Time Of Pandemic Research Articles

Psychometric evaluation of a COVID-19 health literacy scale applying Rasch analysis

Abstract Background Assessing health literacy in times of the COVID-19 pandemic is vital, since health literacy has been highlighted as a personal resource for managing health information. The HLS-Covid-Q22 questionnaire was developed to measure self-reported COVID-19 health literacy in adults. It has been used and validated, mainly using confirmatory factor analysis, in some studies with different target groups. However, several comprehensive validation studies are needed to ensure the feasibility of a novel measurement tool. In the current study, Rasch analysis has been chosen, as this analysis transforms the categorical responses of the items of the HLS-Covid-Q22 into linear measures. Methods The psychometric properties of the HLS-Covid-Q22 were evaluated in a sample of 2187 German adults applying Rasch analysis. The data is from the German COVID-HL school survey that was generated by employing an online survey in school principals during the third infection wave from March to April 2021 in four federal states. Applying the Partial Credit Model for polytomous data, the responses to the HLS-Covid-Q22 items were transformed into linear measures, unidimensionality was tested and several indices to assess the quality of the measurement tool were computed. Results Unidimensionality of the questionnaire could be confirmed. The rating scale steps worked as intended. Participants used every rating category. Item fit could be verified. High reliability indices were found with a person separation index of 3.41, person reliability of .92, item separation of 20.08 as well as item reliability of 1.0. Conclusions The HLS-Covid-Q22 appeared to be a reliable and valid questionnaire which has not been validated by applying Rasch analysis before. Even though Rasch analysis is already a well-established validation method in other disciplines, it should be used to evaluate other health literacy questionnaires more often to gain comprehensive insights into the intended functioning of measurement tools. Key messages • The HLS-Covid-Q22 questionnaire appears to be a valid and reliable measurement tool. • Rasch analysis is an appropriate method to evaluate the psychometric properties of likert-type rating-scale questionnaires.

Prevalence of Sick Building Syndrome Symptoms in Residents During the COVID-19 Pandemic—A Case Study of Suzhou City, China

Quarantine policies during the coronavirus disease 2019 (COVID-19) pandemic prolonged time spent at home, leading to an unintended occurrence of sick building syndrome (SBS) symptoms. The aim of this study was to investigate the prevalence of SBS symptoms among residents in Suzhou, China, during the COVID-19 pandemic. A questionnaire survey was conducted online from February to May 2022. A total of 442 adults were included in this study. The prevalence of SBS symptoms was much higher during the COVID-19 pandemic, and the proportions of general, mucosal, and skin symptoms were 59.3%, 45.5% and 49.1%, respectively. The influences of building characteristics, occupant lifestyle, indoor environment and perception of indoor environment were analysed using a multivariate logistic regression model. Neighbourhood pollutant sources, older residences, non-ownership and humidity indicators were significant risk factors for SBS symptoms. Frequent use of air fresheners was significantly associated with general (adjusted odds ratio (AOR): 4.9, 95% confidence interval (CI: 2.4–10.0), mucosal (AOR: 5.3, 95% CI: 2.4–11.5), and skin symptoms (AOR: 4.6, 95% CI: 1.6–13.1), while the use of disinfectants was significantly correlated with skin symptoms (AOR: 4.0, 95% CI: 1.5–10.7). Residents’ perception of an uncomfortable indoor environment was a significant predictor of general (AOR: 2.2, 95% CI: 1.2–4.0) and mucosal symptoms (AOR: 3.1, 95% CI: 1.6–6.0). The use of air cleaners can reduce the prevalence of general symptoms. An important finding of this study is that the psychological impact of staying at home for a long time was associated with general symptoms (AOR: 1.3, 95% CI: 1.1–1.7), which means that attention should also be paid to the mental health of residents during the COVID-19 pandemic. Although the quarantine period has now ended, our results can still serve as a reference for the impact of the indoor environment on the health of people with SBS, especially for those who stay at home for a long time, such as the elderly.

Long-term effects of changes in coparenting quality during the COVID-19 pandemic.

