Lived experiences of older adults during the first COVID-19 lockdown: A qualitative study

Background and aim Public health measures used to mitigate the COVID-19 epidemic may have unintended, detrimental consequences particularly on older adults, whose voices and perspectives are often silent or silenced. The aim of this study was to explore the lived experiences of individuals aged 64 or older during the first COVID-19 lockdown. Methods We conducted a qualitative study in a convenience sample of 19 older adults (aged 64+) living at home in the Italian-speaking region of Switzerland during the first COVID-19 lockdown, between April and May 2020. Participants varied in terms of gender, education, age, nationality, and socio-economic status. We conducted semi-structured phone interviews to elicit emotions, expectations and hopes in relation to the present situation, and the post-pandemic world. We inquired about opinions on the enforced public health measures, including those specifically targeting older adults, and on the societal portrayal of older adults. Findings We found that the epidemic and the public health response to it had both generated a variety of resentments and a high degree of ambivalence at the individual, micro-, meso- and macro-social levels. We also found that labelling older adults as an at-risk sub-population inevitably contributed to public and self-stigmatization. Discussion We conducted an in-depth qualitative investigation of lived experiences of older adults during the first wave of the COVID-19 pandemic in one of the most gravely hit region in Europe. Our findings on the complexity of unintended, detrimental consequences of outbreak responses on older adults have relevant implications for local adaptions of public health measures, and suggest that public health authorities should engage vulnerable sub-populations and promote bi-directional communication to inform and support communities.

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Lockdowns, lives and livelihoods: the impact of COVID-19 and public health responses to conflict affected populations - a remote qualitative study in Baidoa and Mogadishu, Somalia

Conflict and Health ◽

10.1186/s13031-021-00382-5 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Dorien H. Braam ◽

Sharath Srinivasan ◽

Luke Church ◽

Zakaria Sheikh ◽

Freya L. Jephcott ◽

...

Keyword(s):

Public Health ◽

Qualitative Study ◽

Narrative Analysis ◽

Grey Literature ◽

Age Groups ◽

Research Approach ◽

Structured Interviews ◽

Or Education ◽

Public Health Response ◽

The Impact

Abstract Background Authorities in Somalia responded with drastic measures after the first confirmed COVID-19 case in mid-March 2020, closing borders, schools, limiting travel and prohibiting most group functions. However, the impact of the pandemic in Somalia thereafter remained unclear. This study employs a novel remote qualitative research method in a conflict-affected setting to look at how some of the most at-risk internally displaced and host populations were impacted by COVID-19, what determined their responses, and how this affected their health and socio-economic vulnerability. Methods We conducted a remote qualitative study, using Katikati, a 1-to-1 conversation management and analysis platform using short message service (SMS) developed by Lark Systems with Africa’s Voices Foundation (AVF), for semi-structured interviews over three months with participants in Mogadishu and Baidoa. We recruited a gender balanced cohort across age groups, and used an analytical framework on the social determinants of health for a narrative analysis on major themes discussed, triangulating data with existing peer-reviewed and grey literature. Results The remote research approach demonstrated efficacy in sustaining trusted and meaningful conversations for gathering qualitative data from hard-to-reach conflict-affected communities. The major themes discussed by the 35 participants included health, livelihoods and education. Two participants contracted the disease, while others reported family or community members affected by COVID-19. Almost all participants faced a loss of income and/or education, primarily as a result of the strict public health measures. Some of those who were heavily affected economically but did not directly experienced disease, denied the pandemic. Religion played an important role in participants’ beliefs in protection against and salvation from the disease. As lockdowns were lifted in August 2020, many believed the pandemic to be over. Conclusions While the official COVID-19 burden has remained relatively low in Somalia, the impact to people’s daily lives, income and livelihoods due to public health responses, has been significant. Participants describe those ‘secondary’ outcomes as the main impact of the pandemic, serving as a stark reminder of the need to broaden the public health response beyond disease prevention to include social and economic interventions to decrease people’s vulnerability to future shocks.

