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Analysis of the SPARK study COVID-19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services.

ABSTRACT: Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID-19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID-19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID-19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID-19 pandemic on access to services, parent concerns about the same, impact on child's ASD-related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services. Analysis revealed that certain demographic (age, income/SES) and child-related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD-related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low-income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD-related behaviors, parent health/family impact, and found online interactions to be less beneficial. LAY SUMMARY: The SPARK study impact survey shows that at the onset of the COVID-19 pandemic, parents reported significant service disruptions, negative impact on their child's ASD-related behaviors as well as their own mental health; which was greater in families with younger children, children with greater ASD severity, and children from low-income families. Majority of families did not report significant benefits of online services whereas some families did. Low-income families were hopeful about receiving benefits through future online services. Overall, these findings have important implications for future clinical care delivery and healthcare policies to ensure that healthcare services are not interrupted during a potential resurgence of COVID-19 or other pandemics. A combination of in-person and online healthcare and family support services must be implemented to prevent negative health impacts in the future.

SUBMITTER: Bhat A

PROVIDER: S-EPMC8578426 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe presence of COVID-19 has led to the disruption of health systems globally, including essential reproductive, maternal, newborn and child health (RMNCH) services. This study aimed to assess the challenges faced by women who used RMNCH services in Nigeria's epicentre, their satisfaction with care received during the COVID-19 pandemic and the factors associated with their satisfaction.MethodsThis cross-sectional survey was conducted in Lagos, southwest Nigeria among 1,241 women of reproductive age who had just received RMNCH services at one of twenty-two health facilities across the primary, secondary and tertiary tiers of health care. The respondents were selected via multi-stage sampling and face to face exit interviews were conducted by trained interviewers. Client satisfaction was assessed across four sub-scales: health care delivery, health facility, interpersonal aspects of care and access to services. Bivariate and multivariate analyses were used to assess the relationship between personal characteristics and client satisfaction.ResultsAbout 43.51% of respondents had at least one challenge in accessing RMNCH services since the COVID-19 outbreak. Close to a third (31.91%) could not access service because they could not leave their houses during the lockdown and 18.13% could not access service because there was no transportation. The mean clients' satisfaction score among the respondents was 43.25 (SD: 6.28) out of a possible score of 57. Satisfaction scores for the interpersonal aspects of care were statistically significantly lower in the PHCs and general hospitals compared to teaching hospitals. Being over 30 years of age was significantly associated with an increased clients' satisfaction score (ß = 1.80, 95%CI: 1.10-2.50).ConclusionThe COVID-19 lockdown posed challenges to accessing RMNCH services for a significant proportion of women surveyed. Although overall satisfaction with care was fairly high, there is a need to provide tailored COVID-19 sensitive inter-personal care to clients at all levels of care.

Project description:BackgroundThe Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.MethodsMixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.ResultsComparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.ConclusionOur results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.

Project description:BackgroundParent mental health and wellbeing may have implications for understanding attachment transmission. In this systematic review, we synthesise the published literature to determine the nature of the relationship between parent mental health and wellbeing and the intergenerational transmission of attachment and to provide recommendations for future research, clinical practice and intervention.MethodUsing the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, five electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on adult attachment, child attachment, and a domain of parent mental health/wellbeing. No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42020157247).ResultsEleven studies examining the impact on parent mental health and wellbeing on the intergenerational transmission of attachment were identified for inclusion in this review. Our review found preliminary evidence that parent mental health and wellbeing play a role in the intergenerational transmission of attachment. Other key findings from the review were: evidence quality is mixed due to variable measurement of attachment and mental health; studies have mostly included correlational analysis or do not utilise contemporary methodological approaches to testing mediating or moderating relationships; and literature is largely focused on psychopathology and negative factors of mental health.ConclusionsThe limited scope of parent mental health and wellbeing constructs examined in the literature, the sparse use of robust statistical analyses, and the lack of literature in general makes it difficult to draw conclusions on how and why parent mental health impacts attachment transmission. Addressing these limitations will further progress attachment-related literature and may have particular implications for attachment-informed interventions with clinical populations.

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Analysis of the SPARK study COVID-19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services.

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