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2.
Int J Drug Policy ; 106: 103752, 2022 May 27.
Article in English | MEDLINE | ID: covidwho-1867048

ABSTRACT

BACKGROUND: People Who Inject Drugs (PWID) are subject to distinct socio-structural inequalities that can expose them to high risks of COVID-19 transmission and related health and social complications. In response to COVID-19 mitigation strategies, these vulnerabilities are being experienced in the context of adapted drug treatment service provision, including reduced in-person support and increased regulatory flexibility in opioid substitution therapy (OST) guidelines. This study aimed to explore the longer-term impact of the pandemic on the health and wellbeing of PWID in the UK, including provider and client experiences of treatment changes. METHODS: Interviews were conducted with 19 PWID and 17 drug treatment providers between May and September 2021, recruited from drug and homelessness charities providing treatment services and healthcare in the UK. Data were analysed using reflexive thematic analysis. RESULTS: Most participants expressed ongoing fears of COVID-19 transmission, although socio-structural inequalities limited the contexts in which physical distancing could be practised. In addition, virus mitigation strategies altered the risk environment for PWID, resulting in ongoing physical (e.g. changing drug use patterns, including transitions to crack cocaine, benzodiazepine and pregabalin use) and socio-economic harms (e.g. limited opportunities for sex work engagement and income generation). Finally, whilst clients reported some favourable experiences from service adaptations prompted by COVID-19, including increased regulatory flexibility in OST guidelines, there was continued scepticism and caution among providers toward sustaining any treatment changes beyond the pandemic period. CONCLUSIONS: Whilst our findings emphasize the importance of accessible harm reduction measures attending to changing indices of drug-related harm during this period, there is a need for additional structural supports to ensure pre-existing disparities and harms impacting PWID are not exacerbated further by the conditions of the pandemic. In addition, any sustained policy and service delivery adaptations prompted by COVID-19 will require further attention if they are to be acceptable to both service users and providers.

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337855

ABSTRACT

Background: The aim of this study was to examine whether specific health behaviours in the month preceding infection with COVID-19 act as upstream risk factors long COVID as well and three specific long COVID symptoms.Methods1,811 UK adults from the UCL COVID-19 Social Study and who had previously been infected with COVID-19 were analysed. Health behaviours in the month before infection were weekly exercise frequency, days of fresh air per week, sleep quality, smoking, consuming more than the number of recommended alcoholic drinks per week (>14), and the number of mental health care behaviours (e.g., online mental health programme). Logistic regressions controlling for covariates (e.g., COVID-19 infection severity and pre-existing health conditions) examined the impact of health behaviours on long COVID and three long COVID symptoms (difficulty with mobility, cognition, and self-care).Results In the month before infection with COVID-19, poor quality sleep increased the odds of long COVID (odds ratio [OR]: 3.53;(95% confidence interval [CI]: 2.01 to 6.21), as did average quality sleep (OR: 2.44;95% CI: 1.44 to 4.12). Having smoked (OR: 8.39;95% CI: 1.86 to 37.91) increased and meeting recommended weekly physical activity guidelines (3+ hours) (OR: 0.05;95% CI: 0.01 to 0.39) reduced the likelihood of difficulty with self-care (e.g., washing all over or dressing) amongst those with long COVID. Conclusions Results point to the importance of sleep quality for long COVID, potentially helping to explain previously demonstrated links between stress and long COVID. Results also suggest that exercise and smoking may be modifiable risk factors for preventing the development of difficulty with self-care.

