Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic.

This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The study sample comprised 1673 respondents (66% women). Overall, 46% reported high levels of anxiety, and women experienced significantly (p < 0.001) higher levels of anxiety than men. Women were significantly (p < 0.05) more likely to use acceptance, self-distraction, positive reframing, and emotional support than men. Significant interactions between gender and coping strategies were also identified. Women engaging in high (+1SD) vs. low (−1SD) levels of active coping were not found to have significantly different anxiety levels. In contrast, men reported higher levels of anxiety when they engaged in high levels of active coping and lower levels of anxiety when they engaged in low levels of active coping (b2 = 0.88, t = 3.33, p = 0.001). Additionally, women engaging in high levels of acceptance and positive reframing reported significantly lower anxiety levels than when engag-ing in low levels of acceptance (b1 = −1.03, t = −4.58, p < 0.001) and positive reframing (b1 = −0.72, t = −3.95, p < 0.001). No significant associations between acceptance and positive reframing levels and anxiety levels were found with men. Overall, these findings extend our understanding of the nature of gender differences in stress responsivity during periods of high psychological distress and can inform the development of mental health interventions to respond to the COVID-19 pandemic and future infectious disease outbreaks.

COVID-19 Vaccine Uptake among US Adults According to Standard Occupational Groups.

This cross-sectional ecological study examined the relationship between neighborhood-level standard occupational groups in the USA and COVID-19 vaccine uptake using 774 census tract data, each consisting of approximately 1600 housing units. The neighborhood-level COVID-19 vaccination uptake data were retrieved from Harris County Public Health, Harris County, Texas. The standard occupational group data were from the US Census Bureau. We calculated the incidence rate ratios (IRRs) for vaccine uptake using bivariate and multivariable Poisson regression models. In the adjusted models, we found that the healthcare practitioner/technician (IRR: 1.008; 95% CI: 1.003-1.014; p = 0.001), business/management/legal (IRR: 1.011; 95% CI: 1.008-1.013; p < 0.001), computer/engineering/life/physical/social science (IRR: 1.018; 95% CI: 1.013-1.023; p < 0.001), and arts/design/entertainment/sports/media (IRR: 1.031; 95% CI: 1.018-1.044; p < 0.001) occupational groups were more likely to have received the full regimen of a COVID-19 vaccine. On the contrary, the building/installation/maintenance/repair (IRR: 0.991; 95% CI: 0.987-0.995; p < 0.001), construction/extraction/production (IRR: 0.991; 95% CI: 0.988-0.995; p < 0.001), transportation/material moving (IRR: 0.992; 95% CI: 0.987-0.997; p = 0.002), food preparation/serving related (IRR: 0.995; 95% CI: 0.990-0.999; p = 0.023), and personal care/services (IRR: 0.991; 95% CI: 0.985-0.998; p = 0.017) groups were less likely to have received the complete dose of a COVID-19 vaccine. White-collar workers were more likely to be vaccinated than blue-collar workers. We adjusted for age, sex, and race/ethnicity in the multivariable analysis. The low vaccine uptake among certain occupational groups remains a barrier to pandemic control. Engaging labor-centered stakeholders in the development of vaccination interventions may increase uptake.

Predictors of COVID-19 perceived susceptibility: insights from population-based self-reported survey during lockdown in the United States.

