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Wickramasinghe S, Fisher J, Taft A, Makleff S. Experiences of abortion care in Australia: a qualitative study examining multiple dimensions of access. BMC Pregnancy Childbirth 2024; 24:652. [PMID: 39375656 DOI: 10.1186/s12884-024-06758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/14/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND The United Nations' Sustainable Development Goals identify universal access to sexual and reproductive health services as a global priority. Yet barriers to abortion access remain, including legal restrictions, cost, stigma, and limited services and information. The aim was to identify barriers to and facilitators of abortion care access experienced in Australia. METHODS This qualitative phenomenological study examined abortion access in Australia, where abortion is decriminalised, from March 2020 to December 2022. We used social media and flyers in clinics to recruit adults who had sought abortion care, then interviewed them in-depth. We mapped participant experiences to five dimensions of access identified by Levesque et al.'s patient-centred access to healthcare framework: approachability, acceptability, availability and accommodation, affordability, and appropriateness. RESULTS The 24 participants lived across Australia and sought abortion during the COVID-19 pandemic. Approachability: Before seeking abortion, most did not know where to access information about the service and where to obtain it. Acceptability: Many were uncomfortable disclosing their abortion to family or friends; they reported that healthcare providers demonstrated varying levels of support. Availability and accommodation: Regional participants travelled far and faced long wait-times, exacerbated by pandemic restrictions. Affordability: Participants described financial stress paying for the service, travel, and related expenses. Appropriateness: Most participants expected judgemental care. Experiences varied widely: many participants experienced unempathetic, rushed, or judgemental interactions with healthcare staff, and many also reported at least one non-judgmental and supportive interaction on the same pathway to care. DISCUSSION Abortion seekers experienced varying obstacles when seeking care. The findings illustrate the need for population- and system-level initiatives such as: providing accurate information about and normalising abortion; implementing system-level strategies to reduce wait times, travel, and costs, especially for rural populations; and developing regulatory and quality improvement initiatives to increase the workforce and its readiness to provide high-quality, non-judgemental abortion care. Challenges seeking care during pandemic restrictions illustrate the importance of social support during care and choice between abortion modalities and service types. Consumer voices can help understand the diverse pathways to abortion care and inform solutions to overcome the multidimensional barriers to access.
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Affiliation(s)
- Sethini Wickramasinghe
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia
| | - Shelly Makleff
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia.
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Di Dionisio CM, Bitzer J, Greil-Soyka M. A model curriculum in sexual medicine for undergraduate education in Europe. OPEN RESEARCH EUROPE 2024; 3:153. [PMID: 39318999 PMCID: PMC11420616 DOI: 10.12688/openreseurope.16146.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 09/26/2024]
Abstract
Sexual health has been recognized as an essential component of the overall health and wellbeing. The current article aims, first, to review the current state of sexual health education in undergraduate medical curricula, identifying gaps, needs and challenges. The main part of this paper describes the development and content of an undergraduate sexual medicine curriculum based on a clear concept of the competencies students should learn regarding knowledge, skills and attitudes. The content is based on a biopsychosocial understanding of human sexuality elaborated by international experts from different European countries integrating basic knowledge in biology, psychology, sociocultural and political sciences, preventive medicine, and the various therapeutic approaches to help women, men and couples with sexual health problems on a primary care level. In order to enable students to learn the basic skills of sexual history taking and sexual basic counselling two educational videos were produced. The material presented is part of the European Collaboration in Science and Technology (COST) supported project European Sexual Medicine Network (ESMN). The material provided can serve universities to give the training as a 25-30 hours course equivalent to 1 ECTS.