4.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337646

ABSTRACT

Background There has been much research into the mental health impact of the COVID-19 pandemic and how it is related to time-invariant individual characteristics (e.g. age and gender). However, there is still a lack of research showing long-term trajectories of mental health across different stages of the pandemic. And little is known regarding the longitudinal association of time-varying contextual and individual factors (e.g. COVID-19 policy response and pandemic intensity) with mental health outcomes. This study aimed to provide a longitudinal profile of how depressive and anxiety symptoms changed by month between March 2020 and April 2022, and to examine their longitudinal associations with time-varying contextual and individual level factors. Methods and findings Drawing data from a large panel study of over 58,000 adults living in England, we showed that mental health changes were largely in line with changes in COVID-19 policy response and pandemic intensity. Further, data were analysed using fixed-effects, with models fitted separately across three stages of the COVID-19 pandemic. We found that more stringent policy response was associated with increased mental health symptoms, in particular during lockdown periods. Higher COVID-19 deaths were also associated with poorer mental health, but this association weakened over time. Finally, there was also evidence for the longitudinal association of mental health with individual level factors, including confidence in government/healthcare/essentials, COVID-19 knowledge, COVID-19 stress, COVID-19 infection and social support. Conclusions Our results provided empirical evidence on how changes in contextual and individual level factors were related to depressive and anxiety symptoms. While some factors clearly acted as consistent predictors of mental health during a pandemic, other factors were dependent on the specific situations occurring within society. This could provide important implications for policy making and for a better understanding of mental health of the general public during a national or global health crisis.

5.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-336987

ABSTRACT

Objectives Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited, so reasons for this have not been explored in-depth. This study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the Capability, Opportunity, Motivation Model of Behaviour (COM-B). Design Semi-structured qualitative interview study. Methods One-to-one telephone/videocall interviews were conducted with younger (aged 18-24) and older adults (aged 70+), those with long-term physical health conditions or mental health conditions, and parents of young children, probing about their experiences of PA. Barriers and facilitators were identified using reflexive thematic analysis, and themes were mapped onto COM-B dimensions. Results 116 participants were included (18-93 years old, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations and plans) COM-B domains. Conclusions Future interventions should increase physical opportunity and reflective motivation for PA during pandemics, to avoid further negative health outcomes following periods of lockdown. Strategies could include tailoring PA guidance depending on location and giving education on the health benefits of PA. Statement of Contribution What is already known on this subject? Physical activity (PA) levels reduced during the COVID-19 pandemic. The extent of this reduction varied across demographic groups. Very few qualitative studies have explored reasons for these changes. What does this study add? Novel interview data, giving context to existing quantitative data. Insight into which themes were important for different demographic groups. Suggestions for increasing PA in future pandemics, by mapping findings to a theoretical framework.

6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335894

ABSTRACT

To combat the public health crisis of Covid-19, governments and public health officials have been asking individuals to substantially change their behaviours for prolonged periods of time. Are happier people more willing to comply with such measures? Using three independent, large-scale surveys covering about 119,000 adult respondents across 35 countries, including longitudinal data from the UK, we find that past and present life satisfaction predicts compliance with preventive health behaviours during Covid-19 lockdowns. The association is stronger for those with higher levels of life satisfaction. A loss in life satisfaction, on the contrary, predicts lower compliance. We explore risk-avoidance and pro-social motivations for this relationship, and find suggestive evidence that people who are older or have certain medical preconditions seem to be behave in line with risk-avoidance, whereas motivations of people who are less at risk of Covid-19 seem more mixed. Overall, our findings indicate that life satisfaction is important, both as a policy end in itself and for complying with new long-term preventive health measures.

7.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335218

ABSTRACT

This study examined the association between greenspace and the growth trajectories of anxiety symptoms during the COVID-19 pandemic. Using data from 19,848 urban residents in England who were followed for 20 months between March 2020 and October 2021, we found that living in an area with higher greenspace coverage was associated with fewer anxiety symptoms over time independent of population density, area deprivation levels, socio-demographics, and health profiles. There was limited evidence that greenspace was related to the change of anxiety symptoms over time. No association with anxiety trajectories was found when using greenspace proximity.