BACKGROUND: The COVID-19 pandemic during lockdown has highlighted the importance of identifying individuals most at risk of infection with SARS-CoV-2, underscoring the need to assess factors contributing to susceptibility to disease. With the rapidly evolving nature of the pandemic and its new variants, there is an inadequate understanding on whether there are certain factors such as a specific symptom or collection of symptoms that combined with life-style behaviors may be useful to predict susceptibility. The study aims to explore such factors from pre-vaccination data to guide public health response to potential new waves. METHODS: An anonymous electronic survey was distributed through social media during the lockdown period in the United States from April to June 2020. Respondents were questioned regarding COVID testing, presenting symptoms, demographic information, comorbidities, and confirmation of COVID-19 test results. Stepwise logistic regression was used to identify predictors for COVID-19 perceived susceptibility. Selected classifiers were assessed for prediction performance using area under receiver operating characteristic (AUROC) curve analysis. RESULTS: A total of 130 participants deemed as susceptible because they self-reported their perception of having COVID-19 (but without the evidence of positive test) were compared with 130 individuals with documented negative test results. Participants had a mean age of 45 years, and 165 (63%) were female. Final multivariable model showed significant associations with perceived susceptibility for the following variables: fever (OR:33.5; 95%CI: 3.9,85.9), body ache (OR:3.0; 95%CI:1.1,6.4), contact history (OR:2.7; 95%CI:1.1,6.4), age> 50 (OR:2.7; 95%CI:1.1, 6.6) and smoking (OR:3.3; 95%CI: 1.2,9.1) after adjusting for other symptoms and presence of comorbid conditions. The AUROC ranged from poor to fair (0.65-0.76) for cluster of symptoms but improved to a good model (AUROC = 0.803) after inclusion of sociodemographic and lifestyle behaviors e.g., age and smoking tobacco. CONCLUSIONS: Fever and body aches suggest association with perceived COVID-19 susceptibility in the presence of demographic and lifestyle behaviors. Using other constitutional and respiratory symptoms with fever and body aches, the parsimonious classifier correctly predicts 80.3% of COVID-19 perceived susceptibility. A larger cohort of respondents will be needed to study and refine classifier performance in future lockdowns and with expected surge of new variants of COVID-19 pandemic.

Risk and resilience in couple’s adjustment to the COVID-19 pandemic

The COVID-19 pandemic?s global scope and resulting social distancing measures have caused unprecedented economic, lifestyle, and social impacts to personal and relationship well-being. While lockdowns have prompted individuals to increase reliance on intimate partners for support, stressful external contexts can also interfere with partners? capacity to request and provide support, resulting in relationship dissatisfaction and even dissolution. Guided by a risk and resilience framework, this study examined the impact of perceived stress, social contextual factors, and dyadic coping on self-reported relationship satisfaction changes during the initial United States COVID-19 lockdown period. Participants were adults in romantic relationships who completed an online survey between April 13 and June 8, 2020. Overall, survey respondents (N = 1106) reported higher perceived stress levels than established population norms, and small but significant decrements in relationship satisfaction. Multivariable models revealed that higher perceived stress levels were associated with lower relationship satisfaction levels. Additionally, dyadic coping was found to moderate the impact of perceived stress on relationship satisfaction (B = .05, 95% CI = .02? .07), suggesting that engaging in dyadic coping buffered individuals from adverse effects of perceived stress on their relationships. Findings emphasize heightened stress experienced by individuals during the pandemic, potential detrimental effects of stress on couple relationships, and suggest dyadic coping may help buffer couples from adverse effects of the pandemic on their relationships. As such, dyadic coping may be an important target for future interventions designed to assist couples during the ongoing pandemic and future pandemics/natural disasters.

Overcoming COVID-19 Vaccine Hesitancy: Insights from an Online Population-Based Survey in the United States.

This study sought to identify individual-level determinants of COVID-19 vaccine hesitancy based on the Health Belief Model (HBM) and Theory of Planned Behavior (TPB). An online population-based survey was distributed in English and Spanish. Data were derived from 1208 U.S. adults (52% female; 38.7% minorities), 43.5% of whom reported vaccine hesitancy. Multivariable analysis revealed that unemployed individuals were more likely (OR = 1.78, 95% CI: 1.16-2.73, p = 0.009) and married (OR = 0.57, 95% CI: 0.39-0.81, p = 0.002) and higher income individuals (OR = 0.52, 95% CI 0.32-0.84, p = 0.008) were less likely to be hesitant. Individuals with greater perceived susceptibility to COVID-19 (OR = 0.82, 95% CI: 0.71-0.94, p = 0.006), who perceived vaccination as being convenient (OR = 0.86, 95% CI: 0.74-1.00, p = 0.047), and who afforded greater importance to cues to action from government (OR = 0.84, 95% CI: 0.74-0.95, p = 0.005), public health (OR = 0.70, 95% CI: 0.59-0.82, p < 0.001), and healthcare experts (OR = 0.59, 95% CI: 0.50-0.69, p < 0.001) were also less likely to be hesitant. Findings suggest that HBM and TPB constructs may be useful in informing strategies to improve COVID-19 vaccine uptake. Specifically, framing appeals based on perceptions of COVID-19 susceptibility, making vaccination convenient, and rebuilding trust through unified cues to action may help to overcome vaccine hesitancy.

