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1.
Health Commun ; : 1-10, 2022 May 19.
Article in English | MEDLINE | ID: covidwho-1852737

ABSTRACT

This study analyzes differences among Americans in their trust in COVID-19 information from governmental sources and how trust is associated with personal adoption of preventative measures under the Trump administration. Based on our analysis of data from a nationally representative survey conducted in October 2020 (effective sample size after weighting = 2615), we find that Americans in general have more trust in COVID-19 information from state/local governments than from the federal government. Variables such as age, party affiliation, religiosity, and race are significantly associated with Americans' trust or lack of trust in COVID-19 information from governmental sources. During the study period, Republicans had more trust in the federal government as a COVID-19 information source than Democrats did, while Democrats had more trust in state/local governments. African Americans had the least trust in the federal and state/local governments as COVID-19 information sources, while Asian Americans had the most trust in both institutions. Trust in the state/local governments as COVID-19 information sources was positively associated with physical distancing and mask-wearing while trust in the federal government as a COVID-19 information source was negatively associated with physical distancing and mask-wearing, suggesting the distinctive roles that state/local governments and the federal government played in mobilizing Americans to adopt preventive measures.

2.
Ind Health ; 2022 May 16.
Article in English | MEDLINE | ID: covidwho-1847112

ABSTRACT

TheCOVID-19 pandemic has precipitated broad and extensive changes in the waypeople live and work. While the general subject of working from home hasrecently drawn increased attention, few studies have assessed genderdifferences in vulnerability to the potential mental health effects of workingfrom home. Using data from 1,585workers who participated in the Health, Ethnicity, and Pandemic (HEAP) study, anational survey conducted in the U.S. during the COVID-19 pandemic in October2020, associations of working from home with psychological distress wereexamined with weighted logistic regression among 1,585 workers and stratified bygender. It was found that workers who worked from home had higher odds ofpsychological distress (aOR and 95% CI = 2.62 [1.46, 4.70]) compared to workerswho did not work from home, adjusting for demographic factors, socioeconomicstatus, and health behaviors. In gender-stratified analyses, this positiveassociation between working from home and psychological distress was significantin women (aOR and 95% CI = 3.68 [1.68, 8.09]) but not in men. These resultshave implications for female workers' mental health in the transition towardsworking from home in the COVID-19 pandemic era.

3.
J Gen Intern Med ; 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1782935

ABSTRACT

BACKGROUND: While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. OBJECTIVE: We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic. DESIGN: In October 2020, we conducted a national survey with minorities oversampled that covered respondents' sociodemographic background and health-related information. PARTICIPANTS: A total of 2709 participants responded to the survey (response rate: 4.2%). MAIN MEASURES: The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. KEY RESULTS: Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34-3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34-3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00-1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. CONCLUSIONS: Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.

5.
Digit Health ; 8: 20552076221089789, 2022.
Article in English | MEDLINE | ID: covidwho-1770148

ABSTRACT

Objective: This study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China. Methods: A cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts. Results: Participants showed a moderate self-perceived level of eHealth literacy (M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy. Conclusions: This study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.

6.
Inquiry ; 59: 469580211059483, 2022.
Article in English | MEDLINE | ID: covidwho-1731416

ABSTRACT

Objective: To estimate demographic predictors of medical expense in hospitalization of moderate COVID-19. Methods: From January to March 2020, a total of 39 patients were treated and recovered from COVID-19 in a tertiary medical center in East China. Detailed cost data were collected and we estimated the demographic predictors of both total hospital expense and daily hospital expense. Results: The mean medical expense for treating hospitalized moderate COVID-19 cases was $1177.81. Every additional year in the patient's age corresponds to .9% more in total hospital expense (Coef. = 0.009, 95% CI 0.002-0.017, P < 0.01). The difference in daily medical expense between age groups was not statistically significant. Conclusions: Hospitalization cost was significantly elevated among the older patients, and the age effect in cost was mainly driven by the longer length of stay in the hospital. From a cost-saving perspective, the elderly population might deserve priority consideration when COVID-19 vaccination programs are implemented.


