Parental Hesitancy and Concerns around Accessing Paediatric Unscheduled Healthcare during COVID-19: A Cross-Sectional Survey

A decrease in attendance at emergency departments among paediatric populations has been reported during the Coronavirus Disease 2019 (COVID-19) pandemic. The present study sought to understand parents’ hesitancy and concerns around accessing healthcare during the pandemic using a cross-sectional survey of parents of children under the age of 16 (N = 1044) in Ireland. Multinomial and logistic regression analyses were used to determine the factors that influenced avoidance and hesitancy. In total, 34% of participants stated that their child required healthcare during the pandemic, of whom 22% decided against seeking healthcare. Parents who reported being much more hesitant about accessing healthcare were more likely to report mild–moderate (Relative Risk Ratio (RRR) = 2.31, CI: 1.54–3.47) and severe–extremely severe stress (RRR: 3.37, CI: 1.81–6.27). Parents who understood government advice to mean avoiding health services were more likely to be hesitant to attend (RRR: 1.71, CI; 1.10–2.67). These effects held when restrictions were beginning to be lifted. Higher levels of stress were associated with a parent believing that the government advice meant that they should not attend health services (OR: 1.66, CI: 1.14–2.41). Public health messaging must ensure parents are reassured on the accessibility and safety of paediatric healthcare services as this public health emergency continues.

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Understanding the Impact of Public Health Advice on Paediatric Healthcare Use During COVID-19: A Cross-sectional Survey of Parents

10.21203/rs.3.rs-56016/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Emma Nicholson ◽

Thérése McDonnell ◽

Ciara Conlon ◽

Michael Barrett ◽

Fergal Cummins ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Perception Of Risk ◽

Cross Sectional Survey ◽

Service Usage ◽

Cross Sectional ◽

The Public ◽

Health Advice ◽

The Government ◽

The Impact

Abstract Background Hospital avoidance during the COVID-19 pandemic has been reported with a significant decrease in attendance at emergency departments among paediatric populations with potential increased morbidity and mortality outcomes. The present study sought to understand parents’ experiences of healthcare during the initial public health stages of the COVID-19 pandemic.Methods A cross-sectional survey of parents of children under the age of 16 (N = 1044). The survey collected demographic information to profile parents and children, capture relevant health information such as pre-existing conditions and/or chronic illness or disability, and health service usage during the pandemic. Descriptive statistics, chi-square tests and regression analyses were used to determine the factors that influenced avoidance and hesitancy. Results23% of parents stated that they were much more hesitant to access health services upon implementation of the initial public health restrictions. Parents with a higher perception of risk of their children contracting COVID-19 (χ2 (3) =33.8618, p< 0.000), and stronger levels of concern regarding the effects of COVID-19 (χ2 (3) =23.9189, p< 0.000) were more likely to be hesitant. Stress also appeared to be a factor in hesitancy with higher than normal stress levels significantly associated with hesitancy (RRR= 2.31, CI: 1.54 - 3.47), while those with severe/extremely severe stress were over three times more likely to be hesitant (RRR:3.37, CI:1.81 - 6.27). Approximately one third of the sample required healthcare for their children during the public health restrictions to delay the spread of COVID-19, however, one in five of these parents avoided accessing such healthcare when needed. Of those that required healthcare, parents who avoided were more likely to report that the services were needed more by others (χ2 (1) 20.3470, p<0.000). Those who felt that the government advice was to stay away from health services were 1.7 times more likely to be much more hesitant (RRR:1.71, CI; 1.10 – 2.67).ConclusionThe misinterpretation of government public health advice, stress and the perception of risk each contributed to parental avoidance of or hesitancy to utilize healthcare services during the public health measures imposed to combat COVID-19.

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A cross-sectional survey assessing the preparedness of the long-term care sector to respond to the COVID-19 pandemic in Ontario, Canada

10.21203/rs.3.rs-57368/v3 ◽

2020 ◽

Author(s):

Henry Yu-Hin Siu ◽

Lorand Kristof ◽

Dawn Elston ◽

Abe Hafid ◽

Fred Mather

Keyword(s):

Public Health ◽

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Wide Range ◽

Significant Public Health ◽

Public Health Officials ◽

The Government

Abstract Background: The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes.Methods: An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the LTC clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent’s LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent’s LTC home was also assessed.Results: The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home.Conclusions: This study highlights the communication to and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.

