A Wellbeing Specialist Case Management Service Providing Support to Students in a University Setting

Development of the Student Wellbeing Connect (SWBC) service was a response to increased student support needs in the initial stages of the COVID-19 pandemic in 2020. Due to the government-imposed restrictions during the COVID-19 pandemic, students often faced complex psychosocial and wellbeing issues (Dodd et al., 2021). Two years on from its inception, the case management service has become a core component of La Trobe University's Student Health, Wellbeing and Inclusion services responding to the complex and compounding factors that can impact the wellbeing and success of university students. Varying psychosocial needs can underly a student's presentation to a counselling service;thus, the case management service complements the counsellor's role by providing practical-based interventions. The focus of the service on practical issues has provided an alternative support model for students who do not identify as primarily requiring mental health or counselling support. This has opened service provision to a broader cohort of students. Using a multi-disciplinary, strength-based, and person-centred case management approach, students work collaboratively with Wellbeing Coordinators to identify internal and external supports to address their needs through psychosocial assessments and implementation of goal-focused planning. SWBC acts as a safety net within the university setting if/when psychosocial difficulties are impacting the student's experience, academic performance, and wellbeing. This paper will outline the operational and service provision framework for providing case management to tertiary students. © 2023, Australian and New Zealand Student Services Association. All rights reserved.

Productive Aging During COVID-19 - Lessons from WH SeniorLink

Introduction: According to the National Academies of Science, Medicine, and Engineering, even before the pandemic, 24% of Americans 65+ were considered socially isolated, and 43% of adults 60+ were lonely. Both experiences are associated with serious physical and mental health problems, including increased risks of dementia, stroke, depression, and suicidal ideation. As older adults engage in stricter social distancing to protect themselves from COVID-19, their risk of social isolation and loneliness is heightened. According to research by the Kaiser Family Foundation, 46% of adults 65+ reported that the worry and stress caused by pandemic has had a negative impact on their mental health. In order to combat this unique challenge, we must employ innovative, flexible solutions that adapt to the shifting circumstances and an uncertain future. Method(s): WH SeniorLink has developed an innovative program for integrating friendly visiting, mutual aid, needs assessment and case management, all delivered remotely by trained volunteers. The program was conceived, developed and executed since the beginning of COVID-19 restrictions and has grown to become a fully fledged 501(c)(3) organization, and is a model of flexible service delivery during this unusual time. The program operates through a volunteerism-mutual aid model. Volunteers are trained using online modules and quizzes and supervised by a licensed social worker, including training on needs and risk assessment. Volunteers are then matched with an older adult with similar interests and language preferences to provide friendly weekly phone calls, care packages and letters. Older adults with higher needs are referred to WH SeniorLink's service navigation program which operates using the online platform, Apricot, and is staffed by masters level social work interns and supervised by licensed social workers. Service navigation involves conducting comprehensive assessments and identifying resources and referrals. Older adults who express interest are also paired with each other to provide social support. Barriers to program development have included identifying consistent funding sources and volunteer attrition. Result(s): Data shows 169% growth in contacts made with older adults between May and October, with 2.5 times more older adults served in November than in May. Initial responses to the Dejong Gierveld Loneliness Scale and qualitative data collection reflect that older adults continue to feel lonely and isolated in the midst of the pandemic, but that WH SeniorLink is helping. By placing emphasis on empowering older adults to form sustained relationships with volunteers and their peers, WH SeniorLink encourages reciprocal relationships through which older adult participants are valued for their experiences and contributions. Conclusion(s): The mission of WH SeniorLink is to strengthen community ties and improve health outcomes among older New Yorkers by providing social-emotional support and connection to essential services. WH SeniorLink was founded during the COVID-19 pandemic, in response to the myriad of new challenges faced by older adults including greater risk of social isolation and increased disconnection from essential services. However, we recognize that the pandemic has only exacerbated a problem that began long before, and older adults are at risk of being left behind in the coming months and beyond. Funding(s): WH SeniorLink is funded by a starter grant from Columbia School of Social Work and subsequent crowdfunded donations.Copyright © 2021

