Non-participation to a longitudinal and interventional survey on the psychological impact of the COVID-19 pandemic among healthcare workers (PSYCOVER) in France

Introduction: We conducted a national longitudinal survey among healthcare workers in the context of the Covid-19 pandemic, (1) to assess mental health and (2) to describe the results of an intervention to improve capacity of resilience. Non-participation is rarely studied despite being an important methodological matter when performing studies on mental health. Objective(s): The study aims to describe and identify the factors associated with non-participation of healthcare workers to the intervention part of a national longitudinal study on the psychological impact of the COVID-19 pandemic. Method(s): Participants were recruited from April to October 2021 via an Internet link widely disseminated. Data collected include participant' socio-demographic, occupational and working conditions, general health, professional burnout and mental health. The intervention proposed the use of tools for self-management of stress and resilience (PsySTART-Responder and Anticipate.Plan.DeterTM program). A robust Poisson regression was used to identify factors associated with non-participation. Result(s): Among 724 participants, 41% participated to the intervention part. Factors associated to non-participation to the intervention were to work with few or no COVID-19 patients, and low scores in the anxiety scale. Social determinants, occupational characteristics or general health were not associated with non-participation. Conclusion(s): Our study provides a better understanding of the participation of healthcare workers that was not frequently studied. The results logically suggest lower participation among those with better mental health and not directly concerned with management of COVID-19 patients. Non-participation to the intervention was not associated with social factors, which is an argument in favour of using such a design/intervention in a socially heterogeneous population.

Symptoms of anxiety/depression during the COVID-19 pandemic and associated lockdown in the community: longitudinal data from the TEMPO cohort in France

Introduction: The COVID-19 pandemic and associated preventive measures have an impact on the persons' mental health, including increasing risk of symptoms of anxiety and depression in particular. Individual experiencing mental health difficulties in the past could be especially vulnerable during lockdown, however, few studies have tested this empirically considering preexisting mental health difficulties using longitudinal data. Objective(s): The objective of this study is to examine the longitudinal association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown due to the COVID-19 pandemic in a community sample. Method(s): Seven waves of data collection were implemented from March-May 2020. Generalized estimation equations models were used to estimate the association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown among 662 mid-aged individuals from the French TEMPO cohort. Result(s): We found an elevated odds ratio of symptoms of anxiety/ depression (OR=6.73 95% [CI=4.45-10.17]) among individuals experiencing such symptoms prior lockdown. Furthermore, the odds of symptoms of anxiety/depression during lockdown was elevated among women (OR=2.07 [95% CI=1.32-3.25]), subjects with low household income (OR=2.28 [1.29-4.01]) and persons who reported loneliness (OR=3.94 [2.47-6.28]). Conclusion(s): This study demonstrates a strong relationship between preexisting symptoms of anxiety/depression and anxiety/depression during the COVID-19 outbreak among mid-aged French adults. The findings underline the role of preexisting symptoms of anxiety/depression as a vulnerability factor of anxiety/depression during lockdown. Furthermore, the study shows that loneliness is independently associated with symptoms of anxious/depression, when controlling for prior anxiety/ depression symptoms.

COVID-19 vaccine hesitancy among persons living in homeless shelters in France.

COVID-19 vaccine hesitancy is frequent and can constitute a barrier to the dissemination of vaccines once they are available. Unequal access to vaccines may also contribute to socioeconomic inequalities with regard to COVID-19. We studied vaccine hesitancy among persons living in homeless shelters in France between May and June 2020 (n = 235). Overall, 40.9% of study participants reported vaccine hesitancy, which is comparable to general population trends in France. In multivariate regression models, factors associated with vaccine hesitancy are: being a woman (OR = 2.55; 95% CI 1.40-4.74), living with a partner (OR = 2.48, 95% CI 1.17-5.41), no legal residence in France (OR = 0.51, 95% CI 0.27-0.92), and health literacy (OR = 0.38, 95% CI 0.21, 0.68). Our results suggest that trends in vaccine hesitancy and associated factors are similar among homeless persons as in the general population. Dissemination of information on vaccine risks and benefits needs to be adapted to persons who experience severe disadvantage.

Knowledge, attitudes, practices and impact of COVID-19 among persons living in homeless shelters in France: first results of the echo study

Introduction - People experiencing socioeconomic disadvantage appear to have been especially impacted by the COVID-19 epidemic. Multiple factors could constitute obstacles to the implementation of preventive measures of SARS-CoV-2 infection and to access to health care. Persons experiencing socioeconomic disadvantage could also be more impacted by the social and economic consequences of the sanitary crisis. We aimed to study the knowledge, attitudes and practices related to the COVID-19 epidemic and its impact among persons living in homeless shelters in France. Methods - ECHO is a cross-sectional study conducted in 18 homeless shelters mostly in the Paris and Lyon regions from the 2d of May to the 7th of June 2020, during and just after the first COVID-19-related lockdown. The questionnaire was delivered by trained interviewers, with the help of an interpreter whenever needed. Results - Among the 535 participants who were included, we observed a good level of knowledge of COVID-19 symptoms and satisfactory acceptance of preventive and curative measures (ex. tests, isolation). Associated factors include age, schooling level, health literacy, duration of residence in the shelter and region of origin. An important proportion of participants reported not being able to access healthcare for non-related COVID-19 reasons during lockdown, and seeing their mental health and socioeconomic situation deteriorate.