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1.
Egypt Heart J ; 74(1): 48, 2022 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-35662385

RESUMEN

BACKGROUND: Cases of COVID-19 presenting after elective cardiac surgery are rare. Published literature suggests that such cases have a high morbidity and mortality rate. Here, we report a case of COVID-19 presenting after an elective, isolated off-pump coronary artery bypass (OPCAB). CASE PRESENTATION: A 65-year-old obese, hypertensive, hypothyroid lady, with moderate left ventricular dysfunction, presenting with unstable angina, tested negative for COVID-19 at admission, having undergone thrombolysis for a recent inferior wall myocardial infarction, at an outside centre, and coronary angiography revealing left main triple vessel disease, developed signs and symptoms of COVID-19, four days after OPCAB. She was diagnosed with moderate COVID-19 infection. Subsequent contact tracing revealed that her husband was suffering from mild COVID-19 infection and was managed in home isolation. Isolation and early supportive management with moist oxygen, steroids, intravenous antibiotics, zinc and vitamin C helped the patient recover. She was followed up at one month, six months, one year and at eighteen months and has been doing well. CONCLUSIONS: A strong clinical suspicion and repeat testing for COVID-19 is required as the diagnosis may often be missed with COVID-19 mimicking the signs and symptoms of post-cardiotomy syndrome. Preferentially dealing with such cases off-pump, thereby avoiding cardio pulmonary bypass-related complications, may improve outcomes. Isolation and early supportive management help. Adequate follow-up is required in all such cases as cardiovascular complications are common, alongside known long-term sequelae, like anxiety, depression, cardio-respiratory complications, venous thromboembolism and even postural orthostatic tachycardia syndrome.

2.
Cities ; 127: 103770, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35663145

RESUMEN

The COVID-19 pandemic continues to have a significant impact on the transport sector worldwide. Lockdown and physical distancing requirements continue to be enforced in many cities leading to severe travel restrictions and travel demand reduction to limit the spread of the disease. This article provides bibliometric evidence-based insights into how the pandemic has exposed the vulnerability of established public transport systems and shared mobility solutions. It shows how some transport interventions can accelerate the shift to sustainable urban mobility practices such as micro-mobility and active transport. To accomplish this, the article examines recent studies (244 publications) from the Scopus database using a rigorous systematic literature review approach covering the period from January 2020 to February 2021. Importantly, the mapping of bibliographic coupling and co-citation analysis showed four heterogeneous clusters representing research efforts into "environment", "travel behavior and mode choice", "public transport", and "interventions". Inductive reasoning is used to analyze the disruptions that cities have encountered worldwide, the rapid interventions that were put in place, the aftershocks and the short and long-term impacts. Finally, the paper summarizes the lessons learned and opportunities ahead, and the challenges that must be overcome. The article also outlines pathways to build on the momentum of sustainable practices as part of a holistic approach for enabling resilient transport solutions for the new urban world.

3.
Artículo en Inglés | MEDLINE | ID: mdl-35668286

RESUMEN

COVID-19 has presented a variety of challenges to the provision of psychology services. In the first month of the pandemic, pediatric consultation-liaison (CL) psychologists reported significant changes in methodology of service delivery (Steinberg et al. in Clin Pract Pediatr Psychol 9:1, 2020). To better understand how and if these changes persisted, as well as other emerging trends, a follow-up study examined changes and challenges six months into the pandemic. An anonymous questionnaire assessed topics related to pediatric CL psychology including practice changes, perception of changes, and institutional support. The questionnaire was sent to the APA Society of Pediatric Society's special interest group listservs. Thirty responses were analyzed. Quantitative results showed participants' beliefs that telemedicine is equally efficacious to in-person services for outpatient psychological care, but less effective for inpatient care. Participants reported their perception of how institutions supported their safety, psychology trainee safety and training goals, and patient care. Qualitative results demonstrated that most psychologists experienced changes related to their dynamics with medical teams, which included changes in team efficiency, workload, transition, and team collaboration.