Pandemic related mental health

OnTrackNY is a nationally recognized Coordinated Specialty Care model disseminated across New York state for young people experiencing early non-affective psychosis. OnTrackNY is a network of 22 teams located in licensed outpatient clinics, serving over 2500 individuals. OnTrackNY offers medication management, case management, individual and group cognitive behaviourally oriented therapy, family support and psychoeducation, supported employment and education, and peer support services. Teams receive training for implementation through an intermediary organization called OnTrack Central. OnTrackNY was selected as a regional hub of the National Institute of Mental Health Early Psychosis Intervention Network (EPINET), a national learning healthcare system (LHS) for young adults with early psychosis. This symposium will present the different ways in which EPINET OnTrackNY implemented systematic communitybased participatory processes to ensure robust stakeholder involvement to improve the quality of OnTrackNY care. Florence will present results of an assessment of stakeholder feedback experiences used to develop strategies for assertive outreach and engagement of program participants, families and providers. Bello will present on mechanisms for integrating of co-creation principles to design, develop and execute quality improvement projects in EPINET OnTrackNY. Stefancic will present on quality improvement projects that used rapid cycle qualitative methods, tools, and strategies to build team capacity and flexibility to respond to an LHS. Montague will present adaptations to OnTrackNY services during the COVID-19 pandemic using an implementation science framework. Finally, Patel will lead a discussion on the implications of involving individuals with lived experiences in all phases of the process to maximize learning in an LHS.

Exploring Thailand's Probationary Practices Since COVID-19: Changes in Strategies with Regards to Probation Supervision

The COVID-19 pandemic had a critical impact on the Thai criminal justice system. The goal of this study is to explore policies and practices of Thailand's Department of Probation as it responded to the COVID-19 pandemic. This study surveyed probation officers in Thailand (N = 534) from March to April 2021, focusing on probation practices and case management issues prior- and post- COVID-19. Data reveals that, overall, the frequency of officer-offender contacts remained steady even though the type of contact changed after COVID-19. In-person contact was replaced by remote contact strategies, specifically telephone calls, which increased significantly following the onset of the pandemic.

Evaluation of Confidence Level of Primary Healthcare Workers to Manage Patients with COVID-19 Infection

The COVID-19 epidemic has significantly impacted frontline healthcare workers (HCWs) and challenged an existing fragile healthcare system of South Africa (SA). Evaluation of the confidence levels of Primary Healthcare (PHC) workers in managing COVID-19 cases was conducted. A cross-sectional survey was used to investigate the level of training and confidence to manage COVID-19 cases. Descriptive statistics, univariate and multivariate analysis were undertaken. The majority of HCWs were female (82.8%), unmarried (56.6%), and nurses (65.4%). The study identified that only 30.1% of the respondents received training on the COVID-19 treatment guidelines and 30.6% of staff were trained on reporting of COVID-19 cases to the authorities. Significantly, higher proportions of HCWs learned about COVID-19 case management by self-reading as opposed to formal training (88% vs 64.7%, P<0.05). The overall confidence level in handling and managing COVID-19 cases of the HCW translated to a 58% level of confidence. Medical practitioners had a significantly higher level of confidence (88.9%) than nursing practitioners (75.5%) and allied HCWs (52.5%, p<0.05). HCWs who received training on 5 or more items of COVID-19 case management had a significantly higher ( 83.1%) level of confidence (p<0.05) than those who had training on 4 or less items (61.7%). This study revealed that training on aspects of COVID-19 case management significantly increased their confidence levels. Timely interventions are needed to improve the confidence levels of HCWs and perceived barriers in the training of COVID-19 need to be urgently addressed.

Comprehensive medication management services provided via telehealth or hybrid models: A scoping review

Comprehensive medication management (CMM) is increasingly provided by health care teams through telehealth or hybrid modalities. The purpose of this scoping literature review was to assess the published literature and examine the economic, clinical, and humanistic outcomes of CMM services provided by pharmacists via telehealth or hybrid modalities. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Randomized controlled trials (RCTs) and observational studies were included if they: reported on economic, clinical, or humanistic outcomes;were conducted via telehealth or hybrid modalities;included a pharmacist on their interprofessional team;and evaluated CMM services. The search was conducted between January 1, 2000, and September 28, 2021. The search strategy was adapted for use in Medline (PubMed);Embase;Cochrane;Cumulative Index to Nursing and Allied Health Literature;PsychINFO;International Pharmaceutical s;Scopus;and grey literature. Four reviewers extracted data using a screening tool developed for this study and reviewed for risk of bias. Authors screened 3500 articles, from which 11 studies met the inclusion criteria (9 observational studies, 2 RCTs). In seven studies, clinical outcomes improved with telehealth CMM interventions compared to either usual care, face-to-face CMM, or educational controls, as shown by the statistically significant changes in chronic disease clinical outcomes. Two studies evaluated and found increased patient and provider satisfaction. One study described a source of revenue for a telehealth CMM service. Overall, study results indicate that telehealth CMM services, in select cases, may be associated with improved clinical outcomes, but the methods of the included studies were not homogenous enough to conclude that telehealth or hybrid modalities were superior to in-person CMM. To understand the full impact on the Quadruple Aim, additional research is needed to investigate the financial outcomes of CMM conducted using telehealth or hybrid technologies.Copyright © 2022 Pharmacotherapy Publications, Inc.