This study examines changes in coparenting quality during the initial stage of the COVID-19 pandemic on long-term parent, child, and family well-being. Although there is clear evidence that the COVID-19 pandemic negatively impacted families, less is known about family resilience factors that could mitigate this impact. Understanding whether positive coparenting quality is a protective factor during crises is important for promoting parent, child, and family well-being. The study collected data from 150 parents who participated in a transition-to-parenthood intervention trial 10 years prior. Hierarchical linear modeling was used to examine the association between changes in coparenting quality from before the pandemic (Time 1) to the early stage of the pandemic (Time 2) with parent, child, and family adjustment 19 months later (Time 3). Moderation effects were also explored. Over half of parents reported a decline in coparenting relationship quality between Time 1 and Time 2 while about one third reported an improvement. A more positive change in coparenting was associated with better parent and family adjustment at Time 3. Moderation analyses showed that positive changes in coparenting were associated with fewer internalizing symptoms for female children and, for families with younger children, increased positive and decreased negative parenting behaviors. These findings support the idea that positive coparenting can serve as a resilience factor during times of crisis. Practitioners working with families in crisis should consider incorporating coparenting interventions and strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of self-restraint by COVID-19 pandemic on mental health in college students-COVID-19 Longitudinal survey of the 2nd and 3rd waves

[Purpose] The purpose of this study was to investigate the effects of the COVID-19 pandemic on mental health in students at university. [Method] 1880 students from university were surveyed. Survey period: July-August 2020 Demographic factors were used department, grade, gender, age. Mental health factors (PHQ-9 Japanese version, GAD-7 Japanese version, IES-R) were used. Decreased motivation to learn, loneliness: Japanese version UCLA loneliness scale was used. [Results] As a result of the survey, in (July-August), 737 patients (123 males and 614 females) were recovered (recovery rate 40.9%). As a result, in terms of gender difference, males had a higher total of "loneliness" than females and had a higher total of PTSD and "invasive symptoms". Students whose parents corresponded to corona had high "anxiety" and "depression". Students who felt rumors had high scores for "PTSD," "depression," "anxiety," and "loneliness." Students "seeking support" also scored higher on PTSD, depression, anxiety, and loneliness. Those who were "not very careful" about infection control were more likely to be depressed than those who were "careful", and those who were "quite careful" were less motivated to learn. Family structure and parental profession have no effect. In addition, the relationship between each psychiatric symptom (PTSD, depression, anxiety disorder) and "loneliness" and "motivation to learn" was examined using covariance structure analysis. When the model was examined, the models of "loneliness" ⇒ "decreased learning motivation" ⇒ "PTSD" ⇒ "depression" and "anxiety" were verified. In other words, it was shown that it is important to deal with "loneliness" to improve mental health and learning motivation during the COVID 19 pandemic. [Conclusion] At the time of the COVID-19 pandemic, college students may be high-risk persons with mental health problems.

Leveraging Digital Health Data to Transform the United Nations Systems for Palestine Refugees for the Post Pandemic Time

ABSTRACT The COVID-19 pandemic presented a grave threat to the continuity of health services that UNRWA provides to 5.9 million Palestine Refugees in the Near East. UNRWA runs 140 primary health care clinics, providing approximately nine million medical consultations a year. During the pandemic, UNRWA’s e-Health system (and other digital health tools) were crucial in maintaining health services. The e-Health system enabled the identification of at-risk patients and transformed UNRWA’s services for sustainability and efficiency. Innovations like telemedicine and two smartphone applications (e-NCD and e-MCH) enhanced service delivery and staff management. To evaluate the effectiveness of digital health integration in UNRWA’s services during and after the pandemic, the team analyzed reports, events, and e-Health data from 2019–2022. Results show that digital tools, like e-NCD and e-MCH applications, helped reduce COVID-19 among Palestine Refugees, enabling remote care and continuous access to essential health services. Digital health has now become essential in UNRWA’s post-pandemic operations. This paper offers a paradigm for future outbreak responses. By harnessing the power of digital health, UNRWA’s e-Health system served as a beacon of hope, demonstrating how innovative approaches can empower patients, enhance health care outcomes, and ensure equitable access to health care services during crisis situations and beyond.

Dilemmas of Care (Re) Allocation: Care and Consumption in Pandemic Times

Dilemmas of Care (Re) Allocation: Care and Consumption in Pandemic Times

Texting in the Fourth Trimester: mHealth for Postpartum Care.

