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2.
PLoS Global Public Health ; 2(6), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021488

ABSTRACT

As with previous global public health emergencies, the COVID-19 pandemic has had distinct and disproportionate impacts on women and their health and livelihoods. As the leader in global public health, it is incumbent upon the World Health Organization (WHO) to ensure gender is prioritized in pandemic response. We conducted a policy analysis of 338 WHO COVID-19 documents and found that only 20% explicitly discuss gender and over half do not mention women, gender, or sex at all. Considering the well documented gendered effects of pandemics and the WHO's commitment to gender mainstreaming, this paper: (1) asks to what degree and how the WHO incorporates a gender inclusive approach;(2) maps where and how gender considerations are included;and (3) analyses what this suggests about WHO's commitment to gender mainstreaming within its COVID-19 response and beyond. We demonstrate that WHO should increase its gender mainstreaming efforts and incorporate gender considerations related to health emergencies more often and in more policy areas.

3.
Emergency Medicine Journal : EMJ ; 39(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2020110

ABSTRACT

IntroductionCOVID-19 has had significant impacts on the provision of pre-hospital care. Media and academic reports have heavily covered the impacts of Covid-19 on society and health care but have primarily focused on the densely packed urban environments which were hardest hit. This study examines the impact of COVID-19 on pre-hospital care outside of major urban centers.MethodsThe electronic patient care records (ePCR) of 3 Ontario paramedic services were compared for 365 days starting March 13 (start of lockdown for Ontario in 2020) for Historic (2018-2019), PreCOVID (2019-2020) and COVID (2020-2021) periods. Demographics were examined using t-Tests and proportion (Goodness of Fit) tests. Call counts in temporal categories were analysed using Chi-Squared tests of goodness of fit, while changes in the distribution of call time intervals were examined using a LR test for equivalence. Ethics for the study was approved by the Trent University Ethics Review Board.Results89,126 ePCRs were examined (Historic: 30,070;PreCOVID: 30,576;COVID: 28,480). Small but statistically significant differences between COVID and PreCOVID were found in the gender and primary problem of patients (p < 0.01) as well as in all temporal fields (p < 0.03), except day-of-the-week (p = 0.87). In time interval comparison, time-on-scene and time-to-patient-contact were significantly increased in the COVID-19 era while time-to-offload (in the ER) was much shorter. Response times were found to be marginally slower, while transport-time-to-ED was found to be significantly faster during COVID.PreCOVID versus Historic comparisons found no significant difference, except in age and CTAS, which had significant differences in both the COVID vs PreCOVID and PreCOVID vs Historic periods (p < 0.001 for both).ConclusionCOVID-19 has had many impacts on prehospital care. However, the practical significance of COVID on rural pre-hospital care may not be as large as that reported in higher density area.

4.
Jama Network Open ; 5(8), 2022.
Article in English | Web of Science | ID: covidwho-2013239

ABSTRACT

IMPORTANCE School meals are associated with improved nutrition and health for millions of US children, but school closures due to the COVID-19 pandemic disrupted children's access to school meals. Two policy approaches, the Pandemic Electronic Benefit Transfer (P-EBT) program, which provided the cash value of missed meals directly to families on debit-like cards to use for making food purchases, and the grab-and-go meals program, which offered prepared meals from school kitchens at community distribution points, were activated to replace missed meals for children from low-income families;however, the extent to which these programs reached those who needed them and the programs' costs were unknown. OBJECTIVE To assess the proportion of eligible youths who were reached by P-EBT and grab-and-go meals, the amount of meals or benefits received, and the cost to implement each program. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from March to June 2020. The study population was all US youths younger than 19 years, including US youths aged 6 to 18 years who were eligible to receive free or reduced-price meals (primary analysis sample). EXPOSURES Receipt of P-EBT or grab-and-go school meals. MAIN OUTCOMES AND MEASURES The main outcomes were the percentage of youths reached by P-EBT and grab-and-go school meals, mean benefit received per recipient, and mean cost, including implementation costs and time costs to families per meal distributed. RESULTS Among 30 million youths eligible for free or reduced-price meals, grab-and-go meals reached an estimated 8.0 million (27%) and P-EBT reached 26.9 million (89%). The grab-and-go school meals program distributed 429 million meals per month in spring 2020, and the P-EBT program distributed $3.2 billion in monthly cash benefits, equivalent to 1.1 billion meals. Among those receiving benefits, the mean monthly benefit was larger for grab-and-go school meals ($148;range across states, $44-$176) compared with P-EBT ($110;range across states, $55-$114). Costs per meal delivered were lower for P-EBT ($6.46;range across states, $6.41-$6.79) compared with graband-go school meals ($8.07;range across states, $2.97-$15.27). The P-EBT program had lower public sector implementation costs but higher uncompensated time costs to families (eg, preparation time for meals) compared with grab-and-go school meals. CONCLUSIONS AND RELEVANCE In this economic evaluation, both the P-EBT and grab-and-go school meal programs supported youths' access to food in complementary ways when US schools were closed during the COVID-19 pandemic from March to June 2020.

