Health Care Programs Research Articles

Co-designing a social robot for child health care

Social robots provide new opportunities to support general child healthcare programs. However, it is still unclear how social robots could be used in this context and how corresponding behaviours should be designed. To ensure satisfying implementations of such new technological solutions, it is essential to include the end-users in the designing process. We have conducted a co-design study at two primary schools based on three complementary, creative methods: Draw-write-and-tell and/or story-writing-and-telling, Theatre play, and Robot avatar programming. A total of 46 children aged 7–12 years old participated in four robot co-design workshops. The drawings, stories and theatre plays were analysed, resulting in evaluations of 10 scenarios as well as 21 new scenarios and 7 main user requirements for social robots providing mental support in general child healthcare. Evaluation of the activities highlight their stimulation of out-of-the-box thinking and the development of creative solutions (i.e. drawings/stories/theatre plays resulted in robot designs, scenarios and requirements), while children’s reflections show them being enjoyable for participation. The inputs gathered during these co-design workshops will greatly influence future work on the design and application of social robots in the child healthcare domain.

이주민의 건강권 증진을 위한 지역보건의료사업: 미국 캘리포니아와 LA 사례를 중심으로

이주민의 건강권 증진을 위한 지역보건의료사업: 미국 캘리포니아와 LA 사례를 중심으로

Effect of empowerment program on the quality of life of the elderly cancer patients’ caregiver: A quasi-experimental study

Cancer patients and their family face challenges in their quality of life (QoL). Families have an important role in health care programs for their patients. This study evaluates the family-centered trainings on the QoL of the family caregivers of elderly cancer patients. This quasi-experimental study was conducted in 30 caregivers of elderly cancer patients who randomly divided into control and experiment groups (n=15 per group). Data was collected using a demographic and the Caregiver Quality of Life Index-Cancer (CQOLC) scale. The intervention was carried out as an individual education in two one-hour sessions. Six weeks after the intervention, the quality of life (QoL) was remeasured in the groups. ANCOVA and Bonferroni tests showed a statistically significant difference in the mean score of the QOL between the experiment (60.53±15.99) and the control groups (68.07±18.49) in the post-test (P <0.001). The family-centered intervention is beneficial in enhancing the QoL of caregivers of the elderly cancer patients. Consequently, providing educational programs can be an effective method and essential for improving the clients’ QoL.

Health profiling of elderly in Gujarat: evidences from longitudinal ageing study in India

Background: Considering the burden of different health related disorders amongst the elderly, the present study aims to examine the health profile and the factors associated with various health issues among the elderly in Gujarat. Methods: The current study has used the Longitudinal Ageing Study in India (LASI) Wave-1 data. The chi-square test and logistic regression model have been used to establish the association between the study variables and factors associated with the chronic diseases among elderly in Gujarat. Results: The prevalence of chronic diseases among elderly in Gujarat is 51.3 percent. Hypertension was the highest prevalent disease suffered by nearly one-fourth (24.3%) of the elderly people covered under the study followed by prevalence of chronic bone/joint diseases (15.7%) and diabetes (12.4%). The present study showed that the risk of occurrence of chronic diseases increases along with the age. Consumption of alcohol increases the risk of chronic morbidities. On the other hand, education, work status and physical activity play significant role in reducing the prevalence of chronic diseases. Conclusions: The study highlights the prevalence of different health related disorders amongst the elderly in Gujarat. In addition to this, the study tries to identify the critical factors associated with health issues of elderly. The findings from the study can also help in strengthening the scope of National level preventive and health care programme for the elderly population in Gujarat.

Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants – a scoping review

BackgroundThe significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals’ lifeworlds and need to be considered in implant care and in the course of technical developments.MethodsThis scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data.ResultsSixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability.ConclusionsEmpirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in “lived experiences” may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design.

A systematic review of real-world applications of genome sequencing for newborn screening

