Get the message? A scoping review of physical activity messaging.

BACKGROUND: Understanding how to create and deliver effective physical activity (PA) messages for and to various population subgroups may play a role in increasing population PA levels. This scoping review aimed to provide an overview of what is known about PA messaging and highlight key research gaps. METHODS: We followed a 5-stage protocol proposed by Arksey & O'Malley and the Preferred Reporting Items For Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist. Stage 1: research questions were identified. Stage 2: we identified relevant studies by searching electronic databases, contacting existing networks and hand searching reference lists. Stage 3: studies were screened in Covidence™ software. Stage 4: study data were extracted and charted. Stage 5: findings from included studies were collated, summarised and reported in two ways: (1) a descriptive numerical analysis providing insight into extent, nature and distribution of the included studies, and (2) a narrative summary summarizing the evidence reviewed organised by messaging concepts and by population subgroup. RESULTS: A total of 9525 references were imported into Covidence™ for screening. Of these, 123 studies were included in final analysis. We found that PA messaging evidence is complex and multidimensional in nature, with numerous concepts to consider when creating or evaluating messages. The extent to which these different PA messaging concepts have been researched is variable. Where research has accumulated and evidence is consistent, it supports the following: (1) PA messages should be framed positively and highlight short-term outcomes specifically relating to social and mental health, (2) message content should be tailored or targeted to intended recipient(s), and (3) when developing messages, formative research, psychological theory and/or social marketing principles should be used. CONCLUSION: While it is unlikely to address global inactivity on its own, PA messaging may play a valuable role improving population PA levels. However, it is a complex and multidimensional concept and greater understanding is still needed. We present a synthesis of the existing evidence, highlighting key areas where evidence has accumulated and where gaps lie, as well as recommendations for PA messaging to different population subgroups.

Identifying with all humanity predicts cooperative health behaviors and helpful responding during COVID-19.

In the ongoing COVID-19 pandemic, public health experts have produced guidelines to limit the spread of the coronavirus, but individuals do not always comply with experts' recommendations. Here, we tested whether a specific psychological belief-identification with all humanity-predicts cooperation with public health guidelines as well as helpful behavior during the COVID-19 pandemic. We hypothesized that peoples' endorsement of this belief-their relative perception of a connection and moral commitment to other humans-would predict their tendencies to adopt World Health Organization (WHO) guidelines and to help others. To assess this, we conducted a global online study (N = 2537 participants) of four WHO-recommended health behaviors and four pandemic-related moral dilemmas that we constructed to be relevant to helping others at a potential cost to oneself. We used generalized linear mixed models (GLMM) that included 10 predictor variables (demographic, contextual, and psychological) for each of five outcome measures (a WHO cooperative health behavior score, plus responses to each of our four moral, helping dilemmas). Identification with all humanity was the most consistent and consequential predictor of individuals' cooperative health behavior and helpful responding. Analyses showed that the identification with all humanity significantly predicted each of the five outcomes while controlling for the other variables (Prange < 10-22 to < 0.009). The mean effect size of the identification with all humanity predictor on these outcomes was more than twice as large as the effect sizes of other predictors. Identification with all humanity is a psychological construct that, through targeted interventions, may help scientists and policymakers to better understand and promote cooperative health behavior and help-oriented concern for others during the current pandemic as well as in future humanitarian crises.

Uniting Public Health and Primary Care for Healthy Communities in the COVID-19 Era and Beyond.

The Coronavirus disease 2019 (COVID-19) pandemic has laid bare the dis-integrated health care system in the United States. Decades of inattention and dwindling support for public health, coupled with declining access to primary care medical services have left many vulnerable communities without adequate COVID-19 response and recovery capacity. "Health is a Community Affair" is a 1966 effort to build and deploy local communities of solution that align public health, primary care, and community organizations to identify health care problem sheds, and activate local asset sheds. After decades of independent effort, the COVID-19 pandemic offers an opportunity to reunite and align the shared goals of public health and primary care. Imagine how different things might look if we had widely implemented the recommendations from the 1966 report? The ideas and concepts laid out in "Health is a Community Affair" still offer a COVID-19 response and recovery approach. By bringing public health and primary care together in community now, a future that includes a shared vision and combined effort may emerge.

COVID-19 and the collapse of global trade: building an effective public health response.

