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Vameghi M, Saatchi M, Bahrami G, Soleimani F, Takaffoli M. How did we protect children against COVID-19 in Iran? Prevalence of COVID-19 and vaccination in the socio-economic context of COVID-19 epidemic. PLoS One 2024; 19:e0303043. [PMID: 38722835 PMCID: PMC11081304 DOI: 10.1371/journal.pone.0303043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. METHOD A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. RESULTS The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15-18, with boys more likely to refuse vaccination than girls. CONCLUSION The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations.
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Affiliation(s)
- Meroe Vameghi
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Giti Bahrami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farin Soleimani
- Paediatric Neurorehabilitation Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Takaffoli
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Rusk SA, DiBari J, Mason DM, Li M, Hong X, Wang G, Pearson C, Mirolli G, Cheng TL, Kogan MD, Zuckerman B, Wang X. The impact of COVID-19 on psychiatric clinical encounters among low-income racially-diverse children. J Child Psychol Psychiatry 2024; 65:631-643. [PMID: 37088737 PMCID: PMC10590822 DOI: 10.1111/jcpp.13809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND There is a lack of longitudinal data to examine the impact of COVID-19 on all types of clinical encounters among United States, underrepresented BIPOC (Black, Indigenous, and people of color), children. This study aims to examine the changes in all the outpatient clinical encounters during the pandemic compared to the baseline, with particular attention to psychiatric encounters and diagnoses. METHOD This study analyzed 3-year (January 2019 to December 2021) longitudinal clinical encounter data from 3,394 children in the Boston Birth Cohort, a US urban, predominantly low-income, Black and Hispanic children. Outcomes of interest were completed outpatient clinical encounters and their modalities (telemedicine vs. in person), including psychiatric care and diagnoses, primary care, emergency department (ED), and developmental and behavioral pediatrics (DBP). RESULTS The study children's mean (SD) age is 13.9 (4.0) years. Compared to 2019, psychiatric encounters increased by 38% in 2020, most notably for diagnoses of adjustment disorders, depression, and post-traumatic stress disorders (PTSD). In contrast, primary care encounters decreased by 33%, ED encounters decreased by 55%, and DBP care decreased by 16% in 2020. Telemedicine was utilized the most for psychiatric and DBP encounters and the least for primary care encounters in 2020. A remarkable change in 2021 was the return of primary care encounters to the 2019 level, but psychiatric encounters fluctuated with spikes in COVID-19 case numbers. CONCLUSIONS Among this sample of US BIPOC children, compared to the 2019 baseline, psychiatric encounters increased by 38% during 2020, most notably for the new diagnoses of adjustment disorder, depression, and PTSD. The 2021 data showed a full recovery of primary care encounters to the baseline level but psychiatric encounters remained sensitive to the pandemic spikes. The long-term impact of the pandemic on children's mental health warrants further investigation.
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Affiliation(s)
- Serena A. Rusk
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Jessica DiBari
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Dana M. Mason
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Mengmeng Li
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Colleen Pearson
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Gabrielle Mirolli
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Tina L. Cheng
- Department of Pediatrics, Cincinnati Children’s Hospital and University of Cincinnati
| | - Michael D. Kogan
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Barry Zuckerman
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
- Department of Pediatrics, Johns Hopkins University School of Medicine
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Blakeslee SB, Vieler K, Horak I, Stritter W, Seifert G. Planting Seeds for the Future: Scoping Review of Child Health Promotion Apps for Parents. JMIR Mhealth Uhealth 2023; 11:e39929. [PMID: 37471125 PMCID: PMC10401193 DOI: 10.2196/39929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/12/2022] [Accepted: 05/02/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Increasingly, parents use child health promotion apps to find health information. An overview of child health promotion apps for parents currently does not exist. The scope of child health topics addressed by parent apps is thus needed, including how they are evaluated. OBJECTIVE This scoping review aims to describe existing reported mobile health (mHealth) parent apps of middle- to high-income countries that promote child health. The focus centers on apps developed in the last 5 years, showing how the reported apps are evaluated, and listing reported outcomes found. METHODS A scoping review was conducted according to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guidelines to identify parent apps or web-based programs on child health promotion published between January 2016 and June 2021 in 5 databases: PubMed, ERIC, IEEE Xplore, Web of Science, and Google Scholar. Separate sources were sought through an expert network. Included studies were summarized and analyzed through a systematic and descriptive content analysis, including keywords, year of publication, country of origin, aims/purpose, study population/sample size, intervention type, methodology/method(s), broad topic(s), evaluation, and study outcomes. RESULTS In total, 39 studies met the inclusion criteria from 1040 database and 60 expert-identified studies. Keywords reflected the health topics and app