Transcending technology boundaries and maintaining sense of community in virtual mental health peer support: a qualitative study with service providers and users.

BACKGROUND: This qualitative study explores the experiences of peer support workers (PSWs) and service users (or peers) during transition from in-person to virtual mental health services. During and following the COVID-19 pandemic, the need for accessible and community-based mental health support has become increasingly important. This research aims to understand how technological factors act as bridges and boundaries to mental health peer support services. In addition, the study explores whether and how a sense of community can be built or maintained among PSWs and peers in a virtual space when connections are mediated by technology. This research fills a gap in the literature by incorporating the perspectives of service users and underscores the potential of virtual peer support beyond pandemic conditions. METHODS: Data collection was conducted from a community organization that offers mental health peer support services. Semi-structured interviews were conducted with 13 employees and 27 service users. Thematic analysis was employed to identify key themes and synthesize a comprehensive understanding. RESULTS: The findings highlight the mental health peer support needs that were met through virtual services, the manifestation of technology-based boundaries and the steps taken to remove some of these boundaries, and the strategies employed by the organization and its members to establish and maintain a sense of community in a virtual environment marked by physical distancing and technology-mediated interrelations. The findings also reveal the importance of providing hybrid services consisting of a mixture of in person and virtual mental health support to reach a broad spectrum of service users. CONCLUSIONS: The study contributes to the ongoing efforts to enhance community mental health services and support in the virtual realm. It shows the importance of virtual peer support in situations where in-person support is not accessible. A hybrid model combining virtual and in-person mental health support services is recommended for better accessibility to mental health support services. Moreover, the importance of organizational support and of equitable resource allocation to overcome service boundaries are discussed.

The Changing Face of Public Services in Health Sciences Libraries Post-Pandemic.

Health sciences library public services underwent profound changes due to the COVID-19 pandemic. Circulation, reference services, instruction, interlibrary loan, and programming were all significantly affected. Libraries adapted by moving to virtual services, featuring online workshops, video consultations, and digital information sharing. Reference services moved to virtual consultations for a streamlined experience, and instruction transitioned to interactive video tutorials. Interlibrary loan services saw a decrease in print material lending but an increase in electronic subscriptions. Library programming shifted from in-person to virtual, focusing on wellness activities. This post-pandemic transformation underscores the importance of ongoing adaptation to meet changing user needs.

Behavioral healthcare organizations' experiences related to use of telehealth as a result of the COVID-19 pandemic: an exploratory study.

BACKGROUND: Due to the COVID-19 pandemic, healthcare providers were forced to shift many services quickly from in-person to virtual, including substance use disorder (SUD) and mental health (MH) treatment services. This led to a sharp increase in telehealth services, with health systems seeing patients virtually at hundreds of times the rate as before the onset of the COVID-19 pandemic. By analyzing qualitative data about SUD and MH care organizations' experiences using telehealth, this study aims to elucidate emergent themes related to telehealth use by the front-line behavioral health workforce. METHODS: This study uses qualitative data from large-scale web surveys distributed to SUD and MH organizations between May and August 2020. At the end of these surveys, the following question was posed in free-response form: "Is there anything else you would like to say about use of telehealth during or after the COVID-19 pandemic?" Respondents were asked to answer on behalf of their organizations. The 391 responses to this question were analyzed for emergent themes using a conventional approach to content analysis. RESULTS: Three major themes emerged: COVID-specific experiences with telehealth, general experiences with telehealth, and recommendations to continue telehealth delivery. Convenience, access to new populations, and lack of commute were frequently cited advantages of telehealth, while perceived ineffectiveness of and limited access to technology were frequently cited disadvantages. Also commonly mentioned was the relaxation of reimbursement regulations. Respondents supported continuation of relaxed regulations, increased institutional support, and using a combination of telehealth and in-person care in their practices. CONCLUSIONS: This study advanced our knowledge of how the behavioral health workforce experiences telehealth delivery. Further longitudinal research comparing treatment outcomes of those receiving in-person and virtual services will be necessary to undergird organizations' financial support, and perhaps also legislative support, for virtual SUD and MH services.

