A Descriptive Analysis of Smartphone Access and Frontline Service Delivery During the COVID-19 Lockdown in Chhattisgarh, India

To address the gaps between need and access, and between treatment guidelines and their implementation for mental illness, through capacity building of front-line health workers. Following a learning needs assessment, work-based continuing education courses in evidence-supported psychotherapies were developed for front-line workers in underserviced community settings. The 5-hour courses on the fundamentals of cognitive-behavioural therapy, interpersonal psychotherapy, motivational interviewing, and dialectical behaviour therapy each included videotaped captioned simulations, interactive lesson plans, and clinical practice behaviour reminders. Two courses, sequentially offered in 7 underserviced settings, were subjected to a mixed methods evaluation. Ninety-three nonmedical front-line workers enrolled in the program. Repeated measures analysis of variance was used to assess pre- and postintervention changes in knowledge and self-efficacy. Qualitative data from 5 semistructured focus groups with 25 participants were also analyzed. Significant pre- and postintervention changes in knowledge (P < 0.001) were found in course completers. Counselling self-efficacy improved in participants who took the first course offered (P = 0.001). Dropouts were much less frequent in peer-led, small-group learning than in a self-directed format. Qualitative analysis revealed improved confidence, morale, self-reported practice behaviour changes, and increased comfort in working with difficult clients. This work-based, multimodal, interactive, interprofessional curriculum for knowledge translation of psychotherapeutic techniques is feasible and helpful. A peer-led group format is preferred over self-directed learning. Its application can build capacity of front-line health workers in helping patients who suffer from common mental disorders.

Background: Weak community referral systems contribute to preventable maternal and neonatal morbidity and mortality in low-resource settings, particularly in arid and semi-arid regions. Frontline health workers are critical in recognizing danger signs and initiating timely referrals, yet knowledge gaps and limited training undermine effectiveness. This study assessed referral system knowledge among frontline health workers in Isiolo County. The specific objectives of the study were to determine the level of knowledge on community referral systems among frontline workers on maternal and neonatal health services and establish the influence of training frontline workers on the knowledge on maternal and neonatal referrals systems among frontline workers in Isiolo County. Methods: A quasi-experimental pretest-post test control group mixed-methods design was used. A total of 260 frontline health workers were enrolled (130 intervention; 130 control). Structured questionnaires were administered at baseline and endline, complemented by focus group discussions and interviews. Data was analyzed using descriptive and multivariable statistics. Results: At baseline, overall knowledge of community referral systems was low across both groups, with only 34.6% of FHWs demonstrating adequate knowledge of referral pathways, danger sign recognition, and referral documentation. Post-intervention, the proportion of FHWs with adequate knowledge in the intervention arm increased significantly to 78.5%, compared to 38.2% in the control arm (p &lt; 0.001). Knowledge of maternal danger signs improved from 41.2% to 83.1% in the intervention group, while neonatal danger sign knowledge increased from 37.6% to 79.4%. Multivariable logistic regression showed that trained FHWs were over four times more likely to have adequate referral knowledge than untrained counterparts (AOR = 4.37; 95% CI: 2.61–7.31). Qualitative findings corroborated quantitative results, highlighting improved confidence, referral decision-making, and documentation practices following training. Conclusion: Structured training significantly improved frontline health workers’ knowledge of community referral systems for maternal and neonatal health services in Isiolo County. Capacity-building remains essential.

Background: The COVID-19 pandemic has emerged as the most important public health issue in the past two years. Multiple preventive and treatment modalities are being tried to contain this pandemic. Several countries have documented vaccines as a vital tool to combat this pandemic across the globe. Hence, we tried to evaluate the adverse events following immunisation at the study site following Covishield vaccination among front-line health workers in our tertiary care hospital. Methods: A cross-sectional descriptive study was planned in the vaccination site of our institute, where all details of the frontline workers who were vaccinated for the Covishield vaccine were included, and they were followed up to study the prevalence and pattern of AEFIs. The participants were observed for 30 minutes after the jab and were reviewed/called upon on the third day following immunization to gather information. The data was collected using a semi-structured questionnaire Results: Our study included around 159 frontline workers and medical students who received their vaccination during the study period. The mean age distribution was 24.3±7.6 years, with female predominance. We observed an AEFI prevalence of 33.3% among the study participants at the end of 30 minutes, while after 30 mins and during the next 3 days of follow-up by our staff, we observed that the prevalence increased to 80%. We observed that the commonest AEFI observed at 30 minutes and during the 3 days follow up was tenderness/pain, fever, body ache and light-headedness. Only 4% of the patients required hospitalisation following AEFI. Conclusions: Around 1/3rd of our study participants reported AEFI following vaccination during the first 30 minutes of observation which is much higher than the national average.