Women and Children's Victims of Violence Case Management During COVID-19 Pandemic

Many studies have been conducted to prove the threat of violence against children and women during COVID-19. Unlike other studies, this study focuses more on government services in receiving complaints from victims of violence experienced by women and children during the COVID-19 pandemic. Using case studies as a qualitative method, documentary studies and in-depth interviews have been conducted on 13 informants from various parties in Bandung Regency, West Java, Indonesia. The results showed that the use of digital technology during the pandemic sometimes hampered the follow-up process for complaints of violence by victims due to a lack of equipment and the inability of officers or victims to use it. In addition, there is still a stereotype that the victim is the "guilty party" or "the party who bears the shame" of making the family cover up or refrain from pressing charges. There needs to be collaboration and coordination among the processing and accompanying officers who handle case management of violence against women and children. These cases are multi-dimensional;therefore, they require multiple approaches from many parties.

VACtrac: enhancing access immunization registry data for population outreach using the Bulk Fast Healthcare Interoperable Resource (FHIR) protocol.

COVID-19 vaccination uptake has been suboptimal, even in high-risk populations. New approaches are needed to bring vaccination data to the groups leading outreach efforts. This article describes work to make state-level vaccination data more accessible by extending the Bulk Fast Healthcare Interoperability Resource (FHIR) standard to better support the repeated retrieval of vaccination data for coordinated outreach efforts. We also describe a corresponding low-foot-print software for population outreach that automates repeated checks of state-level immunization data and prioritizes outreach by social determinants of health. Together this software offers an integrated approach to addressing vaccination gaps. Several extensions to the Bulk FHIR protocol were needed to support bulk query of immunization records. These are described in detail. The results of a pilot study, using the outreach tool to target a population of 1500 patients are also described. The results confirmed the limitations of current patient-by-patient approach for querying state immunizations systems for population data and the feasibility of a Bulk FHIR approach.

Local initiative supports case isolation and contact tracing during a SARS-CoV-2 surge in summer 2020: a community case study in Antwerp, Belgium.

In Antwerp, Belgium's second largest city, a COVID-19 surge in July 2020 predominantly affected neighborhoods with high ethnic diversity. Local volunteers reacted and set up an initiative to support contact tracing and self-isolation. We describe the origin, implementation, and transfer of this local initiative, based on semi-structured interviews of five key informants and document review. The initiative started in July 2020, when family physicians signaled a surge of SARS-CoV-2 infections among people of Moroccan descent. Family physicians feared that the mainstream contact tracing organized by the Flemish government through centralized call centers would not be efficient in halting this outbreak. They anticipated language barriers, mistrust, inability to investigate case clusters, and practical problems with self-isolation. It took 11 days to start up the initiative, with logistical support from the province and city of Antwerp. Family physicians referred SARS-CoV-2-infected index cases with complex needs (including language and social situation) to the initiative. Volunteer COVID coaches contacted cases, got a contextualized understanding of their living conditions, assisted with backward and forward contact tracing, offered support during self-isolation, and checked if infected contacts also needed support. Interviewed coaches were positive about the quality of the interaction: they described extensive open conversations with cases. The coaches reported back to referring family physicians and coordinators of the local initiative, who took additional action if necessary. Although interactions with affected communities were perceived as good, respondents considered that the number of referrals by family physicians was too low to have a meaningful impact on the outbreak. In September 2020, the Flemish government assigned the tasks of local contact tracing and case support to the local health system level (primary care zones). While doing so, they adopted elements of this local initiative, such as COVID coaches, tracing system, and extended questionnaires to talk with cases and contacts. This community case study illustrates how urgency can motivate people to action yet support from people with access to resources and coordination capacity is vital for effective organization and transition to long-term sustainability. From their conception, health policies should consider adaptability of new interventions to local contexts.

