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BACKGROUND: The ongoing COVID-19 pandemic is characterized by different morbidity and mortality rates across different states, cities, rural areas, and diverse neighborhoods. The absence of a national strategy for battling the pandemic also leaves state and local governments responsible for creating their own response strategies and policies. OBJECTIVE: This study examines the content of COVID-19-related tweets posted by public health agencies in Texas and how content characteristics can predict the level of public engagement. METHODS: All COVID-19-related tweets (N=7269) posted by Texas public agencies during the first 6 months of 2020 were classified in terms of each tweet's functions (whether the tweet provides information, promotes action, or builds community), the preventative measures mentioned, and the health beliefs discussed, by using natural language processing. Hierarchical linear regressions were conducted to explore how tweet content predicted public engagement. RESULTS: The information function was the most prominent function, followed by the action or community functions. Beliefs regarding susceptibility, severity, and benefits were the most frequently covered health beliefs. Tweets that served the information or action functions were more likely to be retweeted, while tweets that served the action and community functions were more likely to be liked. Tweets that provided susceptibility information resulted in the most public engagement in terms of the number of retweets and likes. CONCLUSIONS: Public health agencies should continue to use Twitter to disseminate information, promote action, and build communities. They need to improve their strategies for designing social media messages about the benefits of disease prevention behaviors and audiences' self-efficacy.
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COVID-19/epidemiology , Pandemics , Public Health , Social Media/statistics & numerical data , Humans , Natural Language Processing , Texas/epidemiologyABSTRACT
COVID-19 skepticism can be conceptualized as the denial of the seriousness of the illness and the perception that the pandemic is overblown or a hoax. In the current study, we examined the association between COVID-19 skepticism and frequency of engaging in COVID-19 prevention behaviors, political ideology, social norms about distancing, COVID-19 information-seeking behaviors, and COVID-19 conspiracy theories. A survey was administered from May 5th-14th. At that time, there were over 1 million COVID-19 cases in the US. Participants were recruited online through MTurk. The three outcome variables were handwashing, mask wearing, and social distancing. Injunctive and descriptive norms were assessed as well as measures of perceived risk to self and others. There were 683 participants in the analyses. In the multiple logistic regression model, those who were of younger age (aOR = 0.97, p < 0.05), better health (aOR = 0.56, p < 0.01), and more politically conservative (aOR = 1.32, p < 0.01) were more likely to endorse COVID-19 skepticism statements. People who reported higher Skepticism were also less likely to that believe people close to them would die from COVID-19 (aOR = 4.2, p < 0.01), engage in COVID-19 prevention behaviors, including spending time inside to prevent coronavirus (aOR = 0.33, p < 0.01) and frequently wear a mask outside (aOR = 0.44, p < 0.01). Those who were more skeptical about COVID-19 were also more likely to believe the conspiracy theory that China purposefully spread the virus (aOR = 6.38 p < 0.01). COVID-19 Skepticism was strongly associated with reduced engagement in COVID-19 prevention behaviors. These findings bolster the arguments for making these public health recommendations mandatory.
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BACKGROUND & AIM: The study describes the experiences and opinions of Serbian physicians regarding workforce management during the COVID-19 pandemic. MATERIALS & METHODS: A total of 1553 licensed physicians (65% males; average age 44.0 years) responded to an online survey in September 2020. Differences in the respondents' general data and attitudes regarding workforce management and outbreak preparedness in Serbia were analysed in relation to their engagement during the COVID-19 pandemic (Pearson χ2 and the independent samples t-test, p < 0.05). The logistic regression model explained the need for changing health workforce management. RESULTS: The results reveal that the physicians engaged in the fight against the spread of COVID-19 (64.4% of the respondents) more often than their counterparts, were clinicians from the public sector, younger, with less work experience, influenced negatively by the pandemic, and reassigned to other positions (p < 0.001). Health workers dissatisfied with workplace preparedness and those reassigned due to COVID-19 were by 2.61 times and 1.38 times, respectively, more likely than their counterparts to consider changes in health workforce management. DISCUSSION & CONCLUSION: COVID-19 underlines the need for changes in health workforce management during public health emergencies. An internal incident management team and a panel of external experts may support health workforce management during the prolonged and rapidly changing crises.