foci. About 64% (25/39) of included studies were published after 2019 and most stemmed from the United States, Australian, and European-based research. Studies aimed to review or evaluate apps or conducted app-based study interventions. The number of participants ranged from 7 to 1200. Quantitative and qualitative methods were used. Interventions included 28 primary studies, 6 app feasibility studies, and 5 app or literature reviews. Eight separate topics were found: parental feeding and nutrition, physical activity, maternal-child health, parent-child health, healthy environment, dental health, mental health, and sleep. Study intervention evaluations cited behavior change theories in 26 studies and evaluations were carried out with a variety of topic-specific, adapted, self-developed, or validated questionnaires and evaluation tools. To evaluate apps, user input and qualitative evaluations were often combined with surveys and frequently rated with the Mobile App Rating Scale. Outcomes reported some positive effects, while several intervention studies saw no effect at all. Effectively evaluating changes in behavior through apps, recruiting target groups, and retaining app engagement were challenges cited. CONCLUSIONS New parents are a key target group for child health apps, but evaluating child health promotion apps remains a challenge. Whether tailored to parent needs or adapted to the specific topic, apps should be rooted in a transparent theoretical groundwork. Applicable lessons for parent apps from existing research are to tailor app content, include intuitive and adaptive features, and embed well-founded parameters for long-term effect evaluation on child health promotion.
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Affiliation(s)
- Sarah B Blakeslee
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kristin Vieler
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Horak
- Digital Health Entrepreneur, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Nenna R, Zeric H, Petrarca L, Mancino E, Midulla F. Weighing policymaking: A narrative review of school closures as COVID-19 pandemic-mitigation strategies. Pediatr Pulmonol 2022; 57:1982-1989. [PMID: 34894111 DOI: 10.1002/ppul.25787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In the era of data-driven decision-making, unacceptable haziness, and inconsistency surrounds the yearlong scientific and public debate on the school closure policy in the coronavirus disease-2019 (COVID-19) pandemic mitigation efforts. AIM The present literature review stems out of the need for a clear scaffold collecting in one place all current evidence, as well as helping to organize incoming future evidence, concerning both the role of schools in driving the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community spread and the cost-effectiveness of school closure in containing such spread. METHODS References for this review were initially identified through searches of PubMed, Scopus, and Cochrane Library for articles published from March 2020 to March 2021 by the use of key terms "Schools," "COVID-19," "pandemic," "clusters," "outbreak," and "seroprevalence," selecting all articles from 2020 to 2021 with full-text availability. A further search was undertaken by screening citations of articles found in the original search and through Google Scholar and ResearchGate. RESULTS Overall, evidence shows that opening schools and keeping them open in the context of the SARS-CoV-2 pandemic is possible, although behaviorally challenging and unfeasible if educational facilities or testing services are inadequate. Contrary to other respiratory viruses, children are not chief targets of SARS-CoV-2 infection, transmission, and disease. It also appears that the second wave of the SARS-CoV-2 virus spread in the WHO European region has been unrelated to school re-opening. CONCLUSIONS A fact-based understanding of what is currently known on such a consequential policy is required to provide a basis of evidence for advocacy of either school closure or school opening at times of high-intensity community transmission of SARS-CoV-2.
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Affiliation(s)
- Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Hana Zeric
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Melzer SM. Addressing social determinants of health in pediatric health systems: balancing mission and financial sustainability. Curr Opin Pediatr 2022; 34:8-13. [PMID: 34889308 DOI: 10.1097/mop.0000000000001083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW With increasing recognition of the impact of poverty, racism and other social factors on child health, many pediatric health systems are undertaking interventions to address Social Determinants of Health (SDoH). This review summarizes these initiatives and recent developments in state and federal health policy impacting funding for these efforts. RECENT FINDINGS Although the evidence defining optimal approaches to identifying and mitigating SDoH in children is still evolving, pediatric health systems are making significant investments in different initiatives to address SDoH. With limited reimbursement available through traditional payment streams, pediatric health systems and Accountable Care Organizations are looking to value-based payments to help fund these interventions. Federal and state policy changes, including use of Medicaid funds for nonmedical interventions and introduction of the Accountable Health Communities model to pediatrics, offer additional funding sources to address SDoH. SUMMARY Initiatives among mission-driven pediatric health systems to address SDoH are increasingly common despite funding challenges. Value-based payments, expansion of Medicaid funding resulting from policy changes and delivery system reform, along with health system philanthropy and operating revenues, will all be needed to meet mission-based goals of addressing SDoH while supporting financial sustainability.