The scale of the COVID-19 pandemic is a consequence of international trade and globalisation, with the virus spreading along established trade and travel routes. However, the pandemic also affects international trade through reductions in both supply and demand. In this Viewpoint we describe the many implications for health and propose ways to mitigate them. Problems include reduced access to medical supplies (in particular, personal protective equipment and tests), budgetary shortfalls as a result of reduced tariffs and taxes, and a general decline in economic activity-leading, in many cases, to recessions, threats to social safety nets, and to increased precariousness of income, employment, and food security. However, in exceptional cases, the pandemic has also brought some transient benefits, including to the environment. Looking ahead, there will be great pressure to further liberalise rules on trade to encourage economic recovery, but it is essential that trade policy be informed by its many consequences for health to ensure that the benefits are maximised and threats are minimised through active identification and mitigation.

More than just contraception: the impact of the levonorgestrel-releasing intrauterine system on public health over 30 years.

Universal access to sexual and reproductive health services is essential to facilitate the empowerment of women and achievement of gender equality. Increasing access to modern methods of contraception can reduce the incidence of unplanned pregnancy and decrease maternal mortality. Long-acting reversible contraceptives (LARCs) offer high contraceptive efficacy as well as cost-efficacy, providing benefits for both women and healthcare systems. The levonorgestrel-releasing intrauterine system (LNG-IUS) first became available in 1990 with the introduction of Mirena (LNG-IUS 20), a highly effective contraceptive which can reduce menstrual blood loss and provide other therapeutic benefits. The impact of the LNG-IUS on society has been wide ranging, including decreasing the need for abortion, reducing the number of surgical sterilisation procedures performed, as well as reducing the number of hysterectomies carried out for issues such as heavy menstrual bleeding (HMB). In the context of the COVID-19 pandemic, Mirena can provide a treatment option for women with gynaecological issues such as HMB without organic pathology, minimising exposure to the hospital environment and reducing waiting times for surgical appointments. Looking to the future, research and development in the field of the LNG-IUS continues to expand our understanding of these contraceptives in clinical practice and offers the potential to further expand the choices available to women, allowing them to select the option that best meets their needs.

Early relaxation of community mitigation policies and risk of COVID-19 resurgence in the United States.

This study aimed to assess the impact of coronavirus disease (COVID-19) prevalence in the United States in the week leading to the relaxation of the stay-at-home orders (SAH) on future prevalence across states that implemented different SAH policies. We used data on the number of confirmed COVID-19 cases as of August 21, 2020 on county level. We classified states into four groups based on the 7-day change in prevalence and the state's approach to SAH policy. The groups included: (1) High Change (19 states; 7-day prevalence change ≥50th percentile), (2) Low Change (19 states; 7-day prevalence change <50th percentile), (3) No SAH (11 states: did not adopt SAH order), and (4) No SAH End (2 states: did not relax SAH order). We performed regression modeling assessing the association between change in prevalence at the time of SAH order relaxation and COVID-19 prevalence days after the relaxation of SAH order for four selected groups. After adjusting for other factors, compared to the High Change group, counties in the Low Change group had 33.8 (per 100,000 population) fewer cases (standard error (SE): 19.8, p < 0.001) 7 days after the relaxation of SAH order and the difference was larger by time passing. On August 21, 2020, the No SAH End group had 383.1 fewer cases (per 100,000 population) than the High Change group (SE: 143.6, p < 0.01). A measured, evidence-based approach is required to safely relax the community mitigation strategies and practice phased-reopening of the country.

Interpreting SARS-CoV-2 seroprevalence, deaths, and fatality rate - Making a case for standardized reporting to improve communication.

The SARS-CoV-2 virus has spread across the world, testing each nation's ability to understand the state of the pandemic in their country and control it. As we looked into the epidemiological data to uncover the impact of the COVID-19 pandemic, we discovered that critical metadata is missing which is meant to give context to epidemiological parameters. In this review, we identify key metadata for the COVID-19 fatality rate after a thorough analysis of mathematical models, serology-informed studies and determinants of causes of death for the COVID-19 pandemic. In doing so, we find reasons to establish a set of standard-based guidelines to record and report the data from epidemiological studies. Additionally, we discuss why standardizing nomenclature is be a necessary component of these guidelines to improve communication and reproducibility. The goal of establishing these guidelines is to facilitate the interpretation of COVID-19 epidemiological findings and data by the general public, health officials, policymakers and fellow researchers. Our suggestions may not address all aspects of this issue; rather, they are meant to be the foundation for which experts can establish and encourage future guidelines throughout the appropriate communities.

Redesigning Public Mental Health Systems Post-COVID-19.

The COVID-19 pandemic has disrupted public mental health systems across the country, nowhere more than in New York State (NYS). The authors describe the NYS public health agency's response to the pandemic and offer ideas for redesigning public mental health systems post-COVID-19.

Ten Epidemiological Parameters of COVID-19: Use of Rapid Literature Review to Inform Predictive Models During the Pandemic.

