Invited discussant comments during the UCL-Penn Global COVID Study webinar 'Alone Together: Loneliness Research and Social Health Innovation in Lockdown and Beyond'.

The coronavirus (Covid-19) pandemic has influenced people's social relationships around the world in surprising ways. It has also underscored the importance of and accelerated innovation in solutions for social isolation and loneliness. This commentary offers takeaways from emerging research findings and a wide lens on the societal movement underway to create more socially connected communities.

Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities.

The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.

Experiences of South Asians in the COVID-19 pandemic in Hong Kong

This qualitative study aims to investigate how the COVID-19 pandemic has affected South Asians in Hong Kong. A total of 34 South Asian adults completed the interview. Data were analysed thematically and three broad themes emerged: the impact of the pandemic on daily life, discrimination experienced, coping with challenges. The impacts of COVID-19 have spanned across from individual, family, community, to societal domains. Future research using a longitudinal approach and the inclusion of those with quarantine or infection experiences would yield a more comprehensive understanding of the experiences of South Asian communities in Hong Kong. [ FROM AUTHOR] Copyright of South Asian Diaspora is the property of Routledge 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 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 . (Copyright applies to all s.)

Pharmacists' Mental Health during the First Two Years of the Pandemic: A Socio-Ecological Scoping Review.

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the pandemic on pharmacists' mental health and their antecedents using three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies included primary research articles that examined the mental health antecedents and outcomes among pharmacists during the first two years of the pandemic. We used the Social Ecological Model to categorize antecedents per outcome. The initial search yielded 4165 articles, and 23 met the criteria. The scoping review identified pharmacists experiencing poor mental health during the pandemic, including anxiety, burnout, depression, and job stress. In addition, several individual, interpersonal, organizational, community, and policy-level antecedents were identified. As this review revealed a general decline in pharmacists' mental health during the pandemic, further research is required to understand the long-term impacts of the pandemic on pharmacists. Furthermore, we recommend practical mitigation strategies to improve pharmacists' mental health, such as implementing crisis/pandemic preparedness protocols and leadership training to foster a better workplace culture.

Qualitative exploration of the physical activity engagement among college students with intellectual disabilities

Higher education institutions today have offered a range of postsecondary transition programs for adults with.intellectual disabilities (ID). Applying the social-ecological framework, this study was aimed to analyze qualitative data about the experiences and perceptions of physical activity (PA) among eight college students with ID at a post-secondary transition program in the United States. The phenomenological approach was utilized to describe participants' lifeworld experience of PA. Results indicated that the most PA opportunities on campus merely derived from the availability of adapted programs. Only one participant met the minimum requirement of engaging moderate-intensity exercise weekly. Based on the analysis using the social-ecological framework, the results include twelve themes at the intrapersonal level (self-efficacy, personality, emotion, past experiences, knowledge, and time), interpersonal level (family support and friend support), and institutional level (specifically, university recreation center, available adapted programs, adverse weather, and COVID effect) that influenced their PA participation. The current transition program seemed to promote sedentary behaviors during school hours. Strategies to enhance PA engagement for this population should include increasing students and parents' knowledge of PA and health, providing adequate social support from college mentors and more adapted PA opportunities and alternative options on campus. These recommendations could boost PA self-efficacy and overcome barriers at multiple levels in students with ID.Copyright © The British Society of Developmental Disabilities 2023.

Canadian children's independent mobility during the COVID-19 pandemic: A national survey.

Independent mobility (IM) is associated with children's physical activity and indicators of social, motor, and cognitive development. We surveyed Canadian parents of 7- to 12-year-olds (n = 2291) about social-ecological correlates of IM in the second wave of COVID-19 (December 2020). We used multi-variable linear regression models to identify correlates of children's IM. Our final model (R2 = 0.353) included four individual-, eight family-, two social environment- and two built environment-level variables. The correlates of boys' and girls' IM were similar. Our findings suggest that interventions to support children's IM in a pandemic context should target multiple levels of influence.