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COVID-19 Impact on Disparity in Childhood Immunization in Low- and Middle-Income Countries Through the Lens of Historical Pandemics. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:225-233. [PMID: 36569790 PMCID: PMC9760533 DOI: 10.1007/s40475-022-00273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2022] [Indexed: 12/23/2022]
Abstract
Purpose of Review The COVID-19 pandemic, since 2020, has affected health care services and access globally. Although the entire impact of COVID-19 pandemic on existing global public health is yet to be fully seen, the impact of COVID-19 pandemic on global childhood immunization programs is of particular importance. Recent Findings Disruptions to service delivery due to lockdowns, challenges in vaccination programs, vaccine misinformation and hesitancy, and political and social economic inequalities all posed a threat to existing childhood immunization programs. These potential threats were especially critical in LMIC where childhood immunization programs tend to experience suboptimal implementation. Summary This review provides an overview of childhood immunizations and discusses past pandemics particularly in LMIC, factors contributing to disparities in childhood immunizations, and reviews potential lessons to be learned from past pandemics. Vaccine hesitancy, social determinants of health, and best practices to help lessen the pandemic's influence are also further elaborated. To address current challenges that hindered the progress made in prevention of childhood illnesses through vaccination campaigns and increased vaccine availability, lessons learned through best practices explored from past pandemics must be examined to mitigate impact of COVID-19 on childhood immunization and in turn conserve health and improve economic well-being of children especially in LMIC.
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7
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Molloy EJ, Bearer CB. Pediatric Research and COVID-19: the changed landscape. Pediatr Res 2022; 92:618-619. [PMID: 34887524 PMCID: PMC8656136 DOI: 10.1038/s41390-021-01857-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022]
Affiliation(s)
- E. J. Molloy
- grid.8217.c0000 0004 1936 9705Paediatrics, School of Medicine, Trinity College, , The University of Dublin, Dublin, Ireland ,Trinity Research in Childhood Centre (TRICC), Dublin, Ireland ,grid.411886.20000 0004 0488 4333Neonatology, Coombe Women’s and Infant’s University Hospital, Dublin, Ireland ,grid.413305.00000 0004 0617 5936Childrens Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin, Ireland ,Neonatology, CHI at Crumlin, Dublin, Ireland
| | - C. B. Bearer
- grid.415629.d0000 0004 0418 9947Rainbow Babies & Children’s Hospital, Cleveland, OH USA ,grid.67105.350000 0001 2164 3847Case Western Reserve University School of Medicine, Cleveland, OH USA
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8
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Matera L, Nenna R, Ardenti Morini F, Banderali G, Calvani M, Calvi M, Cozzi G, Falsaperla R, Guidi R, Kantar A, Lanari M, Lubrano R, Messini B, Niccoli AA, Tipo V, Midulla F. Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9547. [PMID: 34574469 PMCID: PMC8467762 DOI: 10.3390/ijerph18189547] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/29/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022]
Abstract
Previously, we demonstrated an 81% reduction in pediatric Emergency Room (ER) visits in Italy during the strict lockdown due to the SARS-CoV-2 pandemic. Since May 2020, lockdown measures were relaxed until 6 November 2020, when a strict lockdown was patchily reintroduced. Our aim was to evaluate the impact of the relaxed lockdown on pediatric ER visits in Italy. We performed a retrospective multicenter study involving 14 Italian pediatric ERs. We compared total ER visits from 24 September 2020 to 6 November 2020 with those during the corresponding timeframe in 2019. We evaluated 17 ER specific diagnoses grouped in air communicable and non-air communicable diseases. We recognized four different triage categories: white, green, yellow and red. In 2020 total ER visits were reduced by 51% compared to 2019 (16,088 vs. 32,568, respectively). The decrease in air communicable diseases was significantly higher if compared to non-air communicable diseases (-64% vs. -42%, respectively). ER visits in each triage category decreased in 2020 compared to 2019, but in percentage, white and red codes remained stable, while yellow codes slightly increased and green codes slightly decreased. Our results suggest that preventive measures drastically reduced the circulation of air communicable diseases even during the reopening of social activities but to a lesser extent with regard to the strict lockdown period (March-May 2020).