Multimodal strategy for the prevention of COVID 19 in a mining site.

Background: Mining companies must implement management sys-tems dedicated to health and safety at work to prevent the transmission of SARS-CoV-2 among their workers, however, the literature on this is scarce. Aim(s): To describe a multimodal strategy for the management of health and safety at work, to address the risk of COVID-19 in large mining. Method(s): Descriptive cross-sectional study, carried out in a large mining company. A management system was structured that considered administrative measures, of an environmental nature, risk screening, and management of risk cases within the company. The data analysis was done using descriptive statistics. Result(s): The administrative measures resulted in 8,116 (34%) workers at the site being suspended from their usual work. Risk screening before entering the site identified 450 suspected cases that were referred to their home. In the case management procedure, 1,073 people were classified in some of the risk groups. 10 cases of workers with PCR were detected in the follow-up period. Environmental measures were not very sensitive. Conclusion(s): These results shed light on the importance of implementing a multimodal strategy, adapted to the local reality, in preventing the spread of SARS-CoV-2 in the period under study, at the mining site intervened.Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

Increasing interest in post-secondary education in the CF population

Background: Planning for college and post-secondary education has historically been a challenge for people with cystic fibrosis PwCF) because of a shortened life expectancy and the high cost of CF treatments. According to the Cystic Fibrosis Foundation Patient Registry, the median age of death was 32 in 2019 for PwCF in the United States [1]. Those who are healthy enough to plan for post-secondary education typically need financial assistance to offset the cost of tuition. This need has led many PwCF to contact Cystic Fibrosis Foundation Compass, a free, personalized case management service that provides information and resource referrals, for assistance with education-related expenses. Over the course of the pandemic, Compass observed a spike in interest of people seeking financial assistance and other resources to explore further education. We sought to better understand the increase in education requests from 2019 to 2021. Method(s): Compass data from January 1, 2019, through December 31, 2021, were reviewed.We reviewed data for all inquiries categorized as education, which include requests for scholarships, financial aid, and vocational rehabilitation. Compass also collects information on caller demographic characteristics such as age, household size, and household income, and this information was reviewed for all education inquiries during the 3-year period. We do not typically ask why callers are requesting financial assistance. Result(s): There was an increase in requests for financial assistance for education in 2020 and 2021: 98 scholarship requests in 2019, 140 in 2020, and 238 in 2021. The average age of PwCF requesting financial assistance with educationwas 24 all 3 years. One PwCF with an income of $100,000 or more requested financial assistance with education in 2019, five in 2020, and 13 in 2021. Conclusion(s): The number of education requests Compass receives has increased every year since 2019. The average age of PwCF making requests was 24, which is considered a non-traditional student by the National Center for Education Statistics [2]. Therewas also an increase in callers with high household incomes requesting financial assistance with education expenses. The approval of elexacaftor/tezacaftor/ivacaftor in 2019 may have contributed to the increase in requests each year, because PwCF eligible for and taking this medication may be experiencing better health outcomes and able to focus on furthering their educations. The COVID-19 pandemic may also have contributed because fewer people were able to work outside the home and may have elected to further their education as a result. Financial hardships due to the pandemic may also explain the increase in requests for financial assistance, even for those with high household incomes. Our results showa continued increase in requests each year. We are interested in identifying and exploring the cause of this increase through survey or conversations with those seeking education assistance through Compass. We will continue to follow the data to see if the increase continues as the COVID-19 pandemic ends.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Implementation of free-draft text messaging to enhance care retention and satisfaction for persons living with HIV infection.

Eligible persons with HIV infection can receive client-centered case management to coordinate medical and social services. Novel mobile health interventions could improve effective case management and retention in care, an important goal to help end the HIV epidemic. Using a hybrid type I effectiveness-implementation design, we assessed whether access to bidirectional, free-draft secure text messaging with a case manager and clinic pharmacist could improve client satisfaction and care retention in a Southern academic HIV clinic. Sixty-four clients enrolled between November 2019 and March 2020, had a median age of 39 years, and were mostly male, single, and African-American. Heavy app users texted over 100 times (n = 6) over the course of the 12-month intervention while others never texted (n = 12). App usage peaked during months of clinic closure due to COVID-19. Most participants reported high satisfaction with the app and planned continued usage after study completion. Changes in clinic retention and virologic suppression rates were not observed, a result confounded by practice changes due to COVID-19. High usage and satisfaction of free-draft text messaging in case-managed HIV clients supports inclusion of this communication option in routine HIV clinical care.