BackgroundThe unmet need for mental health care affects millions of Americans. A growing body of evidence in implementation science supports the effectiveness of task sharing in the delivery of brief psychosocial interventions. The digitization of training and processes supporting supervision can rapidly scale up task-shared interventions and enable frontline health workers (FLWs) to learn, master, and deliver interventions with quality and support.ObjectiveWe aimed to assess the perceived feasibility and acceptability of a novel mobile and web app designed and adapted to support the supervision, training, and quality assurance of FLWs delivering brief psychosocial interventions.MethodsWe followed human-centered design principles to adapt a prototype app for FLWs delivering brief psychosocial interventions for depression, drawing from an app previously designed for use in rural India. Using a multimethod approach, we conducted focus group sessions comprising usability testing and group interviews with FLWs recruited from a large health system in Texas to assess the feasibility and acceptability of the app. The positive System Usability Scale was used to determine the app’s overall usability. We also calculated the participants’ likelihood of recommending the app to others using ratings of 0 to 10 from least to most likely (net promoter score). Focus group transcripts were coded and analyzed thematically, and recommendations were summarized across 4 key domains.ResultsA total of 18 FLWs varying in role and experience with client care participated in the study. Participants found the app to be usable, with an average System Usability Scale score of 72.5 (SD 18.1), consistent with the industry benchmark of 68. Participants’ likelihood of recommending the app ranged from 5 to 10, yielding a net promoter score of 0, indicating medium acceptability. Overall impressions of the app from participants were positive. Most participants (15/18, 83%) found the app easy to access and navigate. The app was considered important to support FLWs in delivering high-quality mental health care services. Participants felt that the app could provide more structure to FLW training and supervision processes through the systematic collection and facilitation of performance-related feedback. Key concerns included privacy-related and time constraints regarding implementing a separate peer supervision mechanism that may add to FLWs’ workloads.ConclusionsWe designed, built, and tested a usable, functional mobile and web app prototype that supports FLW-delivered psychosocial interventions in the United States through a structured supervision mechanism and systematic collection and review of performance measures. The app has the potential to scale the work of FLWs tasked with delivering these interventions to the hardest-to-reach communities they serve. The results of this project will inform future work to evaluate the app’s use and efficacy in real-world settings to support task-shared mental health programs across the United States.

This chapter details the economic theory of net advantages, which is central to setting the pay of frontline health and social care workers. It details the basic economic principles which should underpin how health and social care workers are paid. It explains how job characteristics affect pay and identifies the very distinctive characteristics of the jobs that frontline workers do which will affect what they are paid. It explains why frontline workers’ pay should be related to the time they spend at work, not what they produce, and why pay should increase incrementally during early years of work. It further explains why frontline workers’ pay should vary according to the area of the country in which they work. It discusses measures of labour shortage, details vacancy rates, and documents the extent of shortage in key occupations.

