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Prevention and screening during the COVID-19 pandemic: qualitative findings from the BETTER WISE project.
Sopcak, N; Wong, M; Fernandes, C; Ofosu, D; Khalil, I; Manca, D.
  • Sopcak N; Department of Family Medicine, University of Alberta, Edmonton, Canada. nsopcak@ualberta.ca.
  • Wong M; Department of Family Medicine, University of Alberta, Edmonton, Canada.
  • Fernandes C; Department of Family Medicine, University of Alberta, Edmonton, Canada.
  • Ofosu D; Department of Family Medicine, University of Alberta, Edmonton, Canada.
  • Khalil I; MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.
  • Manca D; Department of Family Medicine, University of Alberta, Edmonton, Canada.
BMC Prim Care ; 24(1): 27, 2023 Jan 23.
Article in English | MEDLINE | ID: covidwho-2214533
ABSTRACT

BACKGROUND:

The COVID-19 pandemic challenged healthcare systems worldwide and disrupted primary care, particularly prevention, screening, and lifestyle counselling. BETTER WISE is a comprehensive and structured approach that proactively addresses cancer and chronic disease prevention and screening (CCDPS), including cancer survivorship and screening for poverty and lifestyle risks for patients aged 40 to 65. Patients from 13 primary care clinics (urban, rural, and remote) in Alberta, Ontario, and Newfoundland & Labrador, Canada were invited for a 1-hour visit with a prevention practitioner (PP), a member of the primary care team with specialized training in CCDPS to provide patients an overview of eligible screening and assist with lifestyle counselling. This qualitative sub-study describes how the COVID-19 pandemic impacted BETTER WISE in a constantly changing medical landscape.

METHODS:

We conducted 17 focus groups and 48 key informant interviews with a total of 132 primary care providers (PPs, physicians, allied health professionals, and clinic staff) over three different time points to better understand their perspectives on the BETTER WISE project. We also received 585 patient feedback forms of the 1005 patients who agreed to participate in the study. We also collected field notes and memos and employed thematic analysis using a constant comparative method focused on the impact of the pandemic on BETTER WISE.

RESULTS:

We identified four themes related to how the COVID-19 pandemic impacted the BETTER WISE study 1) Switch of in-person visits to visits over the phone; 2) Lack of access to preventive care and delays of screening tests; 3) Changes in primary care providers' availability and priorities; 4) Mental health impacts of the pandemic on patients and primary care providers.

CONCLUSIONS:

The COVID-19 pandemic had and, at the time of writing, continues to have an impact on primary care, particularly on prevention, screening, and lifestyle counselling. Despite structural, procedural, and personal challenges throughout different waves of the pandemic, the primary care clinics participating in BETTER WISE were able to complete the study. Our results underscore the importance of the role of primary care providers in adapting to changing circumstances and support of patients in these challenging times. TRIAL REGISTRATION This qualitative study is a sub-component of the BETTER WISE pragmatic, cRCT, trial registration ISRCTN21333761 (date of registration 19/12/2016).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Prim Care Year: 2023 Document Type: Article Affiliation country: S12875-022-01954-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Prim Care Year: 2023 Document Type: Article Affiliation country: S12875-022-01954-x