4.
Bone Joint Res ; 11(6): 342-345, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35642467

RESUMEN

Research into COVID-19 has been rapid in response to the dynamic global situation, which has resulted in heterogeneity of methodology and the communication of information. Adherence to reporting standards would improve the quality of evidence presented in future studies, and may ensure that findings could be interpreted in the context of the wider literature. The COVID-19 pandemic remains a dynamic situation, requiring continued assessment of the disease incidence and monitoring for the emergence of viral variants and their transmissibility, virulence, and susceptibility to vaccine-induced immunity. More work is needed to assess the long-term impact of COVID-19 infection on patients who sustain a hip fracture. The International Multicentre Project Auditing COVID-19 in Trauma & Orthopaedics (IMPACT) formed the largest multicentre collaborative audit conducted in orthopaedics in order to provide an emergency response to a global pandemic, but this was in the context of many vital established audit services being disrupted at an early stage, and it is crucial that these resources are protected during future health crises. Rapid data-sharing between regions should be developed, with wider adoption of the revised 2022 Fragility Fracture Network Minimum Common Data Set for Hip Fracture Audit, and a pragmatic approach to information governance processes in order to facilitate cooperation and meta-audit. This editorial aims to: 1) identify issues related to COVID-19 that require further research; 2) suggest reporting standards for studies of COVID-19 and other communicable diseases; 3) consider the requirement of new risk scores for hip fracture patients; and 4) present the lessons learned from IMPACT in order to inform future collaborative studies. Cite this article: Bone Joint Res 2022;11(6):342-345.

5.
JMIR Hum Factors ; 9(2): e35032, 2022 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-35679114

RESUMEN

BACKGROUND: The Discovery Critical Care Research Network Program for Resilience and Emergency Preparedness (Discovery PREP) partnered with a third-party technology vendor to design and implement an electronic data capture tool that addressed multisite data collection challenges during public health emergencies (PHE) in the United States. The basis of the work was to design an electronic data capture tool and to prospectively gather data on usability from bedside clinicians during national health system stress queries and influenza observational studies. OBJECTIVE: The aim of this paper is to describe the lessons learned in the design and implementation of a novel electronic data capture tool with the goal of significantly increasing the nation's capability to manage real-time data collection and analysis during PHE. METHODS: A multiyear and multiphase design approach was taken to create an electronic data capture tool, which was used to pilot rapid data capture during a simulated PHE. Following the pilot, the study team retrospectively assessed the feasibility of automating the data captured by the electronic data capture tool directly from the electronic health record. In addition to user feedback during semistructured interviews, the System Usability Scale (SUS) questionnaire was used as a basis to evaluate the usability and performance of the electronic data capture tool. RESULTS: Participants included Discovery PREP physicians, their local administrators, and data collectors from tertiary-level academic medical centers at 5 different institutions. User feedback indicated that the designed system had an intuitive user interface and could be used to automate study communication tasks making for more efficient management of multisite studies. SUS questionnaire results classified the system as highly usable (SUS score 82.5/100). Automation of 17 (61%) of the 28 variables in the influenza observational study was deemed feasible during the exploration of automated versus manual data abstraction. The creation and use of the Project Meridian electronic data capture tool identified 6 key design requirements for multisite data collection, including the need for the following: (1) scalability irrespective of the type of participant; (2) a common data set across sites; (3) automated back end administrative capability (eg, reminders and a self-service status board); (4) multimedia communication pathways (eg, email and SMS text messaging); (5) interoperability and integration with local site information technology infrastructure; and (6) natural language processing to extract nondiscrete data elements. CONCLUSIONS: The use of the electronic data capture tool in multiple multisite Discovery PREP clinical studies proved the feasibility of using the novel, cloud-based platform in practice. The lessons learned from this effort can be used to inform the improvement of ongoing global multisite data collection efforts during the COVID-19 pandemic and transform current manual data abstraction approaches into reliable, real time, and automated information exchange. Future research is needed to expand the ability to perform automated multisite data extraction during a PHE and beyond.