A social-ecological model of working from home during COVID-19.

Working from Home (WFH) is emerging as a critical measure for reducing transport demand. Indeed, the COVID-19 pandemic has revealed that trip avoidance measures, especially WFH, could help address Sustainable Development Goal 11.2 (creating sustainable transport systems in cities) by decreasing commuter trips by private motor vehicles. This study aimed to explore and identify the attributes that supported WFH during the pandemic and construct a Social-Ecological Model (SEM) of WFH within the context of travel behaviour. We conducted in-depth interviews with 19 stakeholders from Melbourne, Australia and found that WFH during COVID-19 has fundamentally changed commuter travel behaviour. There was a consensus among participants that a hybrid-work model will emerge post-COVID-19 (e.g., working three days in the office and two days at home). We identified 21 attributes that influenced WFH and mapped these attributes across the five traditional SEM levels (intrapersonal, interpersonal, institutional, community and public policy). In addition, we proposed a sixth higher-order level: "global", to reflect the worldwide phenomena of COVID-19 and computer programs that also supported WFH. We found that WFH attributes were concentrated at the intrapersonal (individual) and institutional (workplace) levels. Indeed, workplaces are key to supporting WFH in the long-term. Whereby, workplace provision of laptops, office equipment, internet connection and flexible work policies enable WFH, and unsupportive organisational cultures and managers are potential barriers to WFH. This SEM of WFH benefits both researchers and practitioners by providing guidance of the key attributes required to sustain WFH behaviours post-COVID-19.

Understanding the Impacts of the COVID-19 Pandemic on Small Businesses and Workers Using Quantitative and Qualitative Methods.

The COVID-19 pandemic has simultaneously exacerbated and elucidated inequities in resource distribution for small businesses across the United States in terms of worker health and the financial stability of both owners and employees. This disparity was further intensified by the constantly changing and sometimes opposing health and safety guidelines and recommendations to businesses from the local, state, and federal government agencies. To better understand how the pandemic has impacted small businesses, a cross-sectional survey was administered to owners, managers, and workers (n = 45) in the beauty and auto shop sectors from Southern Arizona. The survey identified barriers to safe operation that these businesses faced during the pandemic, illuminated worker concerns about COVID-19, and elicited perceptions of how workplaces have changed since the novel coronavirus outbreak of 2019. A combination of open-ended and close-ended questions explored how businesses adapted to the moving target of pandemic safety recommendations, as well as how the pandemic affected businesses and workers more generally. Almost all the beauty salons surveyed had to close their doors (22/25), either temporarily or permanently, due to COVID-19, while most of the auto repair shops were able to stay open (13/20). Beauty salons were more likely to implement exposure controls meant to limit transmission with customers and coworkers, such as wearing face masks and disallowing walk-ins, and were also more likely to be affected by pandemic-related issues, such as reduced client load and sourcing difficulties. Auto shops, designated by the state of Arizona to be 'essential' businesses, were less likely to have experienced financial precarity due to the pandemic. Content analysis of open-ended questions using the social-ecological model documented current and future worker concerns, namely financial hardships from lockdowns and the long-term viability of their business, unwillingness of employees to return to work, uncertainty regarding the progression of the pandemic, conflict over suitable health and safety protocols, and personal or family health and well-being (including anxiety and/or stress). Findings from the survey indicate that small businesses did not have clear guidance from policymakers during the pandemic and that the enacted regulations and guidelines focused on either health and safety or finances, but rarely both. Businesses often improvised and made potentially life-changing decisions with little to no support. This analysis can be used to inform future pandemic preparedness plans for small businesses that are cost-efficient, effective at reducing environmental exposures, and ultimately more likely to be implemented by the workers.

Determinants of Outdoor Time in Children and Youth: A Systematic Review of Longitudinal and Intervention Studies.