Subject(s)
COVID-19 , Aged , COVID-19 Vaccines , Hospital Costs , Hospitalization , Hospitals , Humans , Length of Stay , Retrospective Studies , SARS-CoV-2
7.
J Asian Econ ; 80: 101460, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1729548

ABSTRACT

This paper investigates the sleeplessness in Chinese cities during the coronavirus disease 2019 (COVID-19) pandemic. We provide first evidence of a link from daily COVID-19 cases resulting in sleep loss in a panel of Chinese cities. We use Wuhan, which was the first city to be completely locked down, as basis to present the result that sleeplessness has become a considerably serious issue owing to the COVID-19 pandemic. In using the intervention policy of various cities as exogenous shocks, we find that lockdown policies significantly increase the sleeplessness level of Chinese cities. In addition, the severity of COVID-19 pandemic significantly exacerbates the negative effect of lockdown policies on sleep quality in the city. Overall, this study indicates that policy makers should pay more attention to public mental health when citizens recover from COIVD-19 by investigating the unintended consequences of COVID-19 on sleeplessness level of cities.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312588

ABSTRACT

To investigate parenting and children’s emotional and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of random, representative sample of residents with children aged 3–17 years in mid-March, 2020 in China. 1655 parents were surveyed with 80.1% response rate. During the epidemic, half (49%) of children had stress symptoms and 10% had emotional problems;children had higher screen time, less exercise and worse sleep than before. Socially disadvantaged children were more vulnerable to the epidemic. Children whose parents communicated about the epidemic more frequently, who had irritable parents and experienced worse parent-child closeness had higher probabilities of emotional problems, stress symptoms and worse lifestyles. Improve parenting skills and communication quality is necessary during the epidemic.

9.
Front Psychol ; 12: 800183, 2021.
Article in English | MEDLINE | ID: covidwho-1674380

ABSTRACT

OBJECTIVE: The psychological condition of healthcare workers since the COVID-19 pandemic has attracted the attention of many studies. However, few have reported on psychosocial problems of primary healthcare workers in the COVID-19 pandemic. This study aimed to examine the mediating roles of social support and resilience in COVID-19-related work stress and symptoms of anxiety and depression. METHODS: A total of 840 primary healthcare workers in 17 community health centers in Guangzhou, China, were recruited from May to July 2021. Data on demographic characteristics, COVID-19-related work stress, social support, resilience, anxiety and depression were collected. A structural equation model was used for mediation analysis. RESULTS: More than half of participants reported mild or more severe (at least borderline abnormal) symptoms of anxiety (68.1%) and depression (55.6%). Social support and resilience mediate the association between COVID-19-related work stress and symptoms of anxiety and depression, respectively. Furthermore, the association between work stress and symptoms of anxiety and depression was also mediated by an accumulation of social support and resilience. The indirect effect of COVID-19-related work stress on anxiety and depression through resilience was much greater than other indirect effects. CONCLUSION: Anxiety and depression were prevalent among primary healthcare workers. This study highlights the psychological impact of the COVID-19-related psychosocial work environment on primary healthcare workers. There is an urgent need to improve working conditions for primary healthcare workers in the COVID-19 and to implement intervention strategies aimed at increasing individual resilience alongside the establishment of external supportive work environments.

10.
Molecular & cellular toxicology ; : 1-11, 2022.
Article in English | EuropePMC | ID: covidwho-1614866

ABSTRACT

Background Inflammation is involved in the healing process;however, when inflammation is overactivated, multiple diseases can occur. The continued discovery of new anti-inflammatory drugs is crucial in the treatment of inflammation-linked diseases. Objectives Ferulic acid (FA), a precursor necessary for lignan synthesis, is widely distributed in plant-based whole foods and is a strong antioxidant. However, the effect of FA on the expression level of inflammatory factors in macrophages has not been fully clarified. The current study aimed to explore the anti-inflammatory effect and mechanism of ferulic acid. Results The results showed that THP-1 cells were induced to differentiate into macrophages by Phorbol-12-myristate-13-acetate (PMA), and THP-1-derived macrophages were stimulated by LPS to establish an inflammatory cell model. Compared with the control group, low (5 μmol·mL−1), medium (10 μmol·mL−1), and high (20 μmol·mL−1) concentration ferulic acid groups have decreased cell viability and increased apoptosis rate in a dose-dependent manner. FA reduced the transcriptional levels of Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α). Importantly, FA-induced autophagy and inhibited NLRP3 inflammasome activation. 3-MA (a widely used autophagy inhibitor) enhanced the secretion of TNF-α, IL-6 and IL-1β. Moreover, autophagy inhibition by 3-MA resulted in increased proteins expression associated with NLRP3 inflammasome signaling pathway. Besides, the inhibition of inflammasome activation by MCC950 reduced the expression of TNF-α, IL-6 and IL-1β. Conclusion It is concluded that FA enhanced autophagy, inhibited the activation of NLRP3 inflammasome and reduced the expression and release of inflammatory factors.