Rationale and Methods for a Randomized Controlled Trial of a Dyadic, Web-Based, Weight Loss Intervention among Cancer Survivors and Partners: The DUET Study.

Scalable, effective interventions are needed to address poor diet, insufficient physical activity, and obesity amongst rising numbers of cancer survivors. Interventions targeting survivors and their friends and family may promote both tertiary and primary prevention. The design, rationale, and enrollment of an ongoing randomized controlled trial (RCT) (NCT04132219) to test a web-based lifestyle intervention for cancer survivors and their supportive partners are described, along with the characteristics of the sample recruited. This two-arm, single-blinded RCT randomly assigns 56 dyads (cancer survivor and partner, both with obesity, poor diets, and physical inactivity) to the six-month DUET intervention vs. wait-list control. Intervention delivery and assessment are remotely performed with 0-6 month, between-arm tests comparing body weight status (primary outcome), and secondary outcomes (waist circumference, health indices, and biomarkers of glucose homeostasis, lipid regulation and inflammation). Despite COVID-19, targeted accrual was achieved within 9 months. Not having Internet access was a rare exclusion (<2%). Inability to identify a support partner precluded enrollment of 42% of interested/eligible survivors. The enrolled sample is diverse: ages 23-81 and 38% racial/ethnic minorities. Results support the accessibility and appeal of web-based lifestyle interventions for cancer survivors, though some cancer survivors struggled to enlist support partners and may require alternative strategies.

Sociodemographic and Health Belief Model Factors Associated with Nonadherence to COVID-19 Mitigation Strategies in the United States.

BACKGROUND AND PURPOSE: Virus mitigation strategies such as adhering to stay-at-home orders, practicing social distancing, and engaging in personal protective behaviors are central to slowing the spread of COVID-19. This population-based cohort study sought to identify sociodemographic characteristics and Health Belief Model factors that are associated with nonadherence to COVID-19 mitigation strategies with the goal of informing public health messaging campaigns. METHODS: An online population-based survey was distributed via social media over an 8-week period from April 13, 2020, to June 8, 2020. RESULTS: Data were derived from 2,222 adults (57% female; 40% racial/ethnic minorities). Univariate analyses revealed that men, younger aged (18-30 years) and unmarried adults, and noncollege educated individuals had lower levels of perceived threat, control, and knowledge about COVID-19 (p ≤ .001). Multivariable linear regression models further revealed that male gender was significantly associated with reporting lower levels of adherence to COVID-19 mitigation strategies (p < .001), and that higher levels of perceived threat, perceived control, and knowledge about how to keep oneself and others safe from COVID-19 were significantly associated with reporting higher levels of adherence to COVID-19 mitigation strategies (p < .01). CONCLUSIONS: Findings suggest that public health appeals that target men, emphasize individual risk, and provide clear, consistent guidance on what individuals can do to decrease their risk for COVID-19 may be effective in motivating increased mitigation adherence.

Psychosocial and health behavioural impacts of COVID-19 pandemic on adults in the USA: protocol for a longitudinal cohort study.

INTRODUCTION: Although social distancing may help contain the spread of COVID-19, the social isolation and loneliness it causes can heighten stress, contribute to unhealthy lifestyle behaviours and have deleterious effects on social relationships. This ongoing longitudinal cohort study aims to (1) characterise the psychological, social and health behavioural impacts of the COVID-19 pandemic over a 12-month period in the USA; (2) determine whether these impacts differ for certain subgroups based on sociodemographics and other individual-level factors; and (3) explore whether there are modifiable factors (eg, coping, social support) that moderate the effects of the pandemic over time. METHODS AND ANALYSIS: Adults (aged ≥18 years) who were fluent in either English or Spanish were recruited via social media and invited to complete an online survey during the 8-week period from 13 April to 8 June 2020 (baseline). Follow-up surveys will be conducted 6 and 12 months after baseline. Data transformations, non-parametric tests or other alternative methods will be used when appropriate. Descriptive statistics and cross-sectional analyses will be performed. Longitudinal associations will be analysed using multilevel modelling with time-variant and time-invariant predictors of change in trajectory over the study period. ETHICS AND DISSEMINATION: Research ethics approval was received from the Baylor College of Medicine Institutional Review Board (H-47505). Overall, this study will provide timely information that can be used to inform public health messaging strategies and guide development of assessment tools and interventions to support vulnerable individuals dealing with the long-term impacts of the COVID-19 pandemic.