The impact of COVID-19 on depressive symptoms and loneliness for middle-aged and older adults

This study examines the impact of the COVID-19 pandemic on depressive symptoms and loneliness in older adults, using the Protection Motivation Theory Framework. Using data collected between March 2020 and May 2021 as part of the Health and Retirement Study (N = 2145 adults over age 50), the roles of threat and coping appraisals as predictors of protective health behaviors and, ultimately, mental health outcomes, were analyzed using structural equation modeling. Being at high risk for COVID-19 complications and death was associated with more depressive symptoms and loneliness. Higher levels of concern about COVID-19 were associated with more depressive symptoms while knowing someone who had died of the coronavirus was associated with less loneliness. Lower scores for perceived control over one's health and social life were associated with more depressive symptoms and higher loneliness. These results suggest that moving forward, mental health assessments should consider the impact of the pandemic and include measures specifically asking about COVID-19 concerns and experiences (e.g., death of close friends or family due to COVID-19, protective health measures). Additionally, future responses to this pandemic and other public health emergencies should consider the influence that self-efficacy has on health behaviors and mental health. The pandemic has raised public awareness of the negative consequences of social isolation and acted to destigmatize mental illness, and this greater awareness could encourage middle-aged and older adults to seek various treatments for depression and loneliness.

FACTORS THAT PREDICT LONELINESS FOR MIDDLE-AGED AND OLDER ADULTS DURING THE COVID-19 PANDEMIC

The Protection Motivation Theory (Eberhardt & Ling, 2021;Rogers, 1975) describes factors that influence intention and engagement in preventive health behaviors, including knowledge/experience, threat appraisal, and coping/efficacy appraisal. Public health responses to the covid-19 pandemic were designed to increase knowledge, emphasize potential severity of being infected, and promote preventive health behaviors – all with the goal of reducing infection transmission. However, these efforts may have inadvertently increased loneliness, particularly for older adults. This study used 2020 Health and Retirement Study data (N=1,687 adults over age 50) to examine predictors of loneliness based on the PMT framework, controlling for demographic factors and 2016 loneliness scores. Structural Equation Model results indicate that being at higher risk for covid-19 complications and death was associated with lower feelings of control over health (B=-.09), greater likelihood of knowing someone who died from covid-19 (B = .20), and higher overall concerns about covid-19 (B=.12), all p<.01. Higher concerns about covid-19 and knowing someone who died from covid-19 were associated with more protective behaviors (B=.41, p<.01;B=.05, p<.05;respectively). Not knowing someone who died of COVID-19, and lower perceived control over health and social life were all significantly associated with higher loneliness scores. These results suggest that interventions that promote perceived control over one's health and social life may be effective in reducing feelings of loneliness in this population, and that feelings of control over health also increases preventive health behaviors that reduce the risk of covid-19 infection.

Dash-safe: A multi-modal geographic information system (GIS) dashboard for near real-time mapping of perceived covid risk/safety in a campus environment

Objective: To provide near-real-time information for risk assessment, risk management and stress reduction during COVID campus re-entry. Methods: The DASH-SAFE dashboard (DASHboard-Stress At-Risk Facilities Environment), shows safer and riskier areas for COVID-re-entry to the University of Arizona (UArizona) campus by overlaying inputs from multiple surveillance technologies onto an interactive GIS campus map, including: survey of perceived feelings of safety/risk related to observed health behaviors (face coverings, physical distancing);predictive modeling of people's movement through campus;building coding related to viral spread risk (occupancy/ density, ventilation rate). Users also rated their stress level and DASH-SAFE's stress reducing effect. Survey responses appear as color-coded points on the map. A pilot study using QR code prompt posters, user observations, user interviews, and a qualitative survey to explore user expectations and assess ease of use was carried out at UArizona Libraries. Predictive modeling for movement through campus was based on class schedules and known mealtimes. Results: Beta testing through a campus-wide e-mailing garnered 67 responses. 61% noted areas of safety;9% areas of distancing risk;7.5% areas of masking risk;58% noted low stress. 3 of 6 respondents who scored the tool's stress reduction effect rated it 4 stars and 2 as 5 stars. 21 respondents in the UArizona Libraries pilot study provided data that improved understanding of how they perceive safety in addition to masking and distancing space, e.g., monitoring and hand sanitizers, and informed improvements for ease of use (e.g. simplify instructions, improve location instructions, specify COVID-related stress reduction). Predictive modeling revealed anticipated pinch points and maximal building occupancy over time. Conclusion: DASH-SAFE can help users assess and avoid areas of risk and help reduce their stress. Beta and pilot testing data will be used to modify and improve the tool and a navigation and alarm tool will be added in subsequent versions.