Subject(s)
COVID-19 , Personnel Management , Physicians/psychology , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Safety Management , Serbia , Staff Development , Surveys and QuestionnairesABSTRACT
BACKGROUND: University students are increasingly reporting common mental health problems, such as stress, anxiety, and depression, and they frequently face barriers to seeking psychological support because of stigma, cost, and availability of mental health services. This issue is even more critical in the challenging time of the COVID-19 pandemic. Digital mental health interventions, such as those delivered via chatbots on mobile devices, offer the potential to achieve scalability of healthy-coping interventions by lowering cost and supporting prevention. OBJECTIVE: The goal of this study was to conduct a proof-of-concept evaluation measuring the engagement and effectiveness of Atena, a psychoeducational chatbot supporting healthy coping with stress and anxiety, among a population of university students. METHODS: In a proof-of-concept study, 71 university students were recruited during the COVID-19 pandemic; 68% (48/71) were female, they were all in their first year of university, and their mean age was 20.6 years (SD 2.4). Enrolled students were asked to use the Atena psychoeducational chatbot for 4 weeks (eight sessions; two per week), which provided healthy-coping strategies based on cognitive behavioral therapy, positive psychology, and mindfulness techniques. The intervention program consisted of conversations combined with audiovisual clips delivered via the Atena chatbot. Participants were asked to complete web-based versions of the 7-item Generalized Anxiety Disorder scale (GAD-7), the 10-item Perceived Stress Scale (PSS-10), and the Five-Facet Mindfulness Questionnaire (FFMQ) at baseline and postintervention to assess effectiveness. They were also asked to complete the User Engagement Scale-Short Form at week 2 to assess engagement with the chatbot and to provide qualitative comments on their overall experience with Atena postintervention. RESULTS: Participants engaged with the Atena chatbot an average of 78 (SD 24.8) times over the study period. A total of 61 out of 71 (86%) participants completed the first 2 weeks of the intervention and provided data on engagement (10/71, 14% attrition). A total of 41 participants out of 71 (58%) completed the full intervention and the postintervention questionnaires (30/71, 42% attrition). Results from the completer analysis showed a significant decrease in anxiety symptoms for participants in more extreme GAD-7 score ranges (t39=0.94; P=.009) and a decrease in stress symptoms as measured by the PSS-10 (t39=2.00; P=.05) for all participants postintervention. Participants also improved significantly in the describing and nonjudging facets, based on their FFMQ subscale scores, and asked for some improvements in the user experience with the chatbot. CONCLUSIONS: This study shows the benefit of deploying a digital healthy-coping intervention via a chatbot to support university students experiencing higher levels of distress. While findings collected during the COVID-19 pandemic show promise, further research is required to confirm conclusions.
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COVID-19 , Pandemics , Adaptation, Psychological , Adult , Female , Humans , Male , SARS-CoV-2 , Students , Universities , Young AdultABSTRACT
The coronavirus (COVID-19) pandemic has impacted education systems globally, making digital devices common arrangements for adolescent learning. However, vision consequences of such behavioral changes are not well-understood. This study investigates the association between duration of daily digital screen engagement and myopic progression among 3,831 Chinese adolescents during the COVID-19 pandemic. Study subjects report an average of 2.70 (SD = 1.77), 3.88 (SD = 2.23), 3.58 (SD = 2.30), and 3.42 (SD = 2.49) hours of television, computer, and smartphone for digital learning use at home, respectively. Researchers analyzed the association between digital screen use and myopic symptoms using statistical tools, and find that every 1 h increase in daily digital screen use is associated with 1.26 OR [Odds Ratio] (95% CI [Confidence Interval: 1.21-1.31, p < 0.001]) higher risks of myopic progression. Using computers (OR = 1.813, 95% CI = 1.05-3.12, p = 0.032) and using smartphones (OR = 2.02, 95% CI = 1.19-3.43, p = 0.009) are shown to be associated with higher risks of myopic progression than television use. Results from additional sensitivity tests that included inverse probability weights which accounted for heterogeneous user profile across different device type categories confirm that these findings are robust. In conclusion, this study finds that daily digital screen use is positively associated with prevalence of myopic progression and holds serious vision health implications for adolescents.
