Patients' and professionals' experiences with remote care during COVID-19: a qualitative study in general practices in low-income neighborhoods.

AIM: To explore how patients and general practice professionals in low-income neighborhoods experienced the increase of remote care during COVID-19. BACKGROUND: As the GP (general practitioner) is the first point of contact in Dutch health care, there are concerns about access to remote care for patients from low-income neighborhoods. Now that general practice professionals have returned to the pre-pandemic ways of healthcare delivery, this paper looks back at experiences with remote care during COVID-19. It investigates experiences of both patients and general practice professionals with the approachability and appropriateness of remote care and their satisfaction. METHODS: In this qualitative study, 78 patients and 18 GPs, 7 nurse practitioners and 6 mental health professionals were interviewed. Interviews were held on the phone and face-to-face in the native language of the participants. FINDINGS: Remote care, especially telephone consultation, was generally well-approachable for patients from low-income neighborhoods. Contrarily, video calling was rarely used. This was partly because patients did not know how to use it. The majority of patients thought remote care was possible for minor ailments but would also still like to see the doctor face-to-face regularly. Patients were generally satisfied with remote care at the time, but this did not necessarily reflect their willingness to continue using it in the future. Moreover, there was lack in consensus among general practice professionals on the appropriateness of remote care for certain physical and mental complaints. Nurse practitioners and mental health professionals had a negative attitude toward remote care. In conclusion, it is important to take the opinions and barriers of patients and care providers into account and to increase patient-centered care elements and care provider satisfaction in remote care. Integrating remote care is not only important in times of crisis but also for future care that is becoming increasingly digitalized.

Prevalence and Correlates of Sext-Sharing Among a Representative Sample of Youth in the Netherlands.

Many adolescents use their electronic devices to send each other sexually explicit texts, photos, and videos of themselves-commonly known as sexting. This can be fun and is not usually problematic. However, if the intended recipient decides to share these sexts with a broader audience, the consequences for the depicted can be detrimental. The purpose of this study was to investigate the prevalence of (non-consensual) sext-sharing among Dutch adolescents and explore the characteristics of those who do, to gain a better understanding of factors involved in dissemination. We used data from "Sex under the age of 25," a representative national survey on sexual health among a sample of 20,834 Dutch 12-24-year-olds. The prevalence of sext-sharing was estimated using Complex Samples. Logistic regressions were used to assess associations between demographics, school-based sexting education, sexual- and online behavior, and mental health and sext-sharing. About 4% of the adolescents reported having shared someone else's sext in the last six months. Being male, aged 12-14 years, frequent social media usage, watching online porn, sexual experience, and being subjected to sext-sharing themselves associated most strongly with sext-sharing. Our findings show that the likelihood of sext-sharing is lower in older adolescents and that it associates with the extent of adolescents' sexual curiosity and online activity. The overlap between sharing sexts of others and having one's own sext shared suggests that dissemination of personal sexual content might be normalized or used as an act of retribution. Further research could be helpful to explain the mechanisms underlying this overlap. The results of this study illustrate the importance of exposing adolescents to evidence based preventive educational interventions on sexting from 12 years onwards and not just within the context of traditional school-based sex education, but also as a part of the (online) media-literacy curriculum.