Catch-up Services Research Articles

Impact of the COVID-19 pandemic on routine surveillance for adults with chronic hepatitis B virus (HBV) infection in the UK.

To determine the impact of the COVID-19 pandemic on the population with chronic Hepatitis B virus (HBV) infection under hospital follow-up in the UK, we quantified the coverage and frequency of measurements of biomarkers used for routine surveillance (alanine transferase [ALT] and HBV viral load). We used anonymized electronic health record data from the National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) pipeline representing five UK National Health Service (NHS) Trusts. We report significant reductions in surveillance of both biomarkers during the pandemic compared to pre-COVID-19 years, both in terms of the proportion of patients who had ≥1 measurement annually, and the mean number of measurements per patient. These results demonstrate the real-time utility of HIC data in monitoring health-care provision, and support interventions to provide catch-up services to minimise the impact of the pandemic. Further investigation is required to determine whether these disruptions will be associated with increased rates of adverse chronic HBV outcomes.

Catch-up immunisation for migrant children in Melbourne: A qualitative study with providers to determine key challenges

BackgroundCurrent models of immunisation service delivery in Australia are not meeting the needs of migrant children, who experience a higher burden of vaccine preventable disease and lower immunisation rates compared to non-migrant children. Understanding the experiences of immunisation providers is critical for designing effective and tailored interventions to improve this service. This study aimed to identify the facilitators and barriers to providers delivering a comprehensive catch-up immunisation service to migrant children in Melbourne, Australia. MethodsSemi-structured interviews with council and general practice immunisation providers were conducted. Recorded interviews were transcribed and coded inductively using thematic analysis. Identified themes were then deductively categorised according to the Capability, Opportunity and Motivation of Behaviour (COM-B) model. ResultsTwenty-four providers (five practice nurses, six general practitioners, six council nurses and seven council administration officers) were interviewed between March and June 2021. Fourteen themes were identified that contributed to the delivery of an effective catch-up immunisation service. Capability themes included training, experience and skills to perform the service and communicate with families. Opportunity themes incorporated time, workplace norms, traits of migrant families, costs, systems and resources. Themes related to motivation were provider responsibility, beliefs about migrant health, and immunisation prioritisation. ConclusionsKey barriers for providers to deliver a comprehensive catch-up immunisation service were related to opportunity. Developing an online tool to support catch-up schedule development and reporting, and funding provider time to calculate the schedule are primary actions that could overcome opportunity barriers. Capability and motivation barriers for general practitioners included limited time, skills, and motivation compared to nurses. These barriers may be overcome with improvements to training that focus on upskilling nurses to deliver the catch-up service. Service delivery challenges are multifactorial, requiring a range of strategies to optimise this service and increase immunisation coverage in migrant children.

Impact of the COVID-19 pandemic on routine surveillance for adults with chronic hepatitis B virus (HBV) infection in the UK

Background: To determine the impact of the COVID-19 pandemic on the population with chronic Hepatitis B virus (HBV) infection under hospital follow-up in the UK, we quantified the coverage and frequency of measurements of biomarkers used for routine surveillance (alanine transferase [ALT] and HBV viral load). Methods: We used anonymized electronic health record data from the National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC) pipeline representing five UK National Health Service (NHS) Trusts. Results: We report significant reductions in surveillance of both biomarkers during the pandemic compared to pre-COVID-19 years, both in terms of the proportion of patients who had ≥1 measurement annually, and the mean number of measurements per patient. Conclusions: These results demonstrate the real-time utility of HIC data in monitoring health-care provision, and support interventions to provide catch-up services to minimise the impact of the pandemic. Further investigation is required to determine whether these disruptions will be associated with increased rates of adverse chronic HBV outcomes.

Understanding COVID-19 impact on cervical, breast, and colorectal cancer screening among federally qualified healthcare centers participating in “Back on track with screening” quality improvement projects

The COVID-19 pandemic has contributed to decreases in breast, colorectal, and cervical cancer screenings between 86 and 94% compared to three-year averages. These postponed screenings have created backlogs that systems will need to address as healthcare facilities re-open for preventive care. The American Cancer Society is leading a 17-month intervention with 22 federally qualified health centers (FQHCs) across the United States aimed at reducing cancer incidence and mortality disparities and alleviating additional strain caused by COVID-19. This study describes COVID-related cancer screening service disruptions reported by participating FQHCs. Selected FQHCs experienced service disruptions and/or preventive care cancellations due to COVID-19 that varied in severity and duration. Fifty-nine percent stopped cancer screenings completely. Centers transitioned to telehealth visits or rescheduled for the future, but the impact of these strategies may be limited by continued pandemic-related disruptions and the inability to do most screenings at home; colon cancer screening being the exception. Most centers have resumed in-person screening, but limited in person appointments and high levels of community transmission may reduce FQHC abilities to provide catch-up services. FQHCs provide critical cancer prevention services to vulnerable populations. The delivery of culturally competent, high-quality healthcare can mitigate and potentially reverse racial and ethnic disparities in cancer prevention testing and treatment. Ensuring and expanding access to care as we move out of the pandemic will be critical to preventing excess cancer incidence and mortality in vulnerable populations.