5.
Innovation in Aging ; 5:719-719, 2021.
Article in English | Web of Science | ID: covidwho-2012185
6.
Innovation in Aging ; 5:510-510, 2021.
Article in English | Web of Science | ID: covidwho-2012139
7.
Innovation in Aging ; 5:739-739, 2021.
Article in English | Web of Science | ID: covidwho-2011713
8.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009594

ABSTRACT

Background: The coronavirus disease (COVID-19) pandemic has created unprecedented strain on healthcare systems across the world. COVID-19 has thought to have significant impacts on the oncology patient population and has affected their care. Additional research is needed to ascertain the impact of the COVID-19 pandemic at the patient level. We sought to evaluate whether the delivery of cancer care, quality of life (QoL) and treatment outcomes of oncology patients at Mount Sinai Hospital (MSH), Toronto, Canada was impacted by the COVID-19 pandemic. Methods: A 3-part longitudinal questionnaire study including 138 oncology patients receiving active treatment or in active follow-up at MSH was conducted between June 15, 2020 and August 25, 2021. The questionnaire consisted of the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer QoL Questionnaire Version 3) and satisfaction with virtual healthcare questionnaire. The questionnaire was completed at baseline (Jun 15-Sep 8, 2020), 1 month follow-up (Jul 15-Oct 8, 2020), and 12 months followup (Aug 4-Aug 25, 2021). Repeated measures analysis of variance tests were performed to evaluate EORTC QLQ-C30 subscale score changes and satisfaction with virtual care question scores over time. Results: Overall, the mean EORTC QLQ-C30 QoL scores were seen to improve in oncology patients from 65.1 (SD±22.3) at baseline to 69.1 (SD±16.9) at 12 months follow-up (p = 0.2). Within the EORTC QLQ-C30 functional scales, mean role functioning and mean social functioning scores were observed to increase over 12 months of follow-up, 66.4 to 79.2 (p < 0.05) and 67.7 to 76.4 (p = 0.17), respectively. Little change was observed within other EORTC QLQ-C30 functional scales and individual symptom scales during follow-up. Over 12 months of follow-up, mean agreement (0 = strongly disagree to 6 = strongly agree) to the questionnaire statement regarding avoiding going to the hospital during COVID-19 pandemic had declined, from 4.6 (SD±2.0) at baseline to 3.9 (SD±2.2) at 12 months follow-up (p = 0.09). Although not significant, virtual care satisfaction generally decreased over the follow-up time period. 97% of 48 patients who completed the survey at 12 months of followup reported feeling more safe coming into the hospital when considering the current increased vaccination rates in Ontario. Conclusions: As the COVID-19 pandemic has evolved, there has been increased knowledge of disease transmission, along with the introduction of health care measures such as vaccination and treatment. During this time, cancer outpatients at MSH became more comfortable as demonstrated by improvements in both QoL and virtual care scores. Prospective studies should still be considered to assess the efficacy of different methods of improving oncology patient care and QoL during the COVID-19 pandemic.

