ABSTRACT
INTRODUCTION: Research undertaken since the beginning of the COVID-19 pandemic has provided us information about the impact of the pandemic on the gambling habits of the general population. However, very little is known about certain subgroups at increased risk of developing gambling disorder, such as the LGBTQIA2S+ population. The purpose of this study is to describe the impact of the COVID-19 pandemic on gambling behaviours among LGBTQIA2S+ individuals. In addition, we want to understand the experiences of the LGBTQIA2S+ population with gambling disorder and identify interventions that LGBTQIA2S+ people have found to be effective in addressing problem gambling during the COVID-19 pandemic. METHODS AND ANALYSIS: This study has a sequential explanatory mixed-method design in two phases over 2 years. The first phase is a correlational study. We will conduct a cross-sectional survey using a stratified random sampling among Canadian residents who are 18 years of age or older, self-identify as sexually and gender-diverse (ie, LGBTQIA2S+) and have gambled at least once in the previous 12 months. This survey will be administered online via a web panel (n=1500). The second phase is a qualitative study. Semistructured interviews will be conducted with LGBTQIA2S+ people with problematic gambling (n=30). ETHICS AND DISSEMINATION: This research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l'Estrie-CHUS scientific evaluation committee on 3 March 2022 (reference number: 2022-4633-LGBTQ-JHA). Electronic and/or written informed consent, depending on the data collection format (online survey and online or in-person interviews), will be obtained from each participant. A copy of the consent form and contact information will be delivered to each participant.
Subject(s)
COVID-19 , Gambling , Humans , Adolescent , Adult , COVID-19/epidemiology , Pandemics , Gambling/epidemiology , Cross-Sectional Studies , Canada/epidemiologyABSTRACT
While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS). From October to December 2020, we conducted an online survey of young adults (18-29 years) living in Canada and France to investigate factors associated with unmet MHS needs. Of the 3222 participants expressing a need to access MHS (50.7% of the total sample), 58.2% in Canada and 74.8% in France reported unmet MHS needs. In both countries, those who identified as men and those who lost income due to COVID-19, were more likely to report unmet MHS needs. In Canada, participants from Quebec, those living in rural areas, and those who experienced ethno-racial discrimination had higher odds of reporting such unmet needs. Urgent investments are needed to improve access to MHS for young adults during and after the COVID-19 pandemic.
ABSTRACT
Les personnes utilisatrices de substances qui fréquentent les services d'addictologie et de réduction des risques font partie des publics en situation de précarité dont les vulnérabilités sont aggravées en temps de pandémie. Notre article étudie l'expérience de la pandémie par ces personnes et l'impact de celle-ci sur les pratiques professionnelles et l'action publique, comme productrice d'inégalités mais aussi d'innovations et de solidarités. La collecte de données a été réalisée en France et au Québec, incluant des entretiens semi-directifs auprès de personnes usagères de substances (France, n = 25 ;Québec, n = 15) et de professionnels en addictologie et réduction des risques (France, n = 25 ;Québec, n = 18). Une approche théorique pragmatiste a été mise en oeuvre et analyse les niveaux macro et micro ensemble et de manière réflexive. Dès le premier confinement, les dispositifs professionnels ont tenté au mieux d'organiser une continuité de services afin de répondre aux besoins des usagers dans un contexte d'urgence sanitaire : par le déploiement de l'accès à l'hébergement, le développement de la téléconsultation afin d'assurer la continuité des soins. Des innovations ont été réalisées par des collaborations entre acteurs sur l'hébergement ou sur l'inclusion accélérée