Interdisciplinary Response Research Articles

Shaping health and well-being in a COVID era: the role of design

PurposeIn this study, an interdisciplinary research team at a Midwest US University collaborated with a local county to co-envision interior design strategies for five county buildings: three libraries and two government buildings to reduce in-person contact in response to the COVID-19 pandemic.Design/methodology/approachThe authors' interdisciplinary team used a community-based participatory design process which focused on creating consensus, while seeking out divergent perspectives among stakeholders to serve the needs of diverse users. The design process involved meetings with stakeholders remotely and analyzing survey results from the target occupants collected by the county.FindingsThe county with a population of 550,321 is the second most populous and diverse county in the state. The authors' collaborative efforts resulted in short-and long-term recommendations for the interior space planning to promote health, safety, and well-being for the county's diverse user groups of young children, adults, elderly and vulnerable populations. The short-term recommendations focus on service redesigns that can be implemented as the state shifts out of the stay-at-home order and the community returns to the county's public-facing buildings. The long-term recommendations focus on experiences and design strategies that can be carried forward to future-proof buildings in a post-COVID era and provide models for other counties.Research limitations/implicationsOne limitation is the dynamic nature of how rapidly our team responded to a critical need in the community to develop tangible interior design solutions during the initial stages of the COVID-19 pandemic for the county. The solutions we proposed were based on the scientific evidence available earlier on during that phase of the pandemic. The authors hope to conduct further studies in the future and conduct assessments of our rapid design responses.Practical implicationsThis paper documents a dynamic experience during a once in a lifetime pandemic and thus contributes to further the body of knowledge about the role of interior design in shaping health and well-being during the COVID-19 pandemic.Originality/valueThe article presents a timely interdisciplinary response to the COVID-19 pandemic to promote community safety inside public buildings at the county. The interior design solutions reflected intensive literature reviews, critical space planning, innovative use of lighting, and thoughtful furniture/material selections.

VAMOS-VaxNOW: A nurse-led interdisciplinary disaster response to address vaccine equity in central Texas during the COVID-19 pandemic

VAMOS-VaxNOW: A nurse-led interdisciplinary disaster response to address vaccine equity in central Texas during the COVID-19 pandemic

Pharmacists as members of an interdisciplinary pulmonary embolism response team.

Pulmonary embolism response teams (PERTs) were developed to assist with diagnosis, risk stratification, and management of intermediate and high-risk pulmonary embolism (PE) and have been shown to reduce 90-day mortality. The pharmacist's role on the PERT is not well defined. Describe the pharmacist's role as a PERT member and determine if pharmacists can improve time to anticoagulation and promote use of low molecular weight heparin (LMWH) instead of unfractionated heparin (UFH). A retrospective, observational study of adult patients with massive or submassive PE between January 2014 and May 2020. Patient demographics, clinical variables, anticoagulation treatment/timing, and pharmacist activities during PERT response were evaluated. Patients were divided into three groups for comparisons (pre-PERT vs post-PERT with a pharmacist vs post-PERT without a pharmacist). Wilcoxon rank-sum or Kruskal-Wallis test and chi-squared analysis were used for continuous and categorical data, respectively. A total of 573 patients were included (mean age 63.2 ± 15.6 years, 54% male, 78% submassive PE); 137 in the pre-PERT and 436 in the post-PERT groups. Within the post-PERT group, 305 patients (70%) had a pharmacist as a member of the PERT, of which 222 (73%) had a documented pharmacotherapy-related intervention/activity. Most (n = 178, 58%) involved a pharmacist facilitating ordering/administration of an anticoagulant/thrombolytic. Median time from diagnosis to anticoagulation was significantly reduced in the post-PERT groups (pre-PERT: 104 minutes [IQR 124.5], post-PERT with a pharmacist: 63 minutes [IQR 84], post-PERT without a pharmacist: 75.5 minutes [IQR 113], P = .0001). More patients in the post-PERT groups received LMWH compared to UFH when a pharmacist was involved vs without a pharmacist (69.5% vs 53.3%, P = .0019) and major bleeding events were reduced (pre-PERT: 14.6%, post-PERT with a pharmacist: 4.6%, and post-PERT without a pharmacist: 9.9%, P = .0013). Pharmacists have an active role on the PERT and their involvement was associated with a shorter diagnosis to anticoagulation time, increased LMWH use, and fewer major bleeding events.