Aim: With the costs of genomic sequencing falling quickly and an ever-increasing number of clinical laboratories equipped with new-generation sequencing machines, healthcare systems around the world are getting ready to enter the era of genomic newborn screening (NBS). However, the adoption of Genomic Sequencing (GS), encompassing whole-exome sequencing (WES) and whole-genome sequencing (WGS), in NBS programs raises a number of clinical, ethical, and legal questions as well as organizational and economic challenges. This systematic review is part of a feasibility study to assess the introduction of WGS for NBS in Lombardy region with the specific aim of gathering evidence from existing pilots in the field whose results have been published. Methods: Three different sources were identified for the selection of articles in order to obtain a various and unbiased set of publications. 33 articles were retained for analysis to answer the following questions: 1. Clinical: Does genomic sequencing demonstrate clinical utility in the context of NBS? What are the limitations of these kind of programs? 2. Societal: What are the social, ethical and psychological implications of using GS for NBS? 3. Governance: What are the legal, economic, and organizational challenges for GS-based NBS programs? Results: There is a general consensus in the literature on the key principles that should guide the adoption of GS in NBS, such as the inclusion of actionable genes only, the need for informed consent from the parents, the right of the newborn to an open future, which means the exclusion of late-onset diseases even when those are considered treatable. However, there are still several differences in how these principles are detailed and applied. Conclusion: Real-world evidence from a handful of pilot projects (namely BabySeq and NC-Nexus, both carried out in the USA) have been published recently; however, this evidence is not yet sufficient to put an end to the broad and animated debate on the use of GS for NBS. Ethical, legal, and social issues still constitute great challenges and major barriers to wide and uniform adoption of GS in NBS. On the clinical side, a number of issues remain unaddressed, such as the benefits and limitations of the different approaches (targeted sequencing, GS only versus GS+standard NBS), the genes/diseases to include and the frequency of incidental findings, identification of carrier status, and variants of uncertain significance (VUS). Further pilots and consultations with involved stakeholders will be necessary before GS-based NBS can be accepted and systematically implemented in national healthcare programs.

Nurses' Perceptions on How Recovery-Oriented Mental Health Care Can Be Developed and Implemented.

This study explored how nurses working in inpatient mental health units perceived the development and implementation of a recovery-oriented mental healthcare programme (ROMHCP). The recovery-oriented mental healthcare approach (ROMHCA) in mental health is regarded as the future of mental health services and has been implemented in different countries worldwide. However, regarding developing and implementing the recovery approach, Africa appears to have been left behind by the rest of the continents. The study used a qualitative approach to describe how a recovery-oriented mental healthcare approach could be developed. Thirty nurses who worked in Botswana's four inpatient mental health facilities consented and voluntarily participated in the study. Data were collected from February to mid-March 2022 through online focus group discussions and analysed using thematic analysis. The COREQ checklist was used to report the findings. Two main themes emerged as follows: (i) developing and implementing a recovery-oriented mental healthcare programme is possible and (ii) certain elements are required to develop and implement ROMHCP. The participants believed that people diagnosed with mental illness could recover from the illness and suggested how it could be achieved. They also contended that the programme's success would lie mainly with multisectoral support from policymakers, facilities, hospital personnel, patients, and the community. Clinical Relevance. ROMHCP has the potential to benefit people with mental illness in the country. In addition, it would allow nurses to improve their knowledge and skills in managing mental illnesses. Patient or Public Contribution. The patients and the general public did not contribute to the study's concept, design, and outcomes. However, the nurses working in mental health facilities volunteered to participate in the study.

Does following an “excellent” candidate in the objective structured clinical examination affect your checklist score?

PurposeThe OSCE is regarded as the gold standard of competence assessment in many healthcare programs, however, there are numerous internal and external sources of variation contributing to checklist marks. There is concern amongst organisers that candidates may be unfairly disadvantaged if they follow an “excellent” preceding candidate. This study assessed if average checklist scores differed depending on who a candidate follows accounted for different sources of variation.Design/methodology/approachThis study examined assessment data from final year MBChB OSCEs at the University of Aberdeen and categorised candidates into three levels dependent on examiner awarded global scores of preceding candidates for each station. Data were modelled using a linear mixed model incorporating fixed and random effects.FindingsA total of 349 candidates sat the OSCEs. The predicted mean (95% CI) score for students following an “excellent” candidate was 21.6 (20.6, 22.6), followed “others” was 21.5 (20.5, 22.4) and followed an “unsatisfactory” student was 22.2 (21.1, 23.3). When accounted for individual, examiner and station levels variabilities, students following an “excellent” candidate did not have different mean scores compared to those who followed “other” (p = 0.829) or “unsatisfactory” candidates (p = 0.162), however, students who followed an “unsatisfactory” student scored slightly higher on average compared to those who followed “other” (p = 0.038).Originality/valueThere was weak evidence that candidate's checklist variations could be attributed to who they followed, particularly those following unsatisfactory students; the difference in predicted mean scores may be of little practical relevance. Further studies with multiple centres may be warranted assuring perceived fairness of the OSCE to candidates and educators.