9.
Psychosomatic Medicine ; 84(5):A75, 2022.
Article in English | EMBASE | ID: covidwho-2003447

ABSTRACT

Purpose Stressor events, such as COVID-19, may trigger adaptive or maladaptive pain management strategies among individuals with persistent low back pain (LBP). Emerging research shows individuals with lower fear avoidance, depression and anxiety, and greater positive affect and quality of life can better maintain positive pain management strategies during stressor events. For individuals with persistent LBP, physical activity (PA) has been shown to be a beneficial pain management strategy. This study investigated psychosocial variables of individuals with LBP who demonstrated adaptive pain management strategies during COVID-19, indicated by the maintenance of physical activity. Methods Twenty-five individuals with persistent LBP (age 22.4 (3.4) years, 7m, 18f) from an existing longitudinal cohort participated. Participants completed a baseline survey prior to COVID-19. This survey quantified demographics, pain severity, frequency, and duration. Other baseline measures were the Physical Activity Scale, the WHOQOL-Bref physical, psychological, social, and environmental quality of life subscales, Fear Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, and Trait Affect scale. Participants then completed follow-up surveys for 18 months. During COVID-19 lockdown, the impact of lockdown on PA was assessed. The cohort was dichotomized into individuals reporting the same or more PA (MPA) and those reporting less PA (LPA) and baseline characteristics were compared between groups. Results The LPA group contained 17 individuals and the MPA group contained 8 individuals. There was no significant demographic difference between groups. The MPA group had greater duration of LBP symptoms (p=0.015, d =1.16). The MPA group trended towards higher physical quality of life (p=0.101, d=0.79) and higher environmental quality of life (p=0.057, d=0.96) at baseline. Individuals in the MPA group had lower negative affect (fatigue domain) scores than the LPA group (p=0.038, d=0.86). Depression scores were lower in the MPA group (p=0.006, d=1.12). Conclusions Individuals with persistent LBP who had greater duration of symptoms, better physical and environmental quality of life, lower negative affect, and less depression were more likely to maintain or increase physical activity during COVID-19. These characteristics may facilitate positive adaptation to a stressor event.

10.
Br J Clin Pharmacol ; 2022.
Article in English | PubMed | ID: covidwho-2001607

ABSTRACT

AIMS: Pressurised metered-dose inhalers (MDIs) have a much higher carbon footprint than dry powder inhalers (DPIs). We aimed to describe variations of inhaler options in local adult asthma prescribing guidance. METHODS: We reviewed local clinical commissioning group (CCG) adult asthma prescribing guidance for primary care in England in 2019 and recorded DPI and MDI inclusion. The relationship to prescribing data from OpenPrescribing.net was examined. RESULTS: 58 unique guidance documents were analyzed covering 144 out of 191 CCGs in England. Only 3% of CCG guidelines expressed an overall preference for DPIs, while 12% explicitly preferred MDIs. The inclusion of DPIs first-line was 77% for short-acting beta-agonists (SABA), 78% for low-dose inhaled corticosteroid inhalers (ICS), and 90-96% for combination long-acting beta agonist (LABA)/ICS inhalers. MDIs were included first-line in 98-100% of these classes. In 26% of CCGs, there was no first-line DPI option for at least one asthma management step. 10% of CCGs had no DPI included first-line for any of the 5 classes examined. Many CCGs recommended higher carbon footprint options;Ventolin MDI (25.6%), inhalers containing HFA227ea (57.9%), and ICS regimes recommending 2 puffs of a lower dose over 1 puff of higher dose (94.2%). MDIs were prescribed more in CCGs that recommended them. CONCLUSIONS: Before the COVID pandemic, there was substantial variation between CCGs in adult asthma prescribing guidance regarding higher and lower carbon footprint options. There may still be scope to amend local guidance to improve clinical and environmental outcomes. This study provides a method and baseline for further investigation of this.

12.
Social Politics ; : 24, 2022.
Article in English | Web of Science | ID: covidwho-1985119

ABSTRACT

Recognition of the differential effects of COVID-19 on women has led to calls for greater application of gender-based analysis within policy responses. Beyond pointing out where such policies are implemented, there is little analysis of the effects of efforts to integrate gender-based analysis into the COVID-19 response. Drawing on interviews informing a lived experienced approach to policy analysis, this article asks if, how, and to what effect gender-based analysis was implemented within social and economic policy responses during the initial lockdown, in British Columbia, Canada. It finds that, despite a rhetorical commitment to gender-based analysis, policies failed to address everyday inequalities.

