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1.
Gynecologic Oncology ; 166:S251, 2022.
Article in English | EMBASE | ID: covidwho-2031758

ABSTRACT

Objectives: To determine (1) if health disparities experienced by rural, obese endometrial cancer survivors (ECS) were exacerbated by the COVID-19 pandemic and (2) preferred components and delivery methods for behavioral interventions. Methods: A cross-sectional survey was distributed to obese, early- stage ECS to ascertain demographic information, physical activity (PA level), self-efficacy, lifestyle intervention preferences, as well as the impact of COVID-19 on PA, diet, and mental health. Responses were compared between obese (BMI= 30-39.9 kg/m2) and morbidly obese (BMI= 40+ kg/m2) survivors as well as those who did or did not meet national PA recommendations. Results: Among 335 eligible survivors, only 70 (20.9%) completed the survey. The median age was 63 years (IQR: 14 years). Survivors were 37 months from diagnosis (IQR: 37 months). The median BMI was 39.2 kg/m2 (IQR: 8.4 kg/m2). Overall, only one-quarter of ECS were fairly or fully confident in their ability to undertake moderate PA. More morbidly obese survivors reported low self-efficacy in performing moderate PA than obese survivors (90% vs 65%;p= 0.02). Pre COVID-19, 66% of survivors did not meet PA guidelines and were more likely to be morbidly obese than obese, but the difference was not significant (78% vs 58%;p=0.08). Post COVID-19, 83% of survivors did not meet PA guidelines, with no difference between BMI groups (82% vs 84%;p>0.05). After COVID-19, 54% of survivors reported a decrease in PA, 32% made poorer nutritional choices, and 47% reported worsening mental health. Post COVID-19, no difference in the nutrition or mental health changes was seen between survivors who were meeting PA guidelines and those who were not (p>0.05). Regarding lifestyle interventions, survivors preferred information delivered electronically (online (56%) or via email (41%)) versus in person (30%) or via text (21%). Preferences for PA included exercising at home (46%) or online with a coach (33%) versus with a group fitness class (18%) or at the gym (17%). Combining health promotion with exercise was appealing to the majority of participants (37%), while others were not interested (27%) or unsure (31%). Responses were similar between patients meeting and not meeting PA recommendations (p>0.05). The most preferred lifestyle intervention components included tracking progress (56%), health recipes (56%), one-on-one counseling (46%), tips for cheap and healthy eating (41%), exercising alone (41%), and online sessions (39%). Conclusions: As a result of COVID-19, rural, obese ECS experienced a decrease in PA, worse nutritional decision-making, and poorer mental health. Preferred components of lifestyle interventions in this patient population were identified and can be used to develop future, evidence-based behavioral interventions. These interventions may be scalable in rural communities with limited access during the COVID-19 pandemic and beyond.

2.
Obstetrics and Gynecology ; 139(SUPPL 1):78S-79S, 2022.
Article in English | EMBASE | ID: covidwho-1925146

ABSTRACT

INTRODUCTION: The American College of Obstetrics and Gynecology (ACOG) recommends screening for depression and anxiety at least once during the perinatal period and again during postpartum checks. The delivery of validated screening tools varies amongst institutions and individual obstetricians. The objectives of this study were to assess our institution's baseline screening rates and the impact of the COVID-19 pandemic on maternal mental health. METHODS: Our patient population was pregnant and postpartum patients at Carilion Clinic from January 2019 to July 2020. Data collected from medical records included scores of the Edinburgh Perinatal Depression Screening (EPDS), Personal Health Questionnaire (PHQ) 2 and 9, demographics, and psychiatric history. Screening rates and incidence of mood disorders were compared between pre- and intra-COVID-19 cohorts. RESULTS: Of the 850 women included, 43.5% (n=370) were screened during perinatal visits and 49.8% (n=424) postpartum. Screenings were completed more frequently during postpartum checks pre-COVID-19 compared to during the pandemic with PHQ-2 (27.4% vs. 16.1%, P=.0001) and PHQ-9 (10.3% vs. 5.4%, P=.011). More women screened positive for depression at perinatal checks during the pandemic compared to pre-pandemic (13.2% vs. 4.7%, P=.0377). CONCLUSION: The COVID-19 pandemic has affected rates of maternal depression screening and has significant mental health impacts on this population. This study reveals baseline rates of screening in perinatal and postpartum visits at our institution, which is critical to delivery of quality care. This information will help inform strategies to increase rates of screening and ensure that mental health needs are being addressed, especially in times of emergency.

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