Preliminary findings in a platform‐based MCI trial designed to promote adaptive behaviors

AbstractBackgroundReceiving a diagnosis of mild cognitive impairment (MCI) may lead to experiences of emotional turmoil stemming from a perceived lack of clarity around diagnosis and prognosis. Previous research has identified several maladaptive behaviors resulting from the diagnosis of MCI that may be targeted for intervention in order to help those with a new diagnosis of MCI best adapt behaviors to maintain functional abilities.MethodA platform‐based MCI trial cohort of individuals, newly diagnosed with MCI from a U.S. Alzheimer’s Disease Research Center, was used to pilot a multicomponent interdisciplinary intervention targeting adaptive behavioral responses to the diagnosis of MCI. Thematic analysis was employed with fifteen focus groups across three study groups of 14 participants. After engaging with each of the platform‐based MCI trial components, participants’ and their study partner’s perceptions of each intervention’s acceptability, satisfaction, and compliance across the multicomponent interdisciplinary intervention were assessed.ResultsThemes that emerged from the data included a preference towards education, learning new information, and skill development. Both persons with MCI and study partners favored intervention components that were novel to them. They also reported higher satisfaction with activities facilitated by a professional (e.g., social worker, physical therapist, or pharmacist) as opposed to intervention activities that were self‐directed. Participants with MCI and their study partners reported those with impairment’s challenges utilizing technology independently, requiring assistance in setting up online medical portals, using wearable exercise trackers and automated pillboxes that represented technology‐dependent components of the intervention.ConclusionThese data suggest that persons, newly diagnosed with MCI, are interested in adaptive, biopsychosocial interventions for persons with MCI. Acceptability, satisfaction, and compliance may be increased when individuals are engaging in learning novel information and skills that are led and supported by professionals. Assistance with and or training in the use of technology‐based interventions may be needed to maximize the impact of such approaches. Further studies exploring the impact on the cognitive and functional decline that may be mediated by adaptive behavioral interventions in persons newly diagnosed with MCI are warranted.

Next Generation of AMR Network

Antimicrobial resistance (AMR) is one of the top 10 global public health threats facing humanity, especially in low-resource settings, and requires an interdisciplinary response across academia, government, countries, and societies. If unchecked, AMR will hamper progress towards reaching the United Nations Sustainable Development Goals (SDGs), including ending poverty and hunger, promoting healthy lives and well-being, and achieving sustained economic growth. There are many global initiatives to curb the effects of AMR, but significant gaps remain. New ways of thinking and operating in the context of the SDGs are essential to making progress. In this entry, we define the next generation of the AMR research network, its composition, and strategic activities that can help mitigate the threats due to AMR at the local, regional, and global levels. This is supported by a review of recent literature and bibliometric and network analyses to examine the current and future state of AMR research networks for global health and sustainable development.

Interdisciplinary Bridging Response Teams in the COVID-19 outbreak aid provision in China

This essay provides a brief introduction of a social-worker-led interdisciplinary work model and its operating process which is inspired by the well-known Holistic Model of Spirituality. The Interdisciplinary Bridging Response Team(IBRTs) model was applied to communities, centralized isolation sites, and shelter hospitals in Wuhan. A survey of 316 clients after 53 days of service revealed that the mental and physical health of most clients improved. Moreover, compared to the early days of the pandemic, most clients’ social relationships were strengthened. Nevertheless, the World Health Organization Quality of Life (WHOQOL)-BREF scores show that this service was more effective for uninfected rather than infected people.

Confidence in Mental Health Professionals and Other Interdisciplinary Involvement in Disaster Response

Increased utilization of coordinated disaster response in the United States has resulted in the integration of interdisciplinary professions, which must involve mental health professionals to maximize potential success. The lack of interdisciplinary training has been cited as problematic. An anonymous survey identifying current training and scaling effectiveness was distributed. Seventy-two responses were recorded from various industries including fire rescue, law enforcement, emergency management, mental health professionals, physicians, and health professional students. As expected, very high percentages of these professionals had received response training. However, the average response often included “neutral” within the standard deviation of responses assessing training efficacy suggesting a possible lack of comfort and confidence. Most significantly, respondents were least comfortable working with mental health professionals, suggesting a need for considerable improvement in mental health professionals' involvement in interdisciplinary disaster response training and exercises.

Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study.

Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the population’s interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPs’ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participants’ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels.

Impacts of the COVID-19 Pandemic on Preexisting Racial and Ethnic Disparities, and Results of an Integrated Safety Net Response in Arlington County, Virginia.

This paper presents research conducted by the Arlington County Department of Human Services to understand the use of safety net services during the pandemic, identify disparities, and reduce or eliminate them. Arlington County's levels of health and economic wellbeing are generally high; however, residents of color experience significant disparities compared with White residents, with lower median incomes, lower rates of college completion, lower life expectancies, and higher rates of chronic illness. During the COVID-19 pandemic, these disparities were amplified as Black and Latinx residents experienced disproportionately high rates of COVID-19 infection, hospitalization, and death, as well as disproportionately high rates of job loss. During the COVID-19 pandemic, Arlington County mounted an interdisciplinary response to stabilize community needs, including food security, eviction prevention, isolation housing, behavioral health stabilization, and digital equity. This integrated approach was especially important during the pandemic, as the direct and indirect effects of the pandemic disproportionately impacted health and economic wellbeing among Arlington's Black and Latinx residents, low-income residents, and vulnerable communities.

Getting Interdisciplinary Teams into the Field: Institutional Review Board Preapproval and Multi-Institution Authorization Agreements for Rapid Response Disaster Research.

This article describes an interdisciplinary community resilience research project and presents a case study that supports bringing researchers together before a disaster to develop plans, procedures, and preapproved Institutional Review Board (IRB) protocols. In addition, this article explains how researchers from various academic institutions and their federal agency partners can effectively collaborate by creating an IRB Authorization Agreement (IAA). Such preparations can support interdisciplinary rapid response disaster fieldwork that is timely, ethically informed, and scientifically rigorous. This fieldwork preplanning process can also advance interdisciplinary team formation and data collection efforts over the long term.

Covid 2019 and suicide - a global pandemic: How to prevent?

IntroductionThe mental health effects of Coronavirus2019(COVID-19) outbreak might be profound, including higher suicide rates.This phenomena is likely to become a more pressing concern as the pandemic spreads.While remarkable social distancing interventions have been implemented to reduce the rate of new infections,the potential for adverse outcomes on suicide risk is high, especially among vulnerable populations.ObjectivesThe aim is to do a review of the literature of suicide prevention during the COVID-19 outbreak.MethodsNon-systematic review of the literature with selection of scientific articles published in the last 7 months; by searching the Pubmed databases, the following MeSH terms were used: Suicide prevention; COVID-19ResultsIn order to prevent suicide, urgent consideration must be extend beyond general mental health approaches. A wide-ranging interdisciplinary response that recognises how the pandemic might heighten risk is needed. The application of knowledge about effective suicide prevention is the key. Mental health services should develop clear remote assessment and care pathways, and staff training to support new ways of dealing with. Publications on mental health and psychological effects of COVID-19 outbreak provide important information and recommendations for all three levels of suicide prevention: primary, secondary, and tertiary.ConclusionsThe challenge of the COVID-19 outbreak might bring with it an opportunity to advance the field of suicide prevention and, thus, to save lives, which also represent a public health priority. The mental health community, backed by active vigilance and international collaboration, should be prepared and can use this challenging period to advance suicide prevention.

How to assess technological developments in basic research?

In an era of ever faster and more momentous technological development, both technology assessment and transdisciplinary interventions are in danger of structurally lagging behind the speed of innovation. This paper proposes a new tiered approach to technology assessment at low Technology Readiness Levels that enables a both rapid and concerted interdisciplinary science response to this Great Acceleration. Covering sustainability, ethics, and consumer issues, this approach encourages and enables the innovators themselves to conduct assessments embedded in the innovation process as early as possible. Suitable tools for early engagement that help facilitate development-integrated assessments are introduced and described. The design and use of these instruments in the field of basic research is illustrated using the Cluster of Excellence livMatS as an example.

COVID-19 into Chemical Science Perspective: Chemical Preventive Measures and Drug Development.