Picture This: Evaluating Healthcare Education Using Student Generated Pictorial Data

Objective: Healthcare student expectation and experience of professional training is likely to impact retention on their chosen programme. Understanding the experience of healthcare students is essential to support programme completion and ensure a future workforce with sufficient staff. The objectives of this study were to: (1) investigate the similarities and differences between undergraduate nursing and radiotherapy students’ expectations and experiences of the first year of their programme through pictorial data, and (2) develop a process of interpreting pictorial data for student evaluation. Methods: With written consent, students participating in nursing (n=31) and radiotherapy (n=22) completed a pictorial data collection tool on commencement and completion of year one. Data were analyzed using an adapted thematic content analysis. Independent data analysis, use of an audit trail and a reflective approach ensured a rigorous process. Results: Three themes were identified: professional identity, expectation of workload, and confidence. The students in both cohorts indicated an expectation that they would complete their studies, demonstrating a growing understanding of their profession over the first year of their studies, alongside a high workload. Nursing students indicated pride associated with being a nurse that was evident at the start and end of their first year of training. They experienced fatigue and lacked time to spend in activities other than studying and sleeping. Radiotherapy students indicated a better work-life balance. Conclusion: Informed by the findings, recommendations for healthcare programmes are made. Pictorial data were found to be quick, accessible, and inexpensive to collect and analyse. Impact of the visual data was powerful, giving novel insights into student expectation and experience. Pictorial data may provide a valuable complement to traditional methods of evaluation in healthcare education.

Implementation of an embedded behavioral health care model in a pediatric rheumatology subspecialty juvenile myositis clinic.

Youth with chronic medical illness, such as juvenile myositis (JM), require specialized behavioral health care. However, access to such care is challenging due to the youth mental health crisis, which impacts accessibility of mental health services in the community, as well as challenges accessing behavioral health care above and beyond the demands of care related to their JM management. In this paper we describe an embedded behavioral health care model, including the establishment and implementation of such a model, at a pediatric hospital where youth with JM receive medical care in a Center of Excellence (CoE). We describe a unique partnership with a philanthropic organization; the challenges and benefits of delivering care within this model; as well as recommendations for maximizing its effectiveness. Ultimately, we provide an example of a successful embedded behavioral health care program for youth with rare disease, which may be applied to other institutions providing similar care.

Translation, Cross-Cultural Adaptation, and Psychometric Evaluation of the Third Version of the Atlanta Heart Failure Knowledge Test.

Background and Purpose: This study is aimed at translating the third version of the Atlanta Heart Failure Knowledge Test (AHFKTv3) into the Persian language and evaluating its psychometric properties. Methods: In this methodological study, the AHFKTv3 was translated into Persian and its face, content, construct validity, and reliability were assessed. Results: The content validity of AHFKTv3 items was >0.78 and the validity of the instrument was 0.96. The standardized factor loading value of all items, except for item 16, was >0.3. The scores of the AHFKTv3 and European Heart Failure Self-Care Behavior Scale had a significant correlation with each other (p < .001). The AHFKTv3 score had a significant relationship with the educational level. The Kuder-Richardson Formula 20 coefficient was 0.908. Conclusion: The Persian AHFKTv3 is a valid and reliable instrument for assessing HF-related knowledge; therefore, it can be used in nursing practice to identify and address the deficits aiming for better patient care and in research to evaluate treatment and healthcare programs.

Trauma systems in Canada: striving for quality across an expansive landmass

Abstract Although Canada has a universal health care program that provides free in-hospital services to all citizens, its vast landmass and nonstandardized prehospital and posthospital systems make delivering quality trauma care challenging, particularly to resource-limited rural regions. This article summarizes the strengths of the prehospital system, facility-based care, trauma network, trauma registry, rehabilitation, and governance/financing/quality assurance components of Canada’s trauma system. Future directions, including the use of telemedicine, standardization of practices, and resource optimization, are also explored. Canada’s trauma system is well developed, yet geography impedes equitable access. More standardization and resource optimization are needed.

Current status of outpatient heart failure management in Egypt and recommendations for the future.

Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt. We conducted a literature search on PubMed on the requirements and essential infrastructure of HFCs. Retrieved articles deemed relevant were discussed by a panel of 10 expert cardiologists from Egypt and a basic HFC model for the Egyptian settings was proposed. A multidisciplinary team managing the HFC should essentially be composed of specialized HF cardiologists and nurses, clinical pharmacists, registered nutritionists, physiotherapists, and psychologists. Other clinical specialists should be included according to patients' needs and size and structure of individual clinics. HFCs should receive patients referred from primary care settings, emergency care units, and physicians from different specialties. A basic HFC should have the following fundamental investigations available: resting electrocardiogram, basic transthoracic echocardiogram, and testing for N-terminal pro-B-type natriuretic peptide. Fundamental patients' functional assessments are assessing the New York Heart Association functional classification and quality of life and conducting the 6min walking test. guideline-directed medical therapy should be implemented, and device therapy should be utilized when available. In the first visit, once HF is diagnosed and co-morbidities assessed, guideline-directed medical therapy should be started immediately. Comprehensive patient education sessions should be delivered by HF nurses or clinical pharmacists. The follow-up visit should be scheduled during the initial visit rather than over the phone, and time from the initial visit to the first follow-up visit should be determined based on the patient's health status and needs. Home and virtual visits are only recommended in limited and emergency situations. In this paper, we provide a practical and detailed review on the essential components of HFCs and propose a preliminary model of HFCs as part of a comprehensive HF programme model in Egypt. We believe that other low-to-middle income countries could also benefit from our proposed model.