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Affiliation(s)
- Carlo Matteo Di Dionisio
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, Universita degli Studi di Roma Tor Vergata, Rome, Lazio, Italy
| | - Johannes Bitzer
- University Hospital - Department of Obstetrics and Gynecology, Universitat Basel, Basel, Basel-Stadt, Switzerland
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3
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O'Connell M, Gluskin B, Parker S, Burke PJ, Pluhar E, Guss CE, Shrier LA. Adapting a Counseling-Plus-mHealth Intervention for the Virtual Environment to Reduce Sexual and Reproductive Health Risk Among Young Women with Depression. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:196-208. [PMID: 36881344 PMCID: PMC9989584 DOI: 10.1007/s11121-023-01506-4] [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] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/08/2023]
Abstract
MARSSI (Momentary Affect Regulation - Safer Sex Intervention) is a counseling-plus-mobile health (mhealth) intervention to reduce sexual and reproductive health (SRH) risks for women with depression and high-risk sexual behavior. Due to the COVID-19 pandemic limiting in-person care, we sought to develop the counseling and mhealth app onboarding for virtual implementation. A team with SRH, adolescent medicine, motivational interviewing, cognitive behavioral therapy, and technology expertise adapted the counseling through an iterative consensus process. We identified essential aspects of the counseling, specified the content so the counseling could be delivered in person or virtually with fidelity, and considered best practices for telehealth for the focus population. Virtual counseling retained key elements from in-person counseling while including enhancements with engaging visual and audio-video aids. Instructions and programming were developed to support virtual counseling delivery and onboarding for the mhealth app component of MARSSI. After testing the virtual format in mock sessions, we implemented a small-scale feasibility study in an adolescent medicine clinic with women with depressive symptoms and high-risk sexual behavior age 18-24 years (N = 9). Participants experienced minimal technical difficulties and expressed satisfaction with the virtual format, and all were able to complete app onboarding successfully. Expanding delivery options for SRH interventions to include virtual can improve access, particularly for populations with psychological and environmental barriers to care.
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Affiliation(s)
- Maddie O'Connell
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Brittany Gluskin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Sarah Parker
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA, USA
| | - Pamela J Burke
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Emily Pluhar
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Carly E Guss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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4
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Singh L, Abbas SM, Roberts B, Thompson N, Singh NS. A systematic review of the indirect impacts of COVID-19 on sexual and reproductive health services and outcomes in humanitarian settings. BMJ Glob Health 2023; 8:e013477. [PMID: 37984894 PMCID: PMC10660896 DOI: 10.1136/bmjgh-2023-013477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Humanitarian settings, particularly those in low-income and middle-income countries (LMICs), present increased sexual and reproductive health (SRH) challenges for individuals and health systems. Previous infectious disease outbreaks in such settings have negatively impacted SRH services and outcomes, as fragmented health systems are further overstretched. The COVID-19 pandemic has magnified the SRH challenges in LMIC humanitarian settings on an unprecedented scale. However, understanding of the impacts of COVID-19 is lacking. This review aimed to understand how the COVID-19 pandemic has impacted SRH service coverage, utilisation and outcomes in LMIC humanitarian settings, to inform current and future humanitarian research, programming and practice. METHODS A systematic review methodology was followed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards. Three search fields related to humanitarian settings, SRH and COVID-19 were applied, and limited to LMIC settings only. Three bibliographic databases and nine grey literature sources were searched. Articles meeting inclusion criteria at full-text screening were critically appraised using standardised tools. Data extraction was undertaken on included articles and analysed through narrative synthesis. RESULTS In total, 7742 citations were screened and 42 were included in the review. All included studies were cross-sectional. The quality was mostly medium to high. Narrative synthesis identified the reduced provision of, and access to, SRH services, and increased morbidity including sexual and gender-based violence and unplanned pregnancies. Impacts on service uptake varied across and within settings. Adaptations to improve SRH service access including telemedicine were reported; however, implementation was hindered by resource constraints. CONCLUSIONS The COVID-19 pandemic has indirectly negatively impacted SRH at the individual and health system levels in LMIC humanitarian settings. Further research on the impacts on service uptake is required. SRH programmers should target interventions to meet the increased SRH needs identified. Policy-makers must incorporate SRH into emergency preparedness and response planning to mitigate indirect impacts on SRH in future outbreaks.
