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Aims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy. Methods The Australian Epilepsy Longitudinal Survey's 5 th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t -tests, analysis of variance and block recursive regression, and qualitative analysis identified themes. Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here. Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE. Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs. Copyright © 2023. Indian Epilepsy Society. All rights reserved.
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Background:The COVID-19 pandemic has considerably impacted individuals' lives, extensively from mental and socioeconomic aspects, that requires someone to adapt. For postpartum mothers who also need to go through the maternal psychological adaptation phase, the pandemic could impose overwhelming emotional tension on them, increasing the risk of experiencing postpartum blues. This study aims to analyze the relationship between social factors that are affected during a pandemic with the incidence of postpartum blues on screening test results during the transition period of the COVID-19 pandemic in Banyumanik, Semarang. Subjects and Method: This was a cross-sectional study conducted in Banyumanik, Semarang, from November to December 2022.39 subjects were selected using a consecutive sampling technique. The dependent variable is postpartum blues. The independent variables include marital status, employment status of the mother, employment status of the spouse, and family income level. The study instrument was EPDS questionnaire. The data were analyzed used Chi-square. Results: Out of 39 subjects, 13 (33.3%) were experiencing postpartum blues, and 26 (66.7%) were not experiencing it. Mother's employment status associated with postpartum blues. Mothers who unemployed have a risk of experiencing postpartum blues 1.65 times compared to employed, but these were not statistically significant (OR= 1.65;95% CI= 0.40 to 6.77;p= 0.727). Family income level associated with postpartum blues. Mothers with low to moderate family income reduced postpartum blues by 0.73 times compared to mothers with high income levels, but these were not statistically significant (OR= 0.73;95%CI= 0.19 to 2.80;p= 0.908). Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues. Conclusion: Mother's employment status and family income status associated with postpartum blues. Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues.
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Background. Postpartum mothers' mental health has a significant role in mothers' well-being and child's growth and develop-ment. This issue is worsened during a pandemic when social restrictions are regulated, resulting in perceived stress, baby blues, postpartum depression, and other mental health issues. Objective. This study intends to investigate postpartum moth-ers' mental health during the COVID-19 pandemic. Methods. This study's methodology is a scoping review using the prism-ScR checklist, the Joanna Briggs Institute critical appraisal tool, and a population, exposure, outcome framework. It uses 4 databases: Pubmed, Willey, Proquest, and ScienceDirect;its inclusion criteria is original English articles that can be accessed in full text between 2020 and 2022. Results. Out of 190 publications, we found 7 that are pertinent to the research goals. Qualitative research, cross-sectional studies, and longitudinal studies make up the research. The mapping result includes 4 themes: the types of mental health problems experi-enced by postpartum moms during the Pandemic, risk and predic-tive factors, postpartum mothers' experiences, and the effects of mothers' mental health problems. Conclusion. After giving birth, most mothers experience stress, anxiety, and depression. Postpartum mental health concerns are influenced by isolation, social exclusion, and crises. The cre-ation of a customized plan for early assistance for a woman's mental health requirements, as well as the establishment of an accessi-ble mental health provider, including medical personnel and medical facilities, is advised for pregnant and postpartum women. only.Copyright © the Author(s), 2023.