8.
Lancet Reg Health Eur ; 14: 100317, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1829134

ABSTRACT

BACKGROUND: The continued success of the COVID-19 vaccination programme in the UK will depend on widespread uptake of booster vaccines. However, there is evidence of hesitancy and unwillingness to receive the booster vaccine, even in fully vaccinated adults. Identifying factors associated with COVID-19 booster vaccine intentions specifically in this population is therefore critical. METHODS: We used data from 22,139 fully vaccinated adults who took part in the UCL COVID-19 Social Study. Multinomial logistic regression examined predictors of uncertainty and unwillingness (versus willingness) to receive a COVID-19 booster vaccine (measured 22 November 2021 to 6 December 2021), including (i) socio-demographic factors, (ii) COVID-19 related factors (e.g., having been infected with COVID-19), and (iii) initial intent to receive a COVID-19 vaccine in the four months following the announcement in the UK that the vaccines had been approved (2 December 2020 to 31 March 2021). FINDINGS: 4% of the sample reported that they were uncertain about receiving a COVID-19 booster vaccine, and a further 4% unwilling. Initial uncertainty and unwillingness to accept the first COVID-19 vaccine in 2020-21 were each associated with over five times the risk of being uncertain about and unwilling to accept a booster vaccine. Healthy adults (those without a pre-existing physical health condition) were also more likely to be uncertain or unwilling to receive a booster vaccine. In addition, low levels of current stress about catching or becoming seriously ill from COVID-19, consistently low compliance with COVID-19 government guidelines during periods of strict restrictions (e.g., lockdowns), lower levels of educational qualification, lower socio-economic position, and age below 45 years were all associated with uncertainty and unwillingness. INTERPRETATION: Our findings highlight that there are a range of factors that predict booster intentions, with the strongest predictor being previous uncertainty and unwillingness. Two other concerning patterns also emerged from our results. First, administration of booster vaccinations may increase social inequalities in experiences of COVID-19 as adults from lower socio-economic backgrounds are also most likely to be uncertain or unwilling to accept a booster vaccine as well as most likely to be seriously affected by the virus. Second, some of those most likely to spread COVID-19 (i.e., those with poor compliance with guidelines) are most likely to be uncertain and unwilling. Public health messaging should be tailored specifically to these groups. FUNDING: The Nuffield Foundation [WEL/FR-000022583], the MARCH Mental Health Network funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation [ES/S002588/1], and the Wellcome Trust [221400/Z/20/Z and 205407/Z/16/Z].

9.
J R Soc Med ; : 1410768221095241, 2022 May 05.
Article in English | MEDLINE | ID: covidwho-1820013

ABSTRACT

OBJECTIVES: To examine whether racial/ethnic discrimination predicts future COVID-19 vaccine refusal, and whether this association is explained by trust in government and the health system. DESIGN: Longitudinal observational study of racial/ethnic discrimination occurring since the start of the first lockdown (measured in July 2020) and later COVID-19 vaccine status. SETTING: UK (England, Scotland, Wales and Northern Ireland). PARTICIPANTS: A total of 633 adults belonging to ethnic minority groups who took part in the UCL COVID-19 Social Study. MAIN OUTCOME MEASURES: COVID-19 vaccine refusal (vs. accepted/waiting/had at least one dose) between 23 December 2020 and 14 June 2021. RESULTS: Nearly 1 in 10 (6.69%) who had refused a COVID-19 vaccine had experienced racial/ethnic discrimination in a medical setting since the start of the pandemic and had experienced twice as many incidents of racial/ethnic discrimination than those who had accepted the vaccine. Structural equation modelling results indicated a nearly four fold (odds ratio = 3.91, 95% confidence interval = 1.40 to 10.92) total effect of racial/ethnic discrimination on refusing the vaccine which was mediated by low trust in the health system to handle the pandemic (odds ratio = 2.49, 95% confidence interval = 1.12 to 5.39). Analyses adjusted for a range of demographic and COVID-19 related factors. CONCLUSIONS: Findings underscore the importance of addressing racial/ethnic discrimination and the role the National Health Service in regaining trust from ethnic minority groups to increase COVID-19 vaccine uptake among ethnic minority adults.

10.
Lancet Public Health ; 7(5): e417-e426, 2022 05.
Article in English | MEDLINE | ID: covidwho-1799629

ABSTRACT

BACKGROUND: To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic. METHODS: In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy). FINDINGS: Controlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·014 [95% CI 0·005 to 0·023] for psychological distress; ß=-0·010 [-0·015 to -0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·016 [0·008 to 0·025] for psychological distress; ß=-0·010 [-0·017 to -0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed. INTERPRETATION: Changes in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects. FUNDING: None.