Objective Rising maternal morbidity and mortality in the US is a complex problem and is often tied to the postpartum period. Postpartum visits are poorly attended leading to gaps in contraception, mental healthcare, and care for chronic conditions. mHealth, healthcare supported by mobile technologies, has been shown to improve antenatal care adherence. Our study aims to determine whether an mHealth intervention of interactive, educational text messages can improve care for women postpartum. Study Design We conducted a randomized-control trial of 191 women receiving OB/GYN care in our clinic from November 2019-April 2020. Patients were randomized postpartum to receive either routine care or routine care with mHealth text messages and appointment reminders specific to delivery type. The primary endpoint was attendance to the six-week postpartum visit with secondary endpoints of breastfeeding, contraception use, emergency visits, and postpartum depression scores (EPDS). A subgroup analysis was additionally conducted to assess the impact of some visits shifting to telehealth due to the timing of the COVID-19 pandemic. Results Patient demographics were similar between the two groups. There was no significant difference in postpartum appointment attendance between text message (n=57, 59%) and control groups (n=62, 66%, p=0.31). 117 patients were scheduled for in-person postpartum visits, and 74 for telehealth visits during the COVID-19 pandemic, with no significant difference in attendance rate between groups for either visit modality. Conclusion Automated text messages alone did not increase our primary outcome of adherence to postpartum care, even when visits were conducted by telehealth. While mHealth has proven successful in other care areas, such as antepartum follow-up, further research is needed to determine whether it is an effective method to improve adherence to postpartum care, or whether other strategies must be developed, including augmentation with human navigators.

Financial impact of pandemics on pension sustainability: an application for Spain

AbstractEpidemiologists are warning that the next pandemic is almost around the corner. As we have seen during the COVID-19 pandemic, the death toll was at the highest for over 60th, transforming the population pyramids. In times of pandemics, two effects on sustainability of the pay-as-you-go (PAYG) pension scheme go in different directions: the increase in old-age mortality (leading to a decrease in pension spending) and the increase in unemployment (leading to a decline in income from contributions). In this paper, we investigate the long-term effects of pandemics on the financial sustainability of PAYG pension schemes, taking into account changes in both mortality and unemployment factors. Using functional data analysis we develop projections of population pyramids and allow for anticipated mortality jumps as a result of future pandemics. An application is carried out using mortality and fertility data from Spain. Given some plausible assumptions, our findings indicate, firstly, that the financial sustainability of the Spanish pension system is compromised. Secondly, in the event of a pandemic, we observe that financial sustainability is primarily driven by the mortality effect—resulting in a decrease in pension expenditure—while the impact of unemployment is almost negligible.

Doing decoloniality in the context of a PhD born in precarity and pandemic

This article takes a deep dive into my doctoral journey and my lived experience as an emerging Black African scholar doing decolonial research in a South African colonial and Westernized university. I wrestle with the contradictions and tensions that emerged during this period that took place at the time of the Covid-19 pandemic. I also look back with ‘willful resistance’ to the oppressive systems of knowledge productions and the limitations of doing decolonial work. I consider my own complicity with these oppressive systems of knowledge production as I attempt to work within institutional constraints to fulfil the requirements of a PhD degree. Using Black existential theory as a lens and autoethnography as method, the goal is to generate a discussion with other emerging scholars about their own lived experiences doing decolonial research in colonial universities.

Resurrecting Song: A Pathway Forward for the Choral Art in the Time of Pandemics, Wendy K. Moy (New York: Routledge, 2024)

Resurrecting Song: A Pathway Forward for the Choral Art in the Time of Pandemics, Wendy K. Moy (New York: Routledge, 2024)

Tweeting to be a constitution-writer in Chile: Social media activity, public discourse, and electoral outcomes during pandemic times

We examine the impact of social media activity and content on the electoral performance of 1,373 candidates who ran in the 2021 Constitutional election in Chile. In line with the two-step flow of communication hypothesis, estimates from binary and fractional response probit models reveal that candidates with an active Twitter/X account and higher user engagement metrics (i.e., retweets and likes per tweet) are more likely to be elected and secure a larger share of votes. Regarding the content disseminated on social media, the effect of emphasized subjects on electoral outcomes is topic-dependent. Specifically, candidates who focus their posts on sociopolitical issues improve their electoral performance, while tweeting about economics tends to reduce the likelihood of being elected as a constitution-writer in Chile. This could be attributed to the 2021 Constitutional election being part of an institutional response to a series of events, including widespread protests across the country and a strong public demand for profound changes to the Chilean status quo.