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BACKGROUND: During a public health crisis such as the current COVID-19 pandemic, governments and health authorities need quick and accurate methods of communicating with the public. While social media can serve as a useful tool for effective communication during disease outbreaks, few studies have elucidated how these platforms are used by the Ministry of Health (MOH) during disease outbreaks in Saudi Arabia. OBJECTIVE: Guided by the Crisis and Emergency Risk Communication model, this study aimed to explore the MOH's use of Twitter and the public's engagement during different stages of the COVID-19 pandemic in Saudi Arabia. METHODS: Tweets and corresponding likes and retweets were extracted from the official Twitter account of the MOH in Saudi Arabia for the period of January 1 through August 31, 2020. Tweets related to COVID-19 were identified; subsequently, content analysis was performed, in which tweets were coded for the following message types: risk messages, warnings, preparations, uncertainty reduction, efficacy, reassurance, and digital health responses. Public engagement was measured by examining the numbers of likes and retweets. The association between outbreak stages and types of messages was assessed, as well as the effect of these messages on public engagement. RESULTS: The MOH posted a total of 1393 original tweets during the study period. Of the total tweets, 1293 (92.82%) were related to COVID-19, and 1217 were ultimately included in the analysis. The MOH posted the majority of its tweets (65.89%) during the initial stage of the outbreak. Accordingly, the public showed the highest level of engagement (as indicated by numbers of likes and retweets) during the initial stage. The types of messages sent by the MOH significantly differed across outbreak stages, with messages related to uncertainty reduction, reassurance, and efficacy being prevalent among all stages. Tweet content, media type, and crisis stage influenced the level of public engagement. Engagement was negatively associated with the inclusion of hyperlinks and multimedia files, while higher level of public engagement was associated with the use of hashtags. Tweets related to warnings, uncertainty reduction, and reassurance received high levels of public engagement. CONCLUSIONS: This study provides insights into the Saudi MOH's communication strategy during the COVID-19 pandemic. Our results have implications for researchers, governments, health organizations, and practitioners with regard to their communication practices during outbreaks. To increase public engagement, governments and health authorities should consider the public's need for information. This, in turn, could raise public awareness regarding disease outbreaks.
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COVID-19/prevention & control , Community Participation/statistics & numerical data , Health Communication/methods , Pandemics/prevention & control , Public Health , Social Media/statistics & numerical data , COVID-19/epidemiology , Humans , Saudi Arabia/epidemiologyABSTRACT
The COVID-19 pandemic has a severe and immediate impact on unemployment and reduced household income, resulting in global food insecurity. Women play a major role as household food providers who manage food insecurity in Thai community. In this qualitative study researchers aimed to understand how communities engage in management of food insecurity resulting from COVID-19. Participants included 12 female food providers who were community volunteers, four community leaders, and four health providers. Focus group interviews were conducted. Data were analyzed using content analysis. We explain community engagement to manage food insecurity through strategies including connecting through empathy, community empowerment, and engaging for sustainability. We present findings to illustrate how women's groups may work through a public-private partnership to achieve sustainable food security.
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COVID-19/epidemiology , Food Insecurity , Social Planning , Female , Humans , Income , Qualitative Research , SARS-CoV-2 , Thailand , WomenABSTRACT
Importance: Reimagining university life during COVID-19 requires substantial innovation and meaningful community input. One method for obtaining community input is crowdsourcing, which involves having a group of individuals work to solve a problem and then publicly share solutions. Objective: To evaluate a crowdsourcing open call as an approach to COVID-19 university community engagement and strategic planning. Design, Setting, and Participants: This qualitative study assessed a crowdsourcing open call offered from June 16 to July 16, 2020, that sought ideas to inform safety in the fall 2020 semester at the University of North Carolina at Chapel Hill (UNC). Digital methods (email and social media) were used for promotion, and submissions were collected online for 4 weeks. Participation was open to UNC students, staff, faculty, and others. Main Outcomes and Measures: Submissions were evaluated for innovation, feasibility, inclusivity, and potential to improve safety and well-being. Demographic data were collected from submitting individuals, and submissions were qualitatively analyzed for emergent themes on challenges with and solutions for addressing safety and well-being in the fall semester. Data were shared with UNC leadership to inform decision-making. Results: The open call received 82 submissions from 110 participants, including current UNC students (56 submissions [68%]), people younger than 30 years (67 [82%]), women (55 [67%]), and individuals identifying as a racial/ethnic minority or as multiracial/ethnic (49 [60%]). Seven submissions were identified as finalists and received cash prizes with the encouragement to use these funds toward idea development and implementation. Seventeen runner-up teams were linked to university resources for further development. Thematic analysis of submissions regarding challenges with the fall semester revealed not only physical health concerns and the limitations of remote learning but also challenges that have been exacerbated by the pandemic, such as a lack of mental health support, structural racism and inequality, and insufficient public transportation. Solutions included novel ideas to support mental health among specific populations (eg, graduate students and racial/ethnic minorities), improve health equity, and increase transit access. All 24 finalists and runners-up indicated interest in implementation after being notified of the open call results. Conclusions and Relevance: This study suggests that open calls are a feasible strategy for university community engagement on COVID-19, providing a stakeholder-driven approach to identifying promising ideas for enhancing safety and well-being. Open calls could be formally incorporated into university planning processes to develop COVID-19 safety strategies that are responsive to diverse community members' concerns.