Objective: To describe the methods used in a rapid review of the literature and to present the main epidemiological parameters that describe the transmission of SARS-Cov-2 and the illness caused by this virus, coronavirus disease 2019 (COVID-19). Methods: This is a methodological protocol that enabled a rapid review of COVID-19 epidemiological parameters. Findings: The protocol consisted of the following steps: definition of scope; eligibility criteria; information sources; search strategies; selection of studies; and data extraction. Four reviewers and three supervisors conducted this review in 40 days. Of the 1,266 studies found, 65 were included, mostly observational and descriptive in content, indicating relative homogeneity as to the quality of the evidence. The variation in the basic reproduction number, between 0.48 and 14.8; and the median of the hospitalization period, between 7.5 and 20.5 days stand out as key findings. Conclusion: We identified and synthesized 10 epidemiological parameters that may support predictive models and other rapid reviews to inform modeling of this and other future public health emergencies.

COVID-19 Symptom-Related Google Searches and Local COVID-19 Incidence in Spain: Correlational Study.

BACKGROUND: COVID-19 is one of the biggest pandemics in human history, along with other disease pandemics, such as the H1N1 influenza A, bubonic plague, and smallpox pandemics. This study is a small contribution that tries to find contrasted formulas to alleviate global suffering and guarantee a more manageable future. OBJECTIVE: In this study, a statistical approach was proposed to study the correlation between the incidence of COVID-19 in Spain and search data provided by Google Trends. METHODS: We assessed the linear correlation between Google Trends search data and the data provided by the National Center of Epidemiology in Spain-which is dependent on the Instituto de Salud Carlos III-regarding the number of COVID-19 cases reported with a certain time lag. These data enabled the identification of anticipatory patterns. RESULTS: In response to the ongoing outbreak, our results demonstrate that by using our correlation test, the evolution of the COVID-19 pandemic can be predicted in Spain up to 11 days in advance. CONCLUSIONS: During the epidemic, Google Trends offers the possibility to preempt health care decisions in real time by tracking people's concerns through their search patterns. This can be of great help given the critical, if not dramatic need for complementary monitoring approaches that work on a population level and inform public health decisions in real time. This study of Google search patterns, which was motivated by the fears of individuals in the face of a pandemic, can be useful in anticipating the development of the pandemic.

Roadblocks to Infection Prevention Efforts in Health Care: SARS-CoV-2/COVID-19 Response.

The outbreak of a novel coronavirus, SARS-CoV-2, is challenging international public health and health care efforts. As hospitals work to acquire enough personal protective equipment and brace for potential cases, the role of infection prevention efforts and programs has become increasingly important. Lessons from the 2003 SARS-CoV outbreak in Toronto and 2015 MERS-CoV outbreak in South Korea have unveiled the critical role that hospitals play in outbreaks, especially of novel coronaviruses. Their ability to amplify the spread of disease can rapidly fuel transmission of the disease, and often those failures in infection prevention and general hospital practices contribute to such events. While efforts to enhance infection prevention measures and hospital readiness are underway in the United States, it is important to understand why these programs were not able to maintain continued, sustainable levels of readiness. History has shown that infection prevention programs are primarily responsible for preparing hospitals and responding to biological events but face understaffing and focused efforts defined by administrators. The current US health care system, though, is built upon a series of priorities that often view biopreparedness as a costly endeavor. Awareness of these competing priorities and the challenges that infection prevention programs face when working to maintain biopreparedness is critical in adequately addressing this critical infrastructure in the face of an international outbreak.

Potential Impact of COVID-19-Related Racial Discrimination on the Health of Asian Americans.

Anti-Asian discrimination and assaults have increased significantly during the Coronavirus disease 2019 (COVID-19) pandemic, contributing to a "secondary contagion" of racism. The United States has a long and well-documented history of both interpersonal and structural anti-Asian discrimination, and the current pandemic reinforces longstanding negative stereotypes of this rapidly growing minority group as the "Yellow Peril."We provide a general overview of the history of anti-Asian discrimination in the United States, review theoretical and empirical associations between discrimination and health, and describe the associated public health implications of the COVID-19 pandemic, citing relevant evidence from previous disasters in US history that became racialized.Although the literature suggests that COVID-19 will likely have significant negative effects on the health of Asian Americans and other vulnerable groups, there are reasons for optimism as well. These include the emergence of mechanisms for reporting and tracking incidents of racial bias, increased awareness of racism's insidious harms and subsequent civic and political engagement by the Asian American community, and further research into resilience-promoting factors that can reduce the negative health effects of racism.