Impact of the SARS-CoV-2 pandemic on access to contraception and pregnancy intentions: a national prospective cohort study of the UK population

ObjectiveEvaluate the impact of the COVID-19 pandemic on access to contraception and pregnancy intentions.DesignNationwide prospective cohort study.SettingUnited Kingdom.ParticipantsWomen in the UK who were pregnant between 24 May and 31 December 2020.Main outcome measuresAccess to contraception and level of pregnancy intentions, using the London Measure of Unplanned Pregnancy (LMUP) in women whose last menstrual period was before or after 1 April 2020. While the official date of the first UK lockdown was 23 March, we used 1 April to ensure that those in the post-lockdown group would have faced restrictions in the month that they conceived.ResultsA total of 9784 women enrolled in the cohort: 4114 (42.0%) conceived pre-lockdown and 5670 (58.0%) conceived post-lockdown. The proportion of women reporting difficulties accessing contraception was higher in those who conceived after lockdown (n=366, 6.5% vs n=25, 0.6%, p<0.001) and continued to rise from March to September 2020. After adjusting for confounders, women were nine times more likely to report difficulty accessing contraception after lockdown (adjusted odds ratio (aOR) 8.96, 95% CI 5.89 to 13.63, p<0.001). There is a significant difference in the levels of pregnancy planning, with higher proportions of unplanned (n=119, 2.1% vs n=55, 1.3%) and ambivalent pregnancies (n=1163, 20.5% vs n=663, 16.1%) and lower proportions of planned pregnancies (n=4388, 77.4% vs n=3396, 82.5%) in the post-lockdown group (p<0.001). After adjusting for confounders, women who conceived after lockdown were still significantly less likely to have a planned pregnancy (aOR 0.88, 95% CI 0.79 to 0.98, p=0.025).ConclusionsAccess to contraception in the UK has become harder during the COVID-19 pandemic and the proportion of unplanned pregnancies has almost doubled.

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The impact of social restrictions during the COVID-19 pandemic on the physical activity levels of older adults: a baseline analysis of the CHARIOT COVID-19 Rapid Response prospective cohort study

10.1101/2021.01.26.21250520 ◽

2021 ◽

Author(s):

David Salman ◽

Thomas Beaney ◽

Catherine E. Robb ◽

Celeste A. de Jager Loots ◽

Parthenia Giannakopoulou ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cohort Study ◽

Social Isolation ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Social Predictors ◽

Community Factors ◽

The Uk ◽

The Impact

AbstractObjectivesPhysical inactivity is more common in older adults, is associated with social isolation and loneliness, and contributes to increased morbidity and mortality. We examined the effect of social restrictions, implemented to reduce transmission of COVID-19 in the UK (lockdown), on physical activity (PA) levels of older adults, and the demographic, lifestyle and social predictors of this change.DesignBaseline analysis of a survey-based prospective cohort studySettingAdults enrolled in the Cognitive Health in Ageing Register for Investigational and Observational Trials (CHARIOT) cohort from GP practices in North West London were invited to participate from April to July 2020.Participants6,219 cognitively healthy adults aged 50 to 92 years completed the survey.Main outcome measuresSelf-reported PA before and after lockdown, as measured by Metabolic Equivalent of Task (MET) minutes. Associations of PA with demographic, lifestyle and social factors, mood and frailty.ResultsMean PA was significantly lower following lockdown, from 3,519 MET minutes/week to 3,185 MET minutes/week (p<0.001). After adjustment for confounders and pre-lockdown PA, lower levels of PA after lockdown were found in those who were over 85 years old (640 [95% CI: 246 to 1034] MET minutes/week less); were divorced or single (240 [95% CI: 120 to 360] MET minutes/week less); living alone (277 [95% CI: 152 to 402] MET minutes/week less); reported feeling lonely often (306 [95% CI: 60 to 552] MET minutes/week less); and showed symptoms of depression (1007 [95% CI: 1401 to 612] MET minutes/week less) compared to those aged 50-64 years, married, co-habiting, and not reporting loneliness or depression, respectively.Conclusions and ImplicationsMarkers of social isolation, loneliness and depression were associated with lower PA following lockdown in the UK. Interventions to improve PA in older adults should take account of social and community factors, and targeted strategies to increase physical activity in socially isolated, lonely and depressed older adults should be considered.