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COVID-19/prevention & control , Communicable Disease Control , Crowdsourcing , Organizational Innovation , Strategic Planning , Universities/organization & administration , Adult , COVID-19/transmission , Education, Distance , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Mental Health , Minority Groups/psychology , North Carolina , Pandemics/prevention & control , SARS-CoV-2 , Social Support , Students/psychology , Young AdultABSTRACT
OBJECTIVES: The global COVID-19 pandemic in 2020 heavily affected the arts and creative industries due to the instigation of lockdown measures in the United Kingdom and closure of venues. However, it also provided new opportunities for arts and cultural engagement through virtual activities and streamed performances. Yet it remains unclear (i) who was likely to engage with the arts at home during lockdown, (ii) how this engagement differed from patterns of arts engagement prior to COVID-19, and (iii) whether home-based arts engagement was related to people's ability to cope with their emotions during lockdown. This study was therefore designed to address these questions. METHODS: We used data collected in late May from the United Kingdom COVID-19 Social Study run by University College London. Multivariate regressions were used for the analysis (N = 19,384). Identified factors included demographic factors, socio-economic position, psychosocial wellbeing and health conditions, adverse events/worries, and coping styles. RESULTS: Four types of home-based arts engagement were identified during the COVID-19 pandemic: digital arts and writing, musical activities, crafts, and reading for pleasure. Our results show that the strongest predictors of the engagement were age, education attainment, social support, and emotion-focused or supportive coping styles. In particular, younger adults (aged 18-29), non-keyworkers, people with greater social support, people who had lost work, those who were worried about catching the virus, and those with an emotion-focused, problem-focused or supportive coping style were more likely to have increased arts engagement during lockdown. Arts activities were used as approach and avoidance strategies to help cope with emotions, as well as to help improve self-development. CONCLUSION: Overall, our study suggests that while some people who engaged in the arts during the COVID-19 pandemic were those who typically engage under normal circumstances, the pandemic has also created new incentives and opportunities for others to engage virtually. Additionally, this study highlights the value of the arts as coping tools during stressful situations.
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This research investigated how implicit theories of health and consideration of future consequences influence people's engagement in health-protective behaviors during the COVID-19 pandemic in China. Three hundred and ninety Chinese completed the study during the peak period of COVID-19 pandemic in China. Gender, education level, implicit theories of health, and consideration of future consequences were significant predictors of people's engagement in health-protective behaviors. Consideration of future consequences mediated the effect of implicit (incremental) theories of health on people's engagement in health-protective behaviors. Implications of the current research for promoting engagement in health-protective behaviors during pandemics of infectious diseases and directions for future research are discussed.
Subject(s)
COVID-19 , China/epidemiology , Health Behavior , Humans , Pandemics/prevention & control , SARS-CoV-2ABSTRACT
This article presents the findings of a study exploring students' reports of their engagement with online learning and assessment during the COVID-19 pandemic in Saudi higher education. Students shared perspectives on Twitter about their engagement, and research data was collected from their tweets posted between March and May 2020. A total of 124,810 tweets were analysed using MAXQDA quantitative and qualitative tools. The findings indicate that students' engagement with learning and assessment was affected by the challenges of the sudden shift in learning mode and alterations in assessment methods. Open communication between students and faculty are essential for ensuring shared understanding and acceptance. Additionally, departmental support and mediating between students and faculty members is necessary and should be a priority in cases where communication is lacking. Results are discussed in relation to current literature, research implications, and future directions.
