Domestic Violence Victimization Among Men Who Have Sex with Men in China During the COVID-19 Lockdown.

Many countries worldwide have implemented dedicated measures, such as shelter at home, to contain the spread of the COVID-19 virus. However, those mitigation measures may have major implications for individuals living with someone abusive or controlling. Domestic violence (DV) may be one of the unintended consequences of public health measures due to increased various stressors and reduced access to support and services. There has been a lack of empirical research on DV victimization among gender and sexual minorities, a population vulnerable to interpersonal violence and its associated adverse health outcomes. This study investigates the prevalence of DV victimization among men who have sex with men (MSM) in Jiangsu Province, China, during the COVID-19 lockdown and its correlates with COVID-19-related psychosocial and health stressors. A total of 413 MSM were recruited via snowball sampling, venue-based, and internet-based sampling from four cities in Jiangsu Province. After providing informed consent, all participants completed study questionnaires, followed by HIV testing. Over a quarter of the participants (27.4%) reported DV victimization during the COVID-19 lockdown, including experience of verbal, physical, or sexual abuse. After adjusting sociodemographic factors, DV victimization was associated with various adverse experiences during the COVID-19 lockdown, including increased stress or anxiety level, increased alcohol use, and housing instability. Study findings underscore the prevalence of DV victimization among MSM during the COVID-19 pandemic in China. The results can inform public health efforts to raise awareness and address DV victimization among MSM in the low- and middle-income country context during the COVID-19 pandemic. Adequate health and social services and economic resources are also critical to address the needs of MSM experiencing DV victimization.

Health Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective Factors.

ABSTRACT: Dual epidemics of coronavirus disease 2019 (COVID-19) and HIV cause burnout among HIV health care workers. Guided by a socioecological framework, we investigated risk and protective factors of their burnout in Guangxi, China based on an online survey (N = 1,029) from April to May 2020. Descriptive and bivariate analyses and hierarchical regression were conducted. COVID-19-related stressors (B = 0.648 [0.482-0.816], p < .001), challenges while delivering HIV services (B = 0.236 [0.174-0.298], p < .001), and working in province/city-level institutes (B = 2.302, [0.828-3.776], p =.002) were risk factors. Protective factors were resilience (B = -0.596 [-0.687 to -0.504], p < .001), workplace social support (B = -0.410 [-0.717 to -0.044], p =.03), and institutional responsiveness to COVID-19 (B = -0.138 [-0.205 to -0.071], p < .001), respectively. Burnout-related interventions may benefit from promoting resilience, creating a supportive work environment, and strengthening institutional response to public health emergencies.

The Psychological Effect of Internet-Based Mindfulness-Based Stress Reduction on the Survivors of Breast Cancer During the COVID-19.

Objective: To examine the efficacy and the role of engagement of an internet-based Mindfulness-based Stress Reduction (iMBSR) for survivors of breast cancer (BC) during the COVID-19 period from January to March in 2020 in China. Methods: 48 survivors of BC were divided into the absentees group and the iMBSR groups according to their attending to the standardized, group-based, 8-week iMBSR. Based on practice time, survivors of BC in the iMBSR were categorized into three subgroups: group 1 (<30 min/day), group 2 (30-60 min/day), and group 3 (>60 min/day). In addition, participants were classified as partial attendees (<4 sessions) and completers (more than 4 sessions) of the iMBSR groups. All participants were evaluated for symptoms of depression, anxiety and insomnia at baseline, mid-intervention, and post-intervention. Results: After an 8-week iMBSR practice, at mid-intervention and post-intervention, participants in iMBSR group had significant improvement in scores and reduction rates of depression, anxiety, and insomnia compared to absentees. Scores of depression and insomnia, reduction rates of depression at post-intervention, scores of anxiety, reduction rates of anxiety and insomnia at mid-intervention and post-intervention, had significant differences among subgroups of practice time. Daily practice time was positively related to reduction rates of depression, anxiety and insomnia at post-intervention in the iMBSR group. Conclusion: Internet-based MBSR showed efficacy in reducing psychological symptoms among survivors of BC. For survivors of BC, iMBSR practice has a potential dose-response efficacy, with a threshold of >30 min daily practice for most optimal symptoms reduction. Trial Registration: Registration number is [ChiCTR2100044309].

A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial.