COVID‐19 facts and literature are discussed into chemical science intuition highlighting the direct role of chemistry to the ongoing global pandemic by covering structural identification of the virus, chemical preventive measures and development of drugs. We reviewed the four most promising repurposed drugs which are presently being investigated in mass clinical trials on COVID‐19 infected persons and synthetic routes of these drugs with their recent advancement. Chemical preventive measures such as soap water, hand sanitizer and disinfectant are the only available options in the arsenal to fight against COVID‐19, till an effective medicine or vaccine will be made available. As such the present review will focus on the mode of action of the major chemical preventives.

73061 The UAB COVID-19 Collaborative Outcomes Research Enterprise (CORE): Developing a Learning Health System in Response to the Global Pandemic

ABSTRACT IMPACT: Interdisciplinary networks represent critical components of translational science and learning system development. Our work impacts translational research by presenting an evidence-based approach to developing interdisciplinary networks in response to the COVID-19 pandemic; the approach presented may have broad applications within other academic institutions and medical centers. OBJECTIVES/GOALS: As a local response to the COVID-19 pandemic, we established the University of Alabama at Birmingham COVID-19 Collaborative Outcomes Research Enterprise (CORE) as an interdisciplinary learning health system (LHS) to achieve an integrated health services and outcomes research response amid the pandemic. METHODS/STUDY POPULATION: We adapted a learning system framework, based upon a scoping review of the literature and the Knowledge to Action Framework for implementation science. Leveraging this framework, we developed an institutional-level collaborative network of extant expertise and resources to rapidly develop an interdisciplinary response to COVID-19. The network was designed to quickly collect newly published or clinical information related to COVID-19, to evaluate potential usefulness of this information, and to disseminate the new knowledge throughout the interdisciplinary network; we strove to engage a wide variety of expertise and skills in the network. Thus, we subsequently used social network analysis to examine the emergence of informal work patterns and diversified network capabilities based on the LHS framework. RESULTS/ANTICIPATED RESULTS: We identified three principal characteristics of institutional LHS development including: 1.) identifying network components; 2.) building the institutional collaborative network; and 3.) diversifying network capabilities. Seven critical components of LHS were identified including: 1.) collaborative and executive leadership, 2.) research coordinating committee, 3.) oversight and ethics committee, 4.) thematic scientific working groups, 5.) programmatic working groups, 6.) informatics capabilities, and 7.) patient advisory groups. Evolving from the topical interests of the initial CORE participants, three scientific working groups (health disparities, neurocognition, and critical care) were developed to support the learning network. DISCUSSION/SIGNIFICANCE OF FINDINGS: Interdisciplinary collaborative networks are critical to the development of LHS. The COVID-19 CORE LHS framework served as a foundational resource that may support further institutional-level efforts to develop responsive learning networks. The LHS approach presented may have broad applications within other academic institutions and centers.

Transferring Inter-disciplinary Flood Reconstruction Responses from Japan to the Netherlands

Japan and the Netherlands have very different physical, historical and cultural contexts but they share a vulnerability to extreme flood related events and have, in both their (relatively) recent pasts, had to recover from such events: the floods of 1953 in the Netherlands or the tsunami that hit Japan’s east coast in 2011. This paper describes the process and results of two workshops investigating flood reconstruction responses undertaken by students representing five disciplines at TU Delft in the Netherlands. A particular workshop method was employed to promote an interdisciplinary design process and then design responses investigated for the Japanese case were transferred to a hypothetical disaster scenario for Vlissingen, in the south of the Netherlands. The conclusions reached focused as much on the efficacy of the workshop method as the particular design proposals for both cases, as well as on what was learnt via the comparison between Japanese and Dutch contexts and reconstruction philosophies. Keywords: interdisciplinary design; international comparison; tsunami; Vlissingen; Yuriage

Simultaneous Circulation of DENV, CHIKV, ZIKV and SARS-CoV-2 in Brazil: an Inconvenient Truth

The emergence of SARS-CoV-2 has prompted the mobilization of a network of public health laboratories to diagnose COVID-19 patients, trace contacts and identify hot-spot areas for active community transmission at the expense of arbovirus diagnosis and control practices. In this article, we discuss the unprecedented challenges faced by the Brazilian public health system in dealing with the incursion of SARS-CoV-2 in the midst of ongoing triple arboviral epidemics caused by dengue, chikungunya, and Zika virus. Finally, we highlight the importance of the introduction of one health approach as an effective inter-disciplinary response and management to mitigate the catastrophic effect caused by these pathogens.