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Preparedness and response in Portuguese emergency plans - Interaction with public health

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.868 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Leiras ◽

A Martins

Keyword(s):

Public Health ◽

Health Authority ◽

Civil Protection ◽

Emergency Plans ◽

Emergency Situations ◽

Health Measures ◽

Health Authorities ◽

Public Health Authorities ◽

Protection Authority

Abstract Background Articulation between Civil Protection and Public Health authorities is of paramount importance to control, reduce and prevent threats to the health of the population in situations of crisis or catastrophes. National Civil Protection Authority produces Emergency Plans which describe the role of every stakeholder in emergency situations. Role and importance of Public Health and Public Health Authorities is not always present or well described and known amongst stakeholders. Methods Data was collected from all Districtal Emergency Plans (n = 18). Each document was analysed considering time frame, refences to Public Health and Health Authorities, definition of roles, communication channels, coordination and inclusion of intersectoral communication flow. Quantitative analysis included absolute and relative frequencies and qualitative analysis to all parts related to the terms “Public Health” and “Health Authority”. Each document was reviewed by 2 independent researchers. Results From 18 Districtal Emergency Plans (DEP) analysed, 94,4% (n = 17) had references to Public Health, but none referred the role of Public Health Officers. Only 16,7% referred to Health Authorities, although 94,4% mentioned the law 135/2013, defining the role and attributes of Health Authority. In 72,2%, coordination of Public Health Measures was attributed to the National Medical Emergency Institute. Epidemiological surveillance and Public Health Emergencies were referred in 55,6%, and attributed to the Regional Administration of Health. Conclusions Public Health Authorities and Public Health Medical Officers role in articulation with National Civil Protection Authority in emergency situations lacks severely, with this role being replaced by other entities. This is of great concern regarding management and control of diseases, particularly communicable diseases. Key messages Public Health Authorities lack the necessary involvement in Emergency Plans and emergency situations. Public health measures are coordinated by other entities rather than Public Health Authorities.

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Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

Scientific Reports ◽

10.1038/s41598-021-95032-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Gerardo Chowell ◽

Sushma Dahal ◽

Raquel Bono ◽

Kenji Mizumoto

Keyword(s):

Public Health ◽

Cost Effective ◽

Contact Network ◽

Social Distancing ◽

Individual Level ◽

Health Measures ◽

Testing Strategies ◽

Novel Coronavirus ◽

The Individual ◽

The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

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Loneliness and aging in China–a public health problem in need of solutions

International Psychogeriatrics ◽

10.1017/s104161021400177x ◽

2014 ◽

Vol 26 (11) ◽

pp. 1771-1772 ◽

Cited By ~ 10

Author(s):

Shulin Chen ◽

Yeates Conwell ◽

Helen Fung Kum Chiu

Keyword(s):

Public Health ◽

Mental Health ◽

Older Adults ◽

Social Relationships ◽

Social Connectedness ◽

Public Health Problem ◽

Physical And Mental Health ◽

Research Attention ◽

Her Family ◽

The Individual

Loneliness is a common, distressing feeling that results when one perceives his/her social relationships and supports as inadequate. Social connectedness refers to the relationships between the individual and his or her family, friends, community, and other supports. Neither loneliness nor social connectedness has received enough research attention, in particular with regard to older adults’ physical and mental health.

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Sodium and nutrition labelling: a qualitative study exploring New Zealand consumers’ food purchasing behaviours

Public Health Nutrition ◽

10.1017/s1368980013001079 ◽

2013 ◽

Vol 17 (5) ◽

pp. 1138-1146 ◽

Cited By ~ 7

Author(s):

Rachael McLean ◽

Janet Hoek

Keyword(s):

Public Health ◽

New Zealand ◽

Qualitative Study ◽

Background Knowledge ◽

Dietary Sodium ◽

Food Labels ◽

Sodium Reduction ◽

Convenience Sample ◽

Food Purchasing ◽

Purchasing Behaviour

AbstractObjectiveDietary sodium reduction is an important public health intervention that would reduce blood pressure and chronic disease. An understanding of how New Zealand consumers’ food purchasing behaviour is influenced by perceptions of dietary sodium will inform future sodium-reduction strategies.DesignThe present qualitative study used in-depth interviews of adult consumers to explore consumer knowledge, understanding of food labels and food purchasing behaviour with respect to dietary sodium.SettingNew Zealand.SubjectsA convenience sample of sixteen adult grocery shoppers.ResultsA thematic analysis of the transcripts showed New Zealand consumers lacked the background knowledge necessary to understand and regulate their own salt intake and were unable to interpret existing food labels with respect to dietary salt.ConclusionsThe findings add further weight to calls for food labels that do not require background knowledge or numerical skills and highlight the need for population-based public health interventions. Education of New Zealand consumers on the health benefits of sodium reduction and how this may be achieved would complement this approach.