"Doctor as a Drug" in a Stroke Follow-Up

Each year about 400 000 people in Russia get strokes. Whereas an acute treatment takes place in specialized intensive care units in hospitals, follow-up is handed over to general (rarely - private) practitioner. The majority of stroke survivors show low adherence to follow-up resulting in repeated hospitalizations and growth of multi-morbidity burden. With COVID-19 pandemic negatively affecting availability of medical services and increasing health risks for stroke survivors, a physician-patient relation becomes the means of persuading patients to health-promoting behaviour.Copyright © 2022 University of Latvia. All Rights Reserved.

Development of Secure Electronic Cybercrime Cases Database System for the Judiciary

The recent covid-19 pandemic created a barrier to every activity that needed physical interaction and involvement, especially in the judiciary. Careful research of some courts in Nigeria shown that case records are still been manually processed and stored and some courts operate a semi-digital and semi-manual processing pattern, which also has its own shortcoming of preprocessing manual records and converting them into digital records and physical presence is required to access court records. This research develops a secure electronic Cybercrime Cases Database System (eCCDBS), for prosecuted cybercrime in the judicial service in Nigeria. The system will provide an efficient method for collecting, retrieving, preserving, and management of court case records. The Rapid Application Development (RAD) methodology is used for the system development, because of its speed and time friendliness and can be easily restructured to meet the client's requirement at any point in time during the development life span. RAD can also present a prototype of the final system software to the client. Access control mechanism and secure password hashing were used to ensure the security of the system. The system was implemented and evaluated through deployment and found to have functioned according to the specification. The application subunits of records' creation, submission, modification, deletion, retrieval, and storage functioned effectively. Hence this system provides a secure online repository specifically for cybercrime case records that have elements of confidentiality, integrity and availability.

How the Judiciary Has Driven Systemic Innovation During the Pandemic

In 1998, the Conference of State Court Administrators (COSCA)8 urged member state courts throughout the United States to join a national effort to exchange data and integrate information systems in ways that would improve case management.9 COSCA issued a position paper on information sharing in 2002,10 followed by joint resolutions adopted by the Conference of Chief Justices (CCJ)11 and COSCA that called for public access to electronic court records and removal of Social Security numbers from court records.12 In 2004, COSCA joined with the National Association for Court Management (NACM)13 to issue a policy statement for court acceptance of information technology.14 It established a "nine part agenda" that emphasized serving the court's business needs, stressed the importance of effective implementation, and addressed security and privacy issues.15 A series of incremental resolutions followed over several years, including one from the CCJ entitled "The Emergence of E-Everything. The Landscape of Civil Litigation determined that nonfamily civil litigation in state courts "takes too long and costs too much," which undermined access to justice.18 Court dockets were dominated by "lowervalue contract and small claims" cases that rarely were adjudicated on the merits.19 Courts were using outdated automated case management systems, and they were giving self-represented parties (involved in 76% of cases) and lawyers too much control over the pace of litigation.20 The Landscape of Civil Litigation lamented the decline in funding for court systems and observed that courts were expected to dispense more justice using fewer resources.21 B.The Call to Action in Civil Cases One year later, the NCSC published its influential Call to Action: Achieving Civil Justice for All22 That report built upon the Landscape of Civil Litigation and criticized the "cost, delay, and unpredictability of civil litigation" under existing court processes.23 It recommended that courts update differentiated case management processes to assign cases to three "pathways," which it designated as "Streamlined," "Complex," and "General. "31 States should design courthouses that incorporate emerging changes in technology.32 Six months before the CCJ and COSCA endorsed the Call to Action, the American Bar Association (ABA) House of Delegates approved the ABA Model Regulatory Objectives for the Provision of Legal Services (Model Regulatory Objectives).33 The Model Regulatory Objectives were drafted by the ABA's Commission on the Future of Legal Services not long before it released its innovative and controversial 2016 Report on the Future of Legal Services in the United States 24 The Model Regulatory Objectives provided guidelines for state courts to regulate nontraditional legal services providers, and discouraged blanket exclusions of nonlawyers based on unauthorized practice of law rules.35 The CCJ agreed, and resolved that state courts should consider broadening their regulatory frameworks to nonlawyers who provide legal services.36 Expanding the regulatory framework would give courts greater flexibility to implement the Call to Action21 In 2011, the NCSC advised state courts on how to automate court processes so that information technology could help assign cases to one of the three pathways.38 Pathway assignments should be data-driven and involve less human discretion. The NCSC joined in partnership with the Institute for the Advancement of the American Legal System (IAALS)41 and the National Council of Juvenile and Family Court Judges (NCJFCJ)42 to launch the Family Justice Initiative (FJI).43 The FJI would operate in collaboration with the CCJ and COSCA to build upon the research contained in the Landscape of Civil Litigation and the policy directives in the Call to Action 44 While the FJI was ramping up its operations, the NCSC issued a 2017 white paper that examined existing case management systems in family courts throughout the United States, titled Triage Protocols for Divorce and Child Custody Cases.45 The white paper noted "tension between what should ideally be done, what courts can afford to do, and what litigants want," and that courts may need to "identify[] 'good enough' solutions" that are more feasible due to resource limitations.46 "As long as budget constraints exist, a court that provides more services to one case is essentially reducing services in another case, so some sense of cost/benefit is definitely helpful in making these kinds of service and process tradeoffs. .