11.
Sci Rep ; 11(1): 23375, 2021 12 03.
Article in English | MEDLINE | ID: covidwho-1550338

ABSTRACT

To investigate associations between parent-child relationships, children's externalizing and internalizing symptoms, and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of a random, representative sample of residents with children aged 3-17 years during mid-March 2020 in Wuhan and Shanghai, China. A total of 1655 parents and children were surveyed with a response rate of 80.1% in the survey. During the epidemic, the frequency of children enquiring about the epidemic (AOR = 1.46, 95% CI: 1.04, 2.06), parents explaining the epidemic to them (AOR = 2.87, 95% CI: 1.80, 4.58), parents expressing negative emotions in front of them (AOR = 2.62; 95% CI = 2.08-3.30), and parents with more irritable attitudes (AOR = 1.93; 95% CI = 1.33-2.81) were significantly associated with children's externalizing symptoms. For internalizing symptoms, significant associations were found with worse parent-child closeness (AOR = 2.93; 95% CI = 1.80-4.79), the frequency of parents expressing negative emotions in front of them (AOR = 2.64; 95% CI = 1.68, 4.12), and more irritable attitudes (AOR = 2.24; 95% CI = 1.42-3.55). We also found that each indicator of parent-child relationships had the significantly similar associations with children's lifestyle behaviors. These findings suggest that improving parents' attitudes towards their children and parent-child closeness during the epidemic, especially among parents with lower educational levels, are important to ensure the wellbeing of children.


Subject(s)
COVID-19/psychology , Child Behavior/psychology , Life Style , Parent-Child Relations , Adolescent , Age Factors , COVID-19/epidemiology , Child , Child, Preschool , China/epidemiology , Emotions , Female , Humans , Male
12.
J Occup Environ Med ; 63(11): 931-937, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1504374

ABSTRACT

OBJECTIVE: We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race. METHODS: Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups. RESULTS: After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (ß and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians. CONCLUSION: Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.


Subject(s)
COVID-19 , Psychological Distress , Cross-Sectional Studies , Employment , Humans , Pandemics , SARS-CoV-2
13.
BMC Public Health ; 21(1): 1520, 2021 08 06.
Article in English | MEDLINE | ID: covidwho-1477369

ABSTRACT

BACKGROUND: Several American universities have experienced COVID-19 outbreaks, risking the health of their students, employees, and local communities. Such large outbreaks have drained university resources and forced several institutions to shift to remote learning and send students home, further contributing to community disease spread. Many of these outbreaks can be attributed to the large numbers of active infections returning to campus, alongside high-density social events that typically take place at the semester start. In the absence of effective mitigation measures (e.g., high-frequency testing), a phased return of students to campus is a practical intervention to minimize the student population size and density early in the semester, reduce outbreaks, preserve institutional resources, and ultimately help mitigate disease spread in communities. METHODS: We develop dynamic compartmental SARS-CoV-2 transmission models to assess the impact of a phased reopening, in conjunction with pre-arrival testing, on minimizing on-campus outbreaks and preserving university resources (measured by isolation bed capacity). We assumed an on-campus population of N = 7500, 40% of infected students require isolation, 10 day isolation period, pre-arrival testing removes 90% of incoming infections, and that phased reopening returns one-third of the student population to campus each month. We vary the disease reproductive number (Rt) between 1.5 and 3.5 to represent the effectiveness of alternative mitigation strategies throughout the semester. RESULTS: Compared to pre-arrival testing only or neither intervention, phased reopening with pre-arrival testing reduced peak active infections by 3 and 22% (Rt = 1.5), 22 and 29% (Rt = 2.5), 41 and 45% (Rt = 3.5), and 54 and 58% (improving Rt), respectively. Required isolation bed capacity decreased between 20 and 57% for values of Rt ≥ 2.5. CONCLUSION: Unless highly effective mitigation measures are in place, a reopening with pre-arrival testing substantially reduces peak number of active infections throughout the semester and preserves university resources compared to the simultaneous return of all students to campus. Phased reopenings allow institutions to ensure sufficient resources are in place, improve disease mitigation strategies, or if needed, preemptively move online before the return of additional students to campus, thus preventing unnecessary harm to students, institutional faculty and staff, and local communities.


