Relationships Among Parenting Stress and Well-Being, COVID-19 Information Management, and Children's COVID-19 Fear.

OBJECTIVE: During the COVID-19 pandemic, caregivers who are facing high stress levels and decreased emotional well-being may parent their children differently. Certain children are experiencing greater fear in response to COVID-19, and research is needed to identify parenting behaviors significantly linked with children's COVID-19 fear. The purpose of this article was to evaluate whether the association between parenting stress and children's COVID-19 fear could be explained by parents' COVID-19 information management and emotional well-being. METHODS: Participants were recruited through Amazon Mechanical Turk. The sample consisted of 595 caregivers of children during the COVID-19 pandemic; 40.0% men, 69.2% non-Latinx White, 12.1% Black, 10.1% Latinx, 6.6% Asian, and <2% others. Children had an average age of 11.3 years. Parents completed self-report measures. RESULTS: The bootstrapped confidence interval (0.040, 0.148) for the indirect effect (0.090) revealed that parent emotional well-being significantly mediated the relation between parenting stress and children's COVID-19 fear. In addition, parent management of children's COVID-19 knowledge significantly mediated the relation between parenting stress and children's COVID-19 fear. CONCLUSION: We found that the combined effect of parents' emotional well-being and parents' management of children's COVID-19 knowledge significantly mediated the positive relation between parenting stress and children's COVID-19 fear. Based on our findings, once parents' parenting stress is decreased and their well-being increases, parents may be more likely to provide children with developmentally appropriate and accurate COVID-19 information.

Examining the Theory of Motivated Information Management (TMIM) in the COVID-19 Pandemic.

In order to inform understanding of the public's health information management during the COVID-19 pandemic, we applied a modification of TMIM from a serial mediation model to a conditional process model (moderated mediation). In doing so, the current study attempted to refine some of the relational propositions of the original TMIM with a focus on efficacy while addressing the distinction between a mediator and a moderator in a behavioral decision model. Findings from an online survey of U.S. adults (n = 488) demonstrated that anxiety can positively motivate evaluation of information seeking during the COVID-19 pandemic context, a unique context of application for TMIM. Efficacy was found to be qualified as an individual difference variable that moderates the relationships of uncertainty perception and health decision. Our newly proposed conditional process framework of the TMIM opens research directions in health information-seeking and encourages researchers to continuously incorporate updated methodological thought and approach in applying and building communication theory.

[Impact of COVID-19 pandemic on information management and adherence to replacement therapy with AAT of patients with alpha-1 antitrypsin deficiency (AATM)]. / Auswirkungen der COVID-19-Pandemie auf das Informationsmanagement und die Therapieadhärenz von substituierten Patienten mit Alpha-1-Antitrypsin-Mangel (AATM).

METHODS: In March 2021, a 19-item survey was sent to 420 patients with AATD who were being treated with AAT replacement therapy (prolastin) and who participated in the German AlphaCare patient program. RESULTS: The majority of the respondents (55.9%; 138) had been diagnosed with AATD ≥10 years prior to the survey and most (93.5%; 231) felt adequately informed about their disease through their physician, AlphaCare and Alpha1 Deutschland. The majority of respondents were concerned/very concerned about acquiring COVID-19. Only 1.2% of the respondents reported having been infected with SARS-CoV-2, less than the infection rate in the general population at that time (3.4%). Almost all of the respondents fully agreed/agreed that they had restricted their social contacts due to the pandemic. A substantial percentage of the responding patients fully agreed/agreed that they were concerned about being infected with COVID-19 during a visit at their doctor's office or clinic. Regarding AAT augmentation therapy, only 18 respondents reported discontinuing therapy during the pandemic, but most of these discontinuations were short-term - one was permanent. CONCLUSIONS: These survey results suggest that AATD patients are well-informed about the risks of COVID-19 with their condition and practised self-protection measures. This may have resulted in an COVID-19 infection rate lower than the general population. Although respondents were concerned about exposure to COVID-19 in their doctor's office or clinic, very few discontinued therapy even temporarily.

Information management practices in the WHO African Region to support response to the COVID-19 pandemic.