de la réduction des risques (alcool et approvisionnement sécuritaire) dans les centres d'hébergement. Des difficultés ont été également observées en lien avec des contraintes organisationnelles. Les usagers se sont bien approprié les mesures de prévention. Ils ont subi des logiques de contrôle social dans les champs sanitaire et répressif. Au-delà des vulnérabilités apportées par la COVID-19, des adaptations peuvent également constituer des opportunités de création de solidarités entre usagers et professionnels, des espaces favorables aux innovations professionnelles, et des nouveaux modes de collaboration et d'organisation entre acteurs.Alternate :People who use psychoactive substances and who attend drug treatment and harm reduction services represent groups whose vulnerabilities are exacerbated during a pandemic. We study the pandemic experience of people with problematic substance use and its impact on professional practices and policies, with an eye towards vulnerability and innovations. This comparative study was conducted in France and Quebec via semi-structured interviews with substance users (France, n=25 ;Quebec, n=15) and care and harm reduction providers (France, n=25 ;Quebec, n=18). We employ a pragmatist theoretical approach that reflexively analyzes the macro and micro levels together. During the first lockdown, professionals tried their best to organize a continuity of service to meet the needs of people in a context of a health emergency via the deployment of access to accommodation and the development of teleconsultation to ensure continuity of care. Innovative collaborations between actors occurred related to accommodation or the inclusion of harm reduction (alcohol and safe supply) in shelters. Difficulties were observed stemming from organizational constraints. Individuals adopted the preventive measures and had to endure social control both in the health and repressive fields. Beyond the vulnerabilities produced by COVID-19, adaptations also constitute opportunities for : solidarity between users and professionals, professional innovations, as well as new modes of collaboration and inter-actor organization.Alternate :Las personas que consumen sustancias y acuden a los servicios de adicción y reducción de riesgos se encuentran entre los grupos de población en situación de precariedad cuya vulnerabilidad se ha agravado durante la pandemia. Nuestro artículo estudia cómo estas personas han vivido la pandemia y el impacto de ésta en las prácticas profesionales y la acción pública, como productora de desigualdades, pero también de innovaciones y de solidaridad. La recogida de datos se llevó a cabo en Francia y en Quebec, incluyendo e trevistas semidirectivas con usuarios de sustancias (Francia, n=25 ;Quebec, n=15) y con profesionales del ámbito de la adicción y la reducción de riesgos (Francia, n=25 ;Quebec, n=18). Se utilizó un enfoque teórico pragmático, analizando conjuntamente los niveles macro y micro de forma reflexiva. Desde el primer confinamiento, los dispositivos profesionales trataron de organizar una continuidad de los servicios para responder a las necesidades de los usuarios en un contexto de emergencia sanitaria : se impulsó el acceso al alojamiento y se desarrolló la teleconsulta para garantizar la continuidad de los cuidados. Las innovaciones se han producido a través de la colaboración de los actores del sector del alojamiento o mediante la inclusión acelerada de la reducción de riesgos (alcohol y suministro seguro) en los centros de alojamiento. También se observaron dificultades en relación con las limitaciones organizativas. Los usuarios han integrado las medidas de prevención. Han sido sometidos a lógicas de control social en el ámbito sanitario y represivo. Más allá de las vulnerabilidades producidas por el COVID-19, las adaptaciones también pueden constituir oportunidades para la solidaridad entre usuarios y profesionales, espacios favorables a las innovaciones profesionales y nuevos modos de colaboración y organización entre los actores.