Going virtual: youth attitudes toward and experiences of virtual mental health and substance use services during the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, youth mental health and substance use services rapidly moved to virtual modalities to meet social distancing requirements. It is important to understand youth attitudes toward and experience of virtual services. OBJECTIVE: This study examined the attitudes toward and experiences of virtual mental health and substance use services among youth drawn from clinical and non-clinical samples. METHOD: Four hundred nine youth completed a survey including questions about their attitudes toward and experience of virtual services. The survey included quantitative and open-ended questions on virtual care, as well as a mental health and substance use screener. RESULTS: The majority of youth with mental health or substance use challenges would be willing to consider individual virtual services, but fewer would consider group virtual services. However, many have not received virtual services. Youth are interested in accessing a wide variety of virtual services and other supportive wellness services. Advantages and disadvantages of virtual services are discussed, including accessibility benefits and technological barriers. DISCUSSION: As youth mental health and substance use services have rapidly gone virtual during the COVID-19 pandemic, it is essential that we hear the perspectives of youth to promote service utilization among those in need. Diverse, accessible, technologically stable virtual services are required to meet the needs of different youth, possibly with in-person options for some youth. Future research, engaging youth in the research process, is needed to evaluate the efficacy of virtual services to plan for the sustainability of some virtual service gains beyond the pandemic period.

Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications.

Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent-Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.

Adapting to Remote Library Services during COVID-19.

In response to the COVID-19 pandemic and the subsequent Stay At Home order, the Southern Illinois University Medical Library utilized new technologies and implemented new virtual service models in order to improve internal communication, and to continue providing services and resources to patrons remotely. The changes happened quickly, and the librarians faced several challenges during this time, but things went smoothly overall and there were some considerable silver linings. Several of the newly adopted technologies, service models, and virtual resource offerings proved to be extremely effective and their use will continue beyond the duration of the pandemic.

Pandemic-Proofing Your Library: Disaster Response and Lessons Learned from COVID-19.

The COVID-19 pandemic has affected libraries across the globe, including academic health sciences libraries, in many ways. This manuscript describes the challenges, solutions, and practices employed by the Stony Brook University Health Sciences Library in order to maintain continuity of services to patrons including faculty, hospital staff, students, and clinicians while operating in one of the earliest epicenters of the pandemic. Some of the major changes the library underwent in response to the pandemic included implementing new online anatomy resources, contactless circulation, remote interlibrary loan services and modified operating practices.

"We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers.

Background and aims: Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. Methods: This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Results: Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Conclusions: Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Implications: Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.

"So many extra safety layers:" Virtual service provision and implementing social distancing in interpersonal violence service agencies during COVID-19.

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured interviews were conducted from July to December 2020 with 33 interpersonal violence service providers from across the United States, and data were analyzed via conventional content analysis with additional steps for data credibility. Findings fall within two primary categories: 1) Technology and Virtual Service Provision; and 2) Social Distancing for In-person Services. Within each category, a number of themes emerged illustrating strengths and challenges of each approach, and the complex web of technological, safety, and public health considerations being balanced in interpersonal violence service agencies. These results provide guidance for the implementation of virtual services in an on-going manner, as well as underscoring the importance of future planning to facilitate effective in-person but physically distant services. There is also a clear need for agencies to support the interpersonal violence workforce to reduce occupational stress and enhance skills and capacities with new forms of services.

Examination of an Online Cooking Education Program to Improve Shopping Skills, Attitudes toward Cooking, and Cooking Confidence among WIC Participants.