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Objective: The mains and objectives of the study was to evaluate the impact of Covid'19 vaccination on mental health status. Study Design: A Cross-Sectional Clinical Study. Place and Duration: It is a cross-sectional study which was conducted by the house officers and the faculty of Dow International Dental College from june2022 to January 2023. Methodology: This study was conducted by distributing the questionnaire among the patients coming to the Outpatient Department at Dow International Dental College. A total of 280 Questionnaires were filled among the Vaccinated Patients coming to the OPD. Questions were inquired related to demographics, dosage, history, last dose, and benefit of vaccine, depression, sleep deprivation, feeling low, trouble concentrating and suicidal thoughts. The consent to fill this questionnaire by the patient was taken by 'Implied Consent'. It was in English language but was translated in Urdu by the house officers whenever it was needed to ensure the comprehension of the questions to the patients. The filled questionnaire was collected by the house officers of the dental department. A total of more than 280 questionnaires were distributed among the participants out of which 250 questionnaires were filled correctly giving us a response rate of 89.2% and dropouts of 10.8%. Practical Implications: The results of this cross-sectional clinical study have practical implications for the wider community. Encouraging Covid-19 vaccination can have a positive impact on both physical and mental health, and promoting vaccine uptake may lead to improved mental health outcomes for individuals. Such benefits can reduce the overall burden of mental health issues during the pandemic, which is beneficial to the community. Thus, public health campaigns should focus on the potential positive effects of Covid-19 vaccines on mental health to improve community well-being and promote vaccine acceptance. Result(s): Approximately 48% women and 52% male have anxiety, depression or either disorder, respectively. Adults with anxiety and depression were more likely to have low educational attainment, low household income, lack of health insurance and either lack or delay medical care. The filled questionnaire was collected by the house officers of the dental department. A total of more than 280 questionnaires were distributed among the participants out of whom 250 questionnaires were filled correctly giving us a response rate of 89.2% and dropouts of 10.8%. There was a common mental impact that was noticed and brought about people's mental health at stake. Conclusion(s): Forceful vaccination has a potential to affect mental health of an individual. Further studies are required to extrapolate the findings of the present study.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: According to national prevalence data, SCD has an estimated economic burden of $2.98 billion per year in the United States and caring for a child with sickle cell disease (SCD) carries its own financial burden, resulting in higher healthcare costs and unintended days lost from employment. Social experiences are known to impact health outcomes in the general pediatric population. These experiences can be examined through the construct of social determinants of health (SDOH), the "condition in which people are born, grow, work, live and age" that impact their health. Since the WHO has designated COVID-19 a pandemic in January 2020, many families in the US have suffered financially, and during the shutdowns, there was a record number of jobs lost. The objective of this study was to determine the impact of the COVID-19 pandemic on financial and employment status of SCD Families Methods: This study was part of the larger CNH Sickle Cell Disease Social Determinants of Health study that was IRB approved. Caregivers of children with SCD completed a 30-question survey reporting their experiences with SDOH that included Demographics, USDA Food Security Scale, the We Care housing screening tool, and the validated COVID-19 Employment Status/COVID-19 related household finances survey in RedCap during clinic visits and hospitalizations Results: 99 caregivers of SCD patients responded to our survey (82.5% Female, 17.5% Male) (N=97). 93.9% identified as African-American, 3% identified as Hispanic or Latinx, 1% identified as "other". Of respondents, 66% were insured through on Medicaid and 33% had private insurance. Twenty-six percent endorsed food insecurity and 2724% relied on low-cost food. Thirty-one percent lived in an apartment, 67.768% lived in a home, 1% lived in shelter or transitional housing. Sixteen percent lived in subsidized or public housing. Thirty-seven (36.8%) percent reported at least once they were being unable to pay the mortgage or rent on time at least once, 9% (8.5%) reported living with other people because of financial difficulties, 55.2% reported their home not being heated, 7.2% reported being evicted from their home and 3.1% lived in an emergency shelter or transitional housing. 6.1% had an educational level of high school graduation or less, 42.2% were college graduates or completed additional post-graduate education (N=98). Two weeks prior to the pandemic, 61.5% worked full time, 13.5% worked part time, 6.3% were unemployed with only 2.1% working from home of the 96 caregivers who responded to this question. 15.5% (N=12 of 77) reported losing their job or were furloughed during the pandemic;34.4% (N=33 of 96) reporting at least one household member losing a job or a significant amount of income. Twenty-five percent (N=21 of 83) reported it was difficult to get work/school done because of the home environment. 36.4 % (N=35 of 96) reported household income was significantly less since February 2020. 53% (N=52 of 97) worried their household income has been or will be negatively impacted by the COVID-19 pandemic. Additionally, 48.9% (N=47 of 96) worried the value of their assets (housing, savings, other financial assets) has been or will be negatively impacted by COVID-19 and its effects. Since February 2020, 9.8% (N= 9 of 97) received unemployment insurance, 30.9% (N=29 of 94) received SNAP or food stamps, 16.5% (N= 15 of 91) received from the food pantry, 6.6% (N=6 of 90) applied for temp ass.
