A culturally tailored personaliseD nutrition intErvention in South ASIan women at risk of Gestational Diabetes Mellitus (DESI-GDM): a randomised controlled trial protocol.

INTRODUCTION: South Asians are more likely to develop gestational diabetes mellitus (GDM) than white Europeans. Diet and lifestyle modifications may prevent GDM and reduce undesirable outcomes in both the mother and offspring. Our study seeks to evaluate the effectiveness and participant acceptability of a culturally tailored, personalised nutrition intervention on the glucose area under the curve (AUC) after a 2-hour 75 g oral glucose tolerance test (OGTT) in pregnant women of South Asian ancestry with GDM risk factors. METHODS AND ANALYSIS: A total of 190 South Asian pregnant women with at least 2 of the following GDM risk factors-prepregnancy body mass index>23, age>29, poor-quality diet, family history of type 2 diabetes in a first-degree relative or GDM in a previous pregnancy will be enrolled during gestational weeks 12-18, and randomly assigned in a 1:1 ratio to: (1) usual care, plus weekly text messages to encourage walking and paper handouts or (2) a personalised nutrition plan developed and delivered by a culturally congruent dietitian and health coach; and FitBit to track steps. The intervention lasts 6-16 weeks, depending on week of recruitment. The primary outcome is the glucose AUC from a three-sample 75 g OGTT 24-28 weeks' gestation. The secondary outcome is GDM diagnosis, based on Born-in-Bradford criteria (fasting glucose>5.2 mmol/L or 2 hours post load>7.2 mmol/L). ETHICS AND DISSEMINATION: The study has been approved by the Hamilton Integrated Research Ethics Board (HiREB #10942). Findings will be disseminated among academics and policy-makers through scientific publications along with community-orientated strategies. TRIAL REGISTRATION NUMBER: NCT03607799.

Identity-based social support predicts mental and physical health outcomes during COVID-19.

During the COVID-19 pandemic, the United Kingdom implemented physical distancing measures to minimize viral transmission, which may have adversely impacted health and wellbeing. Evidence suggests that social support may be key to mitigating against adverse health impacts of such measures, particularly when such social support is identity-based. In this longitudinal study, we examined the role of social identity and perceived social support in mental and physical health outcomes during the COVID-19 pandemic. Participants completed a survey at 4 time points during the first year of the pandemic: May/June 2020 (T1; N = 443); September/October 2020 (T2; N = 235); December 2020/January 2021 (T3; N = 243); and April 2021 (T4; N = 206). Results showed that at each time point, social support was predicted by identification with multiple groups before COVID-19, identity continuity, and identification with communities. Higher identity continuity and identification with communities both predicted greater mental and physical health at the same time point, mediated by perceived social support. Interestingly, higher identity continuity and identification with communities predicted higher social support at the same time point, which in turn predicted worse mental and physical health outcomes at the subsequent time point. Findings are discussed in relation to the context of the first year of the pandemic and the changing nature of societal restrictions across the four survey time points.

Household Composition and Inequalities in COVID-19 Vaccination in Wales, UK.

The uptake of COVID-19 vaccination in Wales is high at a population level but many inequalities exist. Household composition may be an important factor in COVID-19 vaccination uptake due to the practical, social, and psychological implications associated with different living arrangements. In this study, the role of household composition in the uptake of COVID-19 vaccination in Wales was examined with the aim of identifying areas for intervention to address inequalities. Records within the Wales Immunisation System (WIS) COVID-19 vaccination register were linked to the Welsh Demographic Service Dataset (WDSD; a population register for Wales) held within the Secure Anonymised Information Linkage (SAIL) databank. Eight household types were defined based on household size, the presence or absence of children, and the presence of single or multiple generations. Uptake of the second dose of any COVID-19 vaccine was analysed using logistic regression. Gender, age group, health board, rural/urban residential classification, ethnic group, and deprivation quintile were included as covariates for multivariable regression. Compared to two-adult households, all other household types were associated with lower uptake. The most significantly reduced uptake was observed for large, multigenerational, adult group households (aOR 0.45, 95%CI 0.43-0.46). Comparing multivariable regression with and without incorporation of household composition as a variable produced significant differences in odds of vaccination for health board, age group, and ethnic group categories. These results indicate that household composition is an important factor for the uptake of COVID-19 vaccination and consideration of differences in household composition is necessary to mitigate vaccination inequalities.

