Impact of the COVID-19 pandemic on cancer screening attitudes, intentions, and behaviors in older adults.
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ABSTRACT:
SUBMITTER: Schoenborn NL
PROVIDER: S-EPMC8657344 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeIn order to facilitate targeted outreach, we sought to identify patient populations with a lower likelihood of returning for breast cancer screening after COVID-19-related imaging center closures.MethodsWeekly total screening mammograms performed throughout 2019 (baseline year) and 2020 (COVID-19-impacted year) were compared. Demographic and clinical characteristics, including age, race, ethnicity, breast density, breast cancer history, insurance status, imaging facility type used, and need for interpreter, were compared between patients imaged from March 16 to October 31 in 2019 (baseline cohort) and 2020 (COVID-19-impacted cohort). Census data and an online map service were used to impute socioeconomic variables and calculate travel times for each patient. Logistic regression was used to identify patient characteristics associated with a lower likelihood of returning for screening after COVID-19-related closures.ResultsThe year-over-year cumulative difference in screening mammogram volumes peaked in week 21, with 2962 fewer exams in the COVID-19-impacted year. By week 47, this deficit had reduced by 49.4% to 1498. A lower likelihood of returning for screening after COVID-19-related closures was independently associated with younger age (odds ratio (OR) 0.78, p < 0.001), residence in a higher poverty area (OR 0.991, p = 0.014), lack of health insurance (OR 0.65, p = 0.007), need for an interpreter (OR 0.68, p = 0.029), longer travel time (OR 0.998, p < 0.001), and utilization of mobile mammography services (OR 0.27, p < 0.001).ConclusionSeveral patient factors are associated with a lower likelihood of returning for screening mammography after COVID-19-related closures. Knowledge of these factors can guide targeted outreach to vulnerable patients to facilitate breast cancer screening.
| S-EPMC8145189 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.ObjectiveThis study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.MethodsA rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.ResultsA total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.ConclusionsOur results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.
| S-EPMC8043147 | biostudies-literature
Project description:BackgroundHerd immunity through vaccination is the target of public health interventions against COVID-19, but vaccine refusal or hesitancy is one of the global threats that make achievement of community immunity very difficult. The aim of this study was to determine negative attitudes and intentions and their predictors towards COVID-19 vaccines.MethodsThis was cross sectional survey, that targeted 1011 Egyptians aged 18 years and above, from 24 governorates, during the period from 7 January 2021, to 30 March 2021. Using a convenient sampling technique, the data were collected through an online self-administered, structured questionnaire, which was composed of two main sections, that involved sociodemographic and health related factors, intentions, and attitudes towards COVID-19 vaccines.ResultsThe mean age of participants was 29.35 ± 10.78 years, (16.6 %) of them had COVID-19. (54%) of respondents, reported COVID-19 vaccine hesitancy and 21% of them reported vaccine non-acceptance while (27.1%) of participants preferred receiving Pfizer vaccine. (51.8%) of the respondents expressed strong worries about unforeseen effects of the vaccine which was associated with younger age groups, married, females, absence of history of allergy to food or drugs, perceived susceptibility to COVID 19 and never having flu vaccination. Vaccine hesitancy was associated with female sex, urban residence, university/post graduate, married respondents, those never had flu vaccine, and those did not have confidence in the ability of health system to control the epidemic. Female sex, urban residence and having concerns about unforeseen effects were predictors for vaccine hesitancy and vaccine non-acceptance.ConclusionThe observed high level of worries about unforeseen effects of COVID-19 vaccines and widespread vaccine hesitancy amongst Egyptians and its predictors should be considered during implementation of public health intervention campaigns to change negative attitudes and improve acceptance and uptake of COVID-19 vaccines in Egypt.
| S-EPMC8253692 | biostudies-literature
Project description:The COVID-19 pandemic disrupted health care delivery of cancer screenings. The primary aim of our work was to evaluate the degree to which populations were accepting of home-based screenings for colorectal cancer (CRC) and cervical cancer (ie, primary human papillomavirus [HPV] testing). Three groups of adults having distinct health burdens that may affect acceptance of home-based cancer screening were identified through outpatient electronic medical records: those having survived a COVID-19 hospitalization; those having been positive for a non-COVID-19 respiratory illness; or those having type 2 diabetes. A total of 132 respondents (58% female) completed an online survey with hypothetical cases about their acceptance of home-based CRC or cervical cancer screening. Among women respondents, urine and vaginal screening for primary HPV testing was acceptable to 64% and 59%, respectively. Among both men and women, at-home CRC screening with fecal immunochemical test or Cologuard® was acceptable to 60% of the respondents. When adjusting for education, women with a positive attitude toward home-based urine and vaginal screening were 49 times and 23 times more likely, respectively, to have a positive attitude toward CRC screening. These findings indicate that home-based cancer screens for CRC and primary HPV testing are acceptable to men and women and may allow for greater compliance with screening in the future.