The rapid transmissibility of the severe acute respiratory syndrome-coronavirus-2 causing coronavirus disease-2019, requires timely dissemination of information and public health responses, with all 47 countries of the WHO African Region simultaneously facing significant risk, in contrast to the usual highly localised infectious disease outbreaks. This demanded a different approach to information management and an adaptive information strategy was implemented, focusing on data collection and management, reporting and analysis at the national and regional levels. This approach used frugal innovation, building on tools and technologies that are commonly used, and well understood; as well as developing simple, practical, highly functional and agile solutions that could be rapidly and remotely implemented, and flexible enough to be recalibrated and adapted as required. While the approach was successful in its aim of allowing the WHO Regional Office for Africa (WHO AFRO) to gather surveillance and epidemiological data, several challenges were encountered that affected timeliness and quality of data captured and reported by the member states, showing that strengthening data systems and digital capacity, and encouraging openness and data sharing are an important component of health system strengthening.

Development and utility of a close contact information management system for the COVID-19 pandemic.

BACKGROUND: Since the outbreak started in 2019, COVID-19 pandemic has a significant global impact. Due to the highly infective nature of SARS-CoV-2, the COVID-19 close contacts are at significant risk of contracting COVID-19. China's experience in successfully controlling COVID-19 emphasized the importance of managing close contacts because this strategy helps to limit potential infection sources, prevent the unconscious spread of COVID-19 and thus control this pandemic. As a result, to understand and consider the management of close contacts may be beneficial to other countries. However, managing close contacts is challenging owing to the huge number of close contacts and a lack of appropriate management tools and literature references. METHODS: A new system called the COVID-19 Close Contact Information Management System was developed. Here we introduced the design, use, improvement and achievements of this system. RESULTS: This system was designed from the standpoint of the Centers for Disease Control and Prevention in charge of managing close contacts. Two main functions and eight modules/themes were ultimately formed after two development stages. The system introduces what information need to be collected in the close contact management. Since the system allows information flow across cities, the geographical distance and administrative regional boundaries are no longer obstacles for managing close contacts, which promotes the management of each close contact. Moreover, when this system is used in conjunction with other data tools, it provides data assistance for understanding the COVID-19 characteristics and formulating targeted COVID-19 control policies. To date, the system has been widely used in Guangdong Province for over 1 year and has recorded tens of thousands of pieces of data. There is sufficient practical experience to suggest that the system is capable of meeting the professional work requirements for close contact management. CONCLUSIONS: This system provides a new way to manage close contacts and restrict the spread of COVID-19 by combining information technology with disease prevention and control strategies in the realm of public health. We hope that this system will serve as an example and guide for those anticipating similar work in other countries in response to current and future public health incidents.

Summarised, verified and accessible: improving clinical information management for potential haematopoietic stem cell transplantation patients.

The Welsh Transplantation and Immunogenetics Laboratory (WTAIL) is responsible for managing patient work-up for haematopoietic stem cell transplantation (HSCT), the only potentially curative option for many haematological and non-haematological conditions. Work-up requires regular communication between WTAIL and the transplanting clinicians, facilitated by weekly multidisciplinary team (MDT) meetings, to agree decisions and proceed through each work-up stage. Effective communication and minimising error are critical, as transplanting cells from a suboptimal donor could have severe or fatal consequences for the patient. We reviewed our HSCT patient management and identified issues including staff dissatisfaction with the inefficiency of the current (paper-based) system and concern about the potential for incidents caused by errors in manual transcription of patient information and tracking clinical decisions. Another driver for change was the COVID-19 pandemic, which prevented the usual face-to-face MDT meetings in which staff would show clinicians the paper records and reports; the shift to online MDT required new ways of sharing data. In this project we developed a new central reference point for our patient management data along with electronic patient summary sheets, designed with an eye to improving safety and efficiency. Over several improvement cycles we tested and refined the summary sheets with staff and clinicians and experimented with videoconferencing to facilitate data sharing. We conducted interviews with staff from which we concluded that the new process successfully reduced transcription and duplication and improved communication with the clinicians during the pandemic. Despite an increase in workload due to build-up of active patient work-up cases during the pandemic, staff reported that the new summaries enabled them to cope well. A key initiative was creation of a 'Task and Finish' group that helped establish continual improvement culture and identified additional areas for improvement which have been followed up in further improvement projects.

Mapping the Role of Digital Health Technologies in Prevention and Control of COVID-19 Pandemic: Review of the Literature.