This study explored how identification processes among front-line workers influence client orientation. We interviewed 15 front-line workers from two sport/leisure organizations. Thematic analyses of interview results suggest how identification and relational processes can foster client orientation. Front-line workers may identify with co-workers, the organization (mission was particularly important), the client, and even the activity for which they are responsible. Identification with these targets offers insight into how to treat clients. For example, several of those interviewed noted the importance of mission statements in setting the tone for a client orientation. Two conditions seemed important. First, the mission statement must offer clarity into the role of client orientation in the service delivery model. It should focus directly on serving the client. Second, it must be crafted in a way that encourages identification by staff members. They must see their own value system within the mission statement. These identification processes became critical when other identification targets (in this case, other staff) offered direction that was incompatible with client orientation. We found, for example, that at times co-workers’ values and behaviours could be inconsistent with client orientation. On such occasions, though, those with already high client orientation tendencies failed to identify with, or at least model, the behaviours of their co-workers. Instead they looked to vision for service laid out by the organization. These findings also highlight the importance of staff-participant and staff-activity identification. Observers believed that staff members sharing a sense of similarity and familiarity with program participants, often possessed a client orientation. Particularly striking in our interviews was the notion of a shared passion for the activity (e.g., special event or sport) in developing client orientation. Most leisure service staff described here had a background in the activity they facilitated. As a result, they had a strong passion for that activity. When they interacted with participants who also demonstrated a passion for the activity, identification processes were enhanced. This identification seemed to aid in client orientation. Finally, participants described how job descriptions often failed to capture the nuances of client orientation and instead focused on core tasks. It is perhaps unsurprising then, that client orientation was described as being a lower priority among staff who focused on tasks (as laid out in their job descriptions or in policy). Subscribe to JPRA

The concept of ‘scale’ and usage of this term have raised much debate within human geography over the past 25 years. At the same time, these very debates have developed the concept dramatically by offering new considerations of its use. Building on notions that scale is experienced and that scalar concepts offer a vocabulary to articulate complex phenomena, this analysis aims to explore the relevance of scale as an explanatory concept used by informal family caregivers and front-line health and social care workers when discussing their experiences with a Canadian social programme, the Compassionate Care Benefit (CCB). The goal of the CCB is to provide income assistance and job security to those who take temporary leave from employment to care for a terminally ill family member. As part of a larger evaluative study on the CCB, semi-structured interviews with 57 family caregivers and 50 front-line health and social care workers from across Canada were conducted and transcripts were thematically analysed. Emerging from analysis of both datasets was the common usage of scalar concepts, specifically ‘region’, ‘community’ and ‘home’. Respondents employed these scalar categories to reference both differences and relationships in highly spatial and comparative ways, and also to organise and articulate their thoughts in ways meaningful to them and their lives in place. Based upon these scalar categories and issues highlighted by respondents, particular spatial challenges and inequities are illuminated, and implications for the CCB and its administration are identified. These findings provide insight into the complex ways family caregivers and front-line health and social care workers make sense of their world and more specifically, understand how federal programmes like the CCB operate. By considering how such programmes are experienced in scalar ways, knowledge can be maximised and thus, informed decision-makers can more effectively meet the needs of programme users.

IntroductionThe abrupt onset of COVID-19, with its rapid spread, has had brutal consequences in all areas of society, including the workplace. In this paper, we report the working conditions, health,...

Amidst the global struggle to achieve herd immunity against SARS-CoV-2, this study investigates whether the number of vaccine options (the size of the choice set) predicts the public’s intention to get vaccinated, and whether this effect depends on their trust in institutions – a system in which a collection of actors – from scientists and vaccine developers to public servants and front-line health workers – is working to fight the pandemic and to develop and approve vaccines against SARS-CoV-2 and deliver them to the public. Using an online experiment conducted in Japan (N = 600), the study tested whether choice set sizes of 1, 2, and 4 make a difference in the intention to get vaccinated. The study found that the intention was higher when the subjects were given two vaccine options to choose from, rather than offered a single vaccine, when trust was low, but this effect was negative when the subject trusted institutions highly. The study did not find strong evidence to support the effect of presenting a choice set of four. Based on these findings, this study offers nuanced suggestions for vaccine policy.

Introduction: Coronavirus disease vaccination has been accepted as a global health measure to prevent severity,transmission and mortality. Vaccine frequently cause adverse effects which is supposed to be due to protective immune response induced by the vaccine. The study aimed to find out the prevalence of side effects of first dose of AZD 1222 COVISHIELD vaccine among front line health care workers receiving vaccination in a tertiary care hospital. Methods: This was a descriptive cross-sectional study among front line health workers who received the first dose of COVISHIELD vaccine. The study was conducted from February 2021 to March 2021 in a tertiary care hospital after receiving ethical approval from the Institutional Review Committee. Convenience sampling was used for data collection and data was analyzed using SPSS version 17 was used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 629 participants, 344(54.7%) participants reported one or other side effects following vaccination. The major side effects reported were fever 152(19.6%), myalgia 144(22.9%), pain at injection site 123(19.6%), headache 75(11.9%) and in one reactivation of Herpes Zoster. Conclusions: After the first dose of COVISHIELD vaccine, mild symptoms were seen which resolved within few days. Some cases of reactivation of Herpes Zoster was found. The adverse effects were seen more in patients who had history of COVID-19 infection.

