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.

Using the health belief model to explain COVID-19 vaccination hesitancy in Dutch urban citizens under thirty.

BACKGROUND: Worldwide the Covid-19 pandemic resulted in drastic behavioral measures and lockdowns. Vaccination is widely regarded as the true and only global exit strategy; however, a high vaccination coverage is needed to contain the spread of the virus. Vaccination rates among young people are currently lacking. We therefore studied the experienced motivations and barriers regarding vaccination in young people with the use of the health belief model. METHODS: We conducted a correlational study, based on a convenience sample. At the vaccination location, directly after vaccination, 194participants(16-30 years) who decided to get vaccinated at a pop-up location several weeks after receiving a formal invitation, filled out a questionnaire regarding their attitudes towards vaccination based on concepts defined in the health belief model. We used these concepts to predict vaccination hesitancy. RESULTS: Younger participants and participants with lower educational levels report higher levels of hesitancy regarding vaccination (low education level = 38.9%, high education level = 25.4%). Perceived severity (Mhesitancy = .23, Mno hesitancy = .37) and susceptibility (Mhesitancy = .38, Mno hesitancy = .69) were not associated with hesitancy. Health related and idealistic benefits of vaccination were negatively associated with experienced hesitancy (Mhesitancy = .68, Mno hesitancy = -.37), while individualistic and practical benefits were not associated with hesitancy (Mhesitancy = -.09, Mno hesitancy = .05). Practical barriers were not associated with hesitancy (Mhesitancy = .05, Mno hesitancy = -.01), while fear related barriers were strongly associated with hesitancy (Mhesitancy = -.60, Mno hesitancy = .29). CONCLUSIONS: Health related, and idealistic beliefs are negatively associated with experienced hesitancy about vaccination, while fear related barriers is positively associated with experienced hesitancy. Future interventions should focus on these considerations, since they can facilitate or stand in the way of vaccination in young people who are doubting vaccination, while not principally opposed to it.

The role of risk perception and affective response in the COVID-19 preventive behaviours of young adults: a mixed methods study of university students in the Netherlands.

OBJECTIVES: Due to an increased infection rate among young adults, they need to adhere to the preventive guidelines to stop the spread of COVID-19 and protect vulnerable others. The purpose of this mixed methods study was to explore the role of risk perception and affective response in the preventive behaviours of young adults during the COVID-19 outbreak. SETTING: This study followed a convergent mixed methods design, in which a quantitative online survey (n=1081) and 10 qualitative in-depth semistructured video interviews were conducted separately in the Netherlands during April-August 2020. PARTICIPANTS: 1081 participants filled in the online survey, and 10 participants participated in the interviews. Eligibility criteria included being a university student. PRIMARY AND SECONDARY OUTCOME MEASURES: Data on risk perception, affective response, that is, worry, and adherence to preventive guidelines were combined and analysed during this study. There were no secondary outcome measures. RESULTS: The results showed that young adults perceived their risk as low. Their affective response for their own well-being was also low; however, their affective response was high with regards to vulnerable others in their surroundings. Due to their high impersonal risk perception (ie, perceived risk to others) and high affective response, young adults adhered to most preventive guidelines relatively frequently. However, young adults sometimes neglected social distancing due to the negative effects on mental health and the uncertainty of the duration of the situation. CONCLUSIONS: In conclusion, high impersonal risk perception and high affective response regarding others are key motivators in young adults' preventive behaviour. To maximise adherence to the preventive guidelines, risk communication should put emphasis on the benefits to vulnerable others' health when young adults adhere to the preventive guidelines.