Did A Fruit and Vegetable Incentive Program Support low-income Households in North Carolina during the COVID-19 Pandemic? A Mixed Methods Assessment of the Healthy Helping Program and Other Pandemic-Related Food Assistance

In 2020, the Healthy Helping Fruit and Vegetable Program provided SNAP-eligible beneficiaries with $40/month, for up to 3 months, to purchase fruits and vegetablesata chainsupermarket inNorthCarolina.A survey to describeparticipants' experiences with the program and interviews to explore whether these experiences were shaped byparticipating inotherpandemic-related food access programs were conducted.In conjunction with other food access programs,programs that allow participants freedom to choose what they purchase mayalleviate household hardships and provide greater access tonutrient-dense foods during the COVID-19 pandemic and beyond..Copyright © 2022 Taylor & Francis Group, LLC.

Differences in a Chain Supermarket's Sales to SNAP Shoppers Before and Since the COVID-19 Pandemic.

OBJECTIVE: This study 1) compares grocery sales to Supplemental Nutrition Assistance Program (SNAP) shoppers in rural and urban grocery stores and 2) estimates changes in sales to SNAP shoppers in North Carolina (NC) since the pandemic. DESIGN: Weekly transaction data among loyalty shoppers at a large grocery chain across NC from October 2019 to December 2020 (n = 32; 182 store weeks) to assess nutritional outcomes. SETTING: North Carolina large chain grocery stores. PARTICIPANTS: Large chain grocery store/SNAP shoppers. INTERVENTION: Rural/urban status of the stores and COVID-19 pandemic onset. MAIN OUTCOME MEASURES: Share of total calories sold from fruits, vegetables, nuts, and legumes (FVNL) with and without additives, sugar-sweetened beverages (SSB), less healthful foods (LHF), and processed meats (PM). ANALYSIS: Multivariate random effects models with robust standard errors to examine the association of rural/urban status before and since coronavirus disease 2019 with the share of calories sold to SNAP shoppers from each food category. We controlled for county-level factors (eg, sociodemographic composition, food environment) and store-level factors. RESULTS: We did not find significant rural-urban differences in the composition of sales to SNAP shoppers in adjusted models. There was a significant decrease in the mean share of total calories from sugar-sweetened beverages (-0.43%) and less healthful food (-1.32%) and an increase in the share from processed meats (0.09%) compared with before the pandemic (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Urban-rural definitions are insufficient to understand nuances in food environments, and more support is needed to ensure healthy food access.

CHARACTERIZATION OF NANOSTORES DURING 2020-2022

The nanostores known in Latin America as pulperias are an important player in the generation of resources and wealth. Currently, they represent more than 50 million points of sale around the world, where two-thirds of the population go to these centers for retail products and services. The pulperias explain at least 60% of the sales and success of the distribution channels of Mass Consumption companies. However, the literature that describes the pulperias operations with empirical evidence is still lacking. Also, no study describes the pulperias operation in Honduras. Therefore, the purpose of the study is to characterize the pulperias in Honduras, as a first exploratory study that allows to description, determinate variables and establishes the state of this sector during the COVID19 pandemic, 2020-2022 period. Hence, an exploratory investigation was carried out, collecting empirical evidence in 472 pulperias. The results show that competitiveness and infrastructure are low, and technological inclusion and financing are limited. Finally, they have a high market share, and the level of adaptability and agility are medium, being a sector threatened by security and the supermarket and hypermarket chains. © 2023, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.