Subject(s)
COVID-19 , Humans , Mental Health , Pandemics/prevention & control , Public Policy , SARS-CoV-2
11.
PLoS One ; 17(4): e0264134, 2022.
Article in English | MEDLINE | ID: covidwho-1789175

ABSTRACT

BACKGROUND: Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. METHODS: To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. RESULTS: We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). CONCLUSIONS: Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Government , Humans , Pandemics/prevention & control , Public Opinion , SARS-CoV-2 , United Kingdom/epidemiology
12.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-333020

ABSTRACT

Summary Background Long COVID is increasingly recognised as public health burden. Demographic and infection-related characteristics have been identified as risk factors, but less research has focused on psychosocial predictors such as stress immediately preceding the index infection. Research on whether stressors predict the development of specific long COVID symptoms is also lacking. Methods Data from 1,966 UK adults who had previously been infected with COVID-19 and who took part in the UCL COVID-19 Social Study were analysed. The number of adversity experiences (e.g., job loss) and the number of worries about adversity experiences within the month prior to COVID-19 infection were used to predict the development of self-reported long COVID and the presence of three specific long COVID symptoms (difficulty with mobility, cognition, and self-care). The interaction between a three-level index of socio-economic position (SEP;with higher values indicating lower SEP) and the exposure variables in relation to long COVID status was also examined. Analyses controlled for a range of COVID-19 infection characteristics, socio-demographics, and health-related factors. Findings Odds of self-reported long COVID increased by 1.25 (95% confidence interval [CI]: 1.04 to 1.51) for each additional worry about adversity in the month prior to COVID-19 infection. Although there was no evidence for an interaction between SEP and either exposure variable, individuals in the lowest SEP group were nearly twice as likely to have developed long COVID as those in the highest SEP group (OR: 1.95;95% CI: 1.19 to 3.19) and worries about adversity experiences remained a predictor of long COVID (OR: 1.43;95% CI: 1.04 to 1.98). The number of worries about adversity experiences also corresponded with increased odds of certain long COVID symptoms such as difficulty with cognition (e.g., difficulty remembering or concentrating) by 1.46 (95% CI: 1.02 to 2.09) but not with mobility (e.g., walking or climbing steps) or self-care (e.g., washing all over or dressing). Interpretation Results: suggest a key role of stress in the time preceding the acute COVID-19 infection for the development of long COVID and for difficulty with cognition specifically. These findings point to the importance of mitigating worries and experiences of adversities during pandemics both to reduce their psychological impact but also help reduce the societal burden of longer-term illness. Funding The Nuffield Foundation [WEL/FR-000022583], the MARCH Mental Health Network funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation [ES/S002588/1], and the Wellcome Trust [221400/Z/20/Z and 205407/Z/16/Z].

13.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-333019

ABSTRACT

Abstract Background Demographic and infection-related characteristics have been identified as risk factors for long COVID, but research on the influence of health behaviours (e.g., exercise, smoking) immediately preceding the index infection is lacking. Methods 1,811 UK adults from the UCL COVID-19 Social Study and who had previously been infected with COVID-19 were analysed. Health behaviours in the month before infection were weekly exercise frequency, days of fresh air per week, sleep quality, smoking, consuming more than the number of recommended alcoholic drinks per week (>14), and the number of mental health care behaviours (e.g., online mental health programme). Logistic regressions controlling for covariates (e.g., COVID-19 infection severity and pre-existing health conditions) examined the impact of health behaviours on long COVID and three long COVID symptoms (difficulty with mobility, cognition, and self-care). Results In the month before infection with COVID-19, poor quality sleep increased the odds of long COVID (odds ratio [OR]: 3.53;(95% confidence interval [CI]: 2.01 to 6.21), as did average quality sleep (OR: 2.44;95% CI: 1.44 to 4.12). Having smoked (OR: 8.39;95% CI: 1.86 to 37.91) increased and meeting recommended weekly physical activity guidelines (3+ hours) (OR: 0.05;95% CI: 0.01 to 0.39) reduced the likelihood of difficulty with self-care (e.g., washing all over or dressing) amongst those with long COVID. Conclusion Results point to the importance of sleep quality for long COVID, potentially helping to explain previously demonstrated links between stress and long COVID. Results also suggest that exercise and smoking may be modifiable risk factors for preventing the development of difficulty with self-care. Funding The Nuffield Foundation [WEL/FR-000022583], the MARCH Mental Health Network funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation [ES/S002588/1], and the Wellcome Trust [221400/Z/20/Z and 205407/Z/16/Z].