13.
Bipolar Disorders ; 24:53, 2022.
Article in English | EMBASE | ID: covidwho-1978422

ABSTRACT

Introduction: During 2020, measures to contain the global health crisis caused by the coronavirus disease (COVID-19) included social confinement, with the consequent interruption of normal activities. In Argentina, particularly, the confinement was one of the longest and strictest in the world. Within this context, the current study was aimed at exploring changes in illness severity among bipolar disorder (BD) patients living under strict lockdown. Method: Ninety BD outpatients under naturalistic conditions were followed from March (when the lockdown measures were imposed in our country) to September 2020. Thirteen variables of illness severity were assessed during this period, which were compared with the results obtained during the same 28-week period of the previous year (i.e., from March to September 2019). Results: No significant differences were observed between periods in the rate of patients that remained euthymic during the entire follow-up (28.9% before the pandemic versus 41.1% during the pandemic, p = 0.09). For most variables, no significant differences were observed. A small decrease was found in depressive episode density (from 0.39 ± 0.74 to 0.22 ± 0.63, p = 0.003). Symptom and episode density during the pre-pandemic period and the number of previous depressive episodes at study entry predicted worse outcomes during the pandemic. Conclusion: Findings from a large sample of BD individuals indicate that illness severity variables have not worsened as a result of the lockdown. In addition, our findings suggest an important degree of positive coping among BD patients and emphasize the effectiveness of telepsychiatry in treating this clinical population.

14.
2022 IEEE International Conference on Communications Workshops, ICC Workshops 2022 ; : 361-366, 2022.
Article in English | Scopus | ID: covidwho-1973476

ABSTRACT

Location fingerprinting based on Received Signal Strength Indicator (RSSI) has become a mainstream indoor localization technique due to its advantage of not requiring the installation of new infrastructure and the modification of existing devices, especially given the prevalence of Wi-Fi-enabled devices and the ubiquitous Wi-Fi access in modern buildings. The use of Artificial Intelligence (AI)/Machine Learning (ML) technologies like Deep Neural Networks (DNNs) makes location fingerprinting more accurate and reliable, especially for large-scale multi-building and multi-floor indoor localization. The application of DNNs for indoor localization, however, depends on a large amount of preprocessed and deliberately-labeled data for their training. Considering the difficulty of the data collection in an indoor environment, especially under the current epidemic situation of COVID-19, we investigate three different methods of RSSI data augmentation based on Multi-Output Gaussian Process (MOGP), i.e., by a single floor, by neighboring floors, and by a single building;unlike Single-Output Gaussian Process (SOGP), MOGP can take into account the correlation among RSSI observations from multiple Access Points (APs) deployed closely to each other (e.g., APs on the same floor of a building) by collectively handling them. The feasibility of the MOGP-based RSSI data augmentation is demonstrated through experiments using a recently-published work based on Recurrent Neural Network (RNN) indoor localization model and the UJIIndoorLoc, i.e., the most popular publicly-available multi-building and multi-floor indoor localization database;the RNN model trained with the UJIIndoorLoc database, augmented by using the whole RSSI data of a building in fitting an MOGP model (i.e., by a single building), outperforms the other two augmentation methods and reduces the mean three-dimensional positioning error from 8.62 m to 8.42 m in comparison to the RNN model trained with the original UJIIndoorLoc database. © 2022 IEEE.

15.
Journal of the Academy of Consultation-Liaison Psychiatry ; 63:S108, 2022.
Article in English | EMBASE | ID: covidwho-1966678