BackgroundDuring February 2020, the coronavirus disease 2019 (COVID-19) epidemic in Hubei Province, China, was at its height, requiring isolation of the population. This study aimed to compare the emotional state, somatic responses, sleep quality, and behavior of people in Hubei Province with non-endemic provinces in China during two weeks in February 2020.Material/MethodsQuestionnaires were completed by 939 individuals (357 men; 582 women), including 33 from Hubei and 906 from non-endemic provinces. The Stress Response Questionnaire (SRQ) determined the emotional state, somatic responses, and behavior. The Pittsburgh Sleep Quality Index (PSQI) was used to measure the duration of sleep and sleep quality.ResultsThere were 939 study participants, aged 18–24 years (35.89%) and 25–39 years (35.57%); 65.92% were university students. During a two week period in February 2020, the emotional state and behavior of participants in Hubei improved, but the quality of sleep did not. Health workers and business people became increasingly anxious, but other professionals became less anxious. The data showed that most people in Hubei Province developed a more positive attitude regarding their risk of infection and the chances of surviving the COVID-19 epidemic.ConclusionsDuring a two-week period, front-line health workers and people in Hubei Province became less anxious about the COVID-19 epidemic, but sleep quality did not improve. Despite public awareness, levels of anxiety exist that affect the quality of life during epidemics, including periods of population quarantine. Therefore, health education should be combined with psychological counseling for vulnerable individuals.

Background:The restrictions implemented around the world to contain the spread of thecoronavirus disease 2019 (COVID-19) impact workers. Emotional distress andmaladaptive behaviors such as alcohol misuse are expected, particularly invulnerable groups such as front-line health workers. In the present study,we examined if alcohol consumption behaviors in Quebec workers changedduring confinement of the COVID-19 pandemic, and whether healthcare workersreported specific patterns of changes.Methods:Data were obtained from an anonymous online survey conducted among adultworkers aged ⩾18 years in the province of Quebec, Canada, between May 25,2020 and June 26, 2020. Participants provided self-reported data regardingsociodemographic including field of work, as well as mental healthdisorders, alcohol use, alcohol craving, and type of alcohol consumed.Changes in alcohol behaviors were assessed using Wilcoxon signed rank testfor categorial variables and paired-t tests for continuousvariables.Results:The survey was completed by 847 participants (77.8% women), with 42.5%healthcare workers. Participants reported increased daily alcohol use(Z = −10.60; P < .001,r = −.372) and alcohol craving(P < .001, d = 0.485) during theconfinement. Only the type of alcohol consumed during the confinementdiffered between health care workers and other workers (OR = 0.45,P = .003). Health care workers used less high alcoholproducts during the confinement.Conclusion:Our results show a significant increase in daily alcohol consumption and inalcohol craving during the confinement in the Quebec working population.