A FIVE-YEAR SUMMARY OF THE MMM CAMPAIGN IN NEPAL

Objective: To share the implementing experience of the May Measure (MMM) campaign in Nepal. Design and Methods: Nepal has been a part of the MMM initiative since its inception. NeDS Nepal, a not-fort profit NGO was responsible for the overall coordination of the campaign. We trained and mobilized community health workers and health science students as volunteers. Although MMM was not executed globally due to the COVID-19 pandemic in 2020, it was conducted in Nepal by following safety measures. Results: The volunteers set up screening sites in supermarkets, temples, colleges, grocery stores, primary health care clinics, banks, government offices, and meeting halls. Some of the volunteers also did house-to-house visits. Between 2017-2021, we screened over 130,000 participants. We identified > 30,000 high blood pressure participants, provided lifestyle counseling, and referred them to the health facility for further diagnosis and treatment. Out of them, ∼18000 were newly identified hypertension. Conclusions: Opportunistic screening like MMM is feasible and needed in the context of Nepal. This could potentially be embedded in the national screening program. It is also important to have a strategy for linking the patients with the health system for further diagnosis and treatment.

A data-driven decision support system with smart packaging in grocery store supply chains during outbreaks.

The unexpected emergence of the COVID-19 pandemic has changed how grocery shopping is done. The grocery retail stores need to ensure hygiene, quality, and safety concerns in-store shopping by providing "no-touch" smart packaging solutions for agri-food products. The benefit of smart packaging is to inform consumers about the freshness level of a packaged product without having direct contact. This paper proposes a data-driven decision support system that uses smart packaging as a smart product-service system to manage the sustainable grocery store supply chain during outbreaks to prevent food waste. The proposed model dynamically updates the price of a packaged perishable product depending on freshness level while reducing food waste and the number of rejected customers and maximising profit by increasing the inventory turnover rate of grocery stores. The model was tested on a hypothetical but realistic case study of a single product. The results of this study showed that stock capacities, freshness discount rate, freshness period, and quantity discounts significantly affect the performance of a grocery store supply chain during outbreaks.

Risky businesses: Carbon dioxide monitoring to assess ventilation in grocery stores as an indicator of risk for respiratory virus transmission

Background. Poorly ventilated indoor settings pose a risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses. Transmission often occurs in community, but limited information is available on the quality of ventilation in community settings. Methods. We used carbon dioxide measurements to assess adequacy of ventilation in 6 grocery stores, including large warehouse stores, medium-sized stores, and small neighborhood groceries. Carbon dioxide levels were monitored continuously with values recorded once per minute using a handheld device during multiple shopping trips to each store during both busy (defined as long lines at checkout) and nonbusy (defined as no lines at checkout) shopping times. Carbon dioxide readings above 800 parts per million (ppm) were considered an indicator of suboptimal ventilation for the number of people present. Results. Carbon dioxide levels remained below 800 ppm in all 6 grocery stores during trips at non-busy shopping times, except for transient rises above 800 ppm (peak = 860 ppm) during check out in 2 stores. In 3 of the 6 stores (50%), carbon dioxide levels rose above 800 ppm for prolonged periods during busy shopping times, with considerable variability in levels in different store locations (ie, increased levels in crowded store locations). The figure shows carbon dioxide levels for 1 medium-sized grocery store during typical shopping trips during busy and non-busy shopping periods. Increase in carbon dioxide levels in parts per million (ppm) in a grocery store during busy and non-busy shopping trips. Peak levels of carbon dioxide above 800 ppm (dotted lines) were considered an indicator of suboptimal ventilation for the number of occupants present. Conclusion. Ventilation in grocery stores may be sufficient to minimize the risk for airborne transmission of respiratory pathogens during non-busy shopping periods, but in some stores may be sub-optimal in crowded locations during busy shopping times. There is a need for additional studies to assess the quality of ventilation in a wide range of community settings.

Evaluation of WIC Online Ordering during the COVID-19 Pandemic: Evidence from an Oklahoma Grocery Store Chain.

