cover the increased number of critical patients and to cover residents who could not work due to COVID-19 illness or exposure. These metrics were compared with matched historical data from second and third-year residents completing the survey one year previously. Results: A total of 54 of 57 residents responded to the survey for a response rate of 95%, however 7 declined to have their data used for research, giving us an analyzable response rate of 83% (28 males and 19 females). A total of 13 first-year, 9 second-year, 12 third-year and 13 fourth-year residents responded. The median age was 31 years (IQR 29-34). There was no difference by PGY year in the JSE score (range 20-140), average 108.0 (IQR: 99-117), p>0.05). There was also no difference by PGY year in any of the MBI categories. Emotional exhaustion scores revealed 31.9% high, 29.8% moderate, and 38.3% low levels. Depersonalization scores ranged from 38.3% high, 40.4% moderate and 21.3% low levels. Personal Accomplishment scores which are scored inversely (higher is better) ranged as follows: 19.2% high, 34% moderate and 46.8% low. Males were more likely than females (28.6% vs. 5.3%, p=0.01) to have high levels of Personal Accomplishment. Females were more likely than males to have (57.9% vs. 17.9%, p=0.01) moderate levels of Personal Accomplishment. Females [111 (IQR 103-123)] and males [106 (97-116)] had similar levels of empathy on the JSE;p=0.18. No significant difference was found in any of the four metrics measured when matched with the 15 residents who took the same survey in 2019;p>0.1 (see Table). Conclusion: As measured by commonly utilized metrics, EM residents in all years showed concerningly high or moderate levels of Emotional Exhaustion and Depersonalization (61.7% and 78.7%). Females and males demonstrated similar levels of empathy but females were less likely than males to have high Personal Accomplishment scores. Although these results, indicating high rates of burnout in EM residents, remain a concern, there is no evidence that the current pandemic has negatively impacted these metrics. [Formula presented]