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COVID-19 Related Misconceptions and Prevention Practices Among the Public in a Southeastern City in Nigeria

International Journal of Translational Medical Research and Public Health ◽

10.21106/ijtmrph.362 ◽

2021 ◽

Vol 5 (2) ◽

pp. 149-159

Author(s):

Sorochi Iloanusi ◽

Osaro Mgbere ◽

Nchebe-Jah Raymond Iloanusi ◽

Ismaeel Yunusa ◽

Ekere J. Essien

Keyword(s):

Public Health ◽

Scientific Evidence ◽

Demographic Characteristics ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Anambra State ◽

The Public ◽

Creative Commons ◽

Study Population ◽

The Government

Introduction: The COVID-19 pandemic brought several misconceptions that could hinder individuals from taking necessary measures to prevent infection, thus, undermining the public health containment efforts. We aimed to assess the prevalence of COVID-19 related misconceptions and their associations with demographic characteristics and prevention practices in Onitsha city in Anambra state, Nigeria. Methods: We analyzed data from a cross-sectional survey of 140 adult residents of Onitsha city in Anambra state, Nigeria, conducted in March 2020. Descriptive and inferential statistics were used to describe the study population and determine the associations between COVID-19 misconceptions, demographic characteristics, and implementation of COVID-19 prevention practices. Data management and statistical analyses were conducted using SAS JMP Statistical DiscoveryTM Software version 14.3 (SAS Institute, Cary, North Carolina, USA). Results: The participants’ average age was 34.5 (SD: ±10.9) years, and most were males (54.3%). Misconceptions about COVID-19 among the study population resulted in markedly reduced compliance with nearly all prevention practices. Some participants believed that COVID-19 would not spread in Nigeria (34.4%, p<0.0001), was not fatal (10.8%, p<0.0001), can be prevented and cured through spiritual means (48.2%, P <0.0001), use of herbs (13.6%, P <0.0001), use of antibiotics (11.4%, p<0.0001) and that COVID-19 vaccine was available (25.4%, p<0.01). Misconception about the possibility of COVID-19 spread was significantly associated with non-compliance to all prevention practices (P<0.05) except travel restrictions. Conclusions and Implications for Translation: Our study suggests the need for the government to tailor interventions targeting the common misconceptions in Onitsha in order to improve the public’s trust and compliance with recommended COVID-19 prevention practices. Misconception has become a significant public health challenge, primarily as its prioritization over scientific evidence and guidelines directly affects the pandemic preparedness and control efforts and may cause more people to be at risk of contracting COVID-19. Copyright © 2021 Iloanusi et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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Influence of A Public Health Emergency On Care For Patients With Duchenne Muscular Dystrophy: An Online, Cross-Sectional Survey

10.21203/rs.3.rs-1179787/v1 ◽

2022 ◽

Author(s):

Shu Zhang ◽

Shaoxia Wang ◽

Yuru Dong ◽

Xinyu Chen ◽

Miao Hu ◽

...

Keyword(s):