| S-EPMC8530243 | biostudies-literature
Project description:Background/objectivesDifferences in older adults' worry, attitudes, and mental health between high-income countries with diverging pandemic responses are largely unknown. We compared COVID-19 worry, attitudes towards governmental responses, and self-reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID-19 pandemic.DesignOnline cross-sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada.SettingNationally in the United States and Canada.ParticipantsConvenience sample of older adults aged ≥55.MeasurementsLikert-type scales measured COVID-19 worry and attitudes towards government support. Three standardized scales assessed mental health symptoms: the eight-item Center for Epidemiological Studies Depression Scale, the five-item Beck Anxiety Inventory, and the three-item UCLA loneliness scale.ResultsThere were 4453 U.S. respondents (71.7% women; mean age 67.5) and 1549 Canadian (67.6% women; mean age 69.3). More U.S. respondents (71%) were moderately or extremely worried about the pandemic, compared to 52% in Canada. Just 20% of U.S. respondents agreed or strongly agreed that the federal government cared about older adults in their COVID-19 pandemic response, compared to nearly two-thirds of Canadians (63%). U.S. respondents were more likely to report elevated depressive and anxiety symptoms compared to Canadians; 34.2% (32.8-35.6) versus 25.6% (23.3-27.8) for depressive and 30.8% (29.5-32.2) versus 23.7% (21.6-25.9) for anxiety symptoms. The proportion of United States and Canadian respondents who reported loneliness was similar. A greater proportion of women compared to men reported symptoms of depression and anxiety across all age groups in both countries.ConclusionU.S. older adults felt less supported by their federal government and had elevated depressive and anxiety symptoms compared to older adults in Canada during early months of the COVID-19 pandemic. Public health messaging from governments should be clear, consistent, and incorporate support for mental health.
| S-EPMC8250795 | biostudies-literature
Project description:COVID-19 took a heavy toll on older adults. In Belgium, by the end of August, 93% of deaths due to COVID-19 were aged 65 or older. Similar trends were observed in other countries. As a consequence, older adults were identified as a group at risk, and strict governmental restrictions were imposed on them. This has caused concerns about their mental health. Using an online survey, this study established the impact of the COVID-19 pandemic on adults aged 65 years or older, and which factors moderate this impact. Participants reported a significant decrease in activity level, sleep quality and wellbeing during the COVID-19 pandemic. Depression was strongly related to reported declines in activity level, sleep quality, wellbeing and cognitive functioning. Our study shows that the COVID-19 pandemic had a severe impact on the mental health of older adults. This implies that this group at risk requires attention of governments and healthcare.
| S-EPMC7907111 | biostudies-literature
Project description:Background: Our understanding of how the coronavirus disease 2019 (COVID-19) pandemic has impacted decision-making for women planning to conceive is unclear. We aimed to investigate how the COVID-19 pandemic has influenced pregnancy planning behaviors. Methods: An online questionnaire of closed- and open-ended questions was utilized to capture pregnancy planning behaviors and reported behavioral changes during the COVID-19 pandemic in women planning pregnancy between January and July 2020. Closed-ended questions were analyzed quantitatively, and thematic framework analysis was utilized for open-ended responses. Results: A total of 504 questionnaires were included for analysis. The majority of respondents lived in the United Kingdom. Ninety-two percent of the women were still planning a pregnancy but over half (n = 267) reported that COVID-19 had affected their plans, with 72% of these (n = 189) deliberately postponing pregnancy. Concerns were predominantly over changes in antenatal care, but also fear of adverse effects of the virus on mother and baby. From the thematic analysis (n = 37), lack of services to remove contraceptive devices and provide fertility treatment were also cited. In contrast, 27% (n = 71) reported bringing their pregnancy plans forward; common themes included recalibration of priorities and cancelled or changed plans. Conclusions: The COVID-19 pandemic influenced pregnancy-planning behaviors with many women reporting postponement of pregnancy. These alterations in behavior could impact the health and wellbeing of women planning pregnancy while having important implications for health care services worldwide. Continued provision of family planning and fertility services should be ensured to mitigate the effect of future outbreaks or pandemics.