Background: Coronavirus is a large family of viruses that cause illnesses ranging from mild to severe symptoms. Front-line health workers who are directly involved in diagnosing, treating and treating patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms. This study aims: to determine the relationship between anxiety and social support on the work performance of health workers in the COVID-19 pandemic era at the Medan Johor Health Center. The study population: were all health workers in Medan Johor Health Center, totaling 62 health workers and as research subjects. Research type: this is an analytic survey with a cross-sectional research design. Retrieval of data using a questionnaire. The data were processed by univariate analysis using descriptive statistics and bivariate analysis using the Chi-Square test. Results: From the results of the study, it can be seen that from anxiety with the performance of health workers in the era of the COVID-19 pandemic, the results of the Chi-Square test analysis show that the value of p= 0.000 which means less than p = 0.005, it can be concluded that there is a significant relationship between anxiety and the performance of health workers in the era of the COVID-19 pandemic at the Medan Johor Health Center in 2020. And from the research results it can be seen that from social support with performance health workers in the era of the COVID-19 pandemic, namely the results of the Chi-Square test analysis showing that the value of p= 0,000 which means less than p = 0.005, it can be concluded that there is a significant relationship between social support and the performance of health workers in the era of the COVID-19 pandemic. at Medan Johor Health Center 2020. Abstrak: Latar Belakang: Coronavirus merupakan keluarga besar virus yang menyebabkan penyakit mulai dari gejala ringan hingga berat. Tenaga kesehatan garda depan yang terlibat langsung dalam mendiagnosis, merawat, dan merawat pasien COVID-19 berisiko mengalami tekanan psikologis dan gejala kesehatan mental lainnya. Penelitian ini bertujuan: untuk mengetahui hubungan kecemasan dan dukungan sosial terhadap kinerja tenaga kesehatan pada era pandemi COVID-19 di Puskesmas Medan Johor. Populasi penelitian adalah seluruh tenaga kesehatan di Puskesmas Medan Johor yang berjumlah 62 orang tenaga kesehatan dan sebagai subjek penelitian. Jenis penelitian: ini adalah survei analitik dengan desain penelitian cross sectional. Pengambilan data menggunakan kuesioner. Data diolah dengan analisis univariat menggunakan statistik deskriptif dan analisis bivariat menggunakan uji Chi-Square. Hasil: Dari hasil penelitian dapat diketahui bahwa dari kecemasan dengan kinerja tenaga kesehatan di era pandemi COVID-19, hasil analisis uji Chi-Square menunjukkan nilai p= 0,000 yang berarti kurang dari p= 0,005 maka dapat disimpulkan bahwa terdapat hubungan yang signifikan antara kecemasan dengan kinerja tenaga kesehatan pada era pandemi COVID-19 di Puskesmas Medan Johor Tahun 2020. Dan dari hasil penelitian dapat dilihat dari dukungan sosial dengan kinerja tenaga kesehatan di era pandemi COVID-19 yaitu hasil analisis uji Chi-Square menunjukkan nilai p= 0,000 yang artinya kurang dari p= 0,005 maka dapat disimpulkan bahwa ada hubungan yang signifikan antara dukungan sosial dengan kinerja tenaga kesehatan di era pandemi COVID-19. di Puskesmas Medan Johor 2020

Psychotherapies, such as Interpersonal Psychotherapy (IPT), that have proven effective for treating mental disorders mostly lie dormant in consensus-treatment guidelines. Broadly disseminating these psychotherapies by training trainers and front-line health workers could close the gap between mental health needs and access to care. Research in continuing medical education and knowledge translation can inform the design of educational interventions to build capacity for providing psychotherapy to those who need it. This paper summarizes psychotherapy training recommendations that: adapt treatments to cultural and health organizational contexts; consider implementation barriers, including opportunity costs and mental health stigma; and engage local opinion leaders to use longitudinal, interactive, case-based teaching with reflection, skills-coaching, simulations, auditing and feedback. Community-based training projects in Northern Ontario, Canada and Ethiopia illustrate how best-education practices can be implemented to disseminate evidence-supported psychotherapies, such as IPT, to expand the therapeutic repertoire of health care workers and improve their patients' clinical outcomes.

Background: Care givers, who are the front-line health workers during Covid-19 outbreak. Their emotional responses and adaptation of coping strategies are very important for health of themselves as well health services. Logically care givers emotional response and coping strategies measures their emotional well-being which also affects their work productivity. Hence, this study is undertaken to assess the emotional response and coping strategies of care givers in Covid-19 department at Civil hospital, Ahmedabad. Aims and objectives: To assess the emotional response and coping strategies of care givers worked in Covid-19 department at Civil hospital, Ahmedabad. To assess the association between emotional response and demographic variables, coping strategies and demographic variables. Materials and Methods: The study was conducted among 100 care givers worked in Covid-19 department at Civil hospital, Ahmedabad using Random sampling technique. Data were obtained using structured rating scale and checklist to assess emotional response and coping strategies of care givers. Descriptive and inferential statistics were used to analyze demographic data, rating scale and checklist. Results and Conclusions: The study reveled that majority of 73% of caregivers had emotionally strong response and 86% of caregivers adopted healthy coping strategies. Study also revealed that there is significant association between selected emotional responses and selected demographic variables. Also significant association between coping strategies and selected demographic variables.