ABSTRACT
BACKGROUND: The U.S. public health response to COVID-19 has been widely criticized as having downplayed the potential implications COVID-19 could have on one's personal health. Despite the unprecedented threat of COVID-19, many individuals still believed that it was not at all likely that they would become infected. We examined: (1) the yearlong trend of adults' perceived susceptibility to COVID-19, (2) whether distinct trajectories emerged, and (3) whether the trajectories differed by participant sociodemographic characteristics. METHODS: Participants from Chicago were recruited from one of five ongoing NIH-funded studies managed by our research team. Data was collected at five timepoints, where participants were asked about their susceptibility to COVID-19, in addition to their socio-demographic and health-related data. We identified groups of individuals following similar progressions of perceived susceptibility to COVID-19 and classified them into trajectory groups using the traj command in Stata. Associations between participant characteristics and their trajectory group were examined in bivariate analyses. Additionally, a multivariable Poisson model was used to estimate relative risks of following a certain trajectory. RESULTS: Nearly two-thirds (62.2%) of participants perceived themselves to be highly susceptible to COVID-19 from the onset of the pandemic ('early responders') and sustained this over a year, 29.0% eventually perceived themselves to be highly susceptible ('late responders'), and 8.8% maintained a low likelihood of susceptibility throughout the pandemic ('non-responders'). In multivariate analyses, compared to White participants, Latinx participants were significantly more likely to be non-responders and report low likelihood of perceived susceptibility (RR: 3.46;95% CI: 1.19, 10.1), as were Black participants (RR: 5.49;95% CI: 2.19, 13.8). CONCLUSIONS: A year into the COVID-19 pandemic, 1 out of 11 participants persistently did not think they might be susceptible and potentially infected. Future studies are needed to understand reasons why certain individuals, particularly those of racial/ethnic minorities, did not perceive themselves at risk for infection.
ABSTRACT
Background: At the outbreak of the pandemic in Chicago, there were disruptions in daily life, communication and delivery of healthcare services. Our objective was to investigate mental well-being, lifestyle behaviors, self-management capacity and healthcare utilization during the early months of the COVID-19 pandemic among older adults with one or multiple chronic conditions. Methods: Telephone interviews were conducted as part of the ongoing COVID-19 & Chronic Conditions (C3) study between March and May 2020. Participants were recruited from local academic and safety net clinics and participated in existing research studies prepandemic. Self-report items assessed perceived stress due to coronavirus, self-management capacity and healthcare utilization. Validated measures assessed well-being, alcohol consumption, physical activity and self-efficacy. Results: The average age of participants (N=565) was 62.4, most were female (61.4%), and over half (n=310) were non-White or Latinx. One in five (20.7%) participants were stressed about the coronavirus most or all the time. Almost a quarter (22.3%) engaged in hazardous drinking and 79.7% reported insufficient physical activity. Nearly one in four participants (23.7%) avoided seeking medical care due to worry about COVID-19. In multivariable analyses, women reported more stress than men. Greater COVID-19 related stress and low health activation were associated with less physical activity, lower self-efficacy, greater difficulty managing health/medications and more avoidance of medical care. Conclusion: Consequences of COVID-19 on the mental wellbeing, lifestyle and ability of adults with chronic conditions to manage health were apparent in the initial months of the pandemic. As the C3 study is ongoing, it will be possible to examine pre- and postpandemic factors over time to understand the influence of the pandemic on the overall health trajectories of older adults.