| S-EPMC8006747 | biostudies-literature
Project description:Primary outcome(s): The incidence of obstructive colorectal cancer
| 2656898 | ecrin-mdr-crc
Project description:ImportanceCompared with the general population, veterans are at high risk for COVID-19 and have a complex relationship with the government. This potentially affects their attitudes toward receiving COVID-19 vaccines.ObjectiveTo assess veterans' attitudes toward and intentions to receive COVID-19 vaccines.Design, setting, and participantsThis cross-sectional web-based survey study used data from the Department of Veterans Affairs (VA) Survey of Healthcare Experiences of Patients' Veterans Insight Panel, fielded between March 12 and 28, 2021. Of 3420 veterans who were sent a link to complete a 58-item web-based survey, 1178 veterans (34%) completed the survey. Data were analyzed from April 1 to August 25, 2021.ExposuresVeterans eligible for COVID-19 vaccines.Main outcomes and measuresThe outcomes of interest were veterans' experiences with COVID-19, vaccination status and intention groups, reasons for receiving or not receiving a vaccine, self-reported health status, and trusted and preferred sources of information about COVID-19 vaccines. Reasons for not getting vaccinated were classified into categories of vaccine deliberation, dissent, distrust, indifference, skepticism, and policy and processes.ResultsAmong 1178 respondents, 974 (83%) were men, 130 (11%) were women, and 141 (12%) were transgender or nonbinary; 58 respondents (5%) were Black, 54 veterans (5%) were Hispanic or Latino, and 987 veterans (84%) were non-Hispanic White. The mean (SD) age of respondents was 66.7 (10.1) years. A total of 817 respondents (71%) self-reported being vaccinated against COVID-19. Of 339 respondents (29%) who were not vaccinated, those unsure of getting vaccinated were more likely to report fair or poor overall health (32 respondents [43%]) and mental health (33 respondents [44%]) than other nonvaccinated groups (overall health: range, 20%-32%; mental health: range, 18%-40%). Top reasons for not being vaccinated were skepticism (120 respondents [36%] were concerned about side effects; 65 respondents [20%] preferred using few medications; 63 respondents [19%] preferred gaining natural immunity), deliberation (74 respondents [22%] preferred to wait because vaccine is new), and distrust (61 respondents [18%] did not trust the health care system). Among respondents who were vaccinated, preventing oneself from getting sick (462 respondents [57%]) and contributing to the end of the COVID-19 pandemic (453 respondents [56%]) were top reasons for getting vaccinated. All veterans reported the VA as 1 of their top trusted sources of information. The proportion of respondents trusting their VA health care practitioner as a source of vaccine information was higher among those unsure about vaccination compared with those who indicated they would definitely not or probably not get vaccinated (18 respondents [26%] vs 15 respondents [15%]). There were no significant associations between vaccine intention groups and age (χ24 = 5.90; P = .21) or gender (χ22 = 3.99; P = .14).Conclusions and relevanceThese findings provide information needed to develop trusted messages used in conversations between VA health care practitioners and veterans addressing specific vaccine hesitancy reasons, as well as those in worse health. Conversations need to emphasize societal reasons for getting vaccinated and benefits to one's own health.
| S-EPMC8567110 | biostudies-literature
Project description:ObjectivesThe COVID-19 pandemic has had a significant impact on older adults mental health care. Our study aimed to explore staff perspectives on key challenges and innovations in order to help inform the delivery of older adults mental health care in subsequent waves of the pandemic.MethodsA mixed methods online questionnaire developed by National Institute for Health Research Mental Health Policy Research Unit was used to gather staff perspectives on their challenges at work, problems faced by service users and their carers, and sources of help and support. Descriptive statistics were used for quantitative analysis and descriptive content analysis for qualitative analysis.Results158 participants, working in either community or inpatient settings, and from a range of professional disciplines, were included. For inpatient staff, a significant challenge was infection control. In the community, staff identified a lack of access to physical and social care as well as reduced contact with friends and families as being challenges for patients. Remote working was seen as a positive innovation along with COVID-19 related guidance from various sources and peer support.ConclusionOur study, with a focus on staff and patient well-being, helps to inform service development for future waves of the pandemic. We discuss measures to improve infection control in inpatient settings, the role of voluntary organisations in supporting socially isolated community patients, the need for better integration of physical and mental health services at an organisational level, and the importance of training staff to support patients and their families with end of life planning.
| S-EPMC8420103 | biostudies-literature