The COVID-19 pandemic is worsening the disparities in food access in the United States. As consumers have been increasingly using grocery online ordering services to limit their exposure to the COVID-19 virus, participants of federal nutrition assistance programs lack the online benefit redemption option. With the support of the US Department of Agriculture (USDA), retailers are pilot-testing online food benefit ordering in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). By combining the Oklahoma WIC administrative data, the online ordering data from a grocery store chain in Oklahoma, and the COVID-19 data in Oklahoma, this study examines how WIC participants responded to the online food benefit ordering option and how their adoption of online ordering was associated with the COVID-19 incidence. Results show that from July to December 2020, 15,171 WIC households redeemed WIC benefits at an Oklahoma chain store, but only 819 of them adopted online ordering. They together completed 102,227 online orders, which accounted for 2.7% of the store visits and 2.6% of the monetary value of WIC redemptions at these stores. There was no significant relationship between WIC online ordering adoption and COVID-19 incidence in Oklahoma.

Impact of Food Insecurity on Clinical Outcomes in Newly Diagnosed Pediatric Ibd Patients

Purpose: Inflammatory bowel disease (IBD) is an autoimmune disease that consists of Crohn's Disease (CD) and ulcerative colitis (UC). IBD is thought to result from an environmental trigger, one of which could be diet, in a genetically susceptible host. Food insecurity is defined as limited or uncertain access to enough food. It is estimated that 1 in 7 children in the United States experience food insecurity which is estimated to be about 13 million children. This number has increased since the COVID pandemic to 1 in 4. Louisiana has one of the higher rates of food insecurity in the country with an estimate of over 249,000 children affected. Food insecurity is higher in African American and Hispanic households. Despite nutrition playing a significant role in IBD, there is limited data on food insecurity and IBD. Only one adult study identified that adult IBD patients had 69% higher odds of being food insecure compared to peers without IBD. The purpose of this study is to evaluate if pediatric patients with IBD are food insecure. Our hypothesis is that newly diagnosed pediatric IBD patients who are food insecure have worse clinical outcomes than those who are food secure 6 months after diagnosis. The primary aim will be to assess if food insecurity is associated with escalations in therapy within the first 6 months of diagnosis. Secondary aim of the study is to determine if food insecurity is associated with other clinical outcomes. Food access will also be evaluated to see if patients who are food insecure live in areas defined as a food desert, decrease access to nearby grocery stores, or food swamps, defined as adequate access to food but mostly higher calorie food options over healthy food options. Method(s): This is a prospective study of newly diagnosed pediatric IBD patients seen in the Louisiana State University Health Science Center Pediatric Gastroenterology Division at Children's Hospital New Orleans. Patients were screened for food insecurity using the United States Department of Agriculture's food insecurity screening and the American Academy of Pediatrics' Food Insecurity 2-Question Screen. Data was collected including escalations in medication, hospitalizations, surgeries, emergency room visits and nutritional data over the first 6 months of diagnosis. To determine diet quality, food journals were completed, or comprehensive diet recalls were performed then analyzed by a licensed dietitian. Result(s): There are currently 13 patients enrolled in this ongoing study. All patients have Crohn's Disease and receive maintenance therapy with TNF alpha antagonist (infliximab or biosimilar). Most patients are female (69%), Medicaid insurer (54%), with approximately half identifying as white race (46%) and half identifying as African American (46%). The average age at diagnosis was 14.4 years (+/- 2.7 years). Nine of the patients (69%) have no grocery stores within 1 mile of their home. Three patients lived in a food swamp (23%), 1 of which also had low food security. There was one patient who did not live in a food desert or food swamp but identified as having low food security. The average BMI was 19.4 and 3 had a BMI z-score less than -1 at diagnosis. Two parents were identified as having low food security and 2 patients screened positive for low food security. Only one survey matched low food security for both parent and child. For transportation, many traveled to appointments by automobile but were not owners of the automobile. At one month after diagnosis, there was 1 medication change due to the development of antibodies, 2 courses of oral steroids, 2 patients had an additional medication added (methotrexate for both), 3 hospitalizations, 1 surgery;however, none of the patients fit criteria for low food security. There were 2 emergency room visits, 1 of 2 were food insecure. Weight gain in one month ranged from 0.3 to 10.4 kilograms. One food insecure patient lost 0.8 kilograms at 1 month. Conclusion(s): While there were few patients identified as food insecure, each patient had relatively poor access to healthy food options. Every patient in the study either fell into the category of having no grocery stores within a mile of their home, living in a food swamp or having low food security. Establishment of additional surrogates for food insecurity may be warranted to better assess the association of food insecurity with IBD. The significance of food insecurity in pediatric IBD remains unclear. However, longer follow-up is planned to further assess the relationship between food insecurity and clinical and nutritional outcomes. Additional studies are forthcoming to evaluate the impact food quality within the diet of pediatric IBD patients has on short-term and long-term health outcomes.