BACKGROUND: Coronavirus Disease (COVID-19) is currently spreading exponentially around the globe. Various digital health technologies are currently being used as weapons in the fight against the pandemic in different ways by countries. The main objective of this review is to explore the role of digital health technologies in the fight against the COVID-19 pandemic and address the gaps in the use of these technologies for tackling the pandemic. METHODS: We conducted a scoping review guided by the Joanna Briggs Institute guidelines. The articles were searched using electronic databases including MEDLINE (PubMed), Cochrane Library, and Hinari. In addition, Google and Google scholar were searched. Studies that focused on the application of digital health technologies on COVID-19 prevention and control were included in the review. We characterized the distribution of technological applications based on geographical locations, approaches to apply digital health technologies and main findings. The study findings from the existing literature were presented using thematic content analysis. RESULTS: A total of 2,601 potentially relevant studies were generated from the initial search and 22 studies were included in the final review. The review found that telemedicine was used most frequently, followed by electronic health records and other digital technologies such as artificial intelligence, big data, and the internet of things (IoT). Digital health technologies were used in multiple ways in response to the COVID-19 pandemic, including screening and management of patients, methods to minimize exposure, modelling of disease spread, and supporting overworked providers. CONCLUSION: Digital health technologies like telehealth, mHealth, electronic medical records, artificial intelligence, the internet of things, and big data/internet were used in different ways for the prevention and control of the COVID-19 pandemic in different settings using multiple approaches. For more effective deployment of digital health tools in times of pandemics, development of a guiding policy and standard on the development, deployment, and use of digital health tools in response to a pandemic is recommended.

Keep Moving Forward: Health Informatics and Information Management beyond the COVID-19 Pandemic.

OBJECTIVES: To identify gaps and challenges in health informatics and health information management during the COVID-19 pandemic. To describe solutions and offer recommendations that can address the identified gaps and challenges. METHODS: A literature review of relevant peer-reviewed and grey literature published from January 2020 to December 2020 was conducted to inform the paper. RESULTS: The literature revealed several themes regarding health information management and health informatics challenges and gaps: information systems and information technology infrastructure; data collection, quality, and standardization; and information governance and use. These challenges and gaps were often driven by public policy and funding constraints. CONCLUSIONS: COVID-19 exposed complexities related to responding to a world-wide, fast moving, quickly spreading novel virus. Longstanding gaps and ongoing challenges in the local, national, and global health and public health information systems and data infrastructure must be addressed before we are faced with another global pandemic.

Real-Time Tracking of COVID-19 Rumors Using Community-Based Methods in Côte d'Ivoire.

Global misinformation and information overload have characterized the coronavirus disease (COVID-19) pandemic. Rumors are unverified pieces of information spreading online or person-to-person that reduce trust in health authorities and create barriers to protective practices. Risk communication and community engagement can increase transparency, build trust, and stop the spread of rumors. Building on previous work on Ebola and Zika viruses using Global Health Security Agenda systems strengthening support, the U.S. Agency for International Development-funded Breakthrough ACTION project developed a process and technology for systematically collecting, analyzing, and addressing COVID-19 rumors in real-time in Côte d'Ivoire. Rumors were submitted through community-based contributors and collected from callers to the national hotlines and then processed on a cloud-hosted database built on the open-source software District Health Information System 2 (DHIS2). Hotline teleoperators and data managers coded rumors in near-real-time according to behavioral theory frameworks within DHIS2 and visualized the findings on custom dashboards. The analysis and response were done in full collaboration with the Government of Côte d'Ivoire and implementing partners to ensure a timely and coordinated response. The system captured both widespread rumors consistent with misinformation in other settings, such as suspicions about case counts and the belief that masks were deliberately contaminated, as well as very localized beliefs related to specific influencers. The qualitative findings provided rapid insights on circulating beliefs, enabling risk communicators to nuance and tailor messaging around COVID-19.

Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews.

(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients' outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries.

Укрепление системы эпиднадзора за состоянием здоровья населения: инструмент для отбора показателей, необходимых для мониторинга более широких последствий пандемии COVID-19 и оповещения о них

Пандемия COVID-19 и меры, принимаемые в целях борьбы с распространением коронавируса, оказывают существенное воздействие на здоровье населения, и данное воздействие не ограничивается факторами, связанными с заболеваемостью и смертностью от вируса. Чтобы получить полное представление о воздействии пандемии, в национальные мероприятия по мониторингу в связи с COVID-19 следует включить соответствующие показатели для отслеживания подобных более широких последствий и оповещения о них. В настоящем документе приводится инструмент, с помощью которого государства-члены смогут выбрать подходящие показатели для этих целей. Он состоит из 1) обширного перечня механизмов, посредством которых пандемия COVID-19 может оказывать влияние на здоровье населения и связанные с ним области; 2) ряда важных факторов, которые необходимо учесть при мониторинге более широких последствий пандемии (в первую очередь факторы неравенства в отношении здоровья, источники данных и работу с тенденциями); 3) перечня основных показателей, которые могут послужить для государств-членов практической отправной точкой для начала процесса мониторинга более широких последствий пандемии. Настоящее руководство было разработано в рамках деятельности Европейского регионального бюро ВОЗ по поддержке государств-членов в укреплении национальных информационных систем здравоохранения. Оказание помощи странам в сборе надежных сведений в области здравоохранения и подготовке институционализированных механизмов формирования политики на основе фактических данных неизменно является одним из важных направлений работы ВОЗ и остается таковым в рамках Европейской программы работы на 2020–2025 гг.

