Perceptions of social media challenges and benefits during the Covid-19 pandemic: Qualitative findings from a cross sectional international survey

Since the beginning of the Covid-19 pandemic in January 2020 the need for rapid information spread grew and social media became the ultimate platform for information exchange as well as a tool for connection and entertainment. With the rapid information spread along came the various public misconceptions and misinformation which consequently influenced perceptions and behaviors of the public towards the coronavirus pandemic. Thus, there was a need for identification and collation of public perceptions information to address future public health initiatives. This cross-national study aimed to examine the challenges and benefits of using social media during the Covid-19 pandemic outbreak. This study was a content analysis of the open-ended questions from a wider cross-sectional online survey conducted in Norway, UK, USA, and Australia during October/November 2020. 2368 participants out of 3474 respondents to the survey provided the open text responses included in the qualitative analysis. Thematic analysis was conducted independently by two researchers. All statements were coded to positive and negative sentiments. Three overarching themes were identified: 1. Mental health and emotional exhaustion 2. Information and misinformation;3. Learning and inspiration.While providing a powerful mode of connection during the pandemic, social media also led to negative impact on public perceptions, including mistrust and confusion. Clarity in communications by institutions and education about credible information sources should be considered in the future. Further research is required in exploring and documenting social media narratives around COVID-19 in this and any subsequent incidents of pandemic restrictions. Understanding the public perceptions and their social narratives can support the designing of appropriate support and services for people in the future, while acknowledging the uncertainty and overwhelming impact of the pandemic that may have skewed the experiences of social media.

Associations between social media use and loneliness in a cross-national population: do motives for social media use matter?

BACKGROUND: We aimed to examine the association between social media use and loneliness two years after the COVID-19 pandemic outbreak. METHODS: Participants were 1649 adults who completed a cross-sectional online survey disseminated openly in Norway, United Kingdom, USA, and Australia between November 2021 and January 2022. Linear regressions examined time spent on social media and participants' characteristics on loneliness, and interactions by motives for social media use. RESULTS: Participants who worried more about their health and were younger, not employed, and without a spouse or partner reported higher levels of loneliness compared to their counterparts. More time spent on social media was associated with more loneliness (ß = 0.12, p < 0.001). Three profile groups emerged for social media use motives: 1) social media use motive ratings on avoiding difficult feelings higher or the same as for maintaining contact; 2) slightly higher ratings for maintaining contact; and 3) substantially higher ratings for maintaining contact. Time spent on social media was significant only in motive profile groups 2 and 3 (ß = 0.12 and ß = 0.14, both p < 0.01). CONCLUSIONS: Our findings suggest that people who use social media for the motive of maintaining their relationships feel lonelier than those who spend the same amount of time on social media for other reasons. While social media may facilitate social contact to a degree, they may not facilitate the type of contact sought by those who use social media primarily for this reason.

The effect of web-based Hatha yoga on psychological distress and sleep quality in older adults: A randomized controlled trial.

BACKGROUND: To date, there has been very limited experimental research on the impact of Yoga on older adults' mental health during the COVID-19 crisis. We aimed to explore the effect of a web-based Hatha yoga program on psychological and quality of sleep in older adults who self-isolated at home during the initial stage of the COVID-19 outbreak. METHODS: Two hundred volunteers of both sexes were split into experimental (Yoga group, YG) and control (Control group, CG) groups, in a web-based randomized controlled study. All participants were administered the Depression, Anxiety and Stress Scales (DASS-21) and the Pittsburgh sleep quality index (PSQI); at baseline and following an eight-week online Hatha yoga intervention. RESULTS: The YG showed significant reductions in depression (-56.1%; Z = 5.67, p < 0.01, r = 0.70) anxiety (-64.3%; Z = 5.27, p < 0.01, r = 0.65) and stress (-68.2%; Z = 5.86, r = 0.73) scores, while the CG showed a significant increase in depression. In addition, the total PSQI score of the YG was considerably lower during follow-up (3.38 ± 2.02, p < 0.05) than at baseline (4.8 ± 32, p < 0.05), which indicates an improvement of the quality of sleep. The proportion of individuals experiencing good sleep from the YG increased from 63% to 85% after the Hatha yoga intervention. CONCLUSION: The use of a web-based Hatha Yoga intervention program was associated with a beneficial effect on the mental health and quality of sleep in older adults.