The effect of a non-congregate, integrated care shelter on health: A qualitative study.

OBJECTIVE: To describe the experiences of unstably housed, medically vulnerable residents living at the Haven, a novel, non-congregate integrated care shelter operating in a historic hotel during the COVID-19 pandemic. DESIGN: A qualitative descriptive design. SAMPLE/MEASUREMENT: Semi-structured qualitative interviews were conducted in February and March 2022 with a purposive sample of 20 residents living in the integrated care shelter. Data were analyzed in May and June 2022 using the thematic analysis methods described by Braun and Clarke. RESULTS: Six women and 14 men, ages 23-71 (M = 50, SD = 14), were interviewed. Lengths of stay at the time of the interview ranged from 74 to 536 days (M = 311 days). Medical co-morbidities and substance use details were collected at baseline. Three themes were identified: (1) Autonomy, (2) supportive environments, and (3) stability and the need for permanent housing. Participants characterized the integrated care, non-congregate model as having multiple advantages over traditional shelter systems. Participants emphasized the role of nurses and case managers in providing a respectful, caring environment in the integrated shelter model. CONCLUSION: Participants described acute physical and mental health needs which were largely met by the innovative integrated shelter care model. The effect of homelessness and housing insecurity on health is well documented, but few solutions exist that promote autonomy. Participants in this qualitative study emphasized the benefits of living in a non-congregate integrated care shelter and the services which promoted their self-management of chronic diseases. PATIENT OR PUBLIC CONTRIBUTION: Patients were the participants in the study, but were not involved in the design, analysis of interpretation of the data, or preparation of the manuscript. Due to this project's small scope, we could not involve patients or the public after the study concluded data collection.

Peer Case Management Promoting Advancement Along the HIV Care Continuum Among Black Men Who Have Sex with Men Living with HIV: Building Brothers Up.

Black men who have sex with men (BMSM) in the United States are at elevated risk for HIV relative to their heterosexual and/or non-BMSM counterparts, yet on average demonstrate suboptimal HIV care linkage and rates of HIV primary care retention. From October 2019 to December 2020, 69 adult (i.e., aged 18-65) BMSM enrolled in Building Brothers Up (2BU), a 6-session peer case management intervention delivered across 3 months and designed to improve retention in HIV primary care through to full viral suppression. Peer case management sessions included detailed assessment of participants' needs and barriers to treatment, which led to the development of a participant-centered treatment plan. All participants self-identified as Black, about three-quarters self-identified as gay (72.5%), and 46.4% reported an annual income of $5000 or less. A total of 69 participants enrolled in 2BU; however, multiply imputed chained equation logistic regressions were carried out on the final analytical data set (n = 40; 99 imputations) due to a large amount of COVID-19-related missing data. Although analyses of retention and achievement of viral suppression did not reach full significance, the probability of a Type-II hypothesis testing error was high, and viral load results (adjusted odds ratio = 1.56; 95% confidence interval = 0.94-2.60; p = 0.08) suggested that increased attendance to peer case management sessions may be associated with improved odds of achieving full viral suppression among BMSM. The significant impact of national race-related civil unrest and the COVID-19 pandemic on the target population during implementation of 2BU is underscored.