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Affiliation(s)
- Lucy Singh
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - Bayard Roberts
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Neha S Singh
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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5
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Caloudas AB, Amspoker AB, Stanley M, Boykin D, Arredondo K, Walder A, Hogan J, Lindsay JA. Prevalence of sexual desire and arousal difficulties among women veterans: A retrospective cohort design. Psychol Serv 2023; 20:780-788. [PMID: 36534427 PMCID: PMC10277319 DOI: 10.1037/ser0000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Low sexual desire and arousal are associated with several negative health outcomes, including reduced quality of life, depression, anxiety, and relationship discord. Although women veterans have high rates of risk factors for sexual dysfunctions (e.g., elevated rates of trauma, depression, anxiety), research on their sexual functioning is lacking. Using a retrospective cohort design, we examined the prevalence of documented sexual desire and arousal disorder diagnoses or symptoms, using International Classification of Diseases, 10th Revision codes, among 790,726 women veterans receiving care in the Veterans Health Administration (VHA). In fiscal year 2020, these symptoms and disorders were documented for only 0.19% (n = 1,494) of women veterans receiving care and symptoms of low sexual desire were documented more frequently than formal desire and arousal diagnoses. Most women veterans with desire and arousal problems were married (53.88%), and most (52.28%) were prescribed antidepressants. Mental health (MH) treatment for desire and arousal difficulties was commonly delivered in person (as compared to telephone or telehealth). Psychologists primarily treated desire and arousal concerns, providing an average of 2.81 MH encounters (SD = 7.53) compared to an average of 1.62 (SD = 5.25) MH encounters by social workers and 1.22 (SD = 2.53) by psychiatrists. Problems with low sexual desire and arousal are likely underassessed and undertreated within the VHA. Better assessment of women veterans' low desire and arousal is warranted to improve their well-being and quality of life. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Alexandra B. Caloudas
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Amber B. Amspoker
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Melinda Stanley
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
| | - Derrecka Boykin
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Kelley Arredondo
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
| | - Annette Walder
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
| | - Julianna Hogan
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Jan A. Lindsay
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
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6
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Cheng Y, Boerma CJ, McGeechan K, Estoesta J. Impact of policy changes of Medicare-rebated telehealth services on medical abortions provided at a family planning service during the coronavirus (COVID-19) pandemic. Sex Health 2023; 20:357-359. [PMID: 37394487 DOI: 10.1071/sh22196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
This study reviewed data on the mode of delivery of medical abortion care (via face-to-face or telehealth) at a Family Planning service during the coronavirus (COVID-19) pandemic; April 2020 to March 2022. This was considered over time, in the context of changing eligibility criteria for Medicare-rebated telehealth services as well as patient demographic data. The study demonstrated that when Medicare rebates for telehealth are available for all those requiring abortion care, telehealth contributes to care provision alongside face-to-face services, and is more likely to be utilised by people living in regional and remote areas.
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Affiliation(s)
- Yan Cheng
- Family Planning NSW, 8 Holker Street, Newington, NSW 2127, Australia; and Cancer Institute NSW, Level 4, 1 Reserved Road, St Leonards, NSW 2065, Australia
| | - Clare J Boerma
- Family Planning NSW, 8 Holker Street, Newington, NSW 2127, Australia; and University of Sydney, 1-3 Ross Street (K06), NSW 2006, Australia
| | - Kevin McGeechan
- Family Planning NSW, 8 Holker Street, Newington, NSW 2127, Australia
| | - Jane Estoesta
- Family Planning NSW, 8 Holker Street, Newington, NSW 2127, Australia
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7
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Engstrom T, Baliunas D, Smith A, Dean JA, Pole JD. Immediate and Ongoing Impact of COVID-19 on Chlamydia Treatment in Australia. Sex Transm Dis 2023; 50:363-369. [PMID: 36806221 PMCID: PMC10184705 DOI: 10.1097/olq.0000000000001785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/05/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted the sexual health and well-being of individuals, directly through risk of contracting COVID-19, and indirectly through government lockdowns. Government restrictions were especially strict and long-lasting in Australia, they also varied by state, offering an interesting opportunity to study the impacts of varying restrictions. This study compares the impact of the COVID-19 pandemic and resulting restrictions on chlamydia treatment prescriptions during 2020, through to July 2021 between different states and demographic groups in Australia. METHODS The rate of prescriptions per 100,000 population filled each month from January 2017 to July 2021 from Australia's Pharmaceutical Benefits Scheme for Azithromycin with a restricted indication to treat Chlamydia trachomatis was used to measure chlamydia treatment. The impact of COVID-19 lockdowns was modeled using an interrupted time-series Poisson regression model. RESULTS The data included 520,025 prescriptions to treat chlamydia, averaging 37.5 prescriptions per month per 100,000 population. Prescriptions declined 26% in April to May 2020 when initial COVID-19 lockdowns began in Australia; prescriptions increased in the following months but remained on average 21% below prepandemic (2017-2019) levels through to July 2021. Prescriptions declined the most in 1 Australian state, Victoria, both in the initial lockdown and the following period; generally, states with more COVID-19 cases saw bigger reductions in prescriptions. CONCLUSIONS This is the first study to examine how treatment for chlamydia in Australia was impacted by the COVID-19 pandemic and restrictions not only in the immediate-term, but also ongoing up to July 2021, providing important information for planning for sexual health services in future pandemics.