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Background: The COVID-19 pandemic required a rapid expansion of tele dermatology services. Objective(s): Analyse demographic shifts in a pediatric dermatology practice session with children of colour. Method(s): A retrospective chart review of pediatric dermatology patients seen in the four practice weeks preceding the New York COVID-19 lockdown and comparable tele dermatology visits during the COVID-19 pandemic lockdown. Demographic differences (e.g., race, age, gender and household income) were analysed. Result(s): A greater proportion of patients seen were White during lockdown (59.7%), compared to pre-lockdown (43.6%), with a reduction in Asian patients seen in lockdown (6.0%) compared to prelockdown (24.5%). A lower proportion of no-show patients (4.3%, 3/70 scheduled) were noted in lockdown compared to pre-lockdown (16%, 18/112). Preferred provider organizations and higher-income zip codes were more common for children seen during lockdown. Limitation(s): The sample addresses a limited New York pediatric dermatology practice during a short time-period. Conclusion(s): White patients and patients with preferred provider organizations were more likely to access telehealth, supporting disparity in tele dermatology services. These results demonstrate reduced healthcare access for lower-income and Asian children during the COVID-19 pandemic lockdown.
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Objectives: The onset of COVID-19 has resulted in both morbidity and mortality. It also has a consequential impact on the Vietnamese economy. Prior studies examined the COVID-19 impact on healthcare professionals' career decisions. There remains no study examining the work conditions and career choices in a general Vietnamese population. Our study aims to identify factors associated with change in work conditions and career choices in general Vietnamese population. Method(s): An online cross-sectional study between September 2021 through to November 2021 (during the Omicron COVID-19 pandemic). Snowball sampling method was utilized in recruiting the participants. The questionnaire used in this study included the following questions: (a) Socio-demographic information;(b) impact of COVID-19 on personal habits/daily expenses;(c) Current nature of work & impact of COVID-19 on work;(d) Impact of COVID-19 on career decisions. Result(s): 650 participants were recruited, of which only 645 completed the survey. The completion rate was 99.2%. This study demonstrated the impact that COVID-19 has on finances, as only 32% of those sampled reported that they were able to pay in full. 46.6% of the respondents have had a decrease in their overall household income. With regards to their employment and work characteristics, 41.0% reported a decrease in their work satisfaction and 39.0% reported having reduced motivation for work. Females were less likely to consider transiting from their current job to another field, as compared to male participants. Respondents who were married, had a higher level of commitment to their current job, and lower inclination to transition to another field. Respondents experiencing financial difficulties were more likely to consider a transition to another field/work. Conclusion(s): This is the first study to have examined the characteristics of work/intentions with regards to career choices and transition amongst the general Vietnamese population. It is important that future financial policies take into consideration these factors.Copyright © 2023
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Objective: In this study, the effect of having had coronavirus disease-2019 (COVID-19) disease on anti-vaccination was investigated. Material and Methods: The study was conducted between February 2022-August 2022 in the COVID chest diseases clinic in our hospital. The cases who were COVID-19 vaccine hesitancy and not vaccinated against COVID-19 hospitalized in our clinic were included in the study. The level of anti-vaccination of the cases was measured with the Vaccine Hesitancy Scale (VHS). In addition, demographic informations such as age, gender, educational status, marital status, number of people living in the household, average monthly income, smoking history, and additional chronic diseases were recorded. Routine radiological and laboratory examinations, follow-up times in the clinic, and treatment results were recorded for cases like all patients hospitalized in our COVID chest diseases clinic. Results: 46 cases were included in the study. The mean age of the cases was 54.63+or-14.81 years, 24 (52.1%) were female. VHS was applied to all cases at the time of hospitalization. Since 6 cases were referred to the intensive care unit due to respiratory failure, the second VHS could not be applied to these cases, and these 6 cases were excluded from the study. A 2nd VHS was performed in the remaining 40 patients just before discharge. Each question score, A-B-C section score and total scale score were compared for the pre-COVID-19 and post-COVID-19 cases. While the VHS total score before COVID-19 infection was 36.48+or-7.36, the post-COVID-19 total score was found to be 25.65+or-9.10, a statistically significant decrease was observed (p < 0.001). It was observed that the mean scores of A-B-C decreased statistically in all sections (p < 0.001). Conclusion: As a result of our study, we found that the degree of anti-vaccine resistance decreased after the patients who were against the COVID-19 vaccine had the disease. As a result of our study, we found that the degree of COVID-19 vaccine hesitancy of patients decreased after they had the disease. We believe that conducting similar studies and sharing their results through mass media, can change the perspective of vaccine hesitancy individuals in society on this situation, especially during pandemic periods.