Subject(s)
COVID-19 , Universities , Disease Outbreaks/prevention & control , Humans , SARS-CoV-2 , Students
14.
J Telemed Telecare ; : 1357633X211051677, 2021 Oct 11.
Article in English | MEDLINE | ID: covidwho-1463096

ABSTRACT

Telehealth is an important source of health care during the COVID-19 pandemic. Evidence is scarce regarding disparities in telehealth utilization in the United States. We aimed to investigate the prevalence and factors associated with telehealth utilization among US adults. Our data came from the Health, Ethnicity, and Pandemic Study, a nationally representative survey conducted in October 2020, with 2554 adults ≥ 18 and an oversample of racial/ethnic minorities. Telehealth utilization was measured as self-reported teleconsultation with providers via email, text message, phone, video, and remote patient monitoring during the pandemic. Logistic regressions were performed to examine the association between telehealth use and factors at the individual, household, and community levels. Overall, 43% of the sample reported having used telehealth, representing 114.5 million adults in the nation. East and Southeast Asians used telehealth less than non-Hispanic Whites (OR = 0.5, 95% CI: 0.3-0.8). Being uninsured (compared with private insurance: OR = 0.4, 95% CI: 0.2-0.8), and those with limited broadband coverage in the community (OR = 0.5, 95% CI: 0.3-0.8) were less likely to use telehealth. There is a need to develop and implement more equitable policies and interventions at both the individual and community levels to improve access to telehealth services and reduce related disparities.

15.
Nat Commun ; 12(1): 5026, 2021 08 18.
Article in English | MEDLINE | ID: covidwho-1363491

ABSTRACT

Nationwide prospective surveillance of all-age patients with acute respiratory infections was conducted in China between 2009‒2019. Here we report the etiological and epidemiological features of the 231,107 eligible patients enrolled in this analysis. Children <5 years old and school-age children have the highest viral positivity rate (46.9%) and bacterial positivity rate (30.9%). Influenza virus, respiratory syncytial virus and human rhinovirus are the three leading viral pathogens with proportions of 28.5%, 16.8% and 16.7%, and Streptococcus pneumoniae, Mycoplasma pneumoniae and Klebsiella pneumoniae are the three leading bacterial pathogens (29.9%, 18.6% and 15.8%). Negative interactions between viruses and positive interactions between viral and bacterial pathogens are common. A Join-Point analysis reveals the age-specific positivity rate and how this varied for individual pathogens. These data indicate that differential priorities for diagnosis, prevention and control should be highlighted in terms of acute respiratory tract infection patients' demography, geographic locations and season of illness in China.


Subject(s)
Bacteria/isolation & purification , Bacterial Infections/microbiology , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Virus Diseases/virology , Viruses/isolation & purification , Adolescent , Adult , Bacteria/classification , Bacteria/genetics , Bacterial Infections/epidemiology , Child , Child, Preschool , China/epidemiology , Female , Humans , Infant , Male , Prospective Studies , Respiratory Tract Infections/epidemiology , Seasons , Virus Diseases/epidemiology , Viruses/classification , Viruses/genetics , Young Adult
16.
Nutrients ; 13(10)2021 Sep 25.
Article in English | MEDLINE | ID: covidwho-1438685

ABSTRACT

OBJECTIVE: To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA). METHODS: We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models. RESULTS: All 2709 HEAP participants were included in this study. Compared to pre-pandemic, the time spent on exercise decreased (32.06 vs. 38.65 min/day; p < 0.001) and screen time increased (6.79 vs. 5.06 h/day; p < 0.001) during the pandemic. The percentage of individuals who reported consuming fast-food meals ≥3 times/week decreased from 37.7% before the pandemic to 33.3% during the pandemic. The percentage of heavy drinkers (≥5 times/week) increased from 20.9% before the pandemic to 25.7% during the pandemic. Among smokers, heavy smoking (≥11 cigarettes/day) increased from 5.8% before the pandemic to 7.9% during the pandemic. We also identified subgroups who were more vulnerable to adverse influences from the pandemic, including racial/ethnic minority groups and young adults. CONCLUSIONS: The COVID-19 pandemic had negative impacts on multiple lifestyle behaviors among Americans. Mitigating such negative impacts of COVID-19 requires effective interventions, particularly for some vulnerable subgroups.