Spending more time outdoors can improve children's social and cognitive development, physical activity, and vision. Our systematic review summarized the determinants of outdoor time (OT) based on the social-ecological model. We searched nine databases: MEDLINE, APA PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, SPORTDiscus, ERIC, SocINDEX, and ProQuest Dissertations and Theses. To be included, studies needed to be quantitative and longitudinal, include ≥1 potential determinant of OT among 0- to 17-year-olds, and be published in English, French, Japanese, or Spanish. We extracted the authors, publication year, country, design, sample size, OT measures, follow-up period, potential determinants, main results, and potential moderators or mediators. Fifty-five studies examining 119 potential determinants met the inclusion criteria. OT was consistently higher in warmer seasons and among participants reporting more OT at baseline. All three interventions that included both parent sessions and additional resources to promote OT (e.g., specific advice and community guides) were effective. COVID-19 restrictions and sun safety interventions discouraging midday outdoor activities led to less OT. The quality of evidence was rated as weak for 46 studies. Most potential determinants were examined in ≤3 studies; thus, more longitudinal studies are needed to enable stronger conclusions about the consistency of evidence and meta-analyses.

Predictors of Overweight and Obesity in Early Care and Education Teachers during COVID-19.

The purpose of this cross-sectional study was to determine individual, sociocultural, policy, and economic predictors of overweight/obesity in early care and education (ECE) teachers to identify modifiable opportunities to enhance the health of this critical workforce. ECE teachers (n = 1434) in the U.S. completed an online survey in late spring to mid-summer 2020. Teachers self-reported height and weight; body mass index (BMI) and weight status were calculated. Teachers reported micro-environment variables including age, race, gender, obesogenic lifestyle behaviors, well-being, food security, personal health, stress, job stress, type of ECE, COVID-19 teaching modality, and age of children in the classroom. Logistic regression predicting overweight/obesity and linear regression predicting BMI were conducted. Teachers with more years of teaching experience (OR: 1.022: 95% CI 1.005, 1.039) and higher consumption of fast food (2.038: 1.310, 3.169) had higher odds of overweight/obesity. Teachers with higher levels of education (0.58: 0.407, 0.828) and higher physical health (0.836: 0.775, 0.902) had lower odds of overweight/obesity. Other variables were not associated with overweight/obesity. Variables significant in logistic regression were also associated with higher BMI. Additionally, Native American race (ß = 2.467 SE = 1.206) and sedentary hours/day (ß = 0.152 SE = 0.075) were associated with higher BMI. Implications for enhancing workplace health for these ECE teachers are emerging.

Virtual Visits in Prenatal Care: An Integrative Review.

INTRODUCTION: Addressing gaps in access to prenatal care is an important step to reversing rising rates of maternal and neonatal morbidity and mortality and invites the exploration of innovative care models. This integrative review of published literature explores the patient, health care provider, and organizational experience of integrating virtual visits in prenatal care. METHODS: A literature search to identify original studies and quality improvement projects published between 2010 and 2020 was conducted in PubMed, Scopus, CINAHL, and Google Scholar using keywords associated with both telemedicine and prenatal care. Inclusion criteria specified articles pertaining to synchronous virtual visits between pregnant patients and health care providers, and articles were excluded if visits were not pregnancy-centric or pertaining to telemonitoring or mobile applications. Reference lists of identified reviews were screened, and a hand search of 4 applicable journals was also conducted. Findings were organized according to the factors of the social ecological model: individual, interpersonal, organizational, community, and public policy. RESULTS: The search identified 2666 articles after duplicates were removed, of which 13 met all criteria. Findings across these 13 articles indicated strong patient and health care provider satisfaction with virtual care related to cost savings and convenience, with clinic wait times and cancellation rates also improving. Health care provider input and thoughtful organizational planning were key to a smooth telemedicine implementation process. There were notably no significant differences in clinical outcomes for those who used virtual care. DISCUSSION: Although data are limited, offering an integrated model that uses both virtual visits and in-person visits has been well-received by patients and health care providers and could improve access to care well into the future. Virtual visits in prenatal care have been well-received by patients and health care providers, showing promise as an emerging model for improving access to care.