ABSTRACT
Background: To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments and family/friends mobilized financial support interventions (e.g., emergency aid funds) and assistance. However, little is known about how financial assistance alleviated mental health problems. This study aimed to investigate the moderating effect of financial support from the government or from family/friends on the association between income loss and depression among young adults. Methods: Two online cross-sectional surveys among young adults ages 18-29 living in Canada and France were conducted in 2020 (n = 4,511) and 2021 (n = 3,329). Moderate-to-severe depressive symptoms were measured using the Patient Health Questionnaire-9 (cut-off score: ≥10). Two logistic regression models were performed for each survey with an interaction term between income loss and financial support (government or family/friends modeled separately), controlling for demographics. Results: Overall, half reported depressive symptoms (2020/2021: 53.5%/45.6%), and over a third lost income (2020/2021: 10.2%/11.6% all income, 37.7%/21.6% some income). In 2020, 40.6% received government financial support (17.7% in 2021) while family/friends support was received by 12% (in both surveys). In both surveys, among those who received governmental financial support, income loss was associated with depression, whether participants lost all their income (e.g., 2020: Adjusted Odds Ratios (AOR) 1.75, 95% Confidence Interval [1.29-2.44]), or some of their income (e.g., 2020: AOR 1.45 [1.17-1.81]). However, among those who received family/friends financial support, income loss was no longer significantly associated with depression in both cycles, whether participants lost all their income (e.g., 2020: AOR 1.37 [0.78-2.40]), or some of their income (e.g., 2020: AOR 1.31 [0.86-1.99]). Conclusions: Association between income loss and depression was moderated by receipt of family/friends financial support but not by receipt of government financial support. Financial support interventions may help to mitigate the negative effects of income loss on young adults mental health during periods of economic crisis.
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While the COVID-19 pandemic impacted young adults' alcohol use patterns, little is known about how changes in alcohol use may differ across different settings. Our objective was to identify and compare factors associated with changes in alcohol use among young adults in Canada and France during the first year of the COVID-19 pandemic. We conducted an online cross-sectional survey in October-December 2020 with young adults aged 18-29 (n = 5185) in Canada and France. In each country, weighted multinomial logistic regressions were performed to identify factors associated with self-reported decrease and increase in alcohol use separately (reference: no change). Respectively, 33.4% and 21.4% reported an increase in alcohol use in Canada and France, while 22.9% and 33.5% reported a decrease. Being 25-29 was a predictor of decrease in Canada, while living away from family was associated with an increase in France. In both countries, participants were more likely to report an increase if they reported depressive symptoms, smoking tobacco, or cannabis use. Conversely, those who had been tested for COVID-19 and those who were highly compliant with COVID-19 preventive measures were more likely to report a decrease. Efforts are needed to develop alcohol use interventions for young adults, including in ways that prioritize those with mental health challenges.
Subject(s)
COVID-19 , Humans , Young Adult , COVID-19/epidemiology , Self Report , SARS-CoV-2 , Cross-Sectional Studies , Pandemics , Canada/epidemiologyABSTRACT
BACKGROUND: High rates of COVID-19 vaccination uptake are required to attain community immunity. This study aims to identify factors associated with COVID-19 vaccine uncertainty and refusal among young adults, an underexplored population with regards to vaccine intention generally, in two high-income settings: Canada and France. METHODS: A cross-sectional online survey was conducted from October to December 2020 among young adults ages 18-29 years (n = 6663) living in Canada (51.9%) and France (48.1%). Multinomial logistic regression analyses were performed to identify the sociodemographic and COVID-19-related measures (e.g., prevention behavior and perspectives, health-related concerns) associated with vaccine uncertainty and refusal. We conducted weighted analyses by age, gender and province/region of residence. RESULTS: Intention to accept vaccination was reported by 84.3% and 59.7% of the sample in Canada and France, respectively. Higher levels of vaccine uncertainty and refusal were observed in France compared to Canada (30.1% versus 11%, 10.2% versus 4.7%). In both countries, we found higher levels of vaccine acceptance among young adults who reported COVID-19 prevention actions. Vaccine uncertainty and refusal were associated with living in a rural area, having lower levels of educational attainment, not looking for information about COVID-19, not wearing a face mask, and reporting a lower level of concern for COVID-19's impact on family. Participants who had been tested for COVID-19 were less likely to intend to refuse a vaccine. CONCLUSIONS: COVID-19 vaccine acceptance was high among young adults in Canada and France during a time in which vaccines were approved for use. Targeted interventions to build confidence in demographic groups with greater hesitance (e.g., rural and with less personal experience with COVID-19) may further boost acceptance and improve equity as vaccine efforts continue to unfold.