Over 777 million COVID-19 infections have occurred globally, with data suggesting that 10%–20% of those infected develop Long COVID. Fatigue is one of the most common and disabling symptoms of Long COVID. We aim to assess the feasibility and safety of a new, remotely delivered, multimodal rehabilitation intervention, paced to prevent post-exertional malaise (PEM), to support the conduct of a future, definitive randomised trial.

We will conduct a randomised, two-arm feasibility trial (COVIDEx intervention vs usual care). Sixty participants with Long COVID will be recruited and randomised prior to giving informed consent under a modified Zelen design using 1:1 allocation with random permuted blocks via central randomisation to receive either the COVIDEx intervention or usual care. The 50-minute, remotely delivered, COVIDEx intervention will occur twice weekly for 8 weeks. All participants will wear a non-invasive device throughout their entire study participation, to track heart rate, blood oxygen saturation, steps, sleep and monitor PEM. The primary feasibility objectives will be recruitment rates, intervention fidelity, adherence, acceptability (intervention and design), retention, blinding success and outcome completeness. Secondary objectives will include refined estimates for the standard deviation and correlation between baseline and follow-up measurements of fatigue. Feasibility and clinical outcomes will be collected at baseline, 4, 8, 12 and 24 weeks. Qualitative interviews with participants and physiotherapists will explore intervention acceptability and barriers/facilitators.

Ethical approval for this study was obtained by the Western University Health Sciences Research Ethics Board (REB# 123902). Dissemination plans include sharing of trial findings at conferences and through open access publications and patient/community channels.

NCT06156176

The Asian American, Native Hawaiian and Pacific Islander (AANHPI) community is the fastest-growing racial/ethnic population in the USA. Previous research identified that medical students perceived a lack of exposure to AANHPI patients and topics in medical school curricula; however, there remains a lack of potential interventions to address this need. The goal of our study is to present a case study for identifying interventions in medical school curricula that improve cultural humility-based training for providing medical care for AANHPI populations.

In this qualitative study, authors conducted four virtual focus groups with 15 medical students at a single institution to identify curricular interventions. The authors then conducted virtual semistructured interviews with eight medical educators one-on-one to explore the feasibility of the proposed interventions. Data were analysed using qualitative thematic analysis, and analysis was performed with ATLAS.ti.

Medical students and medical educators based at medical institutions in the USA.

15 medical students and eight medical educators participated in the study.

All medical students (n=15) and educators (n=8) noted that there is limited engagement of AANHPI communities in current medical curricula and limited curricular components that address the diversity within the AANHPI umbrella. Medical student focus groups identified three interventions to improve cultural humility-based training for treating AANHPI patients: reflection spaces, community engagement and clinical training on documenting cultural needs. Educators supported the feasibility and importance of these interventions to prepare students to work with not only AANHPI patients but also with patients of other diverse backgrounds.

AANHPIs represent a heterogeneous population consisting of unique cultural heritages. Our research demonstrates the importance of highlighting this community in cultural humility curricula to provide an example of how to consider and appreciate diversity in patient populations. In this paper, we present student and medical educator-supported curricular interventions that not only increase awareness of issues impacting AANHPI communities, but also emphasise building skills of self-reflection, lifelong learning and empathy that are applicable to patients of all backgrounds.