6.
HERD ; : 19375867221101897, 2022 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-35684993

RESUMEN

PURPOSE: The purpose of this article is to review available literature for evidence-based impact of the built environment upon the prevention and management of COVID-19 with a view to emphasizing lessons learned for future infection control of pandemics. BACKGROUND: This is urgently needed given the devastation brought upon long-term care residents worldwide. Long-term care (LTC) facilities face a battle to protect their residents. Previous studies of infection control design issues have focused generally on Fomites: that is, contaminated objects and surfaces. As COVID-19 has been shown to be largely spread through the air, this article will broaden the focus to include engineering controls that effect this type of transmission. METHOD: A literature search was conducted using key words such as long-term care facilities, built environment, COVID-19, infection control, and nursing homes. RESULTS: Results were sorted using an engineering controls pyramid developed by the author to stratify approaches to LTC infrastructure. Basically, six elements were supported: ventilation, spatial separation, physical barriers, hand hygiene stations, resident room zones, and private rooms. IMPLICATIONS: Conclusions were that the built environment has a major impact on infection control that can be deleterious or beneficial. Substantial changes need to be made to protect the very vulnerable LTC population from future pandemics and infectious diseases.

7.
Nurs Open ; 2022 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-35686659

RESUMEN

BACKGROUND: The COVID-19 pandemic has globally impacted nursing education, particularly clinical learning opportunities for undergraduate nursing students. PURPOSE: In this paper, we report on an educational activity wherein students participated in a COVID-19 Rapid Antigen Testing (RAT) clinic on a Canadian university campus. METHODS: Between February-April 2021, in the second term of a five-term accelerated program, nursing students (n = 60) participated in a nurse-led COVID-19 RAT clinic for students and staff living or working in congregate housing. Students participated in education activities which exposed nursing students to the full range of community health nursing roles in a pandemic. RESULTS: From clinical, research, policy, and public health, this educational activity acted as a microcosm of the critical roles that nurses employ in the health ecosystem. CONCLUSION: We offer lessons learned about implementing this activity, and how these lessons can be applied to routine and exceptional nursing curriculum.

8.
Pan Afr Med J ; 41: 201, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35685114

RESUMEN

Introduction: Cameroon's national vaccination campaign was launched on April 12, 2021, amid a nationwide outbreak of COVID-19 with two types of vaccines. This study provides preliminary evidence to assess early outputs of the COVID-19 vaccination response strategy implementation. Methods: a cross-sectional study was conducted from April 12, 2021, to May 11, 2021, and data on COVID-19 vaccination were reviewed from the Ministry of Public Health database. Descriptive statistical analyses were conducted. Results: thirty days after the introduction of COVID-19 vaccines, just about five percent of the target population was vaccinated. Women represented one-third of the people vaccinated regardless of age and health conditions. Although AEFI reported were minor and scanty with both vaccines, most of the vaccinated did not come back for their second dose. There was a need to build confidence among eligible beneficiaries to expand the benefits of vaccination to control the current pandemic. Conclusion: the country was still far below the target, which was worrisome given that vaccine uptake was slow. Also, 391 200 doses of the Covishield were at risk of expiration in August 2021. This study offers insights into those early efforts contributing to significant discussions about the approaches to improve service delivery and vaccine uptake.


Asunto(s)
COVID-19 , Vacunas , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Camerún/epidemiología , Estudios Transversales , Femenino , Humanos , Vacunación
9.
Infez Med ; 30(2): 168-179, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35693057

RESUMEN

Infectious disease outbreaks frequently cause illness and death among Healthcare Workers (HCWs). We compare strategies from recent, past and ongoing outbreak measures used to protect HCWs, including those facing additional challenges such as racial disparities, violence and stigmatization. Outbreaks and pandemics superimposed on countries with preexisting crises have also affected emergency response to these viral outbreaks. Strategies to protect HCWs include adherence to recommended infection prevention and control measures; new technology such as rapid point-of-care tests and remote monitoring; adopting national public health preparedness plans to ensure the supply and allocation of PPE, staff, and testing supplies; occupational health and mental health support services. Lessons learned from recent pandemics should be used by Infection Prevention and Control and Occupational Health staff to refine preparedness plans to protect HCWs better.