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This study conceptualized digital competence in line with self-determined theory (SDT) and investigated how it alongside help-seeking and learning agency collectively preserved university students' psychological well-being by assisting them to manage cognitive load and academic burnout, as well as increasing their engagement in online learning during the coronavirus disease 2019 (COVID-19) pandemic. Moreover, students' socioeconomic status and demographic variables were examined. Partial least square modeling and cluster analysis were performed on the survey data collected from 695 students. The findings show that mental load and mental effort were positively related to academic burnout, which was significantly negatively associated with student engagement in online learning. Digital competence did not directly affect academic burnout, but indirectly via its counteracting effect on cognitive load. However, help-seeking and agency were not found to be significantly negatively related to cognitive load. Among the three SDT constructs, digital competence demonstrated the greatest positive influence on student engagement. In addition, female students from humanities and social sciences disciplines and lower-income families seemed to demonstrate the weakest digital competence, lowest learning agency, and least help-seeking behaviors. Consequently, they were more vulnerable to high cognitive load and academic burnout, leading to the lowest learning engagement. This study contributes to the ongoing arguments related to the psychological impact of the COVID-19 pandemic and informs the development of efficient interventions that preserve university students' psychological well-being in online learning.
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Pedagogy designed to improve student engagement, like the course-based undergraduate research experience (CURE), was given its hardest challenge yet during the COVID-19 pandemic: to find a way to exist and continue productive work in a remote environment. Faculty in STEM disciplines have worked to implement CURE programs into course curriculums, only to have had some of them disrupted during spring 2020. The demonstrated benefits of the CURE in improving student engagement and persistence in the sciences could be at risk if these courses continue to be disrupted. How do faculty make CUREs work when emergency remote learning continues to loom over our institutions? This teaching tip focuses on how one antibiotic discovery CURE used technology and individual meetings to continue the students' experience and research process. The instructor remained alone in the laboratory with the student samples and acted as the students' hands, in order to continue testing and characterizing samples collected earlier in the semester, while students watched and directed the process during the online meetings. The change in methodology helped to restore some of the individual and small group mentor-type activity provided in the principal investigator-student researcher relationship present in undergraduate research experiences that was lost with the development of CUREs and the move to remote learning.
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Many scientists, confined to home office by COVID-19, have been gathering in online communities, which could become viable alternatives to physical meetings and conferences.
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COVID-19 , Pandemics , Humans , SARS-CoV-2ABSTRACT
BACKGROUND: Technology use has become the most critical approach to maintaining social connectedness during the COVID-19 pandemic. Older adults (aged >65 years) are perceived as the most physiologically susceptible population to developing COVID-19 and are at risk of secondary mental health challenges related to the social isolation that has been imposed by virus containment strategies. To mitigate concerns regarding sampling bias, we analyzed a random sample of older adults to understand the uptake and acceptance of technologies that support socialization during the pandemic. OBJECTIVE: We aimed to conduct a population-based assessment of the barriers and facilitators to engaging in the use of technology for web-based socialization among older adults in the Canadian province of British Columbia during the COVID-19 pandemic. METHODS: We conducted a cross-sectional, population-based, regionally representative survey by using the random-digit dialing method to reach participants aged >65 years who live in British Columbia. Data were analyzed using SPSS (IBM Corporation), and open-text responses were analyzed via thematic analysis. RESULTS: Respondents included 400 older adults aged an average of 72 years, and 63.7% (n=255) of respondents were female. Most respondents (n=358, 89.5%) were aware of how to use technology to connect with others, and slightly more than half of the respondents (n=224, 56%) reported that, since the beginning of the pandemic, they used technology differently to connect with others during the pandemic. Additionally, 55.9% (n=223) of respondents reported that they adopted new technology since the beginning of the pandemic. Older adults reported the following key barriers to using technology: (1) a lack of access (including finance-, knowledge-, and age-related issues); (2) a lack of interest (including a preference for telephones and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults also reported the following facilitators: (1) a knowledge of technologies (from self-teaching or external courses); (2) reliance on others (family, friends, and general internet searches); (3) technology accessibility (including appropriate environments, user-friendly technology, and clear instructions); and (4) social motivation (everyone else is doing it). CONCLUSIONS: Much data on older adults' use of technology are limited by sampling biases, but this study, which used a random sampling method, demonstrated that older adults used technology to mitigate social isolation during the pandemic. Web-based socialization is the most promising method for mitigating potential mental health effects that are related to virus containment strategies. Providing telephone training; creating task lists; and implementing the facilitators described by participants, such as facilitated socialization activities, are important strategies for addressing barriers, and these strategies can be implemented during and beyond the pandemic to bolster the mental health needs of older adults.