Self-Reported Long COVID in the General Population: Sociodemographic and Health Correlates in a Cross-National Sample.

We aimed to gain knowledge of possible sociodemographic predictors of long COVID and whether long COVID was associated with health outcomes almost two years after the pandemic outbreak. There were 1649 adults who participated in the study by completing a cross-sectional online survey disseminated openly in Norway, the UK, the USA, and Australia between November 2021 and January 2022. Participants were defined as having long COVID based on self-reports that they had been infected by COVID-19 and were experiencing long-lasting COVID symptoms. Logistic regression analyses were used to examine possible sociodemographic predictors, and multivariate analysis of variance was used to examine whether long COVID status was associated with health outcomes. None of the sociodemographic variables was significantly associated with reporting long COVID. Having long COVID was associated with higher levels of psychological distress, fatigue, and perceived stress. The effect of long COVID on health outcomes was greater among men than among women. In conclusion, long COVID appeared across sociodemographic groups. People with long COVID reported worsened health outcomes compared to those who had had COVID-19 but without long-term symptoms. Men experiencing long COVID appear to be particularly vulnerable to experiencing poorer health outcomes; health services may pay extra attention to potentially unnoticed needs for support among men experiencing long COVID.

Students' Mental Health, Well-Being, and Loneliness during the COVID-19 Pandemic: A Cross-National Study.

During the COVID-19 pandemic, much research has been devoted to assessing mental health in a variety of populations. Students in higher education appear to be particularly vulnerable to experiencing reduced mental health. The purpose of the study was to assess whether higher education students experienced poorer mental health compared to the general population and examine the factors associated with students' mental health during the COVID-19 pandemic. A cross-national sample of students (n = 354) and non-students (n = 3120) participated in a survey in October/November 2020. Mental health outcomes among students and non-students were compared with independent t-tests. Multiple linear regression analysis and general linear estimation were used to assess the impact of student status on mental health outcomes while adjusting for sociodemographic factors. Students reported poorer mental health than non-students. The difference in mental health between students and non-students was bigger for participants aged 30 years or older. More social media use was associated with poorer mental health outcomes. In conclusion, students had poorer mental health than the wider population. Aspects of life as a student, beyond what can be attributed to life stage, appears to increase mental health problems.

A comparison between healthcare workers and non-healthcare workers' anxiety, depression and PTSD during the initial COVID -19 lockdown.

Objective: Several studies have found that Healthcare workers are vulnerable to mental health problems during the COVID-19 pandemic. However, few studies have made comparisons of healthcare workers (HCWs) and non-HCWs. The current study aimed to compare mental health problems among HCWs with non-HCWs during the initial lockdown of COVID 19. Study design: A population-based cross-sectional survey. Methods: The survey was conducted by means of an open web link between April and May 2020. Data were collected by self-report. The PTSD Checklist for DSM-5 (PCL-5) was used to assess posttraumatic stress. Results: A total of 4527 citizens answered the questionnaire and 32.1% were HCWs. The majority were female, under 60 years of age, and lived in urban areas. Among the HCWs, the majority were registered nurses working in hospitals. The prevalence were 12.8% vs 19.1% for anxiety, 8.5% vs 14.5% for depression and 13.6% vs 20.9% for PTSD among HCWs and non-HCWs respectively. The highest prevalence's for anxiety and PTSD among HCWs were found for those under 40 years of age and having low education level (<12 years). Conclusion: Mental health problems was significantly lower among HCWs compared to non-HCWs. However, the COVID-19 poses a challenge for HCWs, especially young HCWs and those with low level of education. Providing support, appropriate education, training, and authoritative information to the different members of the HCWs could be effective ways to minimize the psychological effect.

Development and Preliminary Validation of the Physical Education-Study Process Questionnaire : Insights for Physical Education University Students.

