Spatiotemporal disparities in regional public risk perception of COVID-19 using Bayesian Spatiotemporally Varying Coefficients (STVC) series models across Chinese cities.

Regional public attention has been critical during the COVID-19 pandemic, impacting the effectiveness of sub-national non-pharmaceutical interventions. While studies have focused on public attention at the national level, sub-national public attention has not been well investigated. Understanding sub-national public attention can aid local governments in designing regional scientific guidelines, especially in large countries with substantial spatiotemporal disparities in the spread of infections. Here, we evaluated the online public attention to the COVID-19 pandemic using internet search data and developed a regional public risk perception index (PRPI) that depicts heterogeneous associations between local pandemic risk and public attention across 366 Chinese cities. We used the Bayesian Spatiotemporally Varying Coefficients (STVC) model, a full-map local regression for estimating spatiotemporal heterogeneous relationships of variables, and improved it to the Bayesian Spatiotemporally Interacting Varying Coefficients (STIVC) model to incorporate space-time interaction non-stationarity at spatial or temporal stratified scales. COVID-19 daily cases (median contribution 82.6%) was the most critical factor affecting public attention, followed by urban socioeconomic conditions (16.7%) and daily population mobility (0.7%). After adjusting national and provincial impacts, city-level influence factors accounted for 89.4% and 58.6% in spatiotemporal variations of public attention. Spatiotemporal disparities were substantial among cities and provinces, suggesting that observing national-level public dynamics alone was insufficient. Multi-period PRPI maps revealed clusters and outlier cities with potential public panic and low health literacy. Bayesian STVC series models are systematically proposed and provide a multi-level spatiotemporal heterogeneous analytical framework for understanding collective human responses to major public health emergencies and disasters.

Social Capital Changes After COVID-19 Lockdown Among Youths in China: COVID-19 Impact on Lifestyle Change Survey (COINLICS).

Introduction: Social capital, the effective functioning of social groups through networks of relationships, can affect mental health and may be affected by COVID-19. We aimed to examine the changes in social capital before and after the COVID-19 lockdown among the Chinese youth. Methods: A national convenience sample of 10,540 high school, undergraduate, and graduate students, from the COVID-19 Impact on Lifestyle Change Survey (COINLICS), reported their demographic and social capital information before and after the COVID-19 lockdown. Social capital was retrospectively measured at four levels: individual (ISC), family (FSC), community (CSC), and society (SSC). The changes of social capital were also compared across three educational levels. Results: Overall, ISC and CSC scores generally decreased after lockdown (15.1 to 14.8 and 13.4 to 13.1, respectively), while FSC and SSC scores increased significantly (12.7 to 13.0 and 7.1 to 7.2, respectively). At the individual level, most participants showed a constant perceived social capital; more of the remaining participants showed decreased than increased ISC (30.5% vs. 17.0%) and CSC scores (28.4% vs. 19.1%), while more participants showed increased than decreased FSC (21.7% vs. 9.2%) and SSC scores (10.3% vs. 3.9%). Heterogeneities in social capital changes existed across educational levels. Conclusions: Our findings would provide health professionals and policy-makers solid evidence on the changes in social capital of youths after lockdowns, and therefore help the design of future interventions to rebuild or improve their social capital after epidemics/disasters.

Barriers to clinical trial enrollment among gynecologic oncology patients at a National Cancer Institute Comprehensive Cancer Center

The objective of this retrospective review was to assess barriers to successful clinical trial enrollment among gynecologic cancer patients at a comprehensive cancer center. A retrospective chart review was performed of all new patients and established patients requiring treatment changes seen in a clinic setting by physicians in the gynecologic oncology department at a national cancer institute between July 1, 2019, and June 30, 2020. Demographic information collected for each patient included age, race, language, distance from the cancer center, insurance type, marital status, education, performance status and medical history. Demographic factors were compared between patients who enrolled in trials and those who were deemed eligible for clinical trials but did not enroll. Patients who did not enroll in a clinical trial were stratified by the reason for not enrolling as physician factor, patient factor, trial factor, and screening failure. Data was collected in a secure REDCap database. Data was analyzed using the Wilcoxon rank sum test and Fisher's exact test. 960 records were reviewed and 165 patients were found to be eligible for a clinical trial at the time of their visit. 35 of these 165 patients (21.2%) enrolled in a clinical trial. Among patients who did not enroll in a clinical trial, the reasons for not doing so were due to a physician factor (71/130 or 55%), patient factor (42/130 or 32%), screening failure (13/130 or 10%), or a trial factor (4/130 or 3%). There were no significant differences in demographics between patients who enrolled in trials and those who did not. Patients who did not enroll secondary to a physician factor differed significantly from those enrolled or attempted to enroll in age and insurance type. Patients who did not enroll secondary to a physician factor were older when compared to those who enrolled or attempted to enroll in a clinical trial but failed the screening process (median of 70 vs 61.5 years old, p=0.014). They were also more likely to have Medicare and less likely to have private insurance (p=0.044). Patients who did not enroll secondary to a patient factor did not appear to differ significantly from patients who did enroll or who failed screening. Although patients who did not enroll secondary to a patient factor lived a mean distance almost twice as far away as those who enrolled or attempted to enroll (mean of 184 vs 91 miles), this was not statistically significant (p=0.107). Based on a one year time span of retrospective review, including the COVID 19 pandemic time, physician factor and concern for a patient's age appears to be the biggest barrier to clinical trial enrollment. Exploring additional reasons behind physicians' reluctance to enroll patients in trials may be the key to increasing clinical trial enrollment of eligible patients. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Changes in dietary patterns among youths in China during COVID-19 epidemic: The COVID-19 impact on lifestyle change survey (COINLICS).