This randomized controlled trial evaluated the effect of a mindfulness-based mobile health (mHealth) intervention, tailored to the pandemic context, among young adult students (N = 114) with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a time- and attention-matched social support-based mHealth control. At baseline, postintervention (1 month), and 2-month follow-up, participants completed self-reports of primary outcomes (anxiety and depression), secondary outcomes (mindfulness and social support), and emotional suppression as a culturally relevant mechanism of change. Feasibility and acceptability were also evaluated. Using intent-to-treat (ITT) analysis, linear mixed effects models showed that compared to social support mHealth, mindfulness mHealth had a superior effect on anxiety (p = .024, between-group d = 0.72). Both conditions improved on depression (baseline-to-FU ds > 1.10, between-group difference not significant, d = 0.36 favoring mindfulness). There was an interaction of Emotional suppression reduction × Condition in the improvement of anxiety and depression. Further, mindfulness mHealth was demonstrated to be more feasible and acceptable in program engagement, evaluation, skills improvement, and perceived benefit. Retention was high in both conditions (>80%). The difference in self-reported adverse effect was nonsignificant (3.9% in mindfulness and 8.7% in social support). Results of this pilot trial suggest that both mindfulness and social support, delivered via mHealth, show promise in reducing distress among young adults in quarantine, with mindfulness being particularly effective in addressing anxiety. Successful implementation and dissemination of this mHealth intervention approach have the potential for addressing the psychological consequences of the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Interest in COVID-19 vaccine trials participation among young adults in China: Willingness, reasons for hesitancy, and demographic and psychosocial determinants.

With the demand for rapid COVID-19 vaccine development and evaluation, this paper aimed to describe the prevalence and correlates of willingness to participate in COVID-19 vaccine trials among university students in China. A cross-sectional survey with 1912 Chinese university students was conducted during March and April 2020. Bivariate and multivariate analyses were performed to identify variables associated with willingness to participate. The majority of participants (64.01%) indicated willingness to participate in COVID-19 vaccine trials. Hesitancy over signing informed consent documents, concerns over time necessary for participating in a medical study, and perceived COVID-19 societal stigma were identified as deterrents, whereas lower socioeconomic status, female gender, perception of likely COVID-19 infection during the pandemic, and COVID-19 prosocial behaviors were facilitative factors. Further, public health mistrust and hesitancy over signing informed consent documents had a significant interactive effect on vaccine trial willingness. High standards of ethical and scientific practice are needed in COVID-19 vaccine research, including providing potential participants full and accurate information and ensuring participation free of coercion, socioeconomic inequality, and stigma. Attending to the needs of marginalized groups and addressing psychosocial factors including stigma and public health mistrust may also be important to COVID-19 vaccine development and future uptake.

Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China.

BACKGROUND: The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China (N = 1912) through a cross-sectional survey during March and April 2020. RESULTS: Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Screen media device usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms. CONCLUSIONS: Findings suggest high need for psychological health promotion among university students during the COVID-19 pandemic and inform an ecological perspective on the detrimental role of stigma during an emerging infectious disease outbreak. Interventions targeting multi-level factors, such as promoting mindfulness and social support at individual and interpersonal levels while reducing public stigma about COVID-19, may be particularly promising. Attending to the needs of disadvantaged groups including those financially impacted by COVID-19 is needed.

Challenges to HIV service delivery and the impacts on patient care during COVID-19: perspective of HIV care providers in Guangxi, China.

The COVID-19 pandemic has brought immense challenges on the health system including HIV care service. Based on online survey data of 1,029 HIV care providers in Guangxi, China, we assessed their perspectives on the challenges for HIV service delivery and perceived impacts of such challenges on patient care during the COVID-19 outbreak. Multivariate regression analysis was conducted to test the association between specific challenges and patient care outcomes controlling for socio-demographics of HIV care providers. The prominent impacts of COVID-19 on patient care outcomes included "not being able to make follow-up visits on time", "not being able to get ARV refills timely", and "compromised ART adherence". Patient care outcome was significantly associated with "not being able to go to work due to quarantine and traffic restriction", "no overall arrangement", "no guideline for HIV service", "conflicts between HIV care and response to COVID-19", and "clinics were overwhelmed by COVID-19 care". In response to dual epidemics of COVID-19 and HIV, policy makers may consider the potential impact of large-scale preventive strategies (e.g., lockdowns) on HIV care, assist healthcare providers to navigate shifting tasks and resetting priorities effectively, and develop clear guidelines and clinic-level arrangements to best serve both COVID-19 and HIV patients.