The present study examined if adapting the Cooking Matters (CM) curriculum to be used in an online format would improve participants' shopping skills, attitudes toward cooking, and feelings of cooking confidence, similar to the traditionally offered method, which is conducted in person. Results from factor analyses indicated that the online CM program demonstrated construct and content reliability compared to in-person (Cronbach's α ≥ 0.70). Repeated-measures ANOVA revealed a decrease in shopping skills overall (F = 5.91; p ≤ 0.05), consistent across age groups (F = 3.2; p ≤ 0.05) and food security status (F = 7.48; p < 0.01), with larger impacts on the food insecure (FI). Positive cooking attitudes increased with income (F = 2.86; p ≤ 0.05), especially among the <$20,000 and $30-39,000 income brackets. Cooking confidence increased post-intervention (F = 27.2, p < 0.001), with an interaction effect for food security status (F = 7.45; p ≤ 0.01), with greater improvement for households with food insecurity. These findings provide evidence to program and policymakers that virtual nutrition and cooking education services for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) should continue to be supported beyond the pandemic as they reduce barriers to receiving program benefits, nutrition education, and may lead to reductions in household food insecurity.

Danger Zone or Newfound Freedoms: Exploring Women and Girls' Experiences in the Virtual Space during COVID-19 in Iraq.

During the COVID-19 pandemic, women and girls across the globe faced increased reliance on the digital space to access education, social support, and health and gender-based violence (GBV) services. While research from the last three years has explored how women and girls navigated and responded to their new virtual reality, minimal evidence has been generated from low-resource settings where access to technology may be limited. Further, no studies to date have examined these dynamics in Iraq, where women and girls already face numerous threats to safety due to various forms of structural violence and patriarchal family structures. This qualitative study aimed to examine women and girls' experiences in the digital space during COVID-19 in Iraq, including the benefits and risks of engagement as well as how access to the digital space was controlled. Data for the present analysis come from the authors' larger multi-country study investigating women and girls' safety and access to GBV services in the context of the COVID-19 pandemic and related public health measures employed to control the spread of the virus. In Iraq, semi-structured key informant interviews were conducted virtually with fifteen GBV service providers. Following the translation and transcription of interviews, the thematic analysis highlighted several benefits and challenges women and girls experienced as they tried to access and utilize technology for schooling, support services, and obtaining and spreading information. While many women and girls increasingly and successfully relied on social media to spread awareness of GBV cases, key informants noted that women and girls also faced increased risks of experiencing electronic blackmail. In addition to a substantial digital divide in this context-which manifested as differential access to technology by gender, rural/urban status, and socioeconomic status-intrahousehold control of girls' access to and use of technology left many adolescent girls unable to continue schooling and contributed to their further marginalization and consequent decline in well-being. Implications for women's safety and mitigation strategies are also discussed.

"Don't Know where to Go for Help": Safety and Economic Needs among Violence Survivors during the COVID-19 Pandemic.

The COVID-19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content analysis was used to analyze qualitative data from open-ended questions. A total of 53 participants were recruited for the survey. Individuals with safety concerns have experienced increased challenges with health and work concerns, stress from economic instability, difficulties staying safe, and access resources and support. Over 40% of participants reported safety had decreased. Use of social media and avoidance strategies were the most common safety approaches used. Participants reported mixed experiences with virtual services. The COVID-19 pandemic has exacerbated existing structural concerns for survivors of violence like IPV and sexual assault. Increased support and economic resource access, coupled with modified safety planning and improved virtual approaches, would better help meet survivor needs.

COVID-19, Virtual Church Services and a New Temporary Geography of Home.

The COVID-19 pandemic and subsequent lockdown measures implemented by the United Kingdom government from 23 March 2020 led to unprecedented adaptations from individuals and communities including places of worship, their clergy and congregations. This paper through a multi-disciplinary dialogue between human geography and theology explores the interrelations between place, space and the spiritual. It identifies the bricolage mechanisms that were developed rapidly by churches to shift towards providing virtual church services. This was an uncommon practice by Christian denominations in the UK. COVID-19 changed the rules requiring new practices to emerge resulting in a new form of infrasecular space to emerge. Such rapid transformations through the provision of online services and virtual embeddedness blurred the lines between sacred and secular spaces. During virtual services, the minister's home is temporally linked to the homes of congregants forming an intersacred space. Homes and spaces within homes are transformed into temporary sacred spaces.