Acceptability of contact management and care of simple cases of COVID-19 at home: a cross-sectional study in Senegal.

BACKGROUND: COVID-19 is a major public health problem. In mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The objective of the study was to determine the acceptability of contact and simple case management of COVID-19 at home and its associated factors in Senegal. METHODS: This was a descriptive and analytical cross-sectional study. We collected data from 11 June to 10 July 2020. We used a marginal quota sampling strategy. A total of 813 individuals took part in the survey. We collected data using a telephone interview. RESULTS: The care of simple cases of COVID-19 at home was well accepted (78.5%). The use of home contact management was less accepted (51.4%). Knowledge of the modes of transmission of the virus and confidence in institutional information were associated with the acceptability of home care for simple cases. Regularly searching for information on COVID-19 and confidence in the government's control of the epidemic were associated with the acceptability of managing contacts at home. CONCLUSIONS: Authorities should take these factors into account for better communication to improve the acceptability and confidence in home-based care for COVID-19 and future epidemics.

Providing Comprehensive Services to Treat Patients and the Inpatient Psychiatric Bed Crisis

Objectives: A growing mental health crisis and a shortage of inpatient psychiatric beds have resulted in a surge of patients' boarded' in emergency departments awaiting acute inpatient psychiatric placement. This delays care and causes a further burden on already stressed emergency services. In June 2020, the Centers for Disease Control and Prevention (CDC) reported an increased incidence of anxiety and depressive disorders since March of 2020, in comparison to pre-pandemic data. This has further exacerbated the shortage of psychiatric beds nationwide. In addition, staff shortages at state psychiatric hospitals in the Commonwealth of Virginia led to temporary closures to admissions. State facilities in VA provide care for our most vulnerable population, including (involuntary) patients on a temporary detention order (TDO). Carilion Clinic implemented the Comprehensive Psychiatric Emergency Program (CPEP) in August 2020 with the goal of early identification and robust treatment of psychiatric patients while in the ED. Since implementation of the CPEP, providers have been able to redirect patients away from burdened state psychiatric facilities by rapid stabilization of patients in the ED. Patients were able to step down to a less restrictive environment, often no longer meeting criteria for TDO. This study aims to assess the rate of TDO releases pre- and postimplementation of the CPEP at Carilion Clinic. Method(s): A pilot program was launched in August 2020 at Carilion Roanoke Memorial Hospital through a collaboration of the Departments of Emergency Medicine and Psychiatry. The staff was comprised of a psychiatrist, a psychiatric nurse practitioner, and a social worker. Data was collected from May 2020 to June 2021 from the Epic electronic medical record and included all patients in the ED on a TDO, ages six and above. Patients who no longer met criteria for a TDO were released from involuntary status and either redirected as a voluntary patient to an inpatient psychiatric unit or discharged to the community. The rate of TDO releases three months prior to CPEP implementation was assessed and compared to the TDO release rate post-CPEP implementation. Result(s): Prior to CPEP implementation, the TDO release rate was 7%, amounting to four patients released from a TDO per month. After implementation of CPEP, the TDO release rate increased to 19%, equating to thirteen patients released from a TDO per month during the pilot period. This led to a decrease in the number of patients that would have previously been admitted to a state psychiatric facility. Patients who benefitted from implementation of the CPEP were those with conditions in the following categories: chronic mental illness (32%), individual/family crisis (24%), neurocognitive disorders (20%), substance use disorder (18%), autism spectrum disorders and intellectual/developmental disabilities (6%). Conclusion/Implications: Implementation of the Comprehensive Psychiatric Emergency Program (CPEP) in Carilion Clinic' Emergency Department was successful in reducing the number of state psychiatric admissions by redirecting 11% more involuntary patients to voluntary status. The results of this study highlight the benefits of having in-house psychiatry teams dedicated to early triage, rapid treatment, and comprehensive case management for psychiatric patients in the emergency department. References- CDC, National Center for Health Statistics. Indicators of anxiety or depression based on reported frequency of symptoms during the last 7 days. Household Pulse Survey. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Health Statistics;2020. https:// www.cdc.gov/nchs/covid19/pulse/mental-health.htm.