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Background and Objectives: Faster than expected, the COVID-19 disease changed people's lives on an unprecedented scale. The present research aimed to shed light on the economic challenges of the pandemic and the efforts made concerning economic resilience. Thus, this study delved into the experience of families residing in a suburban town. Methods: The present study was qualitative in type. It used a qualitative content analysis with a guided approach conducted through 17 in-depth semi-structured individual interviews with subjects over 15 years of age living in Tawheed Gonabad town. These subjects had lived in the area for at least three years. The interviews were held and audio-recorded in a purposive sampling method after gaining informed consent from the participants in the spring of 2021. In order to estimate the validity of the data, Lincoln and Goba's criteria were used. Results: The economic resilience of families during the pandemic was marked by three main categories and nine sub-categories. The categories were: (1) changes to the economic dimension of the family (the sub-categories: employment, income, consumption and socioeconomic status), (2) solutions to the economic changes of the family (sub-categories: reliance on internal resources, family and receiving support from outside of the family), and (3) the effectiveness of economic resilience of families at higher levels (sub-categories: macroeconomics, family social capital and regional resilience). As more detailed results showed, the pandemic has caused a decrease in the income and consumption of essential items in quantity and quality and imposed excessive costs on the target community. The dominant solution to economic problems has been changing consumer's behavior and income diversification. The lack of supportive plans, poor social networks and the identity of the neighborhood are the significant barriers to the increase of economic resilience. Conclusion: The families investigated in the present study were vulnerable in many ways and had low economic resilience. In order to improve the families' level of economic resilience, it is necessary to know the context and carry out interventions and support plans based on the families' internal and external capacities, including the neighborhood's empowering conditions.
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Objectives: The use of virtual care has accelerated since the emergence of COVID-19 pandemic. This study aims to analyze the differences in patient characteristics between new and existing type 2 diabetes mellitus (T2DM) patients that utilized virtual care. Method(s): Adult patients (age318 years) with T2DM who had a virtual care (phone or video) visit between April 1, 2020 and March 31, 2022 from the OptumLabs Data Warehouse were identified. The date of the first virtual visit was defined as the index date. Patients were required to be continuously insured at least 1 year prior to their index date (baseline) and at least 90 days of follow-up coverage. T2DM patients were categorized as newly diagnosed and as existing T2DM patients based on whether a diabetes diagnosis was observed in the baseline or not. Result(s): A total of 1,864,203 unique T2DM patients were eligible, with18.5% identified as newly diagnosed and 81.5% as existing T2DM patients. On average, newly diagnosed T2DM patients were younger than existing T2DM patients. Majority (54.5%) of newly diagnosed T2DM patients were commercially insured compared to only 38.6% existing T2DM patients. Among the existing T2DM patients, 61.2% were White, 17.9% Non-Hispanic Black, 12.7% Hispanic and 8.2% others. Of this population, 12.7 % had a household income >= $125,000, 13.3% had at least a Bachelor's degree, and 80.3% reside in a metropolitan area. For the newly diagnosed T2DM cohort, 59.7% were White, 15.3% Non-Hispanic Black, 13.4% Hispanic, and 11.6% others. More of the newly diagnosed T2DM cohort had higher household income, higher education, and resided in a metropolitan area compared to patients with existing T2DM. Conclusion(s): T2DM patients that used virtual care were heterogenous in terms of their baseline characteristics. This underscores the emerging trend that virtual care can potentially play a complementary role in managing patients with diabetes.Copyright © 2023
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Income of farming households with low socio-economic status is a task in emerging nations, rural parts of Nigeria inclusive. In connection with this, the entrance of Covid-19 pandemic posed a grave risk to the economy of the households. This study, therefore, investigate the coping strategies in mitigating Covid-19 pandemic's effect on the farming households' income. Data for the paper were collected from 150 farming household heads, through multistage sampling method, with the use of interview scheduled and analysed using appropriate statistics. The findings showed that many (57.3%) of the respondents were male. The widely practiced coping strategies during the pandemic were rationed spending (=2.63), job diversification (=2.40), reduction in hired labour (=2.36), household food rationing (=2.28) among others. There is substantial relationship between household size (r = 0.075, p = 0.003), annual income (r = 0.033, p = 0.004) and coping strategies practiced at p0.005. It was concluded that the pandemic had great effect on the income of the farming household. The study recommends formulation of necessary, effective and urgent policies for assisting and generating fresh employments and revenue producing prospects for affected households.