Strengthening population health surveillance: a tool for selecting indicators to signal and monitor the wider effects of the COVID-19 pandemic

The COVID-19 pandemic and the actions taken to control the spread of the coronavirus have a substantial impact on population health beyond the morbidity and mortality caused by the virus directly. To provide a comprehensive picture of the impact of the pandemic, suitable indicators for signalling and tracking these wider effects should be incorporated into national monitoring activities related to COVID-19. This document provides a tool for Member States to select suitable indicators for this purpose. It consists of 1) a longlist of mechanisms through which the COVID-19 pandemic influences population health and related indicator areas, 2) a set of important considerations for monitoring the wider effects of the pandemic focusing on health inequalities, data sources, and working with trends, and 3) a list of core indicators that can serve as a practical starting point for Member States for monitoring the wider effects of the pandemic.This guidance document is part of the WHO Regional Office for Europe’s work on supporting Member States in strengthening their health information systems. Helping countries to produce solid health intelligence and institutionalized mechanisms for evidence-informed policy-making has traditionally been an important focus of WHO’s work and continues to be so under the European Programme of Work 2020–2025.

Ghana beyond the epi-curve: initial lessons learned from the implementation of infection prevention and control measures in the COVID-19 response.

Infection prevention and control (IPC) measures remain crucial to breaking transmission of the virus in the wake of inconclusive efforts underway to find an effective vaccine and treatment. While acknowledging that many lessons evolve as the pandemic unfolds, an initial understanding and recognition of the complexities that surround IPC policy implementation and adherence is vital for effective control of on-going pandemic in particular and to inform national IPC policies beyond the epi-curve. This short communication therefore seeks to unravel initial thoughts, themes and concepts that have unfolded in the implementation of IPC policies and guidelines in the context of the ongoing outbreak response in Ghana. A rapid desk review was done. Reflexive journals, field notes, observations and workshop experiences were compiled and overlapped with authors' experience as a member of the COVID-19 national response team for Infection Prevention and Control (IPC). Thematic content analysis was then used to categorize the lessons into common themes. While aligning with global strategies, the concept of 'looking within' for initial solutions and strengths have proven useful for a public health emergency response in Ghana. Future IPC policies must inculcate perspectives from the politics and economics of IPC practices and employ varieties of multidisciplinary approaches required to broaden the scope of IPC practice.

Customer Centricity in Medical Affairs Needs Human-centric Artificial Intelligence.

The evolution of healthcare, together with the changing behaviour of healthcare professionals, means that medical affairs functions of pharmaceutical organisations are constantly reinventing themselves. The emergence of digital ways of working, expedited by the COVID-19 pandemic, means that pharmaceutical-healthcare relationships are evolving to operate in an increasingly virtual world. The value of the pharmaceutical medical affairs function is dependent on understanding customers' needs and providing the right knowledge at the right time to physicians. This requires a human-centric artificial intelligence (AI) approach for medical affairs, which allows the function to query internal and external data sets in a conversational format and receive timely, accurate and concise intelligence on their customers.

Developing trustworthy recommendations as part of an urgent response (1-2 weeks): a GRADE concept paper.

OBJECTIVES: The aim of this study is to propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 week) in the clinical, public health, and health systems fields. STUDY DESIGN AND SETTING: We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the Grading of Recommendations Assessment, Development and Evaluation Rapid Guidelines project group, and obtained feedback from the larger Grading of Recommendations Assessment, Development and Evaluation working group. RESULTS: A request for developing recommendations within 2 week is the usual trigger for an urgent response. Although the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of the 4 potential approaches: adopt existing recommendations, adapt existing recommendations, develop new recommendations using existing adequate systematic review, or develop new recommendations using expert panel input; and (8) consider an updating plan. CONCLUSION: An urgent response for developing recommendations requires building a cohesive, skilled, and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise; adapting to shifting needs; complying with the principles of transparency; and properly managing conflicts of interest.