COVID-19 and Healthy Habitsin Missouri Families

Background: The COVID-19 pandemic and subsequent social distancing measures have undermined several healthy habits that families had or were establishing prior to the start of the pandemic. This study looks at those changes through online survey to Missouri families to evaluate how COVID-19 has impacted healthy lifestyle habits in Missouri families, along with degree of social distancing and any associations in changes in employment, food scarcity issues, and health concerns. Methods: An online survey (through RedCap) was conducted during spring to summer 2020 evaluate changes during the time of initial lock down and social distancing, for families living in Missouri with children ages 2-18 years. The survey was advertised on social media and in local clinics to gather participants' responses. Results: A total of 298 responses were received from the survey. 58% of respondents noted a change in employment (35% stated now working from home, 18% noted decrease in work hours, and 5% noted they had been laid off or lost job completely). While there were no overall statistically significant changes in healthy habits during the initial lock down period in spring-summer 2020 noted, a subset analysis noted that when comparing those with a change in employment to those without a change in employment, Missouri families did note several statistically significant changes in their healthy habits. Those with a change in employment were more likely to note a decrease in their child(ren)'s physical activity, report an increase in screen time (p = 0.044), are more likely to report noticing family members eating between meals or snacking more (p = 0.004), and are also more likely to report worrying about their child(ren)'s nutrition (p = 0.049), and are more likely to note changes in their child(ren)'s sleep patterns (p = 0.021) during the pandemic. These groups were not significantly different in their self-reported income, the degree to which they socially distanced, their grocery store frequency, food scarcity, or how much they were eating out. Conclusion: Our study of Missouri families and healthy-habit maintenance during the initial months of the COVID-19 pandemic revealed that overall healthy habits were maintained during the initial months of COVID-19. However, a subset analysis comparing those who reported a change in employment vs. those who did not report a change in employment revealed that those who experienced a change in employment were more likely to report changes in healthy habits such as amount of screen time and physical activity, snacking between meals, changes in sleep, and overall concern for their child(ren)'s nutrition. This study highlights that major life events may affect healthy habit changes and families' abilities to change healthy habits during these events and can help pediatricians understand the impact of major life changes for families on healthy habit development and maintenance.

Change in Food Purchasing Patterns and Increased Reliance on Support Programs During the COVID-19 Pandemic in Inner-City Dialysis Patients