10.
Access Microbiol ; 4(3): 000330, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35693468

RESUMEN

Introduction. The coronavirus disease 2019 (COVID-19) pandemic emerged as a global health crisis in 2020. The first case in India was reported on 30 January 2020 and the disease spread throughout the country within months. Old persons, immunocompromised patients and persons with co-morbidities, especially of the respiratory system, have a more severe and often fatal outcome to the disease. In this study we have analysed the socio-demographic trend of the COVID-19 outbreak in Nagpur and adjoining districts. Methods. The study was conducted from April to December 2020. Nasopharyngeal and oropharyngeal swabs collected from suspected cases of COVID-19 were tested using reverse-transcription polymerase chain reaction (RT-PCR) at a diagnostic molecular laboratory at a tertiary care hospital in central India. Patient-related data on demographic profile and indication for testing were obtained from laboratory requisition forms. The results of the inconclusive repeat samples were also noted. The data were analysed using SPSS v24.0. Results. A total of 46 898 samples were received from April to December 2020, of which 41 410 were included in the study; 90.6 % of samples belonged to adults and 9.4 % belonged to children. The overall positivity rate in the samples was 19.3 %, although it varied over the period. The yield was significantly high in the elderly age group (25.5 %) and symptomatic patients (22.6 %). On repeat testing of patients whose first test was inconclusive, 17.1% were positive. There was a steady increase of both the number of tests and the rate of positivity in the initial period of the study, followed by a sharp decline. Conclusion. We can conclude that rigorous contact tracing and COVID-appropriate behaviour (wearing a mask, social distancing and hand hygiene) are required to break the chain of transmission. Elderly people are more susceptible to infection and should follow stringent precautions. It is also important to perform repeat testing of those individuals whose tests are inconclusive with fresh samples so that no positive cases are missed. Understanding of demographics is crucial for better management of this crisis and proper allocation of resources.

11.
J Nutr Gerontol Geriatr ; : 1-18, 2022 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-35694773

RESUMEN

Food insecurity (FI) is a growing health problem, worsening during the COVID-19 pandemic. Fresh food prescription programs (FFRx) have been shown to increase healthy eating and decrease FI, but few FFRx are community-informed, or theory based. Our FFRx was a delivery program developed to alleviate FI for older adults. It was implemented in an academic medical center and guided by the Capabilities, Opportunities, Motivations, and Behaviors and Theoretical Domains Framework. We tested impacts of the program on FI, Fruit and Vegetable (FV) intake, depression, and loneliness at six-month intervals. During the FFRx, 31 people completed surveys every six months. FI decreased by an average of 2.03 points (p = <.001) while FV intake increased from a mean of 2.8 servings per day to 2.9 servings per day (p = .53). Depression and loneliness scores stayed stable. Preliminary data from this FFRx program, a partnership between an academic medical center and community partners, had positive impacts on FI.

12.
J Gerontol Soc Work ; : 1-26, 2022 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-35695062

RESUMEN

Place and health are intricately bound. COVID has amplified system burdens and health risks within the housing care continuum, in which older adults with chronic illnesses are disproportionately represented. The paper identifies the health experiences of older adults with severe conditions living in and moving through temporary avoidance hotels during the COVID-19 pandemic. An interpretive descriptive approach was taken with qualitative chart data and provider observation to represent the experiences of 14 older avoidance hotel residents living with serious illnesses. Through provider documentation, we illustrate trends pre-pandemic, in the first nine months of the pandemic, and the second nine months. Such trends include strengths and opportunities such as the health-affirming nature of avoidance hotels, their potential in generating continuity of care and permanent housing, and synergy between harm reduction approaches and palliative care. Challenges were also identified in catering to the diverse medical, behavioral, and psychosocial-spiritual needs of older and seriously ill residents and the consequences of geographic dispersion on health care, health behaviors, and informal care networks. Through these strengths and challenges, avoidance hotels present essential lessons in considering future housing and healthcare intervention and implementation that addresses the needs of older seriously ill people facing homelessness and housing precarity.