Limited studies have focused on how COVID-19 outbreak and thereby lockdown have affected the youth's diet patterns. This study aimed to assess changes in diet patterns among youths in China under the COVID-19 lockdown, based on the COVID-19 Impact on Lifestyle Change Survey (COINLICS), a nationwide retrospective survey distributed via social media platforms during 9-12 May 2020 where 10,082 youth participants in China have voluntarily reported their basic sociodemographic information and routine diet patterns in the months before and after COVID-19 lockdown. We used paired t-tests or χ2 tests to evaluate the significance of differences in consumption patterns of 12 major food groups and beverages across educational levels, between sexes, and before and after COVID-19 lockdown. During the COVID-19 lockdown, significant decreases were observed in the frequency of intake of rice, meat, poultry, fresh vegetables, fresh fruit, soybean products, and dairy products, with significant sex differences (females consuming more rice, fresh vegetables and fruit and less meat, poultry, soybean and dairy products than males). Significant increases were observed in the frequency of consumption of wheat products, other staple foods, and preserved vegetables, with males consuming these foods more frequently than females. Graduate students consumed most foods more frequently except rice and other staple foods and preserved vegetables. The frequency of sugar-sweetened beverage consumption had decreased while frequency of tea drinking had increased. The participating youths' diet patterns had significantly changed during the COVID-19 lockdown, with heterogeneities observed to different extents between sexes and across educational levels. Our findings would inform policy-makers and health professionals of these changes in time for better policy making and public health practice.

Impact of COVID-19 Lockdown on Physical Activity Among the Chinese Youths: The COVID-19 Impact on Lifestyle Change Survey (COINLICS).

Background: The study sought to assess the changes in physical activity (PA) and sedentary time among Chinese youths at different stages after the COVID-19 outbreak. Methods: It was based on a retrospective online survey conducted in May 2020. More than 10,000 youths voluntarily recalled their PA-related information at three stages: before COVID-19 (January), during lockdown (February), and after lockdown (May). χ2 tests were conducted to evaluate the significance of the differences in participants' characteristics between sexes, and Wilcoxon Rank Sum tests were performed to examine the significance of differences in changes in PA and sedentary behavior levels between sexes. Results: A total of 8,115 participants were included, with a mean age of 20. The percentage of no PA per week increased significantly and then slightly fell, and that of ≥150 min/week substantially decreased and then rebounded partially (all p < 0.001) (for instance, the percentage of ≥150 min/week of PA total decreased from 38.6 to 19.4%, then rebounded back to 25.3%). Means hours per day spent in sedentary behaviors had significantly increased during lockdown comparing to pre-COVID-19 (all p < 0.001). There were more participants reported reduced PA level than those indicated increased, and more participating youths had their sedentary behavior level increased than those who had it decreased. Conclusions: The study found COVID-19 had both immediate and longer-term impacts on self-reported physical activities and sedentary behaviors among Chinese youths. Relevant efforts should be strengthened to get youths physically moving again.

Obesity and activity patterns before and during COVID-19 lockdown among youths in China.

This study aim to assess changes in obesity and activity patterns among youths in China during the COVID-19 lockdown. We used the COVID-19 Impact on lifestyle change survey (COINLICS), a national retrospective survey distributed via social media platforms in early May 2020 where more than 10 000 youth participants in China have voluntarily reported their basic sociodemographic information, weight status, and routine lifestyles in the months before and during COVID-19 lockdown. The extended IOTF and WHO standards were used to define overweight and obesity of the participants. We used paired t-tests or χ2 tests and non-parametric methods to evaluate the significance of differences in weight-related outcomes and lifestyles across education levels, between sexes, and before and during COVID-19 lockdown. The mean body mass index of all participating youths has significantly increased (21.8-22.6) and in all education subgroups during COVID-19 lockdown. Increases also occurred in the prevalence of overweight/obesity (21.3%-25.1%, P < .001) and obesity (10.5% to 12.9%, P < .001) in overall youths, especially in high school and undergraduate students. Their activity patterns had also significantly changed, including the decreased frequency of engaging in active transport, moderate-/vigorous-intensity housework, leisure-time moderate-/vigorous-intensity physical activity, and leisure-time walking, and the increased sedentary, sleeping, and screen time. Our findings would inform policy-makers and clinical practitioners of these changes in time, for better policy making and clinical practice. School administrators should also be informed of these changes, so in-class and/or extracurricular physical activity programs could be designed to counteract them.