Subject(s)
Alcohol Drinking/epidemiology , COVID-19/psychology , Cigarette Smoking/epidemiology , Exercise/psychology , Fast Foods/statistics & numerical data , Screen Time , Adolescent , Adult , Age Factors , Alcohol Drinking/psychology , Cigarette Smoking/psychology , Cross-Sectional Studies , /statistics & numerical data , Female , Health Behavior , Humans , Male , Middle Aged , Pandemics , /statistics & numerical data , SARS-CoV-2 , Socioeconomic Factors , United States/epidemiology , Young Adult
17.
J Occup Environ Med ; 63(11): 931-937, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1315712

ABSTRACT

OBJECTIVE: We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race. METHODS: Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups. RESULTS: After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (ß and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians. CONCLUSION: Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.


Subject(s)
COVID-19 , Psychological Distress , Cross-Sectional Studies , Employment , Humans , Pandemics , SARS-CoV-2
18.
JMIR Public Health Surveill ; 7(5): e26372, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1290683

ABSTRACT

BACKGROUND: The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors. OBJECTIVE: The goal of this study was to assess the change in children's and adolescents' prevention and vaccination behaviors amid China's COVID-19 epidemic. METHODS: We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children's and adolescents' prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents' characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors. RESULTS: Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands. CONCLUSIONS: Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.


Subject(s)
Adolescent Behavior , COVID-19/prevention & control , Child Behavior , Hand Disinfection , Masks , Pandemics , Vaccination , Adolescent , Adult , Child , Child, Preschool , China , Cross-Sectional Studies , Epidemics , Female , Health Behavior , Humans , Male , Parents , Patient Acceptance of Health Care , SARS-CoV-2 , Social Class , Surveys and Questionnaires
19.
JMIR Public Health Surveill ; 7(5): e26372, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1197475

ABSTRACT

BACKGROUND: The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors. OBJECTIVE: The goal of this study was to assess the change in children's and adolescents' prevention and vaccination behaviors amid China's COVID-19 epidemic. METHODS: We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children's and adolescents' prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents' characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors. RESULTS: Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands. CONCLUSIONS: Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.


Subject(s)
Adolescent Behavior , COVID-19/prevention & control , Child Behavior , Hand Disinfection , Masks , Pandemics , Vaccination , Adolescent , Adult , Child , Child, Preschool , China , Cross-Sectional Studies , Epidemics , Female , Health Behavior , Humans , Male , Parents , Patient Acceptance of Health Care , SARS-CoV-2 , Social Class , Surveys and Questionnaires
20.
J Integr Med ; 19(3): 219-225, 2021 05.
Article in English | MEDLINE | ID: covidwho-1046251

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become an increasingly severe public health emergency. Although traditional Chinese medicine (TCM) has helped to combat COVID-19, public perception of TCM remains controversial. We used the theory of planned behavior (TPB) to identify factors that affect the intention to use TCM. METHODS: A cross-sectional web-based survey of 10,824 individuals from the general public was conducted between March 16 and April 2, 2020. The participants were recruited using a snowball sampling method. Data were collected using a self-administered questionnaire, based on the TPB. The questionnaire consisted of demographic characteristics and TPB structures. Structural equation modeling was used to identify predictors of intention. RESULTS: The results indicated the model explained 77.5% and 71.9% of intention and attitude variance. Intention to use TCM had the strongest relationship with attitude (P < 0.001), followed by past behavior (P < 0.001), subjective norms (P < 0.001) and perceived behavioral control (P < 0.001). Attitudes toward TCM were significantly affected by perceived behavioral control (P < 0.001), subjective norms (P < 0.001) and cognition of TCM (P < 0.001). CONCLUSION: Attitude is a key factor in determining the intention to use TCM, followed by past behaviors, subjective norms and perceived behavioral control. Our results offer important implications for health policy makers to promote the use of TCM.


Subject(s)
COVID-19/drug therapy , Medicine, Chinese Traditional , Psychological Theory , SARS-CoV-2 , Adult , Attitude , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Intention , Male , Middle Aged
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