13.
Behav Sleep Med ; : 1-13, 2022 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-35699363

RESUMEN

OBJECTIVES: To assess changes in duration, timing, and social jetlag in adolescent sleep during the COVID-19 pandemic and evaluate the impact of mood, physical activity, and social interactions on sleep. STUDY DESIGN: An online survey queried adolescents' sleep before (through retrospective report) and during the initial phase of COVID-19 in May 2020. Adolescents (N = 3,494), 13-19 years old, in the United States (U.S.) answered questions about their current and retrospective (prior to COVID-19) sleep, chronotype, mood, and physical and social activities. Linear regression models were fit for time in bed, reported bed and wake times, and social jetlag during COVID-19, accounting for pre-COVID-19 values. RESULTS: Total reported time in bed (a proxy for sleep duration) increased on weekdays by an average of 1.3 ± 1.8 hours (p < .001) during COVID-19, compared to retrospective report of time in bed prior to COVID-19. During COVID-19, 81.3% of adolescents reported spending 8 hours or more in bed on weekdays compared to only 53.5% prior to COVID-19. On weekdays, bedtimes were delayed on average by 2.5 hours and wake times by 3.8 hours during COVID-19 compared to prior to COVID-19. On weekends, bedtimes were delayed on average by 1.6 hours and waketimes by 1.5 hours (all p's < 0.001). Social jetlag of >2 hours decreased to 6.3% during COVID-19 compared to 52.1% prior to COVID-19. Anxiety and depression symptoms and a decline in physical activity during COVID-19 were associated with delayed bed and wake times during COVID-19. CONCLUSIONS: During COVID-19, adolescents reported spending more time in bed, with most adolescents reporting 8 hours of sleep opportunity and more consistent sleep schedules. As schools return to in-person learning, additional research should examine how sleep schedules may change due to school start times and what lessons can be learned from changes that occurred during COVID-19 that promote favorable adolescent sleep.

14.
Public Health Rep ; : 333549221099238, 2022 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-35699392

RESUMEN

Contact tracing is an evidence-based intervention to control many communicable diseases, including COVID-19. Before the COVID-19 pandemic, contact tracing in Michigan focused on HIV, sexually transmitted infections, and tuberculosis, and it was conducted by state and local health department staff. Within 2 weeks of the first reported COVID-19 cases in Michigan in March 2020, the existing public health workforce was overwhelmed by the need for contact tracing and daily symptom monitoring. This case study narrates the development of a staffing plan that included volunteers and contractual staff to conduct centralized contact tracing in a home-rule state (ie, a state in which local health departments have full authority and autonomy under public health code to conduct the functions necessary to prevent disease, including contact tracing). This case study details various training, workforce management, and technology tools that were used. During the study period (May 2020-June 2021), contact tracers called 432 218 contacts and 269 439 were successfully reached, 48 134 of whom reported developing symptoms. The most important lesson learned was the need for more automated processes to improve efficiency in processing volunteer applicants, training, and scheduling. Nonetheless, the centralized workforce was successful, was flexible, and met the changing demands in Michigan.

16.
Yearb Med Inform ; 2022 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-35654430

RESUMEN

OBJECTIVE: While the COVID-19 pandemic provided a global stimulus for digital health capacity, its development has often been inequitable, short-term in planning, and lacking in health system coherence. Inclusive digital health and the development of resilient health systems are broad outcomes that require a systematic approach to achieving them. This paper from the IMIA Primary Care Informatics Working Group (WG) provides necessary first steps for the design of a digital primary care system that can support system equity and resilience. METHODS: We report on digital capability and growth in maturity in four key areas: (1) Vaccination/Prevention, (2) Disease management, (3) Surveillance, and (4) Pandemic preparedness for Australia, Canada, and the United Kingdom (data from England). Our comparison looks at seasonal influenza management prior to COVID-19 (2019-20) compared to COVID-19 (winter 2020 onwards). RESULTS: All three countries showed growth in digital maturity from the 2019-20 management of influenza to the 2020-21 year and the management of the COVID-19 pandemic. However, the degree of progress was sporadic and uneven and has led to issues of system inequity across populations. CONCLUSION: The opportunity to use the lessons learned from COVID-19 should not be wasted. A digital health infrastructure is not enough on its own to drive health system transformation and to achieve desired outcomes such as system equity and resilience. We must define specific measures to track the growth of digital maturity, including standardized and fit-for-context data that is shared accurately across the health and socioeconomic sectors.