Impact of COVID-19 on cervical cancer screening: Challenges and opportunities to improving resilience and reduce disparities

The COVID-19 pandemic has a major impact on a wide range of health outcomes. Disruptions of elective health services related to cervical screening, management of abnormal screening test results, and treatment of precancers, may lead to increases in cervical cancer incidence and exacerbate existing health disparities. Modeling studies suggest that a short delay of cervical screening in subjects with previously negative HPV results has minor effects on cancer outcomes, while delay of management and treatment can lead to larger increases in cervical cancer. Several approaches can mitigate the effects of disruption of cervical screening and management. HPV-based screening has higher accuracy compared to cytology, and a negative HPV result provides longer reassurance against cervical cancer; further, HPV testing can be conducted from self-collected specimens. Self-collection expands the reach of screening to underserved populations who currently do not participate in screening. Self-collection and can also provide alternative screening approaches during the pandemic because testing can be supported by telehealth and specimens collected in the home, substantially reducing patient-provider contact and risk of COVID-19 exposure, and also expanding the reach of catch-up services to address backlogs of screening tests that accumulated during the pandemic. Risk-based management allows prioritizing management of patients at highest risk of cervical cancer while extending screening intervals for those at lowest risk. The pandemic provides important lessons for how to make cervical screening more resilient to disruptions and how to reduce cervical cancer disparities that may be exacerbated due to disruptions of health services.

From catch-up TV to online TV: digital broadcasting and the case of BBC iPlayer

This article examines the ways in which the on-demand service BBC iPlayer became a site for navigating what it means to be a public service broadcaster in a hybrid TV-digital world. Focusing on a key period of transition for the BBC - bracketed by the publication of the BBC’s strategy document Delivering Quality First (2011) and the anticipation of charter review in 2016 - we consider how BBC iPlayer helped mobilize a set of managerial discourses that informed thinking about the BBC’s online proposition in an age of public service media. Specifically, we argue that a new version of iPlayer, launched in 2014, can be understood as a staging point in the BBC’s attempt to understand and rationalise its role as a digital broadcaster. Reconceived from a catch-up service to an entertainment destination, we examine how the ‘new iPlayer’ catalysed thinking about the meaning of online television - from the internal implications for online commissioning practice and content curation to the broader managerial vision of ‘reinventing public service broadcasting through data’. Informed by critical media industry studies, the article draws on practitioner interviews with senior BBC managers and industry documents to consider the ‘discourses, dispositions and tactics’ that coalesced around BBC iPlayer in a moment when the Corporation was striving to recalibrate its identity, digital content offer, and sense of relevance in a period where distinctions between broadcasting and online were becoming, and remain, increasingly blurred.

Who is working on it? Captioning Australian catch-up television and subscription video on demand

Despite the rapid evolution in the way in which we watch television – through digitalisation and the introduction of video on demand (VOD) and catch-up services – the inaccessibility of television content remains an issue, specifically for people who are Deaf or hard of hearing. This article revisits the claim from 2014 that VOD providers were ‘working on’ providing closed captions. Building on Ellis’ 2014 research, the accessibility of television in Australia in 2016 is analysed using a cross study of current subscription VOD services and catch-up television providers. The research reveals that while some companies have accessibility policies and offer closed captioned content, there have been minimal changes in the provision of captioning, both within the industry and in legislation.

SCORE: Exploiting Global Broadcasts to Create Offline Personal Channels for On-Demand Access

The last 5 years have seen a dramatic shift in media distribution. For decades, TV and radio were solely provisioned using push-based broadcast technologies, forcing people to adhere to fixed schedules. The introduction of catch-up services, however, has now augmented such delivery with online pull-based alternatives. Typically, these allow users to fetch content for a limited period after initial broadcast, allowing users flexibility in accessing content. Whereas previous work has investigated both of these technologies, this paper explores and contrasts them, focusing on the network consequences of moving towards this multifaceted delivery model. Using traces from nearly 6 million users of BBC iPlayer, one of the largest catch-up TV services, we study this shift from push- to pull-based access. We propose a novel technique for unifying both push- and pull-based delivery: the Speculative Content Offloading and Recording Engine (SCORE). SCORE operates as a set-top box, which interacts with both broadcast push and online pull services. Whenever users wish to access media, it automatically switches between these distribution mechanisms in an attempt to optimize energy efficiency and network resource utilization. SCORE also can predict user viewing patterns, automatically recording certain shows from the broadcast interface. Evaluations using our BBC iPlayer traces show that, based on parameter settings, an oracle with complete knowledge of user consumption can save nearly 77% of the energy, and over 90% of the peak bandwidth, of pure IP streaming. Optimizing for energy consumption, SCORE can recover nearly half of both traffic and energy savings.

Television's Transition to the Internet: Disability Accessibility and Broadband-Based TV in Australia

Whereas entertainment has featured negatively in the broader NBN debate currently occurring in Australia, within the disability sector it has been recognised as revolutionary. Government, industry and technical analysts describe digital television, particularly that delivered via broadband, as potentially enabling to people with vision and hearing impairments through the more widespread provision of accessibility features such as audio description and closed captions. This article interrogates the approach to accessibility taken by two case studies of broadband-based television: Netflix and catch-up TV. Netflix, which is not officially available in Australia, is often presented as the future of television, while catch-up services provide an example of the current broadband-based television paradigm in this country. Although accessibility features may be available on broadcast television or DVD release, each of these forms of broadband-based television has either previously (Netflix) or currently (catch-up) stripped accessible functions to stream online. The discussion reflects on both activist interventions of people with disability and the industry standards.