We investigated how food purchasing behavior changed in a cohort of inner-city dialysis patients during the COVID-19 pandemic. 33 dialysis patients were surveyed face-to-face about use of grocery stores, restaurants, take-out, and use of SNAP or other benefits over the past year. The survey also assessed patient attitudes and fear relating to COVID-19. Mean age was 57.1±17.9 yrs, 20 (61%) men, 91% identified as Black. 9/20 pts (27%) reported yearly income under $20,000 with 70% less than $40,000. The number of pts using SNAP, WIC, or Greenmarket Bucks to buy groceries increased from 21% before the pandemic to 33% after (p=0.019). Age correlated negatively with feeling safe eating at a restaurant indoors (r=-0.47, p=0.008), or outdoors (r=-0.58, p=<0.001) and increased use of take-out since the start of the pandemic (r=-0.39, p=0.032). There was a significant difference in pts who purchased breakfast (45.9±4.0 vs 65.3±3.6, p<.001), lunch (49.7±4.1 vs 65.3±4.0, p=.006), and dinner compared to those who didn’t (48.5±4.9 vs 60.9±3.9, p=0.031). There was a positive correlation between income and the frequency that pts purchased breakfast (r=0.45, p=0.048) and lunch (r=0.45, p=0.046). There was a negative correlation between age and the statement “I wish I could cook more meals at home” (r=-0.497, p=0.004) and a positive correlation with income (r=0.06, p=0.006). There was no association between age and income. Only 6% (2) pts were employed and both were <60 yrs old. In our population of inner-city dialysis pts: 1. Use of food assistance programs increased since the start of the pandemic. 2. Older pts felt less safe eating at restaurants regardless of whether it was indoors or outdoors and were more likely to make meals at home. 4. Younger patients were more likely to eat take-out food and reported they wished they could cook more meals at home. 5. Increased use of food programs and association of younger age or lower income with eating out suggests that careful nutritional guidance should be emphasized as dietary habits have changed since the pandemic and eating out has been associated with worse adherence to sodium and other restrictions in pts on dialysis.

The Perceived Effects of Covid-19 on the Preferences and Expectations of Customers of Grocery Stores in Metro Manila

The novel coronavirus disease 2019 (COVID-19, caused by SARS-CoV-2) has spread globally and its impact cause many brick-and-mortar retailers including grocery stores to develop different strategies to operate amidst pandemic which includes revamping the area of facility management and layout, systems design and retail marketing. The objective of the study is (1) determine the relationship between the perceived COVID-19 effects and the buying expectations and preference of grocery customers, (2) determine the significance of the New Normal grocery operations strategy elements and practices and its moderating effect on the grocery customer buying expectations and preferences in view of the Covid-19 repercussions and (3) recommend a grocery operations strategy implementation platform to address the new buying preferences and expectations of grocery customers toward the new normal. With a sample size of 303 respondents of various individual that have experience buying grocery during pandemic answered the online questionnaire. Using Structural Equation Modeling (SEM), the result of the study showed that the COVID-19 effect have direct significant to the buying expectations and preference of grocery customers. Additionally the New Normal grocery operations strategy elements and practices also have significant direct effect to the buying expectations and preference of grocery customers. © IEOM Society International.

Short-Term Impacts of COVID-19 Public Health Regulation on Consumer Food Purchases: A Case Study From a Grocery Store in Montana

The mitigation measures (e.g., lockdown policies) in response to the COVID-19 pandemic impacted food systems in unprecedented ways, in both scope and immediacy. Food retail, for example, changed fundamentally in the United States, as access to nutritious food became limited, supply chain shortages were common, and mandatory public health measures led to behavior changes among customers and employees. In the present case study, we hypothesized that these changes led to food purchasing shifts of grocery store consumers. Such shifts are seen as an outcome of both endogenous factors at the individual level and exogenous factors at the government/policy level. Our case study sought to better understand how the pandemic and associated regulations shaped consumer food choices during the “hard” lockdown period in Montana during 2020. We selected 112 food products based on the highest sales in a Gallatin County, Montana, grocery store. They were analyzed by predefined food groups aligned to the Dietary Guidelines for Americans 2020. All purchases were processed for each selected food item during March and April 2019 (before the pandemic) and March and April 2020 (during the lockdown in Montana). To further describe the pandemic experiences qualitatively, we conducted semi-structured interviews with managers and employees from two stores in Gallatin County. Overall, we found that consumers increased purchases in most food groups during the pandemic, including nutrient-dense and energy-dense products, most outstandingly for starchy vegetables, legumes, and convenience food. Products with long shelf-life and that required preparation at home were preferred. Endogenous causes, specifically panic and rushing, were likely stronger drivers of consumer behavior and food choices than regulations. Nonetheless, lockdown policies impacted consumer food purchases. We present a series of policy and practice recommendations based on our findings and the emerging literature on this topic. Copyright © 2022 Ebel and Byker-Shanks.