Rapid Response to Professional Development: How Online Teacher Professional Learning Networks Supported Teachers in Pandemic Times

During COVID-19, when teachers rapidly shifted to remote teaching and learning, it became evident that there was an educational crisis—teachers were unprepared for teaching using digital pedagogies. A group of teachers and teacher educators in Trinidad and Tobago, ITTPN Global, responded to the call for emergency professional development in ICT tools with a free workshop series via Zoom. The workshop series served to address teachers’ upskilling in key areas of ICT as digital pedagogy became the pandemic pedagogy. Pandemic pedagogy refers to teaching and learning during COVID-19. Teachers built confidence and competence in using ICT tools and designing online lessons. The professional learning model highlighted in this paper utilized authentic and active learning and teacher agency. This reflective essay examines the transformative possibilities of networks in a crisis with implications for professional teacher learning post pandemic.

Conducting Physician Engagement Research in a Pandemic: Persevering when Burnout Mitigation Is Needed Most.

Background: We planned a pilot study on a physician engagement intervention, termed ECHO-MDA, using the Project ECHO framework. The study was approved and launched just as the COVID pandemic reached Texas. We pivoted to accommodate the realities of research in pandemic times. Objectives: The primary outcome was feasibility assessed by the proportion of participants attending at least 9 out of 13 ECHO-MDA sessions. Design: The study was envisioned as a randomized, wait-list pilot study exploring the impact ECHO-MDA with a planned enrollment of 50 physicians (25 per arm). Results: Due to pandemic-related challenges, 35 physicians were enrolled. Ten attended nine or more sessions. Participants indicated that the program was beneficial. Conclusion: Pandemic-related work and personal conditions likely had adverse impacts on enrollment and attendance. Launching professional wellness programs during a global crisis is challenging but can still yield benefits for participants. We offer suggestions for researchers launching professional engagement studies in unexpectedly challenging times.

Rethinking the “Conspiracy Crisis”: Use and Misuse of “Conspiracy Theory” Labels After Covid‐19

Against the backdrop of the Covid-19 pandemic, this article undertakes a critical evaluation of a series of shortcomings of the view of conspiracy theories that is predominant among scholars and the general public. Reviewing numerous studies on the topic, we critically assess: (a) how justified the claim is that we are in a conspiracy-thinking emergency, (b) how the label of conspiracy theorist can be weaponized to delegitimize heterodox views, and (c) the practical consequences, for academic research and the well-functioning of democracies, of unpopular ideas being labeled as conspiratorial. The empirical sources reviewed here suggest that beliefs in conspiracy theories have not increased over time and are less consequential than commonly believed, even in times of a global pandemic. Instead, the concept of conspiracy theory has become more prevalent and its derogatory connotation evokes a stigma that tilts the democratic playing field against dissenting viewpoints. The stigmatization and political leveraging of this notion, we argue, lead to biases not only in the public discussion on various sensitive topics but also in the academic literature on conspiracy theories themselves. We analyze these academic blind spots in light of the diminishing political diversity in academia and recent perspectives on scientific censorship. We propose to complement the research on conspiracy theorists with an analysis of individuals at the opposite end of the spectrum, who are inclined to systematically trust institutional authorities and are highly prejudiced against heterodox opinions. Proposed solutions include promoting balanced news coverage, fostering critical thinking through debates, and piercing information bubbles to provide access to diverse perspectives.

Peranan Aisyiyah Cabang Sebangau di Lahan Gambut Kota Palangka Raya dalam Ketahanan Pangan

Aisyiyah is an Islamic women's movement organization formed by Muhammadiyah, this organization since its inception until now, even more, and more various efforts have been made, including in the fields of religion, education, social and economics, which have benefited the Indonesian people in general and Muslims in particular. One of the 'Aisyiyah movements in the social field is the establishment of Posbakum Aisyiyah in collaboration with the Indonesian Ministry of Law and Human Rights, from the Central Leadership of 'Aisyiyah to the regions. The existence of 'Aisyiyah reached the Regional Leader of 'Aisyiyah Central Kalimantan, at the time of the current Covid-19 Pandemic, the role of women has become more increased in domestic roles as well as in fulfilling the economic needs of the family at this time. This study aims to describe the role and form of the role of 'Aisyiyah Kalampangan Branch in Peatlands to Women in increasing family food security. This research was conducted at 'Aisyiyah Kalampangan Branch, Palangka Raya City, Jalan Mahir Mahar Trans Kalimantan Palangka Raya using observation methods (field and participation), interviews (in-depth interviews, taking notes, recording, listening, observing, and capturing using a camera) and literature studies. Data analysis used a simple tabulation to describe the conditions and characteristics of the research site. The processed data is displayed in a table. The targeted finding in this research is the obtaining of a role description by 'Aisyiyah Kalampangan Branch in Peatlands of Palangka Raya City.

