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Barriers to healthcare access: findings from a co-produced Long Covid case-finding study

Barriers to healthcare access: findings from a co-produced Long Covid case-finding study
Barriers to healthcare access: findings from a co-produced Long Covid case-finding study
Background and aim: Long Covid can be a stigmatising condition, particularly in people who are disadvantaged within society. This may prevent them seeking help and could lead to widening health inequalities. This co-produced study with a Community Advisory Board of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid.

Methods: an active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care, and the stigma faced by participants and analysed thematically. This study forms part of the STIMULATE-ICP Collaboration.

Findings: twenty-three interviews were completed. Participants reported limited awareness of what Long Covid is and the available pathways to management. There was considerable self-doubt among participants, sometimes reinforced by interactions with healthcare professionals. Participants questioned their deservedness of seeking healthcare support for their symptoms. Hesitancy to engage with healthcare services was motivated by fear of needing more investigation and concerns regarding judgement about ability to carry out caregiving responsibilities. It was also motivated by the complexity of the clinical presentation and fear of all symptoms being attributed to poor mental health. Participants also reported trying to avoid overburdening the health system. These difficulties were compounded by experiences of stigma and discrimination. The emerging themes reaffirmed a framework of epistemic injustice in relation to Long Covid, where creating, interpreting, and conveying knowledge has varied credibility based on the teller’s identity characteristics and/or the level of their interpretive resources.

Conclusion: we have developed recommendations based on the findings. These include early signposting to services, dedicating protected time to listen to people with Long Covid, providing a holistic approach in care pathways, and working to mitigate stigma. Regardless of the diagnosis, people experiencing new symptoms must be encouraged to seek timely medical help. Clear public health messaging is needed among communities already disadvantaged by epistemic injustice to raise awareness of Long Covid, and to share stories that encourage seeking care and to illustrate the adverse effects of stigma.

Patient or public contribution: this study was co-produced with a Community Advisory Board (CAB) made up of twenty-three members including healthcare professionals, people with lived experience of Long Covid and other stakeholders.
Clutterbuck, Donna
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Ramasawmy, Mel
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Pantelic, Marija
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Hayer, Jasmine
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Begum, Fauzia
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Faghy, Mark
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Nasir, Nayab
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Causer, Barry
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Heightman, Melissa
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Allsopp, Gail
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Wootton, Dan
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Khan, M. Asad
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Hastie, Claire
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Jackson, Monique
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Rayner, Clare
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Brown, Darren
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Parrett, Emily
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Jones, Geraint
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Clarke, Rowan
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Mcfarland, Sammie
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Gabbay, Mark
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Banerjee, Amitava
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Alwan, Nisreen A.
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STIMULATE-ICP Consortium
Clutterbuck, Donna
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Ramasawmy, Mel
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Pantelic, Marija
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Hayer, Jasmine
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Begum, Fauzia
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Faghy, Mark
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Nasir, Nayab
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Causer, Barry
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Heightman, Melissa
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Allsopp, Gail
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Wootton, Dan
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Khan, M. Asad
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Hastie, Claire
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Jackson, Monique
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Rayner, Clare
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Brown, Darren
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Parrett, Emily
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Jones, Geraint
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Clarke, Rowan
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Mcfarland, Sammie
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Gabbay, Mark
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Banerjee, Amitava
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Alwan, Nisreen A.
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[Unknown type: UNSPECIFIED]

Record type: UNSPECIFIED

Abstract

Background and aim: Long Covid can be a stigmatising condition, particularly in people who are disadvantaged within society. This may prevent them seeking help and could lead to widening health inequalities. This co-produced study with a Community Advisory Board of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid.

Methods: an active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care, and the stigma faced by participants and analysed thematically. This study forms part of the STIMULATE-ICP Collaboration.

Findings: twenty-three interviews were completed. Participants reported limited awareness of what Long Covid is and the available pathways to management. There was considerable self-doubt among participants, sometimes reinforced by interactions with healthcare professionals. Participants questioned their deservedness of seeking healthcare support for their symptoms. Hesitancy to engage with healthcare services was motivated by fear of needing more investigation and concerns regarding judgement about ability to carry out caregiving responsibilities. It was also motivated by the complexity of the clinical presentation and fear of all symptoms being attributed to poor mental health. Participants also reported trying to avoid overburdening the health system. These difficulties were compounded by experiences of stigma and discrimination. The emerging themes reaffirmed a framework of epistemic injustice in relation to Long Covid, where creating, interpreting, and conveying knowledge has varied credibility based on the teller’s identity characteristics and/or the level of their interpretive resources.

Conclusion: we have developed recommendations based on the findings. These include early signposting to services, dedicating protected time to listen to people with Long Covid, providing a holistic approach in care pathways, and working to mitigate stigma. Regardless of the diagnosis, people experiencing new symptoms must be encouraged to seek timely medical help. Clear public health messaging is needed among communities already disadvantaged by epistemic injustice to raise awareness of Long Covid, and to share stories that encourage seeking care and to illustrate the adverse effects of stigma.

Patient or public contribution: this study was co-produced with a Community Advisory Board (CAB) made up of twenty-three members including healthcare professionals, people with lived experience of Long Covid and other stakeholders.

Text
2024.01.03.24300767v1.full - Author's Original
Available under License Creative Commons Attribution.
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Published date: 3 January 2024

Identifiers

Local EPrints ID: 486191
URI: http://eprints.soton.ac.uk/id/eprint/486191
PURE UUID: 39cba5fa-698b-464b-8a47-6b48bfc7dec3
ORCID for Donna Clutterbuck: ORCID iD orcid.org/0000-0001-5622-3076
ORCID for Nisreen A. Alwan: ORCID iD orcid.org/0000-0002-4134-8463

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Date deposited: 12 Jan 2024 17:39
Last modified: 18 Mar 2024 04:05

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Contributors

Author: Donna Clutterbuck ORCID iD
Author: Mel Ramasawmy
Author: Marija Pantelic
Author: Jasmine Hayer
Author: Fauzia Begum
Author: Mark Faghy
Author: Nayab Nasir
Author: Barry Causer
Author: Melissa Heightman
Author: Gail Allsopp
Author: Dan Wootton
Author: M. Asad Khan
Author: Claire Hastie
Author: Monique Jackson
Author: Clare Rayner
Author: Darren Brown
Author: Emily Parrett
Author: Geraint Jones
Author: Rowan Clarke
Author: Sammie Mcfarland
Author: Mark Gabbay
Author: Amitava Banerjee
Corporate Author: STIMULATE-ICP Consortium

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