Perceptions of Mobile Health Apps and Features to Support Psychosocial Well-being Among Frontline Health Care Workers Involved in the COVID-19 Pandemic Response: Qualitative Study.

BACKGROUND: Frontline health care workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential to improve the well-being of frontline workers. However, there has been limited development of wellness interventions using mobile health (mHealth) technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their well-being. OBJECTIVE: This study aimed to explore frontline workers' experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting well-being. It also sought to identify factors that could potentially influence uptake and retention of an mHealth-based wellness program. METHODS: We conducted semistructured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies-those commonly used for mHealth development-to assess participants' preferences for particular features and their reasoning. RESULTS: A total of 42 frontline workers participated in 12 one-on-one interviews or focus group discussions. Frontline workers generally had a limited ability to identify their own psychological problems and liked the reminders functionality of the app to track their mood over time. A personalized goal-setting feature (ie, tailoring) and in-app resources were generally valued, while frequent coaching and messages (ie, framing) were seen as a distraction. The majority of participants desired a built-in chat function with a counselor (ie, guidance) for reasons of accessibility and protection of privacy. Very few participants appreciated a gamification function. Frontline workers commonly reported the need for ongoing social support and desired access to an in-app peer support community (ie, social influence). There were, however, concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality, and tangible rewards were identified as critical for uptake and retention. CONCLUSIONS: Our study highlights the potential of mHealth apps with relevant features to be used as wellness tools by frontline health care workers. Future work should focus on developing a nonintrusive and personalized mHealth app with in-app counseling, peer support to improve well-being, and tangible and extrinsic rewards to foster continued use.

Public Perceptions on the Use of the Physical Activity Readiness Questionnaire.

Self-administered pre-participation screening for physical activity (PA) requires an instrument that should be easily used and identify individuals at high risk. The Physical Activity Readiness Questionnaire (PAR-Q+) has been used for many years. Its ease of use and ability to identify those not fit to undergo PA has not been assessed. This study was to determine the rates of the PAR-Q+ in identifying adults who may not be fit for moderate or intense PA and obtain feedback on the use of this tool. A randomized, cross-sectional study involving a wide spectrum of members of the public was carried out. Participants were asked to provide their bio-characteristics, complete the PARQ+, and provide feedback on the questionnaire. With 1019 participants, about 33.1% of the participants using the PARQ+ would have required further medical evaluation. Except for those patients with respiratory illness, there was no difference in levels of PA in those who answered yes or no to the seven PARQ+ questions. Only 4 of the 7 main PAR-Q+ questions were perceived by the public as easily understood. Difficulties were encountered with 21 of the 45 follow-up questions, especially amongst those with co-morbidities. The wordiness of the questions and the large number of technical terms were also sources of concern. Suggestions were provided by participants on areas where improvements may be made to the wording of the questions. The study suggests that the PAR-Q+ probably over-identified those who require further medical evaluation. In addition, the wordiness of the questions and frequent use of medical jargon made the PARQ+ challenging to understand and use. The suggestions provide opportunities to review areas for possible improvements.

Experience of living with COVID-19: personal preparedness and coping mechanism among deployed healthcare workers.

BACKGROUND: This study aimed to explore how deployed healthcare workers (HCWs) perceived personal preparedness for response and their main avenues for coping to maintain resilience during the prolonged COVID-19 (SARS-CoV-2) pandemic. METHODS: Semi-structured interviews were conducted with 25 HCWs deployed to the frontline for an extended period to provide acute COVID-19 related care. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS: HCWs demonstrated heightened self-confidence and readiness to deal with public health emergencies owing to the ramped-up efforts in infrastructure for outbreak management and pre-emptive infectious disease training. Despite overall confidence, deployed HCWs had to adopt various coping mechanisms to sustain resilience during the prolonged pandemic. Main themes on coping centred around the value of team leaders and support from family members as an effective buffer for work-induced stress while institution-based counseling services and welfare were viewed as important for fostering internal locus of control and wellbeing. CONCLUSION: Our findings suggest that strategies such as on-the-job training, continuous education and improved communication would be essential to maintain resilience of deployed HCWs. Considerations should be also given to the swift implementation of blended wellness support comprising digital and in-person counseling to sustain wellbeing and prepare for endemic COVID-19.

Dynamic emergency department response to the evolving COVID-19 pandemic: the experience of a tertiary hospital in Singapore.

The coronavirus disease 2019 (COVID-19) pandemic has placed large stressors on emergency departments (EDs) worldwide. As the pandemic progressed, EDs faced changing patient epidemiology and numbers. Our ED needed to rapidly transform to deal with the risk of COVID-19. Having limited floor space, we opted for a phased, dynamic response that allowed us to adapt the ED multiple times as the epidemiology of the pandemic evolved. The principles behind our response include guiding ED operations with data, enhancing infection control practices, and being prepared to transform areas of the ED to care for different groups of patients. Our experience can serve to guide other EDs in planning their response to surge capacity and ED operations during such pandemics.