Narrative identity among people with disabilities in the United States during the Covid-19 pandemic: The interdependent self.

This study examines narrative identity among a large, diverse sample of people with disabilities (PWDs) in the United States during the "second wave" of the Covid-19 pandemic (October-December 2020). The study relied on abductive analyses, combining a purely inductive phase of inquiry followed by two rounds of investigation that filtered inductive insights through three theoretical lenses: social-ecological theory, the theory of narrative identity, and perspectives from the interdisciplinary field of disability studies. The central result was the identification of a particular configuration of self, one that was demonstrably interdependent with both immediate interpersonal contexts and with broader cultural contexts. This interdependent self was interpreted in both positive and negative ways by PWDs. These findings invite future inquiry into commonplace conceptualizations of an independent self at the center of personality research and suggest that dominant conceptualizations of "the good life" may overly emphasize independence.

An Ecological Model Analysis of COVID-19 Social Media Posts

This study examined prevention and coping content related to COVID-19 on social media. Publicly available social media posts were examined by levels of the social ecological model (SEM) and by platform (Instagram, TikTok, Twitter). Using systematic random sampling, 1579 public posts were collected from March 2020 to June 2020 using COVID-19 hashtags. Of these, 663 posts written in English about COVID-19 were included. Content was coded by platform, strategies for reducing risk, strategies for coping with stress, and SEM level(s). In total, 41.18% of the posts mentioned a strategy for reducing risk. Few posts mentioned coping strategies (5%). Slightly less than half of the posts focused on the individual level (42.1%). Both the strategies mentioned for reducing risk and SEM levels referenced in each post varied significantly by platform. Results suggest that social media may provide insight into the type of health information the public receives as well as the public’s strategies for reducing risk and coping;however, there is variation among platforms.

‘Unsuitable’ environments: a qualitative study of US college youth learning online while sheltering-in-place in spring 2020

In late April 2020, we asked young adult college students to describe how they were impacted by the COVID-19 pandemic. This study analyzes data from the 370 students (52.3% of all students surveyed) who chose to describe their experiences with online learning in their response. Many students, and especially students from marginalized backgrounds (e.g. women and transgender and gender diverse, LGBTQ+, low-socioeconomic position), reported diverse hardships that were induced and/or exacerbated by the COVID-19 pandemic that affected their learning. Most of these adverse experiences were tied to students’ shelter-in-place and remote learning conditions, which we frame as ‘unsuitable environments’, that limited students from engaging academically in the same ways they might have on campus. We situate these unsuitable environments within an intersectional social-ecological model to demonstrate how students’ transformed nested environments impact academic engagement and have implications for equity within institutions of higher education – an ecological disruption whose impacts remain important to evaluate in future research on online learning in higher education. [ FROM AUTHOR] Copyright of Journal of Youth Studies is the property of Routledge 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 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 . (Copyright applies to all s.)

Exploring the Linkages of Digital Food Communication and Analog Food Behavior: A Scoping Review.

The linkages of digital food communication on social media platforms and analog food behavior of social media users are widely discussed in media and research, but less differentiated. Due to the interdisciplinary nature of the research field, the scientific studies are characterized by great heterogeneity in approaching the role of communication and modelling of food behavior, and thus also the conclusions on how digital food communication might be linked to analog food behavior. There is still much uncertainty regarding the relationship and underlying assumptions between digital communication and analog action. The rationale of this scoping review is to systematically summarize the findings of this heterogeneous body of knowledge. The importance and originality of this review are that it focuses explicitly on studies that provide insights into the nexus of digital food communication and analog food behavior, be it in the theoretical foundation, the results, or their interpretation. It draws on a socio-ecological model of food behavior that depicts food behavior variables in different domains and uses a differentiated categorization of food behavior (food choice, dietary intake, and eating behavior) to synthesize the results. Using the Web of Science and PubMed databases, 267 abstracts were identified and screened, of which 20 articles met the inclusion criteria and were selected for full-text analysis. The review offers some important insights on how different variables of the socio-ecological model of food behavior are related to digital food communication and different areas of analog food behavior. This review provides a more discerning understanding of which aspects of analog food behavior may be linked to social media food communication and in which ways. Implications are derived to reflect the role of communication in previous models of food behavior by adding a more nuanced and cross-cutting understanding of food communication.