Covid management strategies for Reliance Retail store-based employees

Introduction: COVID 19 Pandemic has impacted all businesses across world. Customer facing businesses were impacted the most amongst them. Reliance has more than 8000 Retail stores spread across India with more than 2 lac employees. Involving business in Grocery stores, Apparel stores, Electronic stores, Home delivery by Jio-Mart stores, etc. Interventions: To ensure safety of employee of Retail stores Reliance has implemented standard prevention methods of Sanitization, Mask & Social distancing (SMS) and few other steps of wearing face shield, thermal screening, symptom checker tool were introduced to strengthen screening of suspect cases. Stringent testing protocols and Strict adherence to contact tracing was implemented. For positive patients Home isolation assistance, Hotel isolation facilities and Covid care centers managed by Reliance. Home care cell to monitor home isolation patients using Telemedicine. Assessment of patients by Inhouse Reliance medical team and timely hospitalization assistance. Thrust on vaccination drive were few more interventions. Methodology: Using qualitative techniques, consisting of observations using Pre-tested piloted checklist, Key informant interviews and reviews of Records as well as protocols. Findings: All the strategies were found to be implemented in standardized manner helping the business activities to sustain and serve the customers with uninterrupted supplies of the essentials. Conclusion: Standardized processes using innovative approaches help in efficient and effective implementation of Covid 19 management strategies towards reducing the mortality and morbidity.

The Online Ordering Behaviors among Participants in the Oklahoma Women, Infants, and Children Program: A Cross-Sectional Analysis.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed WIC benefits in XYZ stores during the study period, which was 1 July to 31 December 2020. This period was during the COVID-19 pandemic but after the temporary lockdown in Oklahoma had been lifted. Descriptive statistics were estimated for WIC OO households' adoption behaviors and their orders. The Cox proportional hazard model and zero-truncated negative binomial regression were applied to examine the relationship between participants' socio-demographics and the length of time between 1 July 2020, and their first OO, as well as the number of WIC online orders. About 80% of these online orders were picked up without any changes. Minority households had a significantly longer time before adopting their first OO (hazard ratio (HR) < 1, p < 0.001), while households with a child or a woman participant, or more participants, had a shorter time before adopting OO (HR > 1, p < 0.05). Non-Hispanic black households had a fewer number of OOs than non-Hispanic white households (B = -0.374, p = 0.007). OO adoption varied across socio-demographics. More efforts are needed to ensure equal access and adoption of WIC OO.

Fostering patient-centered resources for food insecurity

Background: Food insecurity—lack of consistent access to enough affordable, nutritious food—is noted in 33% of people with CF. This is 3 times the food insecurity rate of the general U.S. population [1, 2]. Given this increased prevalence within the CF community, we sought to understand how people with CF experiencing food insecurity prefer to receive resources and support. The results were used to inform and prioritize creation of patient-centered resources for CF care teams. Methods: A survey request was posted via the CF Foundation’s Community Voice (CV), a program that provides opportunities for people with CF and their family members to influence programs and initiatives affecting the CF community [3]. A total of 1134 CV participants who identified as an adult with CF, a spouse of a person with CF, or a parent of a child with CF were invited to respond to an anonymousweb-based survey from February 3–17, 2021. Results: Therewere 140 responses to the survey. From these responses, 84% (117/140) reported prior knowledge of food insecurity, and 21% (30/140) reported experiencing some degree of food insecurity. Of those reporting food insecurity, 73% (22/30) worried about running out of food before having money to buy more, and 67% (20/30) reported that their food did not last and that they did not have money to buy more. Half (15/30) indicated that their family or household food status worsened because of the COVID-19 pandemic. Respondents indicating food insecurity reported assistance preferences including local community resources (57%, 17/30), their care team social worker (40%, 12/30), and community and religious support groups (43%,13/30). Additionally, respondents preferred to receive food security resources via email (87%, 26/30), website (50%, 15/30), or patient portal (43%, 13/30). To bolster food status, respondents preferred to receive grocery store gift cards (93%, 28/30) or a food box mailed to the home (77%, 23/30) or to use a food pantry (70%, 21/30). Conclusion: Results indicated that people with CF who experience food insecurity prefer to receive food in a variety ofways, many being virtually or through private organizations. These resources may be preferred because of the level of anonymity, less perceived stigma, increased autonomy of choice, and ease of use.We believe this is in part why people experiencing food insecurity report a preference to obtain resources electronically (email, website, patient portal). About 40% of respondents identified their care team social worker as a preferred contact to advocate, connect, and educate on food resources, highlighting the importance of a trusting, safe relationship between care team social workers and patients. Based on our survey results, the CF Food Security Committee has prioritized the creation of handouts to support care centers interested in starting a food pantry or food box program. These and other educational documents about food insecurity are available to clinicians in the My.CFF resource library.