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Purpose: It is unknown whether certain populations of athletes benefit more from returning to sport following COVID-19 restrictions than others. The purpose of this study was to determine whether socioeconomic status (SES), race, or gender moderate the benefits of returning to sports during COVID-19. Method(s): Adolescents who participated in sports before COVID-19 reported sport participation, anxiety (GAD-7), and depression (PHQ-9) inMay 2021. The interactions of return to sport (yes [PLY], no [DNP]) and (1) sex, (2) race (white, nonwhite), and (3) SES (low vs high county household income) to predict anxiety and depression were evaluated, adjusted for age, school instruction, and concern about COVID-19. Result(s): Four thousand eight hundred seventy-four participants were included (16.1 +/- 1.3 years;52% female;PLY = 4456;DNP = 418). DNP had greater symptoms of anxiety (7.8 60.6 v 5.6+/-0.5, P<0.001) and depression (8.8+/-0.6 v 5.76 0.6, P < 0.001) and had significantly more non-white athletes (36% v 19%, P < 0.001), but no significant differences were identified with respect to gender, instructional delivery method, median county household income, or age. Compared with white athletes, adolescent athletes from racial minority groups who returned to sports had relatively greater decreases in anxiety (interaction estimate (b) = -1.18 +/- 0.6, P = 0.036) and depression (b=-1.19+/-0.6, P=0.045). Similarly, athletes from counties with lower household incomes who returned to sports had relatively greater decreases in anxiety (b= -1.23 +/-0.5, P = 0.017) and depression (b=-1.21+/-0.6, P=0.032). The benefits of returning to sports for female athletes were similar to male athletes with respect to anxiety (b = -0.16 +/-0.5, P = 0.76) and depression (beta = 0.49 +/- 0.6, P = 0.37). Conclusion(s): In this nationwide sample of adolescent athletes, returning to sport during COVID-19 was associated with significant mental health benefits for adolescent athletes. However, the greatest benefits were seen among athletes from racial minority groups and areas of lower household income. No differences in the mental health benefits of returning to sports were identified between male and female athletes. Significance: Restriction from sports may disproportionately impact the mental health of certain groups of adolescent athletes. Expanding access to sports for traditionally underserved groups can potentially provide significant mental health benefits.
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BACKGROUND: On March 11, 2020, the WHO declared the outbreak of the infectious disease COVID-19 as a pandemic. The health strategies of nations lead to possible changes in lifestyle and increase poor eating habits. Hence, the purpose of this study is to compare food consumption during COVID-19 pandemic in Iran. METHODS: This cross-sectional study used secondary data from the Households Income and Expenditure Survey (HIES) conducted annually by the Statistical Centre of Iran. Food cost data of HIES included the amount of all food items in household food baskets during the last month. Then, they were classified into six food groups to evaluate their energy intake. The consequence of food consumption was analyzed as a function of socioeconomic status (SES) variables and residence pre- and post-COVID-19 pandemic. RESULTS: In total, 75,885 households (83.5% male) were included in the study. Among the population of urban and rural areas as well as in different SES categories, people tended to increase the consumption of meat (P < 0.05) and fresh foods, especially vegetable groups (P < 0.001) and decrease the consumption of fruit (P < 0.001), fat and sweets groups (P < 0.05) and also in energy intake (P < 0.05). Macronutrient changes were different in the category of SES, urban and rural. CONCLUSION: Our study indicated that the COVID-19 pandemic had different effects on food groups, energy and macronutrients consumption, which could be due to possible changes in food patterns as a result of the pandemic.
