ABSTRACT
Rural communities are at higher risk for physical inactivity, poor dietary behaviors, and related chronic diseases and obesity. These disparities are largely driven by built environment, socioeconomic, and social factors. A community-based cluster randomized controlled trial of an intervention, the Change Club, aims to address some of these disparities via civic engagement for built environment change. Baseline data collection began in February 2020, only to be paused by the COVID-19 pandemic. In this context, the investigators evaluated multiple approaches for collecting data when the study resumed, focusing on Life's Simple 7, and additional anthropometric, physiologic, and behavioral outcomes in rural and micropolitan (<50,000 population) communities in Texas and New York. Life's Simple 7 includes fasting blood glucose, total cholesterol, blood pressure, weight, physical activity, diet, and smoking. Rigor and feasibility were considered across a variety of in-person versus at-home measurement options. After a comprehensive input from participants, partners, staff, researchers, and the funding liaison, the study team chose self-measurement and use of validated questionnaires/surveys to measure the Life's Simple 7 components. This case provides an example of how a study team might adjust data collection protocol during unexpected and acute events while giving consideration to rigor, feasibility, stakeholder views, and participants' health and safety.
ABSTRACT
PURPOSE: COVID-19 is largely spread through close contact with infected people in indoor spaces. Avoiding these spaces is one of the most effective ways to slow the spread. This study assessed who had engaged in risky travel and leisure behaviors before the availability of vaccines. DESIGN: National cross-sectional on-line survey collected in November and December 2020. Setting: United States; Participants: 2589 adults representative by gender and race/ethnicity to the US population; Measures: The survey assessed if people had resumed 11 risky behaviors during the pandemic, prior to vaccines. Independent variables included age, race/ethnicity, region of the country, education, income, preexisting conditions, perceived severity and susceptibility, positive COVID diagnosis, and political ideology. ANALYSIS: Univariate analysis and logistic regressions were used to assess demographic and psychological factors of those resuming these behaviors. Results: Most (60.3%) of people had resumed at least 1 behavior with eating inside of restaurants (33.2%) and visiting family and friends (37.5%) being the most prevalent. In the multivariate analyses, perceived susceptibility was significant across all behaviors. Young people, fiscal conservatives, and people with higher perceived severity were more likely to perform several of the behaviors. Preexisting conditions did not predict any of the behaviors. CONCLUSIONS: Travel and leisure behaviors vary by type of risk and may need specific tailored, prevention messages to promote risk reduction during future pandemics.