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1.
Journal of Cystic Fibrosis ; 21(Supplement 2):S209-S210, 2022.
Article in English | EMBASE | ID: covidwho-2318707

ABSTRACT

Background: As a result of COVID-19-related precautions, states temporarily relaxed certain restrictions on telehealth services during the pandemic, including waiving licensing requirements so physicians could serve patients across state lines, but many states ended this flexibility in 2021. According to two online surveys fielded by the Cystic Fibrosis Foundation (CFF) to accredited centers in 2020 and 2021, 65% of programs reported providing care to patients living in another state. Of these, 18.5% reported that some of their out-of-state (OOS) patients were not able to access telehealth services because of licensure-related issues [1]. CFF Compass fielded 20 calls from people with cystic fibrosis (CF) in 15 states requesting assistance in accessing their OOS care center, accounting for more than 25% of all network adequacy inquiries received during that time. CFF recognized the need for policy change to improve access to OOS care for people with CF. Method(s): In 2021, we interviewed five CF care centers about their experiences with telehealth and OOS licensing. The administrative burden of applying for multiple state medical licenses was a key barrier to providing remote OOS care, and CFF identified the Interstate Medical Licensure Compact (IMLC) as one solution. The IMLC streamlines the licensing application process for physicians who want to practice in multiple states. From January 2021 to March 2022, CFF supported legislation in 10 states to join the IMLC by sending letters with 31 care center director co-signers. CFF also hosted a webinar in June 2021 to educate CF care centers about the IMLC as away to pursue multiple medical licenses with one application. We shared follow-up information about the IMLC through CFF COVID-19 digest emails. CFF sent a survey in March 2022 to all CF care centers to understand current use of and barriers to telehealth for CF care teams. Data from this survey are forthcoming. Result(s): Before CFF's engagement in January 2021, 30 states and the District of Columbia were members of the IMLC. As of April 8, 2022, five additional states have passed legislation to join the IMLC, reflecting a 17% increase in state participation from January 2021 to March 2022. Within the 35 participating states at present,126 CF care center programs will have the potential to use the IMLC. CFF has supported legislation in all six states with pending legislation to join the IMLC in 2022. Increased physician awareness of IMLCwas evidenced by physician participation from 20 states in thewebinar, aswell as broad distribution of the recording via the COVID- 19 digest to 288 CF programs in 49 states afater the session. Conclusion(s): Although more states taking action to join the IMLC is an important step, challenges persist. Even in IMLC member states, CF providers express concerns about the cost and administrative burden of maintaining licenses in multiple states. Permanent regulations regarding use of and reimbursement for telehealth remain uncertain. To better understand current challenges and opportunities for telehealth and remote OOS care, CFF is supporting additional research and advocacy.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

2.
European Journal of Public Health ; 32, 2022.
Article in English | Web of Science | ID: covidwho-2309893
3.
European journal of public health ; 32(Suppl 3), 2022.
Article in English | EuropePMC | ID: covidwho-2102299

ABSTRACT

Background COVID-19 vaccine hesitancy is a major problem worldwide that impedes vaccine uptake. We explored factors associated with vaccine hesitancy in Kazakhstan. Methods We conducted a cross-sectional face-to-face survey of 991 adults in Kazakhstan in July 2021, using quota sampling of respondents over 18 years old reflecting the distribution of gender, age, residence type, and geographical regions of Kazakhstan, according to the 2020 census. Results Over two third (68.4%) of the sample was vaccine hesitant;22.11% - received a vaccine (18.6%-Sputnik V, 2%-Hayat-Vax, 0.9%-QazCovid and 0.6%- CoronaVac). We used logistic regression to explore factors that were associated with vaccine hesitancy, adjusting age, education, employment, type of residence, self-reported COVID-19. The odds of not being vaccine hesitant were higher among those who had a higher perception that the COVID-19 vaccine was important for health OR = 2.66 (95%CI:2.24,3.17), higher belief in vaccine safety/effectiveness OR = 3.16 (95%CI:2.57,3.89), higher trust in government/health providers OR = 3.32 (95%CI:2.72,4.05), higher trust in official sources of information OR = 1.16 (95%CI:1.12,1.21), higher adherence to preventive measures OR = 1.05 (95%CI:1.03,1.08), knew someone diagnosed with COVID-19 OR = 1.36 (95%CI:1.01,1.82), or who died of COVID-19 OR = 1.47 (95%CI:1.04,2.08), had been ever tested for COVID-19 OR = 1.75 (95%CI:1.30,2.35), had ever received flu vaccine OR = 2.16 (95%CI:1.62,2.88), among health professionals OR = 2.76 (95%CI:1.38,5.51), and who had lower vaccine conspiracy beliefs OR = 0.48 (95% CI:0.40,0.58). Conclusions Vaccine accepting individuals held positive beliefs about the COVID-19 vaccine, had greater trust in government/official sources of information/health care workers, had greater exposure to COVID-19. Interventions aimed at reducing vaccine hesitancy need to address sources people find credible and may need to target individuals who have had limited exposure to the risks of COVID-19. Key messages • Strategies to increase trust in government/ health care workers and official sources of information can be an effective approach to reduce COVID-19 vaccination hesitancy. • Interventions to reduce COVID-19 vaccination hesitancy should target individuals who have had limited exposure to the risks of COVID-19.