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COVID-19 , Pandemics , Humans , Male , Female , Health Expenditures , Iran/epidemiology , Cross-Sectional Studies , COVID-19/epidemiology , Income , FruitABSTRACT
Background: COVID-19 vaccine booster uptake remains low and preventable COVID-19 deaths continue to occur, making access to oral antivirals for those most at risk of severe COVID-19 outcomes essential. Method(s): We estimated age and gender adjusted prevalence ratios of oral nirmatrelvir-ritonavir (NMV/r) uptake by sociodemographics, clinical characteristics, and prescription eligibility (based on age, underlying medical conditions, body mass index, physical inactivity, pregnancy, or smokers), among participants in a large U.S. national prospective cohort who were infected with SARS-CoV-2 between December 2021 and October 2022. Among participants who reported NMV/r uptake, we also described the proportion who reported (1) taking NMV/r as directed and (2) NMV/r was helpful for reducing COVID-19 symptoms. Result(s): Among 1,594 participants with a SARS-CoV-2 infection as of October 2022, 1,356 were eligible for NMV/r prescription;of whom 209 (15.4% [95%CI:13.5-17.3]) reported receiving NMV/r. NMV/r uptake increased from 2.2% (95%CI:1.0-3.4) between December 2021 and March 2022 to 16.5% (95% CI:13.0-20.0) between April and July 2022 and 28.6% (95%CI:24.4-32.8) between August and October 2022, respectively. Participants >=65 years of age reported the highest uptake of NMV/r (30.2% [95%CI:22.2-38.2]). Black non-Hispanic participants (7.2% [95%CI:2.4-12.0]) and those in the lowest income group (10.6% [95%CI:7.3-13.8]) had lower uptake than white non-Hispanic (15.8% [95%CI:13.6-18.0]) and high-income individuals (18.4% [95%CI:15.2-21.7]), respectively. Participants with type 2 diabetes had greater uptake (28.8% [95%CI:20.4-37.3]), compared to those without it (12.4% [95%CI:4.8-20.0]). Among a subset of 278 participants who had a prior SARSCoV-2 infection, those who had a history of long COVID reported greater uptake (22.0% [95%CI:13.9-30.1]) for a subsequent SARS-CoV-2 infection than those without a history of long COVID (7.9% [95%CI:3.9-11.8]). Among all participants who were prescribed NMV/r (N=216), 89% (95%CI:85-93) reported that they took NMV/r as directed and 63% (95%CI:57-70) stated NMV/r was helpful for reducing COVID-19 symptoms. Conclusion(s): Uptake of NMV/r increased over time coinciding with national efforts to increase awareness and access. However, most individuals who were eligible for NMV/r did not receive it. Lower NMV/r uptake among racial/ethnic minorities and individuals with lower household income suggests a need to improve awareness and address barriers to uptake in these populations.