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Affiliation(s)
| | - Dolly Baliunas
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Dalla Lana School of Public Health, The University of Toronto
- Clinical Research–Addictions, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Angela Smith
- Sexual Health and HIV Services, Metro North Hospital and Health Service, Queensland Health, Brisbane, QLD, Australia
| | - Judith A. Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Jason D. Pole
- From the Centre for Health Services Research
- Dalla Lana School of Public Health, The University of Toronto
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8
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Ryu H, Blaque E, Stewart M, Anand P, Gómez-Ramírez O, MacKinnon KR, Worthington C, Gilbert M, Grace D. Disruptions of sexually transmitted and blood borne infections testing services during the COVID-19 pandemic: accounts of service providers in Ontario, Canada. BMC Health Serv Res 2023; 23:29. [PMID: 36635701 PMCID: PMC9836920 DOI: 10.1186/s12913-023-09028-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as "non-essential" health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers' experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services. METHODS Between October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory. RESULTS Service providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic. CONCLUSIONS Acceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals.
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Affiliation(s)
- Heeho Ryu
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, ON M5T 3M7 Canada
| | - Ezra Blaque
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, ON M5T 3M7 Canada
| | - Mackenzie Stewart
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, ON M5T 3M7 Canada
| | - Praney Anand
- Alliance for South Asian AIDS Prevention, Toronto, ON Canada
| | - Oralia Gómez-Ramírez
- grid.418246.d0000 0001 0352 641XBC Centre for Disease Control, Vancouver, BC Canada ,grid.17091.3e0000 0001 2288 9830School of Population and Public Health, University of British Columbia, Vancouver, BC Canada ,Canadian HIV Trials Network, Vancouver, BC Canada
| | - Kinnon R. MacKinnon
- grid.21100.320000 0004 1936 9430School of Social Work, York University, Toronto, ON Canada
| | - Catherine Worthington
- grid.143640.40000 0004 1936 9465School of Public Health and Social Policy, University of Victoria, Victoria, BC Canada
| | - Mark Gilbert
- grid.418246.d0000 0001 0352 641XBC Centre for Disease Control, Vancouver, BC Canada ,grid.17091.3e0000 0001 2288 9830School of Population and Public Health, University of British Columbia, Vancouver, BC Canada
| | - Daniel Grace
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Room 556, Toronto, ON M5T 3M7 Canada
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9
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Trinh LTT, Achat H, Chua S, Gidaszewski B, Stubbs JM, Guevarra V. Effects of the COVID-19 Pandemic on the Use of Telehealth for Antenatal Care. Telemed J E Health 2022; 28:1796-1805. [PMID: 35417264 DOI: 10.1089/tmj.2021.0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aims: To determine changes in the use of telehealth and face-to-face consultations for antenatal care (ANC) associated with the COVID-19 pandemic and to identify the groups of women most affected. Materials and Methods: Routine administrative data from three public hospitals in a Local Health District in New South Wales, Australia, were analyzed. Data from 19,171 women who gave birth before the pandemic started (January 2018-January 2020) were compared with data of 5,479 women who gave birth after the pandemic started (December 2020-June 2021). Results: One in eight antenatal services after the pandemic started was a telehealth consultation. The average number of telehealth consultations per woman increased by 0.6 (0.7-1.3, adjusted incidence rate ratio [IRR] = 1.71, p < 0.001), while face-to-face visits decreased by 1.4 (10.6-9.2, adjusted IRR = 0.87, p < 0.001), resulting in an overall reduction of 0.8 (11.3-10.5, p < 0.001) services (7.1%). The increase in telehealth consultations was evident in all groups, but was greatest among women attending the smallest hospital, younger women, and Indigenous women. Most groups of women experienced a reduction in the number of face-to-face and total consultations, but the greatest reductions were among women who attended the largest hospital, received shared care, were older than 35 years, or had conceived through in vitro fertilization. Conclusions: Use of telehealth accounted for a small proportion of total ANC services; its increase did not compensate for the reduction in face-to-face visits, which might have resulted from the lack of suitable equipment, access to facilities, and skills or willingness to engage in telehealth. Ultimately there was an overall reduction of service utilization, which was not uniform among different groups of women.