4.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009600

ABSTRACT

Background: Assessments of health-related quality of life (HRQOL) are conducted by health systems to analyze and improve patient-centered care. Numerous studies have shown that the COVID-19 pandemic poses unique stressors for patients with cancer. However, the impact of the pandemic on HRQOL in patients with cancer is unknown. This study investigates change in self-reported global health scores in patients with cancer before and during the COVID-19 pandemic. Methods: In this single-institution retrospective cohort study, patients who completed the Patient-Reported Outcomes Measurement Information System (PROMIS) at a comprehensive cancer center before and during the COVID-19 pandemic were identified. Surveys were analyzed to assess change in the PROMIS global mental health (GMH) and global physical health (GPH) scores at different time periods (pre-COVID: 3/1/5/2019-3/ 15/2020, surge1: 6/17/2020-9/7/2020, valley1: 9/8/2020-11/16/2020, surge2: 11/17/2020-3/2/ 2021, and valley2: 3/3/2021-6/15/2021). Results: A total of 29,983 surveys among 7,209 patients were included in the study. Mean GMH scores for patients before the COVID-19 pandemic (50.57) were similar to that during various periods during the pandemic: surge1 (48.82), valley1 (48.93), surge2 (48.68), valley2 (49.19). Mean GPH score was significantly higher pre-COVID (42.46) than during surge1 (36.88), valley1 (36.90), surge2 (37.33) and valley2 (37.14) (Table). During the pandemic, mean GMH (49.00) and GPH (37.37) scores obtained through in-person were similar to mean GMH (48.53) and GPH (36.94) scores obtained through telehealth. Conclusions: In this single institution study, patients with cancer reported stable mental health and deteriorating physical health during the COVID-19 pandemic as indicated by the PROMIS survey. Modality of the survey (in-person versus telehealth) did not affect scores.

5.
Science Communication ; 44(3):320-346, 2022.
Article in English | GIM | ID: covidwho-1993265

ABSTRACT

This study examines how online vaccine information seeking is related to vaccination intention in the United States and China during the initial stage of their coronavirus disease 2019 vaccination programs. Analysis of the pooled sample showed a positive relationship between online vaccine information seeking and vaccination intention. There was also a negative indirect effect via perceived information overload, vaccine risk perception, and negative affective response. Multigroup analysis revealed differences between the United States and China. This study highlights the bright and dark sides of online health information during a global pandemic and has practical implications for communication campaigns to promote health-related behaviors.