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Background: We pilot-tested the feasibility and short-term impacts of "Healthier Wealthier Families" (HWF), which seeks to reduce financial hardship by developing a referral pathway between universal child and family health (CFH) services and financial counselling. Method(s): Setting: CFH services in five sites (Victoria, New South Wales), coinciding with the COVID-19 pandemic. Participant(s): Caregivers of children aged 0-5 years. Eligible clients disclosed financial hardship using a study-designed screening tool. Design(s): Pilot randomised controlled trial (RCT). With mixed progress in Sites 1-3, we conducted an implementation evaluation and adapted the protocol to a simplified RCT (Site 4) and direct referral with pre-post evaluation (Site 5). Intervention(s): Financial counselling. The comparator was usual care. Measures: Feasibility was assessed via proportions of clients screened, enrolled, followed-up, and who accessed financial counselling. Impacts (quantitative surveys, qualitative interviews) included finances to 6 months post-enrolment. Result(s): 72%-100% of clients across sites answered the financial screen. In RCT sites (1-4), less than one-quarter enrolled. In Site 5, n = 44/64 (64%) clients were eligible and engaged with financial counselling. Common challenges facing these clients were utility debts (73%), obtaining government entitlements (43%) and material aid/emergency relief (27%). On average, their household income increased $250 per fortnight ($6504 annually), and families received average single payments of $784. Caregivers identified benefits including reduced stress, practical help, increased knowledge and empowerment. Conclusion(s): Financial hardship screening via CFH, and direct referral, were acceptable to caregivers. Individual randomisation was infeasible. Matching between populations and CFH practice is necessary to incorporate a HWF model of care.
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Background: People with HIV (PWH) may be at increased risk for severe COVID-19 outcomes compared with people without HIV. However, COVID-19 vaccination coverage among PWH is largely unknown, especially among those with advanced HIV or comorbidities. Method(s): We conducted a cohort study to evaluate coverage of the initial COVID-19 vaccine primary series and factors associated with the completion in adult PWH (>=18 years) enrolled in 8 healthcare organizations participating in the Vaccine Safety Datalink (VSD) project during December 1, 2020- December 31, 2021. Completion of two doses of the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines or one dose of the single-dose Janssen COVID-19 vaccine was assessed. Multivariable analysis was conducted using a robust Poisson regression model to estimate the rate ratio (RR) for factors associated with primary series completion, accounting for follow-up time. Result(s): A total of 22,063 PWH were identified, among which 89% were male and 93% were viral suppressed (viral load, VL <=200 copies/ml). Chronic comorbid conditions were prevalent, with 25% having a Charlson comorbidity score of 1-2 and 13% having a score of 3 or greater. About 23% were overweight and 17% were obese. The majority (90%) completed the primary series and 1,782 PWH (8%) did not receive any dose during the study period. A rapid uptake was achieved within the 6 months after the national COVID-19 vaccination program launched on December 14, 2020. (Figure 1) PWH who received one dose of mRNA vaccine (i.e., partially vaccinated) were excluded (n=314) from the analysis for the primary series completion. Having received an influenza vaccination in the past 2 years was the strongest predictor of completion (RR=1.17, 95%CI: 1.15, 1.20). Males (RR= 1.06, 95%CI: 1.04-1.08) and those of Asian race (RR=1.05, 95%CI: 1.03-1.06, vs. White) were more likely to complete the primary series. However, PWH with baseline CD4 counts < 200 (RR=0.97, 95%CI: 0.94-0.99) and those failing to achieve viral suppression (VL= 201-10k: RR= 0.89, 95%CI: 0.85-0.94;VL >10k: RR= 0.92, 95%CI: 0.87-0.98) were less likely to complete the primary series. Body mass index, Charlson comorbidity score, and neighborhood household income level were not associated with completion. Conclusion(s): Coverage of the COVID-19 vaccine primary series was high in adult PWH in the VSD. However, targeted vaccination outreach is warranted for PWH with low CD4 counts and uncontrolled HIV viral load.