Mental Health Problems of HIV Healthcare Providers During the COVID-19 Pandemic: The Interactive Effects of Stressors and Coping.

HIV healthcare providers might be vulnerable to mental health problems during the COVID-19 pandemic. Guided by the stress and coping paradigm, the current study aimed at examining the interactive effects of COVID-19-related stressors and coping on mental health problems. A cross-sectional online survey was conducted among 1029 HIV healthcare providers in Guangxi, China. The prevalence of depression and anxiety in the current study was 13.31% and 6.61%, respectively. Results from path analyses revealed that the main effects of COVID-19-related stressors and coping were significant on both depression and anxiety. The interaction of coping and COVID-19-related stressors had significant effects on depression and anxiety. Simple slope tests revealed that more coping behaviors buffered against the negative effect of COVID-19-related stressors on mental health problems. Coping acted as a protective factor that alleviated the harm of COVID-19-related stressors on mental health. Intervention targeting coping management might benefit the mental health of HIV healthcare providers.

Psychological Distress Among HIV Healthcare Providers During the COVID-19 Pandemic in China: Mediating Roles of Institutional Support and Resilience.

Psychological distress among healthcare providers is concerning during COVID-19 pandemic due to extreme stress at healthcare facilities, including HIV clinics in China. The socioecological model suggests that psychological distress could be influenced by multi-level factors. However, limited COVID-19 research examined the mechanisms of psychological distress among HIV healthcare providers. This study examined organizational and intrapersonal factors contributing to psychological health during COVID-19 pandemic. Data were collected via online anonymous surveys from 1029 HIV healthcare providers in Guangxi, China during April-May 2020. Path analysis was utilized to test a mediation model among COVID-19 stressors, institutional support, resilience, and psychological distress (PHQ-4). Thirty-eight percent of the providers experienced psychological distress (PHQ-4 score > 3). Institutional support and resilience mediated the relationship between COVID-19 stressors and psychological distress. Psychological distress was common among Chinese HIV healthcare providers during COVID-19 pandemic. Psychological health intervention should attend to institutional support and resilience.

Need for a population health approach to understand and address psychosocial consequences of COVID-19.

This commentary article provides observations on the psychosocial consequences of the coronavirus disease 2019 (COVID-19) among people in China and articulates a population health perspective to understand and address identified issues. We highlight key psychosocial effects of COVID-19, such as anxiety, insomnia, and trauma response, in the context of salient factors that shape Chinese people's psychological experiences, including the availability of Internet and technology, large-scale quarantine, economic impact, and the rise of xenophobia globally. Further, from a population health perspective, we make recommendations in COVID-19-related research and interventions that aim to promote the psychosocial health of Chinese people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Brief Transdiagnostic Pandemic Mental Health Maintenance Intervention.

The COVID-19 pandemic qualifies as a major national and global disaster. Behavioral health providers are poised to provide psychological crisis interventions to reduce the psychosocial effects. This paper presents a brief transdiagnostic mental health maintenance intervention tailored to treat adults and families with distress symptoms as a consequence of the ongoing COVID-19 pandemic. The intervention components include evidence-based techniques which have been strategically selected to address mental health distress related to the pandemic and to prevent the escalation of distress as the pandemic continues. The intervention aims to be flexibly incorporated into care based on the provider and needs of the presenting individuals. The intervention incorporates components of evidence-based treatments such as Cognitive Behavioral Therapy and associated "third wave" therapies (e.g. Dialectical Behavioral Therapy and Acceptance and Commitment Therapy). The intervention can be delivered via telehealth and includes the following modules: 1) Agenda Setting & Avoidance Identification; 2) Responding to Difficult News/Normalizing Reactions; 3) Perspective Taking; 4) Situational Control/Acceptance; 5) Maintaining a Healthy Routine; 6) Coping with Stress; 7) Insomnia Preventions; and 8) Building Resiliency & Hope. A list of pleasurable activities that can be completed at home and technology modalities to maintain social interactions is included. The intervention also includes the Pandemic Mental Health Maintenance Intervention handout to provide to patients. Research is needed to test this intervention in a randomized controlled trial and assess efficacious intervention implementation strategies.