Multilevel Factors Associated with Obesity among South Korean Adolescents before and during the COVID-19 Pandemic.

Background: Coronavirus disease 2019 (COVID-19)-necessitated lockdowns and school closures have limited social interactions among adolescents, which result in unhealthy behaviors. This study compared the multilevel factors associated with obesity among adolescents in South Korea before and during the pandemic. Method: We applied the social-ecological model and analyzed the 2019 and 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS), including middle and high school students. We considered factors at the individual, family, and community levels in the logistic regression. Age and gender-adjusted obesity (body mass index ≥ the 95th percentile) was the dependent variable. Result: The prevalence of obesity slightly increased from 11.31% before the pandemic to 12.48% during it; the odds of obesity were 1.12 times (95% confidence interval [CI] = 1.08-1.16) as high during the pandemic compared to before it. Several individual factors (e.g., age, gender, fast-food consumption) and perceived family economic status were commonly associated with obesity before and during the COVID-19 pandemic. Physical activity and city type were related to obesity only before the pandemic. Downgraded economic status owing to COVID-19 was adversely related to obesity during the pandemic. Conclusion: Inclusive multilevel support is needed to combat obesity in adolescence during the pandemic and those economically impacted require additional support.

Understanding the impacts of COVID-19 on the determinants of food insecurity: A state-specific examination.

This paper examines risk factors influencing food insecurity during the first year of the COVID-19 pandemic in a state in the U.S. heavily impacted by it and offers recommendations for multi-sector intervention. The U.S. Census Bureau Household Pulse Survey was analyzed to evaluate the impacts of COVID-19 on food security in Massachusetts from April 2020 through March 2021 using a study sample of 57,678 participants. Food security was defined as a categorical variable (food security, marginal food security, low food security, very low food security) and binary variable (food security and food insecurity). Known or suspected factors that contribute to it, such as childcare, education, employment, housing, and transportation were examined in multivariate logistic regression models. Data imputation methods accounted for missing data. Sociodemographic characteristics, including lower education level and living in a household with children, were determinants of food insecurity. Another factor that influenced food insecurity was economic hardships, such as unemployment, being laid off due to COVID-19, not working due to concerns about contracting or spreading COVID-19, or not having enough money to buy food. A third factor influencing food insecurity was food environment, such as lack of geographic access to healthy foods. Some of these factors have been exacerbated by the pandemic and will continue to impact food security. These should be addressed through a comprehensive approach with public health efforts considering all levels of the social ecological model and the context created by the pandemic.

Individual, interpersonal, and neighborhood measures associated with opioid use stigma: Evidence from a nationally representative survey.

Despite growing awareness of opioid use disorder (OUD), fatal overdoses and downstream health conditions (e.g., hepatitis C and HIV) continue to rise in some populations. Various interrelated structural forces, together with social and economic determinants, contribute to this ongoing crisis; among these, access to medications for opioid use disorder (MOUD) and stigma towards people with OUD remain understudied. We combined data on methadone, buprenorphine, and naltrexone providers from SAMHSA's 2019 directory, additional naltrexone providers from Vivitrol's location finder service, with a nationally representative survey called "The AmeriSpeak survey on stigma toward people with OUD." Integrating the social-ecological framework, we focus on individual characteristics, personal and family members' experience with OUD, and spatial access to MOUD at the community level. We use nationally representative survey data from 3008 respondents who completed their survey in 2020. Recognizing that stigma is a multifaceted construct, we also examine how the process varies for different types of stigma, specifically perceived dangerousness and untrustworthiness, as well as social distancing measures under different scenarios. We found a significant association between stigma and spatial access to MOUD - more resources are related to weaker stigma. Respondents had a stronger stigma towards people experiencing current OUD (versus past OUD), and they were more concerned about OUD if the person would marry into their family (versus being their coworkers). Additionally, respondents' age, sex, education, and personal experience with OUD were also associated with their stigma, and the association can vary depending on the specific type of stigma. Overall, stigma towards people with OUD was associated with both personal experiences and environmental measures.