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Affiliation(s)
- Luigi Matera
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.M.); (R.N.)
| | - Raffaella Nenna
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.M.); (R.N.)
| | | | - Giuseppe Banderali
- Department of Clinical Paediatrics, San Paolo Hospital, University of Milan, 20142 Milan, Italy;
| | - Mauro Calvani
- Operative Unit of Pediatrics, San Camillo-Forlanini Hospital, 00151 Rome, Italy;
| | - Matteo Calvi
- Pediatric Emergency Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy;
| | - Giorgio Cozzi
- Institute for Maternal and Child Health Burlo Garofalo, 34137 Trieste, Italy;
| | - Raffaele Falsaperla
- General Pediatrics and Pediatric Acute and Emergency Unit, Vittorio Emanuele University Hospital, 95121 Catania, Italy;
| | - Roberto Guidi
- Department of Pediatric Emergency, G. Salesi Hospital, 60123 Ancona, Italy;
| | - Ahmad Kantar
- Pediatric Unit, Istituti Ospedalieri Bergamaschi, Gruppo Ospedaliero San Donato, 24059 Ponte San Pietro, Italy;
| | - Marcello Lanari
- Pediatric Emergency Unit, Scientific Institute for Research and Healthcare, Sant’Orsola Hospital, 40138 Bologna, Italy;
| | - Riccardo Lubrano
- Pediatric Unit, Department of Maternal and Child Health, Santa Maria Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy;
| | - Beatrice Messini
- Pediatric Unit, San Giovanni Battista Hospital, 06034 Foligno, Italy;
| | | | - Vincenzo Tipo
- Pediatric Emergency Department, Santobono-Pausilipon Hospital, 06049 Napoli, Italy;
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.M.); (R.N.)
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Bonati M, Benelli E. Vaccinating adolescents wisely against COVID-19. BMJ Paediatr Open 2021; 5:e001191. [PMID: 34493988 PMCID: PMC8413465 DOI: 10.1136/bmjpo-2021-001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/14/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Maurizio Bonati
- Department of Public Health, Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, Milano, Italy
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Abstract
The COVID-19 pandemic poses many direct and indirect consequences for children's health and associated research. Direct consequences include participation of children in COVID-19 research trials, pausing other research in children and the potential implications of a global economic downturn on future research funding. Collaborative and networked research together with streamlined research processes and use of remote technology have been central to efforts by clinicians and scientists around the world and have proved essential for reducing COVID-19 morbidity and mortality. IMPACT: Maintain streamlined and efficient approaches to research governance and data sharing to facilitate high-quality collaborative research. Ensure early inclusion of children in trials of therapies for diseases that affect all age groups. Paediatric Research Societies should co-ordinate effective processes to define key research questions and develop multinational clinical trials for diagnostics, therapeutics and preventative strategies for infants, children and young people.
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Lachman P, Batalden P, Vanhaecht K. A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health. F1000Res 2020; 9:1140. [PMID: 34158927 PMCID: PMC8191516 DOI: 10.12688/f1000research.26368.3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 12/17/2022] Open
Abstract
Background: It is twenty years since the US Institute of Medicine (IOM) defined quality in healthcare, as comprising six domains: person-centredness, timeliness, efficiency, effectiveness, safety and equity. Since then, a new quality movement has emerged, with the development of numerous interventions aimed at improving quality, with a focus on accessibility, safety and effectiveness of care. Further gains in equity and timeliness have proven even more challenging. The challenge: With the emergence of "service-oriented" systems, complexity science, the challenges of climate change, the growth of social media and the internet and the new reality of COVID-19, the original domains proposed by the IOM invite reflection on their relevance and possibility for improvement. The possible solution: In this paper, we propose a revised model of quality that is built on never-ending learning and includes new domains, such as Ecology and Transparency, which reflect the changing worldview of healthcare. We also introduce the concept of person- or "kin-centred care" to emphasise the shared humanity of people involved in the interdependent work. The change of Person Centred Care to Kin Centred Care introduces a broader concept of the person and ensures that Person Centred Care is included in every domain of quality rather than as a separate domain. The concentration on the technological aspects of quality is an example of the problem in the past. This is a more expansive view of what "person-centredness" began. The delivery of health and healthcare requires people working in differing roles, with explicit attention to the lived realities of the people in the roles of professional and patient. The new model will provide a construct that may make the attainment of equity in healthcare more possible with a focus on kindness for all.