Background: The Revised Two Factor Study Process Questionnaire (R-SPQ-2F) is used to examine students' study approaches in higher education. The questionnaire is designed to measure two factors: deep and surface approaches. In order to measure these approaches for students in physical education and sport, a new measurement instrument should take into consideration the practical context of this field of education that makes it specific to other fields. Objective: The present study aims (a) to develop and empirical test of a new instrument for measuring the study process in physical education and sports students, and (b) to test psychometric properties of the tool. Methods: Two exploratory and confirmatory samples of physical education students enrolled in a bachelor's degree program in physical education at the High Institute of Physical Education and Sports of Kef-Tunisia, aged 19-26 years, were recruited online among female students (n = 414) and male students (n = 393). The participants filled in Google Form survey including Physical Education-Study Process Questionnaire (PE-SPQ) and the Arabic version of the Revised Study Process Questionnaire-2 Factors (R-SPQ-2F). Results: Exploratory factor analysis showed a suitable four factors solution, which is approved by confirmatory factor analysis indices [χ2 = 466.47, TLI = 0.94, CFI = 0.95; RMSEA = 0.56 IC 90% (0.050-0.062)]. Internal consistency of the PE-SPQ simultaneously checked by McDonald's ω, Cronbach's α and Gutmann's λ6 showed good reliability of the PE-SPQ. Convergent validity examined by Average variance extracted (AVE) was good. The comparison between the AVE root mean square and Pearson correlation coefficients of each factor with his indicators reveals the discriminant validity of the PE-SPQ. Furthermore, Pearson's correlation between the PE-SPQ factors and the R-SPQ-2F establishes the concurrent validity of the new scale. Conclusion: The PE-SPQ scale is valid and reliable and can be used to assess study process factors in physical education students.

Social Media Use and Its Associations With Mental Health 9 Months After the COVID-19 Outbreak: A Cross-National Study.

Background: The covid-19 pandemic has impacted the health and well-being of millions across the globe. Strict social distancing policies and periodic lockdowns has led to an increased reliance on alternative online means of communication, including social media. Objectives: to examine (i) social media use and mental health in the general population 9 months after the COVID-19 pandemic outbreak and (ii) mental health in relation to motives for and extent of social media use, while adjusting for sociodemographic variables. Methods: A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3,474) reported extent of and motives for social media use and completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests, one-way analyses of variance, and multiple linear regression analysis. Results: Poorer mental health was associated with using social media to decrease loneliness and for entertainment motives, while better mental health was associated with using social media for personal contact and maintaining relationships. Overall increased daily time on social media was associated with poorer mental health. The social media use variables were responsible for a substantial proportion of the outcome variance explained. These findings were consistent across the four countries, with only minor variations. Conclusions: Motives for using, and time spent using, social media were associated with the participants' mental health. Guidance and recommendations for social media usage to the general public for prevention and intervention for behavioral health may be beneficial.

Willingness to Take the COVID-19 Vaccine as Reported Nine Months after the Pandemic Outbreak: A Cross-National Study

Although vaccination has been identified as an effective measure of reducing the spread of COVID-19, hesitancy to obtain a vaccine for COVID-19 has been shared. The aim of this cross-national study was to examine (i) the willingness in the general population to take the COVID-19 vaccine nine months after the pandemic outbreak and (ii) the willingness to take the vaccine in relation to sociodemographic variables, whether one has experienced COVID-19 infection, concerns about health and family, and trust in the authorities’ information about the pandemic. A cross-sectional survey design was used to collect data online in Norway, the UK, the USA, and Australia. Chi-Square tests or Fisher’s Exact test were used to analyze the data. Logistic regression analysis was used to assess direct associations between the independent variables and the outcome. Within the total sample (n = 3474), living in a city, having a college education, being concerned about your own health and the health of next of kin, and trusting information provided by authorities increased the likelihood of reporting willingness to take the COVID-19 vaccine. Across all countries, participants who reported trust in the authorities' information about COVID-19 demonstrated a significantly higher plausibility of taking the COVID-19 vaccine.