14.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-332984

ABSTRACT

Background: Government enforced restrictions on movement during the COVID-19 pandemic are likely to have had profound impacts on the daily behaviours of many individuals, including physical activity (PA). Given the pre-pandemic evidence for associations between PA and other health behaviours, changes in PA during the pandemic may have been detrimental for other health behaviours. This study aimed to evaluate whether changes in PA during and after the first national lockdown in the United Kingdom (UK) were associated with concurrent changes in other health behaviours, namely alcohol consumption, sleep, nutrition quality, diet quantity and sedentary time. Methods: Data were derived from the UCL COVID-19 Social Study. The analytical sample consisted of 52,784 adults followed weekly across 22 weeks of the pandemic from 23rd March to 23rd August 2020. Data were analysed using fixed effects regression. Results: There was significant within-individual variation in both PA and other health behaviours throughout the study period. Increased PA was positively associated with improved sleep and nutrition quality. However, increases in PA also showed modest associations with increased alcohol consumption and sedentary time. Conclusion: Our findings indicate that, whilst the first wave of COVID-19 restrictions were in place, increases in PA were associated with improved sleep and better diet. Encouraging people to engage in PA may therefore lead to positive change in other health behaviours in times of adversity. However, increases in PA were also associated with more engagement in the negative health behaviours of alcohol consumption and sedentary time. These associations could be a result of increases in available leisure time for many people during COVID-19 restrictions and require further investigation to inform future public health guidance.

15.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-332222

ABSTRACT

Background There is a growing global awareness of the psychological consequences of long Covid, supported by emerging empirical evidence. However, the mergence and long-term trajectories of psychological symptoms following the infection are still unclear. Aims To examine when psychological symptoms first emerge following the infection with SARS-CoV-2, and the long-term trajectories of psychological symptoms comparing long and short Covid groups. Methods We analysed longitudinal data from the UCL Covid-19 Social Study (March 2020-November 2021). We included data from adults living in England who reported contracting SARS-CoV-2 by November 2021 (N=3,115). Of these, 15.9% reported having had long Covid (N=495). They were matched to participants who had short Covid using propensity score matching on a variety of demographic, socioeconomic and health covariates (N=962, n=13,325) and data were further analysed using growth curve modelling. Results Depressive and anxiety symptoms increased immediately following the onset of infection in both long and short Covid groups. But the long Covid group had substantially greater initial increases in depressive symptoms and heightened levels over 22 months follow-up. Initial increases in anxiety were not significantly different between groups, but only the short Covid group experienced an improvement in anxiety over follow-up, leading to widening differences between groups. Conclusions The findings shed light on the psychobiological pathways involved in the development of psychological symptoms relating to long Covid. The results highlight the need for monitoring of mental health and provision of adequate support to be interwoven with diagnosis and treatment of the physical consequences of long Covid.

16.
Sci Rep ; 12(1): 5612, 2022 04 04.
Article in English | MEDLINE | ID: covidwho-1773993

ABSTRACT

Many studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87-5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05-0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Communicable Disease Control , Crowding , Family Characteristics , Housing , Humans , Mental Health
17.
Psychol Med ; : 1-9, 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1768739

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has brought about significant behavioural changes, one of which is increased time spent at home. This could have important public health implications. This study aimed to explore longitudinal patterns of 'home confinement' (defined as not leaving the house/garden) during the COVID-19 pandemic, and the associated predictors and mental health outcomes. METHODS: Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 25 390 adults in England who were followed up for 17 months (March 2020-July 2021). Data were analysed using growth mixture models. RESULTS: Our analyses identified three classes of growth trajectories, including one class showing a high level of persistent home confinement (the home-confined, 24.8%), one changing class with clear alignment with national containment measures (the adaptive, 32.0%), and one class with a persistently low level of confinement (the unconfined, 43.1%). A range of factors were associated with the class membership of home-confinement trajectories, such as age, gender, income, employment status, social relationships and health. The home-confined class had the highest number of depressive (diff = 1.34-1.68, p < 0.001) and anxiety symptoms (diff = 0.84-1.05, p < 0.001) at the end of the follow-up than the other two classes. CONCLUSIONS: There was substantial heterogeneity in longitudinal patterns of home confinement during the COVID-19 pandemic. People with a persistent high level of confinement had the worst mental health outcomes, calling for special attention in mental health action plans, in particular targeted interventions for at-risk groups.