Public Health ◽

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Public Health Emergency ◽

Daily Activities ◽

Rehabilitation Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Public

Abstract Background: The public health emergency has created challenges for the care of patients, particularly those with chronic diseases such as Duchenne muscular dystrophy. To elucidate the challenges faced by Chinese patients with Duchenne muscular dystrophy during the public health emergency coronavirus disease 2019 pandemic, we conducted an online cross-sectional survey, the responses of which were collected between March 27 and June 30, 2021. Results: In total, valid questionnaire responses were obtained from 2,105 patients, of whom 49 lived in pandemic lockdown areas. Of the 2,056 responders from non-lockdown areas, 42.8% reduced their outside daily activities, 49.4% reduced their use of rehabilitation services, 39.7% postponed regular follow-up appointments, and 40.8% complained of accelerated declines in motor function over the previous year. The corresponding figures for the 49 participants from lockdown areas were almost all higher, with 67.3% reducing outside daily activities, 44.9% reducing their use of rehabilitation services, 79.6% postponing regular follow-up appointments, and 55.1% complaining of accelerated declines in motor function. When asked whether they expected more assistance from society than they had received before the pandemic, 60.8% of patients in non-lockdown areas and 87.8% of those in lockdown areas responded affirmatively. When asked whether they felt more anxious than they had before the pandemic and needed psychological counseling, 11.5% of respondents in non-lockdown areas and 18.4% of respondents in lockdown areas responded affirmatively. In non-lockdown areas, 76% of respondents had at least one telemedicine visit, and 71% of them thought that telemedicine was helpful. In lockdown areas, 91.8% had used telemedicine at least once, and 66.7% of them found it helpful.Conclusions: These public health emergency control measures have affected the care of patients with chronic diseases worldwide, particularly pronounced in lockdown areas. It is imperative that healthcare workers assist patients and establish more robust chronic disease management systems. Telemedicine is an effective model for providing healthcare to such patients.

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Knowledge and Perception of COVID-19, Prevalence of Pre-Existing Conditions, and Access to Essential Resources and Health Services in Somali IDP Camps

10.1101/2020.08.17.20176271 ◽

2020 ◽

Author(s):

Jude Alawa ◽

Lucas A Walz ◽

Samir Al-Ali ◽

Eleanor Wiles ◽

Nikhil Harle ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Survey Design ◽

Cross Sectional Survey ◽

Access To Treatment ◽

Cross Sectional ◽

Internally Displaced ◽

Survey Results ◽

To Receive ◽

Preventative Services

Background: Three million internally displaced Somalis live in overcrowded settlements with weakened infrastructure, insufficient access to WASH facilities, and inaccessible health services. This vulnerable population is especially susceptible to COVID-19, which is expected to have worsened health outcomes and exacerbate existing structural challenges in the implementation of public health measures. This study examines knowledge of COVID-19, self-reported prevalence of preexisting conditions, and access to essential health services among residents of internally displaced persons (IDP) camps in Somalia. Methods: A descriptive, cross-sectional survey design assessing demographics, current health profiles, knowledge and perceptions of COVID-19, and access to resources was used. 401 Somali IDP camp residents completed the survey. Results: Though 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a severe lack of access to adequate sanitation, an inability to practice social distancing, and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of "I don't know" for roughly 50% of responses. The majority were not familiar with basic information about the virus or confident that they could receive medical services if infected. Those who perceived their health status to be "fair," as opposed to "good," showed 5.69 times higher odds of being concerned about contracting COVID-19. Respondents who felt more anxious or nervous and those who introduced one behavioral change to protect against COVID-19 transmission showed 10.16 and 5.20 times increased odds of being concerned about disease contraction, respectively. Conclusion: This study highlights immense gaps in the knowledge and perceptions of COVID-19 and access to treatment and preventative services among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with educating those individuals most vulnerable to infection.

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A cross-sectional survey assessing the preparedness of the long-term care sector to respond to the COVID-19 pandemic in Ontario, Canada

10.21203/rs.3.rs-57368/v2 ◽

2020 ◽

Author(s):

Henry Yu-Hin Siu ◽

Lorand Kristof ◽

Dawn Elston ◽

Abe Hafid ◽

Fred Mather

Keyword(s):

Public Health ◽

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Wide Range ◽

Significant Public Health ◽

Public Health Officials ◽

The Government

Abstract Background: The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes. Methods: An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the LTC clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent’s LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent’s LTC home was also assessed.Results: The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home. Conclusions: This study highlights the communication to and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.

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Rural Resident Experience on National Basic Public Health Services: A Cross-Sectional Survey in 10 Western Provinces of China

Healthcare ◽

10.3390/healthcare7040160 ◽

2019 ◽

Vol 7 (4) ◽

pp. 160

Author(s):

Jinlin Liu ◽

Ying Mao

Keyword(s):

Public Health ◽

Health Services ◽

Large Scale ◽

Health Management ◽

Rural Resident ◽

Public Health Services ◽

Cross Sectional Survey ◽

Rural Residents ◽

Cross Sectional ◽

Health Related

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.