ABSTRACT

Background: Within the general hospital setting, Consultation-Liaison (C-L) Psychiatry services are critical for managing patients with behaviors that frequently result in behavioral emergencies, including agitation, verbal aggression, physical aggression, and demanding behavior (Pestka et al., 2012). To most effectively manage these difficult patient behaviors, early consultation to C-L Psychiatry may prevent behavior from escalating to the level of a behavioral emergency. Yet, data is limited regarding the effectiveness of C-L Psychiatry in impacting the occurrence and reoccurrence of behavioral emergencies. Method: Data on all behavioral emergencies that occurred at the University of Virginia Medical Center from January 2020 to December 2020 were collected. Variables collected include patient demographic information, frequency of behavioral emergency, type of behavioral emergency, factors contributing to behavioral emergency, and whether the C-L Psychiatry service had been consulted. Patients who received a C-L Psychiatry consult prior to a behavioral emergency will be compared on the above variables to patients who did not receive this consult to identify differences between the two groups. Results: Preliminary data indicates that UVA Medical Center had an average of 61.2 (range 38-82) behavioral emergencies per month between January 2020 and December 2020. These fell into five categories consistent with previous pilot data: physical aggression, leaving the unit, verbal aggression, agitation, and non-compliance (Yost & Smith, 2020). Factors contributing to behavioral emergencies were identified as delirium, dementia, personality disorder, substance withdrawal, frustration, and TBI. Data will be further analyzed to determine how frequently patients who exhibit behavioral emergencies had received C-L Psychiatry services prior to the behavioral emergency or had not received this service during their hospitalization. Additional analyses will be conducted to determine differences between these two groups on type of behavioral emergency and factors contributing to behavioral emergency. Discussion: This data will inform how patients with challenging behavior are identified early in their hospitalization and how C-L Psychiatry can proactively intervene to decrease behavioral emergencies. Further, this project suggests a need to create process for identifying patients at risk for behavioral emergencies. Future directions will be discussed. Conclusions/Implications: The findings from this quality improvement project have important clinical implications concerning how C-L Psychiatry manages patients with challenging behavior and how frontline staff identify and utilize C-L Psychiatry. References: 1. Pestka EL, Hatteberg DA, Larson LA, Zwygart AM, Cox DL, Borgen EE Jr. Enhancing safety in behavioral emergency situations. Medsurg Nurs. 2012;21(6):335-41. 2. Yost, JS & Smith, JB. A taxonomy of behavioral emergencies in the general hospital: A comparison of behavioral emergencies pre-covid-19 and during the covid-19 outbreak. Brief oral presentation delivered at the 2020 Annual Meeting of the Academy of Consultation-Liaison Psychiatry.

16.
8th IEEE International Conference on Big Data Security on Cloud, 8th IEEE International Conference on High Performance and Smart Computing, and 8th IEEE International Conference on Intelligent Data and Security, BigDataSecurity/HPSC/IDS 2022 ; : 92-94, 2022.
Article in English | Scopus | ID: covidwho-1961365

ABSTRACT

Public transit demand is an import indicator of economic and social activity level. To accurately predict the public transport demand change during the COVID pandemic, in this paper, we investigate various factors affecting such demand change and collect related data from multiple sources. Different prediction models including linear regression and deep neural networks are explored. Experiments were conducted and the results show that though COVID-19 pandemic greatly affect the public transport, our proposed approach can accurately predict the next day public transit volume. © 2022 IEEE.

17.
BMJ Leader ; 4:A49, 2020.
Article in English | EMBASE | ID: covidwho-1956854

ABSTRACT

Introduction Great Ormond Street Hospital (GOSH) Summer School aims to inspire medical students and junior doctors to follow a career in Paediatrics, especially given the low competition ratio in Paediatrics training applications in the last three years. This year we had to move the conference to a virtual environment due to the outbreak of COVID-19. Issues We needed to modify the program to be deliverable as a series of webinars. The Summer School's capacity was increased to 500 participants (Virtually) from 75 (face to face). We explored ways to maintain interactivity, keep engagement, and fulfill our aim to inspire with a much larger group within the virtual environment. Furthermore, we refined our program to reflect the current pandemic. Interventions To reduce digital fatigue, we changed the length of the conference from 2.5 long days to 4 short days. Each day consisted of 3 or 4 webinars and a career panel session. The career panel sessions focus on sharing the individual journey, which was met with great enthusiasm from the participants. We utilized multiple tools to facilitate the interaction with the participants and speakers: Slido (Q and A, poll and quiz), a conference App, social media, and the 'Raise Hand' tool within Zoom. Measurements The conference was well attended with zoom data showed 390, 282,305, and 324 along the four days. Slido showed a high level of engagement with a total of 1005 questions posted and 434 active participants. 344 completed the post-conference survey, 80% voted the conference being excellent, and 100% voted for the continuation of delivering the conference online next year. Lessons Learnt COVID-19 compelled us to run our conference digitally, however we have gained a great deal of experience in management, leadership, and education. We learned the necessity of making rapid decisions and flexible leadership to enable ourselves to deliver quality education during the pandemic.