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Affiliation(s)
- Lieu Thi Thuy Trinh
- Epidemiology and Health Analytics, Western Sydney Local Health District, Sydney, Australia
| | - Helen Achat
- Epidemiology and Health Analytics, Western Sydney Local Health District, Sydney, Australia
| | - Seng Chua
- Department of Obstetrics and Gynaecology, Westmead Hospital, Sydney, Australia
| | - Beata Gidaszewski
- Women's Health Research, Department of Women's and Newborn Health, Westmead Hospital, New South Wales, Australia
| | - Joanne M Stubbs
- Epidemiology and Health Analytics, Western Sydney Local Health District, Sydney, Australia
| | - Veth Guevarra
- Epidemiology and Health Analytics, Western Sydney Local Health District, Sydney, Australia
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Saifan AR, Alarabyat IA, Alrimawi I, Al-Nsair N. Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study. Appl Nurs Res 2022; 68:151641. [PMID: 36473721 DOI: 10.1016/j.apnr.2022.151641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Telemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched. PURPOSE To explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems. METHOD A qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014). RESULTS The analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services. CONCLUSION The current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.
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Affiliation(s)
| | | | - Intima Alrimawi
- School of Nursing, Georgetown University, 3700 Reservoir Road Northwest, Washington, DC 20057, United States of America.
| | - Nezam Al-Nsair
- College of Nursing, Xavier University, Cincinnati, OH, United States of America.
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11
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Bittleston H, Goller JL, Temple-Smith M, Hocking JS, Coombe J. 'I didn't want to visit a doctor unless it was extremely necessary': perspectives on delaying access to sexual and reproductive health care during the COVID-19 pandemic in Australia from an online survey. Aust J Prim Health 2022; 28:131-136. [PMID: 35109966 DOI: 10.1071/py21239] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022]
Abstract
Australians were subject to a series of COVID-19 lockdown restrictions throughout 2020. Although accessing medical care was allowable, concerns were raised that people were avoiding healthcare services. We explored young Australians' reasons for delaying seeking sexual and reproductive health (SRH) care during the pandemic, using data from two cross-sectional surveys. The surveys included a question asking whether respondents had delayed accessing care during the pandemic. Free-text responses from young Australians (aged 18-29 years) were analysed using conventional content analysis. In all, 1058 under-30s completed a survey, with 262 (24.8%) reporting they had delayed seeking SRH care. Of these, 228 (87.0%) respondents provided a free-text comment. Participants who commented were predominantly female (86.4%) and had a median age of 23 years (interquartile range 20-26 years). Most commonly, respondents delayed testing for sexually transmissible infections, cervical cancer screening, and contraceptive care. Some delayed accessing care despite experiencing symptoms. Participants avoided seeking care due to concerns about contracting COVID-19, uncertainty about accessing care during restrictions and anxiety relating to accessing SRH care. Although some reported a reduced need for SRH care, others required but did not access care. Young people should be reassured that SRH issues are a valid reason to access services, especially when experiencing symptoms.
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Affiliation(s)
- Helen Bittleston
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic. 3053, Australia; and Corresponding author
| | - Jane L Goller
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic. 3053, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, Melbourne, Vic. 3010, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic. 3053, Australia
| | - Jacqueline Coombe
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic. 3053, Australia
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Shukla A. Living through a pandemic as an MJA editor and a general practitioner. Med J Aust 2021; 215:507-508. [PMID: 34773927 DOI: 10.5694/mja2.51338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
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