Perceived Trust in Public Authorities Nine Months after the COVID-19 Outbreak: A Cross-National Study

This study aimed to examine the perceived trust in information provided by public authorities and financial measures put in place to address the impact of COVID-19. Using a cross-national approach among four Western countries—the United States of America, Norway, Australia, and the United Kingdom—provides an analysis of responses related to trust and how they were associated with age group, gender, education level, employment status, size of place of residence, infection status, and social media use. When controlling for all included variables in logistic regression analyses, the likelihood of having trust in the public authorities’ information was higher for women, those with higher levels of education, and those living in urban areas. Being infected with the coronavirus, and spending more time daily on social media, were both associated with lower likelihood of reporting trust in information. Although policies implemented to respond to economic concerns varied cross-nationally, higher age, identifying as female, being employed, living in a city, no COVID-19 infection experience and lower levels of social media usage were associated with a higher likelihood of trusting in the financial measures put in place to counteract the economic effects of COVID-19.

Use and self-perceived effects of social media before and after the COVID-19 outbreak: a cross-national study.

To (i) examine the use of social media before and after the COVID-19 outbreak; (ii) examine the self-perceived impact of social media before and after the outbreak; and (iii) examine whether the self-perceived impacts of social media after the outbreak varied by levels of mental health. A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3810) reported which social media they used, how frequently they used them before and after the COVID-19 outbreak, and the degree to which they felt social media contributed to a range of outcomes. The participants also completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests and multiple linear regression analysis. Social media were used more frequently after the pandemic outbreak than compared to before the outbreak. Self-perceived effects from using social media increased after the COVID-19 outbreak, and in particular stress and concern for own and others' health. Emotional distress was associated with being more affected from using social media, in particular in terms of stress and concern for own or others' health. The use of social media has increased during the coronavirus outbreak, as well as its impacts on people. In particular, the participants reported more stress and health concerns attributed to social media use after the COVID-19 outbreak. People with poor mental health appear to be particularly vulnerable to experiencing more stress and concern related to their use of social media.

Psychological responses and associated factors during the initial lockdown due to the corona disease epidemic (COVID-19) among Norwegian citizens.

BACKGROUND: Ongoing COVID-19 studies pay little attention to the risk or protective factors related to psychological stress. AIMS: This study aims to estimate the prevalence of anxiety, depression and insomnia during the initial phase of the COVID-19 outbreak, and explore factors that might be associated with these outcomes. METHODS: A population-based cross-sectional survey was conducted using snowball-sampling strategy. Participants from 18 years or older filled out an anonymous online questionnaire. RESULTS: A total of 4527 citizens filled out the questionnaire. Prevalence rates were; insomnia 31.8%, anxiety 17.1% and depression 12.5%. Risk factors associated with anxiety, depression and insomnia were being single (OR = 0.75, OR = 0.57, OR = 0.59), unemployed (OR = 0.47, OR = 0.53, OR = 0.73), financial concerns (OR = 1.66, OR = 2.09, OR = 1.80) at risk for complication from COVID-19 (OR = 1.63, OR = 1.68, OR = 1.60), and being generally worried due to the COVID-19 (OR 0 3.06, OR = 1.41, OR = 1.74). CONCLUSION: Being single, unemployed, at risk of health complications, or having concerns because of financial or other consequences of the pandemic are associated with mental health adversities such as anxiety, depression and insomnia during a pandemic lockdown.

Cross-National Study of Worrying, Loneliness, and Mental Health during the COVID-19 Pandemic: A Comparison between Individuals with and without Infection in the Family.