18.
Organizational Behaviour in Healthcare ; : 179-201, 2021.
Article in English | Scopus | ID: covidwho-1930254

ABSTRACT

The COVID-19 pandemic led to a wholesale re-ordering of primary care service delivery. Virtually overnight, consultations moved to telephone calls or online interactions wherever possible. Service changes which have been debated at length and would ordinarily have taken years to implement became normal practice. In this chapter, we describe the NHS in England primary care policy response and locate this in a wider UK and international context, drawing on co-author Fisher’s frontline experience as a GP to describe how primary care organisations in one locality worked to create a new service. We then present findings from an empirical study supported by the Health Foundation to capture narratives from a sample of GPs, practice managers and community nurses in England and Scotland about their experiences of and responses to this unusual and shifting situation. We draw on analysis of qualitative longitudinal data captured in self-recordings, written contributions and short online interviews. The chapter concludes by discussing the ways in which primary health care professionals’ roles and identities may be changing as new forms of service provision emerge in response to the COVID-19 crisis. It is clear that the long-term implications of the pandemic on primary care and its practitioners are unknown. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

19.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927729

ABSTRACT

Unexplained hypoxia in a pregnant patient is an alarming finding for patient and provider. The differential for hypoxia is broad, and many imaging techniques and procedures are contraindicated in pregnancy. Transient pulmonary arteriovenous malformations (AVMs) are a rare and relatively poorly studied cause of hypoxia in pregnancy. Our patient is a 27-year-old G1P0 female with a remote history of asthma who presented to clinic with slowly progressive exertional dyspnea, exertional tachycardia, and paroxysmal nocturnal dyspnea. She reported use of a home oximeter which read in the high 80s% during exertion. Prior to presentation, the patient was evaluated in the Emergency Department and noted to have an oxygen saturation of 86% on room air. A transthoracic echocardiogram, computed tomography angiography of chest, and basic laboratories including B-type natriuretic peptide, troponin, COVID-19, and hemoglobin were unremarkable. Her clinical timeline is presented in Figure 1. Further testing was obtained, including pulmonary function testing, bubble echocardiogram, nocturnal oximetry, and shunt study. Work-up revealed a 15-20% shunt, depending on calculation, and insignificant desaturations during nocturnal oximetry. Her symptoms progressed, and repeat nocturnal oximetry showed marked overnight desaturations requiring supplemental oxygen for the remainder of her pregnancy. She delivered a healthy baby girl via cesarean section without serious complication. Repeat testing in the post-partum period showed resolution of nocturnal desaturations and decreased shunt, and her exertional dyspnea and desaturations resolved spontaneously. This case illustrates the challenging diagnosis of transient pulmonary AVM in pregnancy. Case reports of this phenomenon have been published, but as in our case, no definitive diagnosis was made secondary to testing limitations in pregnancy and quick resolution of symptoms in the post-partum period. Some reports describe pre-existing pulmonary AVM becoming worse during pregnancy causing hemothorax, fetal demise and even death. While the mechanism is not known, theories include the vasodilatory effects of progesterone on vascular smooth muscle as well as other physiologic changes in pregnancy such as increased plasma volume. These AVM are thought to be like those seen in hepatopulmonary syndrome. Similar to our case, increasing positional hypoxia has been reported as the pregnancy progresses. Further research dedicated to early and accurate detection of pulmonary AVMs in pregnancy is necessary. (Figure Presented).

20.
Millennials, Spirituality and Tourism ; : 252-267, 2021.
Article in English | Scopus | ID: covidwho-1893155

ABSTRACT

This chapter documents the experiences of Millennials in culturally immersive homestays, tours and excursions within indigenous spiritual communities in the Caribbean. The chapter validates that there is an increasing demand for spiritual tourism from a particular group of consumers – Millennial travellers. Grounded in the theories of the Experience Economy and Experiential Marketing, the chapter illuminates the motivations and latent interests of Millennial travellers towards new modes of spirituality that they may not be exposed to in their home country, through examining the indigenous Rastafarian villages in Jamaica which are interactive and offer authentic cultural experiences with a strong spiritual component. In examining the extant literature on spiritual tourism, there is a lacuna of research on Caribbean spiritual tourism experiences with the Millennial traveller;the impacts of COVID-19 on these experiences are also documented. The chapter makes a unique contribution to the literature and global discourse on Millennials and spirituality from the perspective of small island developing states (SIDS) and particularly from islands that are economically dependent on tourism and use aspects of culture such as spirituality as a product/service differentiation strategy and competitive advantage. © 2022 selection and editorial matter, Sandeep Kumar Walia and Aruditya Jasrotia.

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