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Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika

10.21203/rs.2.18491/v1 ◽

2019 ◽

Author(s):

Ana Rosa Linde Arias ◽

Maria Roura ◽

Eduardo Siqueira

Keyword(s):

Public Health ◽

Qualitative Study ◽

Well Being ◽

The United States ◽

Epidemiological Surveillance ◽

Sources Of Information ◽

Snowball Sampling ◽

Structured Interviews ◽

Public Health Response ◽

Individual Level

Abstract Background and Objectives The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. Methods A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. Results Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries’ populations. Conclusions Our findings call for a broad spectrum of public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence womens’ willingness and possibility to protect themselves.

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The Dutch COVID-19 Contact Tracing App (the CoronaMelder): Usability Study

JMIR Formative Research ◽

10.2196/27882 ◽

2021 ◽

Vol 5 (3) ◽

pp. e27882

Author(s):

Britt Elise Bente ◽

Jan Willem Jaap Roderick van 't Klooster ◽

Maud Annemarie Schreijer ◽

Lea Berkemeier ◽

Joris Elmar van Gend ◽

...

Keyword(s):

Public Health ◽

Older Adults ◽

The Netherlands ◽

Health Workers ◽

Contact Tracing ◽

Usability Tests ◽

Health Authorities ◽

Increased Risk ◽

Public Health Authorities ◽

Lower Education

Background Adoption and evaluation of contact tracing tools based on information and communications technology may expand the reach and efficacy of traditional contact tracing methods in fighting COVID-19. The Dutch Ministry of Health, Welfare and Sports initiated and developed CoronaMelder, a COVID-19 contact tracing app. This app is based on a Google/Apple Exposure Notification approach and aims to combat the spread of the coronavirus among individuals by notifying those who are at increased risk of infection due to proximity to someone who later tests positive for COVID-19. The app should support traditional contact tracing by faster tracing and greater reach compared to regular contact tracing procedures. Objective The main goal of this study is to investigate whether the CoronaMelder is able to support traditional contact tracing employed by public health authorities. To achieve this, usability tests were conducted to answer the following question: is the CoronaMelder user-friendly, understandable, reliable and credible, and inclusive? Methods Participants (N=44) of different backgrounds were recruited: youth with varying educational levels, youth with an intellectual disability, migrants, adults (aged 40-64 years), and older adults (aged >65 years) via convenience sampling in the region of Twente in the Netherlands. The app was evaluated with scenario-based, think-aloud usability tests and additional interviews. Findings were recorded via voice recordings, observation notes, and the Dutch User Experience Questionnaire, and some participants wore eye trackers to measure gaze behavior. Results Our results showed that the app is easy to use, although problems occurred with understandability and accessibility. Older adults and youth with a lower education level did not understand why or under what circumstances they would receive notifications, why they must share their key (ie, their assigned identifier), and what happens after sharing. In particular, youth in the lower-education category did not trust or understand Bluetooth signals, or comprehend timing and follow-up activities after a risk exposure notification. Older adults had difficulties multitasking (speaking with a public health worker and simultaneously sharing the key in the app). Public health authorities appeared to be unprepared to receive support from the app during traditional contact tracing because their telephone conversation protocol lacks guidance, explanation, and empathy. Conclusions The study indicated that the CoronaMelder app is easy to use, but participants experienced misunderstandings about its functioning. The perceived lack of clarity led to misconceptions about the app, mostly regarding its usefulness and privacy-preserving mechanisms. Tailored and targeted communication through, for example, public campaigns or social media, is necessary to provide correct information about the app to residents in the Netherlands. Additionally, the app should be presented as part of the national coronavirus measures instead of as a stand-alone app offered to the public. Public health workers should be trained to effectively and empathetically instruct users on how to use the CoronaMelder app.

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Moral Messaging in a Time of COVID-19

10.31219/osf.io/w36zv ◽

2021 ◽

Author(s):

Michał Misiak ◽

Petr Tureček ◽

Oliver Scott Curry

Keyword(s):