Cognitive Security and Resilience: A Social Ecological Model of Disinformation and other Harms with Applications to COVID-19 Vaccine Information Behaviors

Access to and discovery of credible information is the product of numerous, interacting factors including individual characteristics and behaviors as well as features of the information environment, social, cultural, and institutional norms, policies and regulations, and more. To date, most research on information disorder has focused either on the individual or on the information environment (or on the technology that allows an individual to access the information environment), but there is a lack of systematic, theory-driven research on the dynamic relationship between the individual and their environment. In this study, we propose a novel application of Brofenbrenner's social ecological model to the study of cognitive security and resilience in the context of information disorder. First, we describe the refitting of the model from public health and human development to cognitive security. Using extant literature in the field, we identify the key factors at each level of influence - including individual-level factors such as attitudes/beliefs, knowledge/experience, and demographic characteristics, as well as higher-level factors at the interpersonal-, organizational/institutional-, community-, and policy/culture-levels - that shape susceptibility and resilience to information disorder. We also consider the dynamic interactions between individuals, groups, societies, and characteristics of the technological environment, including how algorithms and artificial intelligence interact with individual behaviors, policies, and organizational decision-making to shape access to and discoverability of credible information. Finally, we describe an application of the model to a use case involving COVID-19-related information behaviors. To our knowledge, this is the first time Brofenbrenner's social ecological model has been applied in full as a conceptual foundation for the study of cognitive security and resilience. Our findings provide important new insight into the social, cultural, and structural factors that shape information behaviors and access to credible information, as well as the impact of information disorder. The results can be used to identify vulnerabilities and targets for future information-related initiatives and interventions (such as fact-checking and journalism initiatives) and to inform evaluations of such initiatives, as well as to better understand variation in susceptibility and resilience to information disorder. Further, this study lays an important conceptual foundation for future research to expand on this use case and refine the application of the social ecological model to the information domain. © 2022 Copyright for this paper by its authors.

The prospective relationship between loneliness, life satisfaction and psychological distress before and during the COVID-19 pandemic in the UK.

Aim: Mental wellbeing in the UK seems to have deteriorated significantly during the COVID-19 pandemic, with the rates of loneliness, life satisfaction and psychological distress taking longer to return to the pre-pandemic levels than elsewhere. Nevertheless, there is little knowledge about the interactions between these outcomes, or the factors that played a role in the rates of change. The current study aims to address this gap by simultaneously investigating changes in loneliness, life satisfaction and psychological distress in the UK from pre-pandemic levels to those between April and November 2020, while critically assessing the role of a range of social ecological influencing factors. Subject and Methods: Longitudinal data from Understanding Society (N=3475) were used to explore the changes in loneliness, life satisfaction and psychological distress from pre-pandemic levels (2017-2019) through November 2020, the interactions between these outcomes, and the role of individual, social, community and geographic factors in the rates of change, using multivariate latent growth curve model. Results: Loneliness, life satisfaction and psychological distress deteriorated minimally between April and November 2020, compared to the pre-pandemic levels (2017-2019), while the rate of change in each outcome influenced the rates of change in the other two. Key individual (age, gender, physical health), social (number of friends and similarity to them), and environmental (neighbourhood quality) variables influenced baseline scores and the rates of change. Conclusion: Considering significant dynamic associations between loneliness, life satisfaction and psychological distress, we argue that interventions to tackle any one of the outcomes may have beneficial effects on others, while highlighting malleable factors and individual and community-level interventions to tackle loneliness.