Knowledge, Attitude, and Practices of Parents toward (Infant &amp; Child) Oral Health in Family Medicine Center at PSMMC, Riyadh

Background: Early childhood caries may develop as soon as teeth erupt. Promoting oral health care programs is very important and helps to reduce dental caries in young children. The aim of this study was to assess the infant/child oral health (IOH) related knowledge, attitudes, and practices (KAP) of parents in Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional descriptive study was conducted among 327 parents. Visiting the family medicine center at prince sultan military medical city, Riyadh Saudi Arabia. A 39-item questionnaire covering socio-demographic characteristics and questions pertaining to KAP regarding OH care will be used to collect the data. Descriptive statistics, Student’s t-test, one-way analysis of variance, and Scheffe’s test will use for the statistical analysis (p ≤ 0.05). Results: The result showed that the majority of the parents had good knowledge regarding OH, knowledge of cleaning (92.4.%), and knowledge of the amount of sugar (88.1.%). the parent’s age group (30 to 39) years (n =147) reported the highest mean (knowledge, attitudes, and practice) scores among all other age groups with a knowledge mean score of (6.80 ± 1.73), an attitude mean score of (8.86 ± 1.37), and a practice mean score of (5.14 ± 1.86). Female parents showed significantly higher mean knowledge, attitude, and practice scores than male parents. In addition, the middle-income level parents’ group (n = 295) reported higher knowledge mean score compared to the low-income parents’ group (n = 15) with a mean difference of d = 1.15, p = .041. Conclusion: Parents’ knowledge about maintaining oral and dental health care for infants/children was inadequate. Essentially, medical professionals are the initial ones to interact with expecting and new moms. Therefore, need to raise parents’ awareness about oral and dental health for infants/children, through the development and implementation of long-term education and promotions programs.

Development and evaluation of a problem-based learning simulation module for home-visit nursing.

Although home-visit healthcare programs in Korea are expected to expand, providing hands-on experience to nursing students may be limited. This study aimed to develop and evaluate a problem-based learning (PBL) simulation module that reflects home-visit healthcare services provided by public health centers for pre-frail older adults. The simulation module, including PBL as prebriefing, was developed by the researchers and revised based on expert reviews. The module was evaluated using a mixed-method embedded one-group post-test-only design with focus group interviews (FGIs). Quantitative data (n=29) were collected between April and June, 2021. FGIs (n=10) were conducted twice in June 2021, and qualitative data were analyzed using an inductive content analysis approach. The average score of the Simulation Design Scale was 4.67±0.36. The overall mean score of the Educational Practices Questionnaire was 4.75±0.37. Three themes emerged from the FGIs: immersive learning experience, changes in perspective on nursing, and enhanced nursing competency. This PBL-based simulation module was evaluated as a systematic learning process in which nursing students could become self-directed learners, interacting and collaborating with colleagues, instructors, and environments. The module encourages them to practice home visit services.

Contradictions hindering the provision of mental healthcare and psychosocial services to women experiencing homelessness in Addis Ababa, Ethiopia: service providers’ and programme coordinators’ experiences and perspectives

BackgroundMental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women’s mental health and psychosocial needs. Therefore, we explored service providers’ and programme coordinators’ perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city.MethodsWe conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach.ResultsFour themes were derived from the analysis. The first of these was “divergent intentions and actions”. While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed “problem-solution incompatibility”, which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation’s complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, “the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges”. The fourth theme, “mismatched resources,” indicated structural and systemic barriers to providing services to homeless women.ConclusionsConflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.

