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1.
American Journal of Infection Control ; 2022.
Article in English | ScienceDirect | ID: covidwho-1821102

ABSTRACT

Background : Quantification of the impact of local masking policies may help guide future policy interventions to reduce SARS-COV-2 disease transmission. This study's objective was to identify factors associated with adherence to masking and social distancing guidelines. Methods : Faculty from 16 U.S. colleges and universities trained 231 students in systematic direct observation. They assessed correct mask use and distancing in public settings in 126 US cities from September 2020 through August 2021. Results : Of 109,999 individuals observed in 126 US cities, 48% wore masks correctly with highest adherence among females, teens and seniors and lowest among non-Hispanic whites, those in vigorous physical activity, and in larger groups (p < 0.0001). Having a local mask mandate increased the odds of wearing a mask by nearly three-fold (OR=2.99, p=0.0003) compared to no recommendation. People observed in non-commercial areas were least likely to wear masks. Correct mask use was greatest in December 2020 and remained high until June 2021 (p<0.0001). Masking policy requirements were not associated with distancing. Discussion : The strong association between mask mandates and correct mask use suggests that public policy has a powerful influence on individual behavior Conclusion : Mask mandates should be considered in future pandemics to increase adherence.

2.
Psychiatr Serv ; : appips202100429, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1731390

ABSTRACT

OBJECTIVE: This report examined challenges and adaptations to sustaining multidisciplinary team-based coordinated specialty care (CSC) for early-onset psychosis during the COVID-19 pandemic in Texas. METHODS: In June 2020, team leaders from 23 Texas CSC sites participated in semistructured phone interviews about CSC implementation barriers and adaptations. Transcripts were analyzed with thematic analysis. RESULTS: CSC implementation barriers included difficulty delivering critical CSC components (i.e., community education and vocational exploration) and client recruitment limitations. Virtual technology integration (i.e., texting and videoconferencing) largely sustained CSC outreach, service delivery, and client engagement. However, sites faced virtual competency and accessibility issues, exhaustion from virtual technology use, lack of structural support, and unanticipated disengagement. CONCLUSIONS: The surveyed sites rapidly integrated virtual technology into CSC delivery. This integration promoted CSC engagement during the pandemic, especially in rural areas, and increased insight into what resources and policies are needed to sustain virtual technology use among community mental health providers.

3.
PLoS One ; 17(1): e0261398, 2022.
Article in English | MEDLINE | ID: covidwho-1631249

ABSTRACT

OBJECTIVES: To quantify changes in adherence to mask and distancing guidelines in outdoor settings in Philadelphia, PA before and after President Trump announced he was infected with COVID-19. METHODS: We used Systematic Observation of Masking Adherence and Distancing (SOMAD) to assess mask adherence in parks, playgrounds, and commercial streets in the 10 City Council districts in Philadelphia PA. We compared adherence rates between August and September 2020 and after October 2, 2020. RESULTS: Disparities in mask adherence existed by age group, gender, and race/ethnicity, with females wearing masks correctly more often than males, seniors having higher mask use than other age groups, and Asians having higher adherence than other race/ethnicities. Correct mask use did not increase after the City released additional mask guidance in September but did after Oct 2. Incorrect mask use also decreased, but the percentage not having masks at all was unchanged. CONCLUSIONS: Vulnerability of leadership appears to influence population behavior. Public health departments likely need more resources to effectively and persuasively communicate critical safety messages related to COVID-19 transmission.


Subject(s)
COVID-19/epidemiology , Masks/trends , Adolescent , Adult , Aged , COVID-19/virology , Child , Child, Preschool , Female , Guideline Adherence/trends , Humans , Male , Masks/statistics & numerical data , Middle Aged , Philadelphia , Physical Distancing , Public Health , SARS-CoV-2/isolation & purification , Young Adult
4.
Prev Med ; 154: 106863, 2022 01.
Article in English | MEDLINE | ID: covidwho-1510415

ABSTRACT

Stressors associated with COVID-19 pandemic stay-at-home orders are associated with increased depression and anxiety and decreased physical activity. Given that physical activity and time spent outdoors in nature are associated with improved mental health, we examined the longitudinal association of these variables during the pandemic. Over 20,000 adults who participated in the U.S. Kaiser Permanente Research Bank, did not report COVID-19 symptoms, and responded to an online baseline and 3 follow-up surveys over approximately 3 months formed the cohort. Physical activity was assessed from a modified survey, time spent outdoors was assessed from one question, and anxiety and depression scores were assessed from validated instruments. Almost 60% were women, 82.8% were non-Hispanic white, and more than 93% of respondents were over the age of 50. Less in-person contact with friends and visiting crowded places was highly prevalent (>80%) initially and decreased somewhat (>70%). Participants in the lowest physical activity category (no physical activity) had the highest depression and anxiety scores compared to each successive physical activity category (p < 0.001). Spending less time outdoors was associated with higher depression and anxiety scores. This effect was greater for participants in the younger age categories compared with older age categories. The effect of less time spent outdoors on anxiety (p = 0.012) and depression (p < 0.001) scores was smaller for males than females. Results suggest that physical activity and time outdoors is associated with better mental health. People should be encouraged to continue physical activity participation during public health emergencies.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , Depression/epidemiology , Exercise , Female , Humans , Male , Pandemics , Physical Distancing , Quarantine , SARS-CoV-2 , United States
5.
Br J Sports Med ; 55(19): 1099-1105, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1325094

ABSTRACT

OBJECTIVES: To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. METHODS: We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0-10 min/week, some activity=11-149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. RESULTS: Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. CONCLUSIONS: Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Hospitalization/statistics & numerical data , Intensive Care Units , Sedentary Behavior , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , SARS-CoV-2
6.
Prev Med Rep ; 23: 101449, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1267887

ABSTRACT

Adherence to guidelines for face coverings and physical distancing are critical strategies to stem the COVID-19 pandemic but are not uniformly followed. Understanding factors associated with adherence to mask-wearing and physical distancing may help guide future control efforts. We conducted an observational study using Systematic Observation of Mask Adherence and Distancing (SOMAD) in August 2020 in parks, playgrounds and commercial streets in each of 10 City Council Districts in Philadelphia, PA. Wearing a mask correctly varied by setting with highest adherence in commercial areas and lowest in playgrounds. Almost 17% wore visible masks that did not cover the nose and/or mouth. There were multiple disparities in correct mask use. Females had higher rates than males (unadjusted relative risk = 1.40, p < .0001) and seniors higher than any other age group (unadjusted chi-square p < .0001). Asians wore masks correctly the most often [adjusted log odds ratio (LOR) = 0.53 compared with non-Hispanic white, p = 0.02]. Correct mask-wearing was higher in areas with a higher population density (adjusted LOR = 0.03 per one thousand/square mile, p = 0.02) and lower in higher poverty areas (adjusted LOR = -0.01, p = .03). Disparities in adherence to mask wearing and physical distancing likely reflect differences in perception of risk by gender, age group, and race/ethnicity. While the risk of COVID-19 transmission is lower in outdoor settings, it is unlikely to be zero. The lower rates of mask use by males and minority groups suggest increased efforts are needed to enhance adherence to recommended guidelines.

7.
Br J Sports Med ; 55(19): 1099-1105, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1183311

ABSTRACT

OBJECTIVES: To compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. METHODS: We identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient's self-reported physical activity category (consistently inactive=0-10 min/week, some activity=11-149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. RESULTS: Patients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. CONCLUSIONS: Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Hospitalization/statistics & numerical data , Intensive Care Units , Sedentary Behavior , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , SARS-CoV-2
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