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INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic initiated rapid widespread utilization of telemedicine affecting all health care providers, including those in pediatric urology. Understanding the factors of patient and parent satisfaction can aid in health care delivery. The aim of this study was to identify key indicators of patient and parent satisfaction with pediatric urology telemedicine visits. METHOD(S): We conducted a prospective cross-sectional survey of all patients evaluated with a telehealth visit from October 2021 - April 2022. We included all consecutive patients aged 0-18 years who received an outpatient pediatric urology telehealth visit. All patients received an 8-question patient/parent reported outcome (PRO) survey via email within 30 days of the visit, including 5 satisfaction questions regarding various aspects of telemedicine rated on a scale of 1-5. Statistical analysis was performed using Pearson correlation, Mann- Whitney U, and Chi Squared tests, with p<0.05 considered significant. RESULT(S): A total of 1213 patients completed a telehealth visit, of which 83 (7%) completed the PRO survey. Visit type included 40 (48%) post-operative, 29 (35%) follow-up, and 14 (17%) new consults. From the survey responses, 84% reported time savings, 31% reported money savings, 30% avoided time away from work, and 27% of children avoided missing school. No technical issues were experienced in 86% of the visits. Satisfaction with telehealth was highest for the post-operative patient, 4.8/5 after orchiopexy and 4.4/5 after circumcision. Patients saved a median travel distance of 22 miles [IQR: 15-41]. Patients living farther than 22 miles had higher satisfaction scores in terms of simplicity and preference to in-person visits compared to those who lived closer (p=0.019). Patients living in zip codes below the median household income had significantly higher satisfaction scores (p =0.032). Patients with public health insurance had significantly higher overall satisfaction scores compared to those with private health insurance (p=0.022). There was no difference in satisfaction based on parent age or whether the patient was evaluated for a new, follow-up, or post-operative video visit. CONCLUSION(S): Children and their caregivers were satisfied with pediatric urology telehealth visits when seen as a new, follow-up, or post-operative patient. Indicators for satisfaction may include long travel distance to the clinic, lower than median household income zip codes, and public health insurance. Appropriate use of telehealth may provide better access to care and optimize healthcare delivery.
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Purpose of Study: We hypothesize that patient and parent satisfaction of telemedicine is influenced by patient key indicators. By delineating these key indicators, we can strategically utilize video visits in a way that maximizes patient satisfaction, while maintaining high quality care. The aim of this study is to reveal which key indicators are predictive of patient and parent satisfaction with video visits. Methods Used: We performed a retrospective review of all patients and parents who were evaluated via video visit for Loma Linda University Pediatric Urology from October 2021 - April 2022. All patients received an 8-question validated satisfaction survey via email within 30 days of the visit. Patient demographics, clinical data, and survey responses were collected. We analyzed all patients who completed a telemedicine visit and the post-visit survey. Exclusion criteria included incomplete survey responses. Primary outcomes include high satisfaction scores on survey questions. Univariate analysis was conducted for indicators of patient and parent satisfaction using Pearson correlation, Mann-Whitney U, and Chi Squared, with clinical significance defined as p value < 0.05 using SPSS. Summary of Results: A total of 1213 patients had video visits from October 2021 - April 2022. Of those who completed a video visit, 83 patients (7%) completed the satisfaction survey. Of those who completed the survey, 40 (48%) were post-operative visits, 29 (35%) were follow-up visits, and 14 (17%) were new visits. Families said telemedicine saved them time (84%), saved them money (31%), allowed them to avoid time away from work (30%), allowed their child to avoid missing school (27%), and that they did not experience any technical issues (86%). Mean overall satisfaction score (1-5) was 4.36 for post-op circumcision patients and 4.80 for post-op orchiopexy patients. Median travel distance saved by performing a video visit was 22 miles (IQR 15 - 41 miles). Compared to those who lived closer, patients who lived farther than 22 miles from the clinic had significantly higher satisfaction scores for Q3 (p < 0.019) and Q4 (p < 0.049) [reference Table]. Compared to higher household incomes based on zip code, patients with lower than median household income of $64,384 had significantly higher satisfaction scores for Q1 (p < 0.032), Q3 (p < 0.039), and Q4 (p < 0.040). Patients with public insurance had significantly higher satisfaction scores compared to those with private insurance for Q1 (4.68 vs 4.15, p < 0.022), Q2 (4.90 vs 4.64, p < 0.018), and Q3 (4.82 vs 4.58, p < 0.050). Median parent age was 40 (IQR 32.4 - 42.2 years). There was no difference in satisfaction based on visit type or parent age. Conclusion(s): Overall, patients and parents in pediatric urology are satisfied with video visits across visit type and diagnosis. Patients who live farther away from the office, live in zip codes with lower median household incomes, or have public insurance seem to be more satisfied with video visits. (Table Presented).
ABSTRACT
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