18.
BJPsych Open ; 8(2): e72, 2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1753144

ABSTRACT

BACKGROUND: Around one in ten people who contract COVID-19 report persistent symptoms or 'long COVID'. Impaired mental health and well-being is commonly reported, including anxiety, depression and reduced quality of life. However, there is limited in-depth research exploring why mental health and well-being are affected in people experiencing long COVID. AIMS: To explore factors affecting mental health and well-being from the perspective of people with long COVID. METHOD: Semi-structured qualitative interviews were audio-recorded and transcribed. Data were analysed using reflexive thematic analysis. Twenty-one people with long COVID participated in the study. Participants were eligible if they self-reported a positive swab test/antibody test or one or more commonly reported COVID-19 symptoms at illness onset. and experiences of one or more long COVID symptoms ≥3 weeks following illness onset. RESULTS: Five themes were identified across participant accounts regarding factors affecting mental health and well-being, including symptoms causing severe disruption to daily life, lack of service and treatment options, uncertainty of illness trajectories, experiences of care and understanding from others and changes to identity. CONCLUSIONS: People with long COVID experience a range of factors that negatively affect their mental health and well-being. Providing patient-centred health services that integrate rapidly evolving research in this area is important, as are peer support groups and supported approaches to self-management.

19.
Current psychology (New Brunswick, N.J.) ; : 1-10, 2022.
Article in English | EuropePMC | ID: covidwho-1743588

ABSTRACT

During the COVID-19 pandemic, the United Kingdom (UK) government introduced public health safety measures to mitigate the spikes in infection rates. This included stay-at-home orders that prevented people from leaving their homes for work or study, except for urgent medical care or buying essential items. This practice could have both short and long-term implications for health and wellbeing of people in the UK. Using longitudinal data of 10,630 UK adults, this study prospectively examined the association between home confinement status during the stringent lockdown in the UK (March 23-May 13, 2020) and 20 indicators of subjective well-being, social well-being, pro-social/altruistic behaviors, psychological distress, and health behaviors assessed approximately one month after the stringent lockdown ended. All analyses adjusted for socio-demographic characteristics and social isolation status in the beginning of the pandemic. Home confinement during the lockdown was associated with greater subsequent compliance with COVID-19 rules, more perceived major stressors, and a lower prevalence of physical activity. There was modest evidence of associations with lower life satisfaction, greater loneliness, greater depressive symptoms, greater anxiety symptoms, and more perceived minor stressors post-lockdown. However, there was little evidence that home confinement was associated with other indices of subsequent health and well-being. While our study shows that home confinement impacts some indices of subsequent health and wellbeing outcomes even after lockdown, the degree of the psychological adaptation to the difficult confinement behavior remains unclear and should be further studied. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03001-5.

20.
BMJ Open ; 12(3): e057805, 2022 03 11.
Article in English | MEDLINE | ID: covidwho-1741640

ABSTRACT

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. The main research aim is to evaluate the implementation, effectiveness, impact and experiences of a community-based performance arts programme (SO for stroke survivors). This mixed-methods study will evaluate the experience and impact of SO on those participating using mixed methods (interviews, observations and surveys) before and after each stage and carry out non-participant observations during a percentage of the workshops, training and tour. Data will be analysed using quantitative and qualitative approaches. This is a study within the SHAPER programme. ETHICS AND DISSEMINATION: Ethical approval has been granted by the King's College London PNM Research Ethics Panel, REC reference: LRS/DP-20/21-21549. Written informed consent will be sought for participants and stakeholders. The results of the study will be reported and disseminated at international conferences and in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: NCT04864470.


Subject(s)
Stroke Rehabilitation , Stroke , Humans , Quality of Life , Stroke/therapy , Stroke Rehabilitation/methods , Surveys and Questionnaires , United Kingdom
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