Barriers Preventing Access by Men who have Sex with Men to HIV-related health services in Southeast Asia: A Scoping Review

ABSTRACT The objective of this scoping review was to identify and describe barriers experienced by men who have sex with men (MSM) when accessing HIV-related health care in Southeast Asia. A systematic search identified thirteen papers, which were full text reviewed and data extracted. An intersection of stigma and discrimination, fear and shame, cultural norms and societal expectations coalesce to influence the ability, either physically through lack of service provision or emotionally through personal restraint, of MSM to access HIV-related health services. Many of the factors continuing to drive the ongoing HIV epidemic across the Southeast Asia region have humanitarian origin – access to safe and non-discriminatory healthcare, education on sexual health, and not being persecuted for having a health condition. These must be addressed with an interdisciplinary response at local, government and regional level.

Interdisciplinary bridging response teams for field hospitals in Wuhan during the COVID-19 pandemic

In this essay, we provide an overview of a social worker-led, interdisciplinary practice model designed to combine essential online psycho-social support and local community self-governance for COVID-19 patients with minor symptoms in quarantine field hospitals in the city of Wuhan from February to May 2020. The interdisciplinary bridging response teams (IBRTs) model was designed for congregating settings to bridge offline community mobilization and online interdisciplinary professional services. We discuss the two-tier structure and organization of the practice model, the professionals’ roles and main tasks, and the key features that ensured the success of the model.

Optimizing Interdisciplinary Care of Pediatric Sexual Assault and Abuse in the Emergency Department: A Quality Improvement Approach

The Ann & Robert H. Lurie Children's Hospital of Chicago identified issues with team communication, consistency of services provided, and continuity of care within the sexual abuse and assault program in the emergency department (ED) which necessitated improvement efforts. The aim of this project was to engage an interdisciplinary team to define and delineate roles and streamline clinical workflows from ED presentation to nonacute follow-up. An interdisciplinary team was convened and utilized quality improvement methodology to complete a current state analysis, develop a future state design, and prioritize interventions for improvement. The project team focused on four interventions: (1) establish a team approach with delineated roles and responsibilities; (2) develop and implement consistent workflows to reduce unwarranted variation in care; (3) expand education on the sexual assault nurse examiner (SANE) program more broadly to the care teams in the ED; and (4) implement clinical decision support (CDS) tools to streamline the continuum of sexual assault services provided. Three of the interventions (all but education) were carried out as a comprehensive care guideline for patients presenting to the ED for evaluation. The ED implemented this care guideline in August 2019. The utilization of quality improvement methodology was effective in ensuring an organized, interdisciplinary team response for the evaluation of pediatric and adolescent sexual abuse and assault in the ED. It enabled strong buy-in from team members and ownership of the process with anticipated improvements in patient care and experiences.

Predictors of Family Engagement in Child Post-Traumatic Stress Disorder Screening Following Exposure to Intimate Partner Violence.

Children's exposure to intimate partner violence (IPV) has numerous negative short- and long-term impacts on children's development, mental health, physical health, and adult functioning. While community-based organizations have an array of interventions aimed to increase survivor safety and prevent the development of, or treat post-traumatic stress disorder (PTSD), many families experiencing IPV never enter the doors of community-based organizations. To address this gap, there is an increasing number of partnerships between community-based organizations and first responders to increase support to families experiencing IPV. The Child Trauma Response Team (CTRT) is an innovative model that provides a coordinated, immediate, trauma-informed, and interdisciplinary response to families exposed to IPV. Given the lack of research on coordinated community interventions, the research questions for this study were as follows: (a) What are the family sociodemographic factors, crime factors, and program services most associated with family engagement in child PTSD screening following exposure to IPV? (b) What are the family sociodemographic factors and crime factors most associated with children screening positive for PTSD following exposure to IPV? The data for this study consist of 244 families with 352 children identified by the pilot CTRT. The results of this study suggest that a collaborative intervention designed to address caregiver and children's safety and well-being after a police-reported IPV incident is a promising model. Overall, more than 70% of children identified by the CTRT team completed a child PTSD screen, and 74.3% of children who completed the screens were screened positive for PTSD. The safety assessment service provided by the CTRT team was a predictor of the families' engagement in child PTSD screens. This is a critical finding and suggests the importance of developing program models that comprehensively address the needs of caregivers and children exposed to IPV.