Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada

Introduction We aimed to explore patient and provider perspectives of the impact of the COVID-19 pandemic on tuberculosis healthcare access and service delivery.Methods We used interpretive description, a qualitative approach with the end-goal of informing decisions and actions in clinical practice....

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Main Authors: Michael K Stickland, Paul E Ronksley, Maxi Miciak, Kadija Perreault, Courtney Heffernan, Douglas P Gross, Grace Y Lam, Jason Weatherald, Giovanni Ferrara, Katelyn Brehon, Pam Hung, Angela Lau, Rachel Lim
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/3/1/e002498.full
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author Michael K Stickland
Paul E Ronksley
Maxi Miciak
Kadija Perreault
Courtney Heffernan
Douglas P Gross
Grace Y Lam
Jason Weatherald
Giovanni Ferrara
Katelyn Brehon
Pam Hung
Angela Lau
Rachel Lim
author_facet Michael K Stickland
Paul E Ronksley
Maxi Miciak
Kadija Perreault
Courtney Heffernan
Douglas P Gross
Grace Y Lam
Jason Weatherald
Giovanni Ferrara
Katelyn Brehon
Pam Hung
Angela Lau
Rachel Lim
author_sort Michael K Stickland
collection DOAJ
description Introduction We aimed to explore patient and provider perspectives of the impact of the COVID-19 pandemic on tuberculosis healthcare access and service delivery.Methods We used interpretive description, a qualitative approach with the end-goal of informing decisions and actions in clinical practice. Levesque et al’s ‘Conceptual framework of access to health care’ informed the development of our interview guides. Interviews were conducted virtually and confidentially transcribed verbatim. Data generation and analysis occurred concurrently. Analysis was informed by Braun and Clarke’s six phases of reflexive thematic analysis. Strategies to enhance rigour and trustworthiness of the findings were used.Results We completed 15 interviews: 6 with patients and 9 with providers. Three key themes were generated: (1) diagnostic hurdles created delay; (2) hybrid services promote health equity; and (3) navigating the complexities of a pandemic within a pandemic. Diagnosing tuberculosis was challenging even prior to the pandemic since some providers lacked experience and familiarity with the condition. The diagnostic process was further complicated with the onset of the COVID-19 pandemic. However, COVID-19 also introduced streamlined virtual care for patients which was convenient and improved access but was not viewed as being equivalent to in-person care. The intersection of the COVID-19 and tuberculosis pandemics created competition for limited resources while highlighting learnings that may positively impact future tuberculosis care.Conclusions Our findings can inform health system leadership about how the COVID-19 pandemic impacted care of other public health threats like tuberculosis, helping to prepare more effectively and equitably for future challenges.
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spelling doaj-art-ccdfbf0a987a4e99b59efe13bc9efe732025-08-20T02:32:22ZengBMJ Publishing GroupBMJ Public Health2753-42942025-05-013110.1136/bmjph-2024-002498Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, CanadaMichael K Stickland0Paul E Ronksley1Maxi Miciak2Kadija Perreault3Courtney Heffernan4Douglas P Gross5Grace Y Lam6Jason Weatherald7Giovanni Ferrara8Katelyn Brehon9Pam Hung10Angela Lau11Rachel Lim122 Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada14 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada6 Rehabilitation Research Centre, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, CanadaDepartment of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, CanadaDepartment of Medicine; Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada7 Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada4 Alberta Health Services, Edmonton, Alberta, Canadaassociate professor of pulmonary medicineDepartment of Medicine, Division of Respirology, University of Alberta, Edmonton, Alberta, Canada1 University of Alberta Faculty of Rehabilitation Medicine, Edmonton, Alberta, Canada1 University of Alberta Faculty of Rehabilitation Medicine, Edmonton, Alberta, Canada2 Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada4 Alberta Health Services, Edmonton, Alberta, CanadaIntroduction We aimed to explore patient and provider perspectives of the impact of the COVID-19 pandemic on tuberculosis healthcare access and service delivery.Methods We used interpretive description, a qualitative approach with the end-goal of informing decisions and actions in clinical practice. Levesque et al’s ‘Conceptual framework of access to health care’ informed the development of our interview guides. Interviews were conducted virtually and confidentially transcribed verbatim. Data generation and analysis occurred concurrently. Analysis was informed by Braun and Clarke’s six phases of reflexive thematic analysis. Strategies to enhance rigour and trustworthiness of the findings were used.Results We completed 15 interviews: 6 with patients and 9 with providers. Three key themes were generated: (1) diagnostic hurdles created delay; (2) hybrid services promote health equity; and (3) navigating the complexities of a pandemic within a pandemic. Diagnosing tuberculosis was challenging even prior to the pandemic since some providers lacked experience and familiarity with the condition. The diagnostic process was further complicated with the onset of the COVID-19 pandemic. However, COVID-19 also introduced streamlined virtual care for patients which was convenient and improved access but was not viewed as being equivalent to in-person care. The intersection of the COVID-19 and tuberculosis pandemics created competition for limited resources while highlighting learnings that may positively impact future tuberculosis care.Conclusions Our findings can inform health system leadership about how the COVID-19 pandemic impacted care of other public health threats like tuberculosis, helping to prepare more effectively and equitably for future challenges.https://bmjpublichealth.bmj.com/content/3/1/e002498.full
spellingShingle Michael K Stickland
Paul E Ronksley
Maxi Miciak
Kadija Perreault
Courtney Heffernan
Douglas P Gross
Grace Y Lam
Jason Weatherald
Giovanni Ferrara
Katelyn Brehon
Pam Hung
Angela Lau
Rachel Lim
Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
BMJ Public Health
title Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
title_full Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
title_fullStr Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
title_full_unstemmed Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
title_short Patient and provider perceptions of the impact of COVID-19 on tuberculosis healthcare access and delivery: an interpretive description study of the complexities of a pandemic within a pandemic in Alberta, Canada
title_sort patient and provider perceptions of the impact of covid 19 on tuberculosis healthcare access and delivery an interpretive description study of the complexities of a pandemic within a pandemic in alberta canada
url https://bmjpublichealth.bmj.com/content/3/1/e002498.full
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