Praxis of compliance: feminist solidarity for women tech workers in India during Covid-19

ABSTRACT Feminist activism persisted even in the isolating times of the COVID-19 pandemic. But how did the crisis shape feminist solidarity, especially for subjects facing multiple marginalities? In this article, based on in-depth interviews and participant observation, I examine how women tech workers in India – as gendered labour in the Global South – participated in various online groups to overcome their isolation. These women ostensibly acted as compliant neoliberal and heteronormative subjects, but their compliance paved the way for feminist solidarity. I theorize this paradox as the ‘praxis of compliance.’ As a theoretical framework, ‘praxis of compliance’ foregrounds the structural barriers to women workers’ participation in collective feminist activism. It also reveals some alternative strategies of building feminist solidarity within the constraints of the neoliberal economy as well as local and global crises that deepen inequality. I identify three potential areas of praxis of compliance for women tech workers in India: professional, personal and labour activism.

Parenting strategies to support adolescent mental health during a pandemic: A Delphi consensus study

BackgroundThe COVID-19 pandemic has had ongoing detrimental effects on mental health, especially for young people. Parents can play a crucial role in the prevention of youth depression and anxiety disorders. While parenting guidelines for reducing the risk of adolescent depression and anxiety have been developed, they needed to be adapted for the unique challenges brought by a pandemic. MethodThis study employed the Delphi methodology to establish expert consensus on parenting strategies that are important for preventing adolescent depression or anxiety disorders during a pandemic. Through a literature search and panel recommendations, we identified 304 parenting recommendations. These were presented to an international panel of 35 experts in parenting and youth mental health, who rated the importance of these recommendations in preventing adolescent depression and anxiety over three survey rounds. ResultsThere were 167 parenting strategies endorsed as important or essential in reducing adolescents' risk of developing depression or anxiety disorders during a pandemic by ≥90% of the panel. These strategies were written into a set of specific and actionable guidelines for parenting through the pandemic, and made freely available online for parents. ConclusionsThis study adapted an original set of parenting guidelines for the COVID-19 pandemic, supported by research evidence and/or international experts, which can be promoted in Western English-speaking communities to help parents protect their adolescents from depression and anxiety disorders during pandemic and post-pandemic times.

Lessons from Covid-19 and the potential benefit of the implementation of Axon’s personal electronic health records (PEHR) into aesthetic care, plastic and reconstructive surgery

BackgroundCovid-19 pandemic highlighted the need for implementing Personal Electronic Health Records (PEHR) for patients’ data management. Furthermore, this pandemic underscored the relevance for integrated and interoperable Electronic Health Records (EHR) to support disease surveillance, hospital capacity planning and resource management (Peek N, Sujan M, Scott P (2020) Digital health and care in pandemic times: impact of COVID-19. BMJ Health Care Inf 27(1):e100166. https://doi.org/10.1136/bmjhci-2020-100166). Due to the lack of comprehensive patients’ record in plastic, reconstructive and aesthetic surgery, Axon’s myHealth app offers a break-through patient-centric design allowing patients to be in control of their records and updating them in real-time for their plastic and aesthetic care providers to have a clearer understanding of patients’ history and progress from pre-op to post-op.MethodsThe Axon Dublin survey took place during Covid-19 pandemic in two phases: Phase 1 aimed to assess the feasibility of patients integrating the Axon myHealth application into their clinical visits. Testing occurred in a clinical environment, where patients were encouraged to download and use the Axon system with a health practitioner (HP) present. Phase 2 focused on home testing, evaluating patients’ willingness to manage their health remotely with HP assistance. This phase included self-testing activities such as performing rapid Covid-19 antigen tests, recording medical history, and measuring blood pressure at home.ResultsThe Axon Dublin Study aimed to assess patient engagement, clinical impact, and cost-effectiveness of the Axon myHealth application. Over 85% of patients showed interest in owning a Personal Electronic Health Record. Notably, 36% continuously monitored chronic conditions. Clinical decisions, informed by patient data, saw 61.9% compliance. Noteworthy, 23% of hypertensive participants required immediate medication changes. Patient self-capture of data reduced consultation time. Public health implications were significant, with 39% vaccinated and 31% reporting complications. High user satisfaction (97%) demonstrated the app’s effectiveness in infection control and chronic care.ConclusionsOffering patients the ability to update and control their data is a growing interest, with a clear need in plastic and aesthetic surgery to have a better understanding of a patient’s medical past and progress throughout the surgical process and period. This platform, which is time and cost efficient, can only facilitate personalised care and improve outcomes while maintaining patient’s confidentiality.Level of evidenceNot gradable.

