COVID-19 concerns, health services utilisation and social support among Western Australians with diabetes during the pandemic
| Author | Jenny L Olson,Jessica Jensen,Enrique Mergelsberg,Natasha Watson,Deborah Schofield |
| Published date | 01 December 2021 |
| Date | 01 December 2021 |
| DOI | http://doi.org/10.1177/1035719X211040857 |
| Subject Matter | Academic Article |
Academic Article
Evaluation Journal of Australasia
2021, Vol. 21(4) 206–225
© The Author(s) 2021
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/1035719X211040857
journals.sagepub.com/home/evj
COVID-19 concerns, health
services utilisation and social
support among Western
Australians with diabetes
during the pandemic
Jenny L Olson
Diabetes WA, Subiaco, WA, Australia; College of Health and Human Development, The Pennsylvania State
University, University Park, PA, USA; College of Medicine, The Pennsylvania State University, Hershey, PA,
USA
Enrique Mergelsberg, Jessica Jensen, Deborah Schofield, and
Natasha Watson
Diabetes WA, Subiaco, WA, Australia
Abstract
People with diabetes face increased risk of serious COVID-19 complications, ma king
self-care for optimal metabolic management crucial. However, the pandemic has
reduced access to routine care among people with diabetes. The pandemic can also
elicit distress, which can impact diabetes self-management and health. To understand
the impact of COVID-19 on Western Australians with diabetes, we conducted an
evaluation involving an online survey of consumers of diabetes health services and an
analysis of routine program data (i.e. service utilisation/program attendance). Survey
respondents were concerned about contracting COVID-19, many intended to change
the way they utilised health services and many indicated they would continue to socially
isolate. Utilisation of digital/telephone services peaked between April and June 2020.
Despite the concerns indicated, a participation resurgence was observed upon re-
sumption of face-to-face programs. Continued access to diabetes programs via multiple
modes of delivery is critical to support optimal self-care and mitigate COVID-19 risks,
Corresponding author:
Jenny L Olson, Research and Evaluation, Diabetes WA, Level 3, 322 Hay Street, Subiaco, WA 6904,
Australia.
Email: jenny.olson@psu.edu
distress and social isolation. This timely and pragmatic assessment of consumer beliefs
synthesised with routinely collected evaluation data represents an agile approach to
evaluation through an emerging public health crisis. The findings helped to ensure
optimal service delivery to meet the needs of this priority population throughout the
pandemic.
Keywords
COVID-19, diabetes, pandemic, diabetes self-management education and support,
health services
Background
People with diabetes are more susceptible to serious complications
from COVID-19
Diabetes is the most common comorbidity among patients with COVID-19 admitted to
intensive care units in Australian hospitals (Sacks et al., 2020). The condition is as-
sociated with increased risk of COVID-19-related mortality (112%), disease severity
(145%), disease progression (231%) and acute respiratory distress syndrome (ARDS;
364%) (Huang et al., 2020). Outcomes in people with COVID-19 and type 2 diabetes
mellitus appear to be better among those with more optimal blood glucose levels,
compared to those with sub-optimal levels, including lower rates of in-hospital death,
all-cause mortality, ARDS, acute heart or kidney injury, septic shock and disseminated
intravascular coagulation (Zhu et al., 2020).
The management and incidence of COVID-19 in Western Australia
Towards the end of February 2020, the first COVID-19 case was recorded in Western
Australia. Soon after, a state-wide lockdown was imposed, continuing until the end of
June 2020. State and Federal Governments of Australia responded rapidly to the
emerging COVID-19 crisis, implementing strict physical distancing restrictions and
widespread public health messaging to mitigate risks of community transmission
(e.g. on the importance of regular handwashing). The State Government of Western
Australia implemented some of the tightest border controls in the country, in addition
to mandatory quarantining of known cases and those at risk of infection (i.e. those
visiting identified ‘hotspots’;Government of Western Australia Department of the
Premier and Cabinet, 2021). To date, Western Australia has avoided widespread
COVID-19 outbreaks (Government of Western Australia Department of Health,
2021). The state-wide arrest of community transmission allowed for an initial
cautious staged transition out of restrictions from June 6, 2020, earlier than other
states of Australia. Since that time, two short-term lockdowns were mandated in
Olson et al. 207
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