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Perceived Barriers to Mental Health Services among the Elderly in the Rural of Vietnam: A Cross Sectional Survey in 2019

Health Services Insights ◽

10.1177/11786329211026035 ◽

2021 ◽

Vol 14 ◽

pp. 117863292110260

Author(s):

Nguyen Hang Nguyet Van ◽

Nguyen Thi Khanh Huyen ◽

Mai Thi Hue ◽

Nguyen Thanh Luong ◽

Pham Quoc Thanh ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Rural Areas ◽

Mental Healthcare ◽

Healthcare Services ◽

Perceived Barriers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Important Indicator

While the burden of neurological and mental disorders has been drastically increased in Vietnam, the current mental healthcare services do not meet the public demand. In order to determine perceived barriers to the use of mental health services, we conducted a cross-sectional study on 376 elderly people from a rural district in Hanoi, Vietnam. We found that depression may be an important indicator of the need for formal and informal community and home care mental health services. Barriers to mental healthcare access were categorized into 7 groups namely stigma, emotional concerns, participation restrictions, service satisfaction, time constraints, geographic and financial conditions, and availability of services. The most significant barriers are the limited availability of and accessibility to health professionals and services in rural areas. Our study highlights the urgent efforts that need to be made in order to enhance availability of mental healthcare services in rural areas of Vietnam.

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Predictors of Healthcare-Seeking Behaviour, Health Services Access and Utilization in Ajebo Community, South-West, Nigeria

Annals of Health Research ◽

10.30442/ahr.0704-06-148 ◽

2021 ◽

Vol 7 (4) ◽

pp. 374-390

Author(s):

AK Ahmed ◽

GB Imhonopi ◽

MM Fasiku ◽

A Ahmed ◽

MO Osinubi ◽

...

Keyword(s):

Public Health ◽

Health Services ◽

Formal Education ◽

Healthcare Utilisation ◽

Healthcare Services ◽

Health Facilities ◽

Access To Health Services ◽

Cross Sectional ◽

Healthcare Seeking ◽

Public Health Facilities

Background: Health is a fundamental requirement for living a socially and economically productive life. Poor health inflicts great hardships on households, including debilitation, substantial monetary expenditures, loss of productivity and sometimes, death. Objectives: To describe healthcare-seeking behaviour, access to health services and utilisation, and their predictors in a southwestern Nigerian community. Methods: A descriptive, cross-sectional study was conducted in Ajebo community, Obafemi/Owode Local Government Area in Ogun State. A total of 420 respondents were studied using an interviewer-administered questionnaire to collect quantitative data. Results: More than half (54.0%) of the respondents had access to public health facilities, 41.7% had access to private health facilities, while patent medicine stores were accessed by 4.3% of the respondents. Out of the 249 (59.3%) who were ill in the preceding three months, 92.4% of them sought healthcare. More males utilized government-owned health services s than females (χ² = 3.878, p = 0.049). More than half (56.4%) travelled >10 minutes to access healthcare services. Lack of formal education was not a hindrance to seeking healthcare (OR = 31.392, p = 0.003, CI = 3.323-2.347). Income earning <30,000 Naira was the strongest predictor of healthcare utilization (OR = 3.304, p =0.001, 95% CI = 2.007-5.441). Education with OR = 31.392 (p = 0.003, 95% CI = 3.323-96.570) was the strongest predictor of healthcare-seeking behaviour. Conclusion: Healthcare-seeking behaviour was not limited by lack of formal education. The utilisation of public health facilities was high among the respondents. State of employment and income were strong predictors of healthcare utilisation in Ajebo community.

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A cross-sectional survey assessing the preparedness of the long-term care sector to respond to the COVID-19 pandemic in Ontario, Canada

BMC Geriatrics ◽

10.1186/s12877-020-01828-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Henry Yu-Hin Siu ◽

Lorand Kristof ◽

Dawn Elston ◽

Abe Hafid ◽

Fred Mather

Keyword(s):

Public Health ◽

Long Term Care ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Term Care ◽

Wide Range ◽

Significant Public Health ◽

Public Health Officials ◽

The Government

Abstract Background The COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes. Methods An online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent’s LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent’s LTC home was also assessed. Results The overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home. Conclusions This study highlights the communication and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.

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