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Daily weekday audit and feedback to clinicians for an inpatient intervention in obstetrics: is there sustained impact over the weekend? A secondary analysis of a prospective cohort study

Implementation Science Communications ◽

10.1186/s43058-021-00210-0 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Rebecca F. Hamm ◽

Lisa D. Levine ◽

Meghan Lane-Fall ◽

Rinad Beidas

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Secondary Analysis ◽

Audit And Feedback ◽

Evidence Based ◽

Risk Calculator ◽

Significant Difference ◽

Obstetric Intervention ◽

The Impact

Abstract Background Audit and feedback as an implementation strategy leads to small, but potentially important improvements in practice. Yet, audit and feedback is time and personnel intensive. Many interventions designed for inpatient care are meant to be utilized by care teams all days of the week, including weekends when research staff are at a minimum. We aimed to determine if audit and feedback regarding use of an evidence-based inpatient obstetric intervention performed only on weekdays could have a sustained impact over the weekend. Methods This study was performed as a secondary analysis of a prospective cohort study examining the impact of implementation of a validated calculator that predicts the likelihood of cesarean delivery during labor induction. During the 1 year postimplementation period, Monday through Friday, a member of the study team contacted clinicians daily to provide verbal feedback. While the same clinician pool worked weekend shifts, audit and feedback did not occur on Saturdays or Sundays. The primary outcome was intervention use, defined as documentation of counseling around the cesarean risk calculator result, in the electronic health record. Intervention use was compared between those with (weekdays) and without (weekends) audit and feedback. Results Of the 822 women meeting eligibility criteria during the postimplementation period (July 1, 2018–June 30, 2019), 651 (79.2%) were admitted on weekdays when audit and feedback was occurring and 171 (20.8%) on weekends without audit and feedback. The use of the cesarean risk calculator was recorded in 676 of 822 (82.2%) of eligible patient charts. There was no significant difference in cesarean risk calculator use overall by days when audit and feedback occurred versus days without audit and feedback (weekday admissions 82.0% vs. weekend admissions 83.0%, aOR 0.90 95% CI [0.57–1.40], p = 0.76). There was no significant trend in the relationship between calculator use and weekday versus weekend admission by month across the study period (p = 0.21). Conclusions Daily weekday audit and feedback for implementation of an evidence-based inpatient obstetric intervention had sustained impact over the weekends. This finding may have implications for both research staffing, as well as sustainability efforts. Further research should determine the lowest effective frequency of audit and feedback to produce implementation success.

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The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2021.02.036 ◽

2021 ◽

Vol 136 ◽

pp. 388-397

Author(s):

Aleksi Ruohomäki ◽

Elena Toffol ◽

Ville Airaksinen ◽

Katri Backman ◽

Raimo Voutilainen ◽

...

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Infant Health ◽

Postpartum Depressive Symptoms ◽

Analgesic Consumption ◽

The Impact

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Health literacy, health status and health behaviors of German students– study protocol for the “Healthy Habits” cohort study

BMC Public Health ◽

10.1186/s12889-021-11542-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Martin Lange ◽

Alexandra Löwe ◽

Gerrit Stassen ◽

Andrea Schaller

Keyword(s):

Cohort Study ◽

Health Status ◽

Health Literacy ◽

Health Behavior ◽

Health Behaviors ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

The State ◽

The Impact ◽

Study Format

Abstract Background The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention. To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students’ health literacy, health status, and health behaviors, and on the impact of the study format on students’ health. The aim of this prospective cohort study is to reduce this research gap. Methods Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations. Discussion This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students’ health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions. Trial registration German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).

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