Chat box usage supports primary care staff needs for information, resources and peer support during COVID-19 crisis

As COVID-19 swept across the country in 2020, primary care medical staff were forced to make dramatic changes to their practices with little to no assistance and inconsistent guidance from the federal government. Researchers from Oregon Health & Science University created an 11-session COVID-19 Extension for Community Outcomes (ECHO) program, which served as a telementoring education model for clinicians involved in the ongoing pandemic crisis. They encouraged interactions between the participants via a chat box. Researchers used the text extracted from chat box interactions to assess how communications within the statewide program identified and fulfilled some of the clinicians' needs during the pandemic.

Researchers conducted a qualitative analysis of 11 chat box transcripts and explored the context of clinicians' needs, as conceptualized by Maslow's hierarchy of needs, which include physiological and self-actualization needs, in addition to safety, love, belonging and esteem. Steeves-Reece et al identified three key content themes from clinicians using the chat box: 1) answers and trustworthy information; 2) practical resources; and 3) affirmation and peer support.

Participants were able to create a community through chat box use where colleagues provided connection and validation, as well as a forum for discussing their fears, concerns and grievances. Researchers also saw many participants taking on an advocacy role, another demonstration of self-actualization. Additionally, participants advocated within the chat box for their marginalized and underserved patients and for those with special health needs. The chat box supported many clinicians' needs, including the ability to ask questions and provide comments during this rapidly changing health care environment. The researchers write that identifying and meeting clinicians' needs during a pandemic—or any public health crisis—is critical for primary care as a discipline to reach its full potential. While interactive virtual education programs may be helpful, greater investments in both public health and primary care are fundamental for supporting clinicians' ability to respond in a crisis.