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BACKGROUND: The Covid-19 pandemic is characterized by uncertainty and constant change, forcing governments and health authorities to ramp up risk communication efforts. Consequently, visuality and social media platforms like Twitter have come to play a vital role in disseminating prevention messages widely. Yet to date, only little is known about what characterizes visual risk communication during the Covid-19 pandemic. To address this gap in the literature, this study's objective was to determine how visual risk communication was used on Twitter to promote the World Health Organisations (WHO) recommended preventative behaviours and how this communication changed over time. METHODS: We sourced Twitter's 500 most retweeted Covid-19 messages for each month from January-October 2020 using Crowdbreaks. For inclusion, tweets had to have visuals, be in English, come from verified accounts, and contain one of the keywords 'covid19', 'coronavirus', 'corona', or 'covid'. Following a retrospective approach, we then performed a qualitative content analysis of the 616 tweets meeting inclusion criteria. RESULTS: Our results show communication dynamics changed over the course of the pandemic. At the start, most retweeted preventative messages came from the media and health and government institutions, but overall, personal accounts with many followers (51.3%) predominated, and their tweets had the highest spread (10.0%, i.e., retweet count divided by followers). Messages used mostly photographs and images were found to be rich with information. 78.1% of Tweets contained 1-2 preventative messages, whereby 'stay home' and 'wear a mask' frequented most. Although more tweets used health loss framing, health gain messages spread more. CONCLUSION: Our findings can inform the didactics of future crisis communication. The results underscore the value of engaging individuals, particularly influencers, as advocates to spread health risk messages and promote solidarity. Further, our findings on the visual characteristic of the most retweeted tweets highlight factors that health and government organisations should consider when creating visual health messages for Twitter. However, that more tweets used the emotive medium of photographs often combined with health loss framing raises concerns about persuasive tactics. More research is needed to understand the implications of framing and its impact on public perceptions and behaviours.
Subject(s)
COVID-19 , Social Media , Communication , Humans , Pandemics , Retrospective Studies , SARS-CoV-2ABSTRACT
BACKGROUND: Almost all universities have been forced to close and change to online teaching during the COVID-19 pandemic, which has been a big challenge for students. There is little knowledge about the academic burnout among nursing students in these difficult circumstances, especially in traditional Chinese medicine universities, and the relationship between the burnout and their psychological capital and academic engagement. OBJECTIVE: The aim is to describe academic burnout and clarify the relationships between academic burnout, academic engagement, and psychological capital among nursing students in traditional Chinese medicine universities. DESIGN: This is a cross-sectional, descriptive study. SETTING: The study sampled a four-year undergraduate traditional Chinese medicine university in Jian, Shandong Province, China. PARTICIPANTS: A convenience sampling method was used to select 733 nursing students from April to June 2020. METHODS: The Academic Burnout Scale, the Positive Psychological Capital Scale, and the Academic Engagement Scale were used for data collection, in addition to social-demographic data. Path analysis was used to clarify the relationships among academic burnout, academic engagement and psychological capital. RESULTS: Of all the study participants, 39.29% had a certain degree of academic burnout. Academic engagement and psychological capital were negatively correlated with academic burnout among nursing students in traditional Chinese medicine university. Psychological capital was positively correlated with academic engagement. CONCLUSION: Nursing students had a certain degree of academic burnout. Academic engagement played a partial mediated role in the relationship between psychological capital and academic burnout.