6.
Topics in Antiviral Medicine ; 30(1 SUPPL):330, 2022.
Article in English | EMBASE | ID: covidwho-1880794

ABSTRACT

Background: Monitoring new mutations in SARS-CoV-2 is crucial for identifying diagnostic and therapeutic targets and important insights to achieve a more effective COVID-19 control strategy. Next-generation sequencing (NGS) has been widely used for whole-genome sequencing of SARS-CoV-2. However, NGS methods may be limited by the complexity of workflow, which limits scalability. Here, we address this limitation by designing a workflow optimized for high-throughput studies. Methods: We utilized modified ARTIC network v3 primers for SARS-CoV-2 whole-genome amplification. Similar to a previously reported tailed PCR approach, libraries were prepared by a 2-step PCR method but optimized to improve amplicon balance, integrate robotic liquid handlers, and minimize amplicon dropout for viral genomes harboring primer-binding site mutation(s). Sequencing was performed on the Illumina NovaSeq 6000 and the Illumina MiSeq. An in-house analysis pipeline utilized the BWA aligner and iVar software. Assay precision was assessed with unique clinical samples. Assay sensitivity was assessed with serial dilutions of clinical samples. Robustness was assessed by sequencing samples and controls on the NovaSeq from multiple prior ARTIC v3 runs. Results: Intra-assay (n=188) and inter-assay (n=168) precision at the amino acid substitution level was 99.8% and 99.5%, respectively. Over 98.2% (111/113) of samples with a cycle threshold (Ct) <28 yielded a near-complete (≥97%) consensus sequence, and 98.7% (147/149) of samples with a Ct <30 yielded ≥90% consensus coverage. 2,688 samples and controls were sequenced in a single NovaSeq run yielding a 94.3% (2,416/2,562) sample pass rate. The optimized workflow gave more complete SARS-CoV-2 genome consensus sequences for most viral clades than the original ARTIC v3 workflow (Table). From over 65,000 clinical samples sequenced in 2021, we observed clade and lineage prevalence in-line with those documented by the CDC in 2021, including the Alpha clade that peaked at 65.3% in May, and the Delta clade that attained near-100% prevalence in September. Conclusion: We present an optimized workflow to process up to 2,688 samples in a single NovaSeq 6000 run without compromising sensitivity or robustness and with fewer amplicon dropout events compared to the standard ARTIC protocol. We additionally report results for over 65,000 SARS-CoV-2 clinical specimens collected in the United States between January and September of 2021, as part of an ongoing national genomics surveillance effort.

7.
R I Med J (2013) ; 105(2):38-42, 2022.
Article in English | PubMed | ID: covidwho-1710943

ABSTRACT

OBJECTIVES: There is limited data available specific to young adult tobacco use in Rhode Island. This study examines whether young adult cigarette and e-cigarette use varies by sociodemographics, mental health, and use of other substances. METHODS: This cross-sectional web-based survey was administered during the COVID-19 pandemic, from May to October 2020. RESULTS: A total of 12.9% of young adults reported current cigarette or e-cigarette use. Young adults who currently used cigarettes or e-cigarettes were more likely to be white, non-Hispanic, younger, and have depressive symptoms, a depression diagnosis, suicide ideation, engage in harmful drinking, alcohol dependence, current marijuana use, and frequent marijuana use. CONCLUSIONS: To address the needs of disproportionately affected young adults, steps must be taken to integrate comprehensive, barrier-free, widely promoted coverage of tobacco cessation treatment in all behavioral healthcare settings.

8.
Rhode Island Medicine ; 105(1):26-31, 2022.
Article in English | MEDLINE | ID: covidwho-1652242

ABSTRACT

OBJECTIVES: Use of telehealth for behavioral health services has increased since the start of the COVID-19 pandemic. This study examines which young adults in Rhode Island were using these telehealth services and are interested in its use. METHODS: This cross-sectional web-based survey was administered in the midst of the COVID-19 pandemic, from May to October 2020. RESULTS: Results suggest sexual and gender minorities and those with low social status were more likely to access these services, highlighting its effectiveness at reaching disadvantaged young adults. Those with mental health symptoms were more likely to utilize telehealth, but those with substance use were not. CONCLUSIONS: There is a missed opportunity to target substance use telehealth services to this willing and interested population. Continued coverage and use of telehealth for mental health and substance use services is essential in breaking down barriers to care for young adults in Rhode Island.

9.
Rhode Island Medicine ; 104(10):36-41, 2021.
Article in English | MEDLINE | ID: covidwho-1539517

ABSTRACT

This study documents disparities in the mental health burden of young adults in Rhode Island during the COVID-19 pandemic as it pertains to essential worker status, sexual orientation, gender identity, and childhood trauma. A cross-sectional web-based survey of young adults aged 18 to 25 years conducted between May and October of 2020 assessed anxiety symptoms, depressive symptoms, and thoughts of suicide. In fully adjusted regression models, (n =528 young adults) being an essential worker, a sexual minority, having lower relative SES, and having more adverse childhood experiences were significantly associated with negative mental health outcomes. In models adjusted for individual ACEs, exposure to mental illness in the household, physical violence between adults in the household, emotional abuse, and sexual abuse were independently associated with all three outcomes. Young adults most vulnerable and stigmatized in the community are also those who are most severely affected in terms of mental health.

10.
Journal of Molecular Diagnostics ; 22(11):S31-S31, 2020.
Article in English | Web of Science | ID: covidwho-1070377
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