18.
Dermatol Ther ; : e15624, 2022 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-35674680

RESUMEN

BACKGROUND: Since COVID-19 was declared a pandemic in March of 2020 (1) , frontline healthcare workers wear personal protective equipment (PPE, surgical masks, N95 or similar respirators, gloves, goggles, face shields, and gowns). (2) Alcohol-based sanitizers and wipes were recommended. (3) Such measures lead to disruption of the natural skin habitat and skin barrier and various cutaneous reactions. (4)(5)(6) OBJECTIVES: The aim was to assess the prevalence and characteristics of PPE-related dermatoses among healthcare workers in Sheikh Khalifa Medical City (SKMC), a COVID-19 facility, Abu Dhabi, United Arab Emirates. METHOD: We conducted a voluntary, cross-sectional anonymous survey among first-line healthcare workers addressing types of PPE used, dermatoses classified as PPE-related, and factors that influence them. RESULTS: Facial, nasal, and hand dermatoses were the most prevalent with 40.2%, 19.9%, and 14.1%, respectively. The changes are primarily attributed to surgical masks, N-95 masks, and gloves. The shift duration is a contributing factor correlating with the severity of skin damage. CONCLUSION: Results of this study encouraged decision-makers to recognize PPE-related dermatoses as a continuously growing burden, reorganized the shift duration and PPE exposure, animate the personal to apply preventive measures, and promoted the well-being of medical professionals in new waves of the pandemic. This article is protected by copyright. All rights reserved.

19.
J Clin Transl Sci ; 6(1): e44, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35651958

RESUMEN

The COVID-19 pandemic led to an increased need to conduct research and community engagement using digital methods. Unfortunately, the shift away from in-person research activities can make it difficult to engage and recruit participants from under-resourced communities that lack adequate digital infrastructure. At the beginning of the pandemic, our team recognized that imminent lockdowns would significantly disrupt ongoing engagement with low-income housing resident community partners and that we would ultimately bear responsibility if that occurred. This manuscript outlines the development of methods designed to create capacity for virtual engagement with a community advisory board that were subsequently applied to a longitudinal mixed-methods study. We describe how our experience engaging low-income housing residents during the height of the pandemic influenced the approach and offer guidelines useful for engaging under-resourced communities regardless of setting. Of these, a strong commitment to providing technology, unlimited data connectivity, and basic digital literacy training/technical support is most important. While each of these is essential and failure in any one area will reduce overall effectiveness of the effort, providing adequate technical support while maintaining ongoing relationships with community members is the most important and resource-intensive.

20.
PLoS One ; 17(6): e0269127, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35657813

RESUMEN

Longitudinal clinical studies traditionally require in-person study visits which are well documented to pose barriers to participation and contribute challenges to enrolling representative samples. Remote trial models may reduce barriers to research engagement, improve retention, and reach a more representative cohort. As remote trials become more common following the COVID-19 pandemic, a critical evaluation of this approach is imperative to optimize this paradigm shift in research. The TestBoston study was launched to understand prevalence and risk factors for COVID-19 infection in the greater Boston area through a fully remote home-testing model. Participants (adults, within 45 miles of Boston, MA) were recruited remotely from patient registries at Brigham and Women's Hospital and the general public. Participants were provided with monthly and "on-demand" at-home SARS-CoV-2 RT-PCR and antibody testing using nasal swab and dried blood spot self-collection kits and electronic surveys to assess symptoms and risk factors for COVID-19 via an online dashboard. Between October 2020 and January 2021, we enrolled 10,289 participants reflective of Massachusetts census data. Mean age was 47 years (range 18-93), 5855 (56.9%) were assigned female sex at birth, 7181(69.8%) reported being White non-Hispanic, 952 (9.3%) Hispanic/Latinx, 925 (9.0%) Black, 889 (8.6%) Asian, and 342 (3.3%) other and/or more than one race. Lower initial enrollment among Black and Hispanic/Latinx individuals required an adaptive approach to recruitment, leveraging connections to the medical system, coupled with community partnerships to ensure a representative cohort. Longitudinal retention was higher among participants who were White non-Hispanic, older, working remotely, and with lower socioeconomic vulnerability. Implementation highlighted key differences in remote trial models as participants independently navigate study milestones, requiring a dedicated participant support team and robust technology platforms, to reduce barriers to enrollment, promote retention, and ensure scientific rigor and data quality. Remote clinical trial models offer tremendous potential to engage representative cohorts, scale biomedical research, and promote accessibility by reducing barriers common in traditional trial design. Barriers and burdens within remote trials may be experienced disproportionately across demographic groups. To maximize engagement and retention, researchers should prioritize intensive participant support, investment in technologic infrastructure and an adaptive approach to maximize engagement and retention.


Asunto(s)
COVID-19 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , Ensayos Clínicos como Asunto , Estudios de Cohortes , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Adulto Joven
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