Burnout Professional Fulfilment and Sleep Quality in Indian Healthcare Workers in Times of the Covid-19 Pandemic

Aim and Background: With more than 210 nations affected, the SARS-COV-2 became the most widespread worldwide pandemic. As of 14 April 2022, over 500 million cases were confirmed globally Given these numbers, it was hardly surprising that the Covid-19 epidemic significantly strained healthcare systems worldwide. This study aimed to evaluate the degree of Burnout, Professional fulfilment, and Sleep quality across various groups of healthcare professionals working during the Covid-19 pandemic and looked for any correlation between these three variables. Methods: This study employed a cross-sectional observational research design and gathered data from respondents across various regions of India through an anonymous online or paper-based questionnaire tailored to the preferences of each participating Healthcare Worker (HCW). The assessment of professional fulfilment was conducted by employing the Stanford Professional Fulfillment Index and the sleep quality of healthcare workers was determined via the use of the Pittsburgh Sleep Quality Index. The variables were analyzed using statistical tools; Chi-square test, Fisher’s Exact test,Kruskal-Wallis One Way Analysis of Variance and Spearman’s rank correlation Results: Burnout was notably higher among the HCWs with poorer Sleep quality and lower in HCWs with higher Professional Fulfilment. Correlations further revealed that Burnout scores positively correlated with Work exhaustion and Interpersonal Disengagement Conclusion: This illustrates that HCWs with poorer sleep quality and lesser professional fulfilment experienced greater burnout at work during the COVID-19 pandemic Clinical significance: These insights guide healthcare providers and policy markers to optimize the well being of Healthcare Workers and foster informed preparedness in case of future pandemics. Keywords: COVID-19, PSQI, HCW, SPFI, Burnout, Professional Fulfilment, Sleep Quality.

Attendance in a Neonatal Follow-Up Program before and in the Time of COVID-19 Pandemic: A Mixed Prospective-Retrospective Observational Study.

Attendance to neonatal follow-up programs presents a significant factor associated with positive long-term outcomes of high-risk infants. Strategies to maximize participation benefit not only future interventions' effectiveness but also healthcare systems and society. While a number of studies have focused on attrition or loss to follow-up, no studies have focused on the contributive risk factors to abstaining from neonatal follow-up programs specifically during the COVID-19 pandemic. This study aims to reveal the main factors linked to non-compliance in a neonatal follow-up program of a tertiary hospital. In this ambidirectional observational study, data from 1137 high-risk neonates who participated in a hospital follow-up program were collected (573 before and 564 after the COVID-19 pandemic). The study sample was grouped to three groups: G1 (N = 831), who maintained participation in the program; G2 (N = 196), who discontinued; and G3 (N = 110), who never visited the outpatient clinics. Data were obtained from the hospital's Systems Applications and Products (SAP) Software and a structured questionnaire, answered by parents of newborns either discontinuing (G2) or not attending (G3) the follow-up program through a telephone contact. The most frequently reported reason for discontinuance before the pandemic onset was the parents' perception of no necessity to maintain participation (44.12%). During the COVID-19 pandemic, provider-related barriers to maintaining hospital access, inability to provide high-quality services (37.14%), and feelings of fear and insecurity (18.5%) emerged as factors for non-attendance. Citizenship and morbidity (respiratory distress syndrome, sepsis, necrotic enterocolitis, jaundice) acted as incentives to join the follow-up program during both study periods. Multiple regression analysis showed that multiple-gestation infants had higher odds of maintaining participation during the COVID-19 period (OR, 4.04; CI, 1.09-14.9). Understanding the potential impact of COVID-19 and the transformative changes in neonatal follow-up clinics is crucial for applying compliance strategies. Removing barriers to maintain family participation can lead to increased attendance rates.