Public Health ◽

Health Behaviour ◽

Common Good ◽

Moral Values ◽

Moral Principles ◽

Health Measures ◽

The Usa ◽

The Common ◽

Specific Culture ◽

The Individual

Do appeals to moral values increase compliance with COVID-19 public health measures? According to the theory of ‘Morality as cooperation’, morality consists of a collection of cooperative principles that help us get along, work together and promote the common good. We experimentally investigated whether messages that appeal to these moral principles increase pandemic-related public health behaviour. We investigated: (a) Are moral messages more effective than non-moral messages? (b) Are some moral messages more effective than others? c) Is the effectiveness of moral messages dependant on the corresponding moral values of the individual? (d) Do these effects hold across cultures? Participants (recruited from the USA and India) were presented with one of ten messages, asked questions about their intentions to follow the restrictions, were asked to donate to a charity fighting COVID-19, and completed the Morality-as-Cooperation Relevance Questionnaire. We found that: (a) Moral messages were more effective in increasing the donation than a non-moral message and more effective in increasing the intentions to act prosocially than a lack of message. (b) Messages appealing to heroism increased the intentions to act prosocially in both samples. (c) The effectiveness of moral messages was better when they were concordant with participants’ moral values, but only in the USA sample. (d) We also found that some moral messages were effective only in a particular population. Thus, moral messages may increase compliance with public health guidelines, but it is necessary to appeal to particular values and to tailor these messages for a specific culture.

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Stress symptoms and reactions to COVID-19: A multinational survey from six Asian regions

10.1101/2020.08.24.20179762 ◽

2020 ◽

Author(s):

Ricci P.H. Yue ◽

Edmund W. Cheng ◽

Nick H.K. Or ◽

Samson W.H. Yuen

Keyword(s):

Public Health ◽

Mental Health ◽

South Korea ◽

Economic Status ◽

Stress Reactions ◽

Safety Equipment ◽

Mental Health Information ◽

Health Measures ◽

Stress Symptoms ◽

History Of

People may experience a heightened level of stress reactions during a pandemic event and in an isolated social environment. A multi-national survey about such mental health information about COVID-19 was conducted in May 2020 across six Asian regions: Hong Kong, Japan, Singapore, South Korea, Taiwan and Thailand. Data were collected from a population representative sample of 11,895 adults on their stress symptoms and reactions to COVID-19 and the related public health measures. 59.1% of the respondents showed at least one substantial stress symptom. The situation was particularly worrying in South Korea, where 75% of the respondents reported substantial stress symptoms. Respondents who were young, educated, lived in an urban area, had a high socio-economic status, had a history of chronic illness or mental illness, or who lived with a pregnant woman, elderly or children were most vulnerable to stress during the pandemic. Stress reactions showed a positive relationship with the amount of time spent following news about the COVID-19 outbreak. Asian adults coped with their stress by preparing safety equipment and extra daily commodities (62.4%) and by following government-issued public health measures (60.1%). Most Asian (71%) also frequently checked on the safety of family members and friends to keep each other safe. The COVID-19 pandemic and the associated stringent public health measures have largely increased the prevalence of substantial stress symptoms across multiple Asian regions. Governments should prepare this mental health pandemic and the associated social repercussions.

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The Challenges of Being a Family Caregiver During the COVID-19 Pandemic in Canada

Innovation in Aging ◽

10.1093/geroni/igab046.2105 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 552-552

Author(s):

Gwen McGhan ◽

Deirdre McCaughey

Keyword(s):

Public Health ◽

Older Adults ◽

At Risk ◽

Family Member ◽

Well Being ◽

Community Dwelling ◽

Chronic Health Conditions ◽

Health Conditions ◽

The Public ◽

Health Measures

Abstract The COVID-19 pandemic has impacted all of our lives, but the population most at risk are older adults. Canadians over the age of 60 account for 36% of all COVID-19 cases but 95% of the deaths, and over two-thirds of ICU admissions. Older adults with chronic health conditions are especially at risk. Prior to COVID-19, family caregivers (FCGs) for older adults were managing their caregiving duties at the limits of their emotional, physical and financial capacity. As such, FCGs need special consideration during these times of uncertainty to support them in their role and enable the continuation of care for their older adult family members. This symposium will report on independently conducted studies from across Canada that have examined how the pandemic and associated public health measures have influenced resource utilization by FCGs and the older adults for whom they provide care. McAiney et al’s study examines the deleterious effect of reduced services on community dwelling FCGs and the wellbeing of their family member with dementia. Parmar & Anderson examined the effect of pandemic restrictions on FCGs of frail older adults and found they were experiencing increased distress and decreased wellbeing. Flemons et al report on the experiences of FCGs managing caregiving without critical services and the effect of restrictive visiting policies and the well-being of the caregiving dyad (FCGs and family member with dementia). Finally, McGhan et al will share how FCGs evaluated the efficacy of public health measures and the public health messaging about the pandemic.

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