Subject(s)
Burnout, Psychological , COVID-19 , Education, Distance , Education, Nursing, Baccalaureate , Students, Nursing , Adolescent , Burnout, Psychological/epidemiology , China/epidemiology , Cross-Sectional Studies , Education, Nursing, Baccalaureate/organization & administration , Female , Humans , Male , Students, Nursing/psychology , Students, Nursing/statistics & numerical data , Universities , Young AdultABSTRACT
Pregnant and postpartum women face unique challenges during the COVID-19 pandemic that may put them at elevated risk of mental health problems. However, few large-scale and no cross-national studies have been conducted to date that investigate modifiable pandemic-related behavioral or cognitive factors that may influence mental health in this vulnerable group. This international study sought to identify and measure the associations between pandemic-related information seeking, worries, and prevention behaviors on perinatal mental health during the COVID-19 pandemic. An anonymous, online, cross-sectional survey of pregnant and postpartum women was conducted in 64 countries between May 26, 2020 and June 13, 2020. The survey, available in twelve languages, was hosted on the Pregistry platform for COVID-19 studies (https://corona.pregistry.com) and advertised in social media channels and online parenting forums. Participants completed measures on demographics, COVID-19 exposure and worries, information seeking, COVID-19 prevention behaviors, and mental health symptoms including posttraumatic stress via the IES-6, anxiety/depression via the PHQ-4, and loneliness via the UCLA-3. Of the 6,894 participants, substantial proportions of women scored at or above the cut-offs for elevated posttraumatic stress (2,979 [43%]), anxiety/depression (2,138 [31%], and loneliness (3,691 [53%]). Information seeking from any source (e.g., social media, news, talking to others) five or more times per day was associated with more than twice the odds of elevated posttraumatic stress and anxiety/depression, in adjusted models. A majority of women (86%) reported being somewhat or very worried about COVID-19. The most commonly reported worries were related to pregnancy and delivery, including family being unable to visit after delivery (59%), the baby contracting COVID-19 (59%), lack of a support person during delivery (55%), and COVID-19 causing changes to the delivery plan (41%). Greater worries related to children (i.e., inadequate childcare, their infection risk) and missing medical appointments were associated with significantly higher odds of posttraumatic stress, anxiety/depression and loneliness. Engaging in hygiene-related COVID-19 prevention behaviors (face mask-wearing, washing hands, disinfecting surfaces) were not related to mental health symptoms or loneliness. Elevated posttraumatic stress, anxiety/depression, and loneliness are highly prevalent in pregnant and postpartum women across 64 countries during the COVID-19 pandemic. Excessive information seeking and worries related to children and medical care are associated with elevated symptoms, whereas engaging in hygiene-related preventive measures were not. In addition to screening and monitoring mental health symptoms, addressing excessive information seeking and women's worries about access to medical care and their children's well-being, and developing strategies to target loneliness (e.g., online support groups) should be part of intervention efforts for perinatal women. Public health campaigns and medical care systems need to explicitly address the impact of COVID-19 related stressors on mental health in perinatal women, as prevention of viral exposure itself does not mitigate the pandemic's mental health impact.
Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Mental Disorders/epidemiology , Mental Health , Pregnancy/psychology , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Loneliness/psychology , Middle Aged , Pandemics , Parturition/psychology , Perinatal Care , Postpartum Period/psychology , SARS-CoV-2/isolation & purification , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Surveys and Questionnaires , Women's HealthABSTRACT
The COVID-19 pandemic forced an unprecedented shift to remote instruction across higher education, reducing access to critically important undergraduate research experience and potentially magnifying inequities faced by first-generation and underrepresented minority (URM) students in higher education. Through a novel course-based undergraduate research experience (CURE) at UCLA, delivered completely online, results of a unique, student-generated survey showed that the transition to remote learning was challenging for all students, increasing student workload, decreasing ability to focus on school, and limiting their ability to succeed. However, results showed significant disparities in remote learning that disproportionately impacted URM and first-generation students. These students had significantly greater expectations to help siblings with remote learning,; URM and first-generation students also suffered greater economic and food insecurity related to COVID-19. At the same time, this study demonstrates how student voices in survey development provide novel and actionable insights. While access to CUREs is often limited by laboratory space, by focusing on the research process, rather than specific laboratory skills, this study provides a scalable pedagogical model for remote undergraduate research experiences. Importantly, this model fostered student engagement and increased interest in further undergraduate research, including topics not directly related to the subject of this study, suggesting that online CUREs can be effective and impactful.