ALFP Debate: Online Certificates and Digital Badges Will Positively Disrupt Pharmacy Education

ObjectiveOnline certificates and digital badges are increasingly being explored as a strategy to transform higher education. The primary objective was to describe the potential positive and negative effects of online certificates and digital badges on pharmacy education. MethodsThe Academic Leadership Fellows Program (ALFP) contributes to the development of leaders in the Academy. ALFP Fellows participate in a debate on current topics in academic pharmacy. For this topic, authors searched CINAHL, Embase, ERIC, Ovid MEDLINE, and Scopus to identify publications (in English) about microcredentials, online certificates, and digital badges related to their use in healthcare education programs. Randomized controlled trials, controlled trials, observational studies, systematic reviews, and meta-analyses that focused on learning in higher education were included. All abstracts were reviewed independently by two authors for inclusion, and discrepancies were discussed to reach consensus. Each study was then summarized to identify themes related to the primary objective. ResultsThe literature search identified 681 unique articles (healthcare education n=607; education review articles n=74), of which 77 were included in full-text review. Potential benefits to pharmacy education from digital badges and online certificates included increasing admissions and enrollment, improving student-centered learning, and improving preparation for jobs after graduation through competency-based education. However, studies demonstrating these benefits are limited; administrative and technological issues persist; incentives to replace the current pharmacy education system are unspecified; and regulatory barriers to change remain. ConclusionsOnline certificates and digital badges are flexible tools with the potential to advance pharmacy education. However, questions about the unmet need they address, their value to stakeholder groups, including students, and their lack of standardization are limiting factors that impede their adoption.

Critical Clinical Evaluation of COVID-19 Patients with Tuberculosis in the Indian Sub-Continent.

COVID-19 and tuberculosis (TB) are infectious diseases that predominantly affect the respiratory system with common symptoms, such as cough, fever, and shortness of breath, making them dual burdens. This review will discuss the characteristics of the coexistence of TB and new infectious illnesses to provide a framework for addressing the current epidemic. Currently, there are no clear and significant data on COVID-19 infection in TB patients, they may not respond appropriately to drug therapy and may have worse treatment outcomes, especially if their TB treatment is interrupted. Due to emergence, measurements should be taken to minimize TB and COVID-19 transmission in communal settings and health care institutions were created. For both TB and COVID-19, accurate diagnostic testing and well-designed, and established therapeutic strategies are required for effective treatment. Several health care organizations and networks have specimen transit methods that can be utilized to diagnose and monitor the etiology and progression of COVID 19 and perform contact tracing in developed and underdeveloped nations. Furthermore, patients and health care programs could benefit from increased use of digital health technology, which could improve communication, counseling, treatment, and information management, along with other capabilities to improve health care. Patients with COVID-19 pulmonary/respiratory problems may seek treatment from respiratory physicians, pulmonologists, TB experts, and even primary health care workers. To have prophylactic and therapeutic strategies against COVID-19, TB patients should take the appropriate health care measures recommended by health care professionals/government officials and maintain their TB therapy as indicated.

Problems with accessing healthcare and associated factors among reproductive-aged women in the Gambia using Gambia Demographic and Health Survey 2019/2020: a cross-sectional study

ObjectivesTo assess problems with accessing healthcare and its associated factors among reproductived-age women in the Gambia using the Gambia Demographic and Health Survey 2019/2020.DesignA community-based cross-sectional study.SettingThis study was based...

Ryan White HIV/AIDS Part B and AIDS Drug Assistance Programs during COVID-19: safety net public health programs' challenges and innovations.

We characterized the challenges and innovations of states' Ryan White HIV/AIDS Program (RWHAP) Part B programs, including AIDS Drug Assistance Programs (ADAPs), during the COVID-19 pandemic. In the United States, these are important safety net programs for HIV healthcare, providing essential medical and support services, and medications, to people with HIV with low incomes who are uninsured/underinsured. Data were collected via the 2021-2022 NASTAD National RWHAP Part B and ADAP Monitoring Project Report, a cross-sectional survey of state, district, and territorial programs through a mixed method study design. For quantitative data, we used descriptive statistics. Qualitative responses were coded and analyzed using content analysis. Forty-seven RWHAP Part B and ADAPs responded (92% response rate). The majority of respondents reported that maintaining client eligibility (78%) and working remotely (70%) were the most challenging aspects of the pandemic, particularly in regards to implementing new telehealth and e-certification platforms. In response to COVID-19, programs introduced enrollment "grace periods" (19%), bolstered client outreach (11%), allowed more than a 30 day supply of medications (79%), and supported medication home delivery for clients (80%). Despite the challenges of the COVID-19 pandemic, RWHAP Part B and ADAPs implemented several operational innovations in order to continue providing essential medicines and services. Other public health programs may adopt similar innovations, including digital innovations, for greater public health benefit. Future studies should assess the retention of policy innovations over time, their impact on the individual client level satisfaction or health outcomes, and what factors may improve the acceptability of telehealth and e-certification platforms.