OBJECTIVE: The objective of this study was to examine differences in worry, loneliness, and mental health between those individuals infected by COVID-19 or having someone their family infected, and the rest of the population. METHODS: A cross-sectional online survey was conducted in Norway, UK, USA, and Australia during April/May 2020. Participants (n = 3810) were recruited via social media postings by the researchers and the involved universities. Differences between those with and without infection in the family were investigated with chi-square tests and independent t-tests. Multiple regression analyses were used to assess associations between sociodemographic variables and psychological outcomes (worry, loneliness, and mental health) in both groups. RESULTS: Compared to their counterparts, participants with infection in the family reported higher levels of worries about themselves (p < 0.05) and their family members (p < 0.001) and had poorer mental health (p < 0.05). However, the effect sizes related to the differences were small. The largest effect (d = 0.24) concerned worries about their immediate family. Poorer psychological outcomes were observed in those who were younger, female, unemployed, living alone and had lower levels of education, yet with small effect sizes. CONCLUSIONS: In view of the small differences between those with and without infection, we generally conclude that the mental health effects of the COVID-19 situation are not limited to those who have been infected or have had an infection within the family but extend to the wider population.

Use of Alcohol and Addictive Drugs During the COVID-19 Outbreak in Norway: Associations With Mental Health and Pandemic-Related Problems.

Background: The outbreak of COVID-19 has had a major impact on people's daily life. This study aimed to examine use of alcohol and addictive drugs during the COVID-19 outbreak in Norway and examine their association with mental health problems and problems related to the pandemic. Methods: A sample of 4,527 persons responded to the survey. Use of alcohol and addictive drugs were cross-tabulated with sociodemographic variables, mental health problems, and problems related to COVID-19. Logistic regression analyses were used to examine the strength of the associations. Results: Daily use of alcohol was associated with depression and expecting financial loss in relation to the COVID-19 outbreak. Use of cannabis was associated with expecting financial loss in relation to COVID-19. Use of sedatives was associated with anxiety, depression, and insomnia. Use of painkillers was associated with insomnia and self-reported risk of complications if contracting the coronavirus. Conclusion: The occurrence of mental health problems is more important for an understanding of the use of alcohol and addictive drugs during the COVID-19 outbreak in Norway, compared to specific pandemic-related worries.

Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample.

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

Video-Based Communication and Its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak.

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60-69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between the use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60-69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, the use of video-based communication was associated with less loneliness (ß = -0.12, p < 0.01) and higher quality of life (ß = 0.14, p < 0.01) among participants aged 60-69 years, while no associations were observed for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between the use of video-based communication tools and psychological outcomes amongst older people.

Concerns in the Norwegian Population during the Initial Lockdown Due to the COVID-19 Pandemic.

Although concern affects one's welfare or happiness, few studies to date have focused on peoples' concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.

Loneliness and Its Associated Factors Nine Months after the COVID-19 Outbreak: A Cross-National Study.

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local "social distancing" policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.

Mental health, quality of life, wellbeing, loneliness and use of social media in a time of social distancing during the COVID-19 outbreak. A cross-country comparative study.

BACKGROUND: The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time. AIMS: To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia. METHODS: A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media. RESULTS: There were 3810 respondents from four countries, of which 50 - 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health. CONCLUSIONS: The results suggest that the COVID-19 outbreak took a toll on people's experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors.

Employment Uncertainty and Mental Health During the COVID-19 Pandemic Initial Social Distancing Implementation: a Cross-national Study.

BACKGROUND: Social distancing during the COVID-19 pandemic has resulted in changes in the work environment and employment uncertainty. This paper reports on a cross-national comparison of four countries (Norway, UK, USA and Australia) and examines the differences in mental health between those individuals employed and those not employed during the social distancing implementation. METHODS: Participants (N = 3,810) were recruited through social media in April/May 2020 and were invited to complete a self-administered electronic survey over a 3-week period. Differences between those employed and those not employed with regard to their sociodemographic characteristics and mental health were investigated with chi-square tests, independent t tests, and one-way analysis of variances (ANOVAs). RESULTS: Compared with their counterparts, participants who were employed reported lower levels of mental health distress (p < 0.001), higher levels of psychosocial well-being (p < 0.001), better overall quality of life (p < 0.001), and lower levels of overall loneliness, social loneliness, and emotional loneliness (p < 0.001). Small to medium but consistent differences (Cohen's d = 0.23-0.67) in mental health favor those with employment or those who were retired. CONCLUSION: Further study is needed to assess mental health over time as the COVID-19 pandemic and employment uncertainty continues.