Predictors of Mental Health Outcomes in Grocery Store Workers amid the COVID-19 Pandemic and Implications for Workplace Safety and Moral Injury.

Limited research exists on the mental health (MH) of grocery store workers (GSWs), who have been on the frontlines throughout the COVID-19 pandemic. A disaster MH conceptual model incorporating demographics, disaster exposure and threat (COVID-19 fear and workplace threat perception), perceived stress, and social support (lack of from family and friends) was utilized to predict MH outcomes (anxiety, depression, and post-traumatic stress symptoms; PTSS) of GSWs. GSWs (n = 842) were recruited through a regional union in California. The participants were diverse (62.1% female) and were 18-69 years of age (M = 41.5, SD = 13.9). They completed an online survey regarding COVID-19 fear, workplace threat perception, perceived stress, lack of social support, and workplace needs/recommendations for support. Three hierarchical linear regression models were run assessing each MH outcome. Thematic analysis coding and an inductive approach were utilized for analyzing open-ended responses of workplace needs/recommendations. Females and younger GSWs (ages 18-29 years old) on average, reported higher MH symptoms than males and older age groups, respectively. COVID-19 fear and perceived stress were significant predictors of anxiety, while COVID-19 fear, workplace threat perception, and perceived stress significantly predicted depression and PTSS, explaining almost half of the variance for each model. Social support and demographics were not predictive of MH outcomes. Almost half of GSWs (40%) requested increased safety protections in the workplace. Feelings of fear of COVID-19, threat in the workplace, and overall perceived stress are predictive of GSWs' MH outcomes. Increasing feelings of safety in the workplace and reducing stress may lessen MH symptoms.

Working in the Times of COVID-19. Psychological Impact of the Pandemic in Frontline Workers in Spain.

This study evaluates the psychological impact (PI) of the COVID-19 pandemic in frontline workers in Spain. Participants were 546 workers (296 healthcare workers, 105 media professionals, 89 grocery workers, and 83 protective service workers). They all completed online questionnaires assessing PI, sadness, concerns related to the COVID-19 pandemic, and demographic and work-related variables. All groups but protective services workers showed higher PI levels than the general population. Healthcare and grocery workers were the most affected, with 73.6% and 65.2% of the participants, respectively, showing a severe PI. Women showed a higher PI level. Healthcare workers in the regions with higher COVID-19 incidences reported greater PI levels. The main concerns were being infected by COVID-19 or infecting others. Levels of concern correlated with higher PI levels. The protection equipment was generally reported as insufficient, which correlated with higher PI levels. Professionals reporting to overwork during the crisis (60% mass-media, 38% of healthcare and grocery and 21.7% of protective service) showed higher PI levels. In the healthcare group, taking care of patients with COVID-19 (77%) or of dying patients with COVID-19 (43.9%) was associated with higher PI levels. The perceived social recognition of their work was inversely related to PI. Most of the sample had not received psychological support. We suggest some organizational measures for frontline institutions, such as the periodical monitoring or inclusion of psychologists specialized in crisis-management to prevent negative symptoms and provide timely support.