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OBJECTIVE: To assess risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic using Mind-COVID, a prospective cross-sectional study that compares outcomes in middle-income economies and high-income economies. METHODS: A total of 7102 pregnant women from 12 high-income economies and nine middle-income economies were included. The web-based survey used two standardized instruments, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). RESULT: Pregnant women in high-income economies reported higher PHQ-9 (0.18 standard deviation [SD], P < 0.001) and GAD-7 (0.08 SD, P = 0.005) scores than those living in middle-income economies. Multivariate regression analysis showed that increasing PHQ-9 and GAD-7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ-9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD-7 scores were associated with a pregnancy-related complication, fear of adverse outcomes in children related to COVID-19, and feeling of burden related to finances. CONCLUSIONS: According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.
ABSTRACT
This paper explores participation trends in interventions that promote self‐evaluation exercises on the effective use of digital technologies in schools. We use a unique dataset consisting of 83,185 respondents from 924 Spanish schools that used SELFIE, a tool based on self‐reflection questionnaires that capture different dimensions of school's digital capacity. We benefit from a natural experiment situation caused by the parallel use of SELFIE by two groups of schools. The first group was externally selected as part of a representative sample of Spanish schools. Conversely, the second group voluntarily decided to use SELFIE as a diagnostic tool for a subsequent self‐evaluation exercise. Moreover, a subset of schools were located in regions where authorities embedded SELFIE in broader digitalisation programmes. By comparing these groups, it is shown that schools that decide to participate in SELFIE voluntarily are those with a lower initial digitalisation level. It is also found that the promotion of the use of SELFIE as part of public interventions can increase participation but mainly attracts digitally advanced schools. In conclusion, policy interventions aiming to develop the digital capacity of schools need to plan how to reach those schools that need it more in order to be more equitable. Practitioner notesWhat is already known about this topicResearch has shown the existence of a Matthew effect in the usage of digital technologies in education.The promotion of schools self‐evaluation exercises on digital education is a common policy intervention that is growing in importance.There is a surprising lack of attention to the inequitable effects that programmes aiming to incorporate technologies in educational institutions may generate.What this paper addsThis paper investigates the self‐selection trends and (un)equity effects of SELFIE, an EU programme designed to prompt schools' self‐evaluations of digital capacity.When schools decide autonomously, schools with low digital capacity levels tend to participate in SELFIE more.Incorporation of SELFIE into broader public programmes enlarges participation in SELFIE.Incorporation of SELFIE into broader public programmes over‐attracts digitally advanced schools.Implications for practice and/or policyPublic policies promoting self‐evaluation exercises on school digital capacity in schools might be a good way for upscaling these exercises.However, these policies should be carefully designed to reduce inequalities and reach these schools that need digitalisation more. [ FROM AUTHOR] Copyright of British Journal of Educational Technology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
INTRODUCTION: The article presents a protocol of a cross-sectional study of mental health of pregnant women in relation to the coronavirus disease 19 (COVID-19) pandemic. The primary aim is to compare differences in anxiety and depression scores of pregnant women between countries affected by the COVID-19 pandemic. The secondary aim is to assess demographic, economic, and social aspects affecting maternal anxiety and depression scores among pregnant women worldwide in the time of the COVID-19 pandemic. Finally, we will be able to compare differences in perception of the different aspects of the COVID-19 pandemic (social distancing, restrictions related to delivery) between countries and according to the epidemic status (number of infected patients, number of reported deaths). The comparisons will also be done according to the COVID-19 status of the participants. METHODS AND ANALYSIS: It is a web-based anonymous survey of pregnant women living in countries affected by the COVID-19 pandemic. The survey is comprised of 3 sections:Web-based recruitment for health research has proven to be cost-effective and efficient. At current times with the COVID-19 pandemic, limited resources and social distancing restrictions, performing a mental health study involving pregnant women on a large international scale cannot be safely conducted without involving social-media.The fears of pregnant women fall into 3 categories: the medical condition, the economic status and the organization of daily activity.The study has received approval of the medical ethics committee and has been registered on Clinicaltrials.gov. Results will be published in peer-reviewed journals and made public through all available media.