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Affiliation(s)
- Peter Lachman
- Royal College of Physicians Ireland (RCPI), Dublin, Ireland
| | - Paul Batalden
- Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Kris Vanhaecht
- KU Leuven Institute for Healthcare Policy, KU Leuven, Leuven, 3000, Belgium
- Department of Quality, University Hospitals Leuven, Leuven, 3000, Belgium
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Lachman P, Batalden P, Vanhaecht K. A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health. F1000Res 2020; 9:1140. [PMID: 34158927 PMCID: PMC8191516 DOI: 10.12688/f1000research.26368.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 09/21/2023] Open
Abstract
Background: It is twenty years since the US Institute of Medicine (IOM) defined quality in healthcare, as comprising six domains: person-centredness, timeliness, efficiency, effectiveness, safety and equity. Since then, a new quality movement has emerged, with the development of numerous interventions aimed at improving quality, with a focus on accessibility, safety and effectiveness of care. Further gains in equity and timeliness have proven even more challenging. The challenge: With the emergence of "service-oriented" systems, complexity science, the challenges of climate change, the growth of social media and the internet and the new reality of COVID-19, the original domains proposed by the IOM invite reflection on their relevance and possibility for improvement. The possible solution: In this paper we propose a revised model of quality that is built on never-ending learning and includes new domains, such as Ecology and Transparency, which reflect the changing worldview of healthcare. We also introduce the concept of person- or "kin-centred care" to emphasise the shared humanity of people involved in the interdependent work. This is a more expansive view of what "person-centredness" began. The delivery of health and healthcare requires people working in differing roles, with explicit attention to the lived realities of the people in the roles of professional and patient. The new model will provide a construct that may make the attainment of equity in healthcare more possible with a focus on kindness for all.
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Affiliation(s)
- Peter Lachman
- Royal College of Physicians Ireland (RCPI), Dublin, Ireland
| | - Paul Batalden
- Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Kris Vanhaecht
- KU Leuven Institute for Healthcare Policy, KU Leuven, Leuven, 3000, Belgium
- Department of Quality, University Hospitals Leuven, Leuven, 3000, Belgium
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Lachman P, Batalden P, Vanhaecht K. A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals in the new COVID-19 period. F1000Res 2020; 9:1140. [PMID: 34158927 PMCID: PMC8191516 DOI: 10.12688/f1000research.26368.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/30/2022] Open
Abstract
Background: It is twenty years since the Institute of Medicine (IOM) defined quality in healthcare, as comprising six domains: person-centredness, timeliness, efficiency, effectiveness, safety and equity. Since then, a new quality movement has emerged, with the development of numerous interventions aimed at improving quality, with a focus on accessibility, safety and effectiveness of care. Further gains in equity and timeliness have proven even more challenging. The challenge: With the emergence of "service-oriented" systems, complexity science, the challenges of climate change, the growth of social media and the internet and the new reality of COVID-19, the original domains proposed by the IOM invite reflection on their relevance and possibility for improvement. The possible solution: In this paper we propose a revised model of quality that is built on never-ending learning and includes new domains, such as Ecology and Transparency, which reflect the changing worldview of healthcare. We also introduce the concept of person- or "kin-centred care" to emphasise the shared humanity of people involved in the interdependent work. This is a more expansive view of what "person-centredness" began. The delivery of health and healthcare requires people working in differing roles, with explicit attention to the lived realities of the people in the roles of professional and patient. The new model will provide a construct that may make the attainment of equity in healthcare more possible with a focus on kindness for all.
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Affiliation(s)
- Peter Lachman
- Royal College of Physicians Ireland (RCPI), Dublin, Ireland
| | - Paul Batalden
- Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Kris Vanhaecht
- KU Leuven Institute for Healthcare Policy, KU Leuven, Leuven, 3000, Belgium
- Department of Quality, University Hospitals Leuven, Leuven, 3000, Belgium
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