The COVID-19 pandemic has dramatically impacted cancer care worldwide. Disruptions have been seen across all facets of care. While the long-term impact of COVID-19 remains unclear, the immediate impacts on patients, their carers and the healthcare workforce are increasingly evident. This study describes disruptions and reorganisation of cancer services in Australia since the onset of COVID-19, from the perspectives of people affected by cancer and healthcare workers. Two separate online cross-sectional surveys were completed by: a) cancer patients, survivors, carers, family members or friends (n = 852) and b) healthcare workers (n = 150). Descriptive analyses of quantitative survey data were conducted, followed by inductive thematic content analyses of qualitative survey responses relating to cancer care disruption and perceptions of telehealth. Overall, 42% of cancer patients and survivors reported experiencing some level of care disruption. A further 43% of healthcare workers reported atypical delays in delivering cancer care, and 50% agreed that patient access to research and clinical trials had been reduced. Almost three quarters (73%) of patients and carers reported using telehealth following the onset of COVID-19, with high overall satisfaction. However, gaps were identified in provision of psychological support and 20% of participants reported that they were unlikely to use telehealth again. The reorganisation of cancer care increased the psychological and practical burden on carers, with hospital visitation restrictions and appointment changes reducing their ability to provide essential support. COVID-19 has exacerbated a stressful and uncertain time for people affected by cancer and healthcare workers. Service reconfiguration and the adoption of telehealth have been essential adaptations for the pandemic response, offering long-term value. However, our findings highlight the need to better integrate psychosocial support and the important role of carers into evolving pandemic response measures. Learnings from this study could inform service improvements that would benefit patients and carers longer-term.

Purpose This study aimed to explore the psychosocial impacts of the coronavirus disease (COVID-19) pandemic on cancer patients, survivors, and carers in Australia. Methods Using real-time insights from two Cancer Council NSW services—131120 Information and Support Line and Online Community (CCOC) forums—we assessed service demand trends, distress levels (using the distress thermometer), and content from 131120 calls and online posts between 01 December 2019 and 31 May 2020. Emergent themes were identified through an inductive conventional content analysis with 131120 call notes, followed by a deductive directed content analysis on CCOC posts. Results In total, 688 COVID-19-related 131120 calls (n = 496) and online posts (n = 192) were analysed. Service demand peaked in March 2020 and self-reported distress peaked in May 2020 at an average of 8/10 [Mean = 7.5; SD = 0.9]. Five themes emerged from the qualitative analysis: psychological distress and fear of virus susceptibility, practical issues, cancer service disruptions, information needs, and carer Issues. Conclusions The psychosocial impacts of COVID-19 on people affected by cancer are multifaceted and likely to have long-lasting consequences. Our findings drove the development of six recommendations across three domains of support, information, and access. Cancer patients, survivors, and carers already face stressful challenges dealing with a cancer diagnosis or survivorship. The added complexity of restrictions and uncertainty associated with the pandemic may compound this. It is important that healthcare providers are equipped to provide patient-centred care during and after this crisis. Our recommendations provide points of consideration to ensure care is tailored and patient oriented.

Aim To investigate New South Wales adults' perceived adequacy of their fruit and vegetable consumption and to identify the barriers to consumption. Method An online cross‐sectional survey of a sample of adults in New South Wales (n = 1603) in February 2019 measured self‐reported fruit and vegetable intakes, perception of consumption adequacy and barriers to consumption. Proportions of participants whose reported consumption met the daily recommended serves of fruit and vegetables per day were calculated. Chi‐square and Fisher's exact tests were used to explore differences between demographic characteristics and meeting fruit and vegetable recommendations. For those not meeting recommendations, Chi‐square and Fisher's exact tests were used to explore perceived adequacy of intake as a potential barrier to consumption. Results The sample included 52.7% women, 40.0% aged under 40 years and 28.6% over 59 years, 68.2% lived in a major city, and 32.6% were university educated. Overall, 64.8% of participants reported consuming adequate fruit and 12.4% reported consuming adequate vegetables. Of those consuming less than the guidelines, 21.3% perceived that they were eating enough fruit and 53.7% perceived they were eating enough vegetables. The most common barriers to eating more fruit were preference for other foods (29.6%), fruit spoiling too quickly (28.3%), and habit (27.0%). The most common barriers to eating more vegetables were the perception that they eat enough (26.8%), preference for other foods (21.9%), and habit (19.7%). Conclusions Greater efforts are needed to support the public to eat adequate fruit and vegetables, consistent with dietary guidelines. Public education campaigns specifically targeting increasing vegetable consumption are required to address knowledge gaps, given a large proportion of our study population consumed inadequate levels of vegetables yet perceived their intake to be adequate.