Variations in classroom ventilation during the COVID-19 pandemic: Insights from monitoring 36 naturally ventilated classrooms in the UK during 2021

Seasonal changes in the measured CO2 levels at four schools are herein presented through a set of indoor air quality metrics that were gathered during the height of the COVID-19 pandemic in the UK. Data from non-intrusive environmental monitoring units were remotely collected throughout 2021 from 36 naturally ventilated classrooms at two primary schools and two secondary schools in England. Measurements were analysed to assess the indoor CO2 concentration and temperature . Relative to UK school air quality guidance, the CO2 levels within classrooms remained relatively low during periods of warmer weather, with elevated CO2 levels being evident during the colder seasons, indicating lower levels of per person ventilation during these colder periods. However, CO2 data from the cold period during the latter part of 2021, imply that the per person classroom ventilation levels were significantly lower than those achieved during a similarly cold weather period during the early part of the year. Given that the classroom architecture and usage remained unchanged, this finding suggests that changes in the ventilation behaviours within the classrooms may have altered, and raises questions as to what may have given rise to such change, in a year when, messaging and public concerns regarding COVID-19 varied within the UK. Significant variations were observed when contrasting data, both between schools, and between classrooms within the same school building;suggesting that work is required to understand and catalogue the existing ventilation provisions and architecture within UK classrooms, and that more work is required to ascertain the effects of classroom ventilation behaviours.

South Asian Youth as Vaccine Agents of Change (SAY-VAC): evaluation of a public health programme to mobilise and empower South Asian youth to foster COVID-19 vaccine-related evidence-based dialogue in the Greater Toronto and Hamilton Area, Canada.

OBJECTIVES: There have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic communities, who may concurrently face other barriers related to vaccine uptake and access. To combat some of the key sources of COVID-19 vaccine misinformation among the South Asian communities of the Greater Toronto and Hamilton Area (GTHA), an interdisciplinary team of researchers and marketing experts established the South Asian Youth as Vaccine Agents of Change (SAY-VAC) programme to support and empower South Asian youth to disseminate COVID-19 vaccine information. DESIGN: Cross-sectional and one-group pretest-post-test design. SETTING: GTHA. PARTICIPANTS: South Asian youth (18-29 years). INTERVENTION: The team partnered with grass-roots South Asian organisations to collaborate on shared objectives, curate key concerns, create video products regarding the COVID-19 vaccine that would resonate with the community, disseminate the products using established social media channels and evaluate the effectiveness of this effort. OUTCOMES: We assessed the change in self-reported knowledge about the COVID-19 vaccine and participant confidence to facilitate a conversation around the COVID-19 vaccine using pre-post surveys, after the implementation of the SAY-VAC programme. RESULTS: In total, 30 South Asian youth (median age=23.2 years) from the GTHA participated in the programme. After completing the SAY-VAC programme, participants reported an increase in their self-reported knowledge regarding the COVID-19 vaccine from 73.3% to 100.0% (p=0.005), and their self-reported confidence to have a conversation about the vaccine with their unvaccinated community members increased from 63.6% to 100.0% (p=0.002). Overall, 51.9% of the participants reported being able to positively affect an unvaccinated/community member's decision to get vaccinated. CONCLUSIONS: The SAY-VAC programme highlights the importance of community partnerships in developing and disseminating culturally responsive health communication strategies. A constant assessment of the evidence and utilisation of non-traditional avenues to engage the public are essential.

Parental mental health and child anxiety during the COVID‐19 pandemic in Latin America

This study examined parents’ (N = 10,141, 64% women) reports of their and their childrens’ depression, anxiety, and stress in Brazil, Mexico, Colombia and Argentina. The data come from the COVID‐19 Family Life Study (Ben Brik, 2020) and cohort recruited between April and December 2020. Participants completed online surveys that included the DASS‐21 and the Revised Children's Manifest Anxiety Scale. Our findings indicate that socio‐economically disadvantaged families fared worse in mental health during the early phases of the COVID‐19 pandemic compared with families with more social and economic resources. Mothers reported higher anxiety, depression, and stress compared with fathers. Parents of adolescents and adolescents fared worse than did families with younger children. Parental physical activity was associated with better parent and child mental health of anxiety symptoms. We discuss the need to address the adverse impacts of the COVID‐19 pandemic on mental health in families in Latin America via coordinated mental health and psychosocial support services that are integrated into the pandemic response currently and after the pandemic subsides.

Seropositivity and risk factors for SARS-CoV-2 infection in a South Asian community in Ontario: a cross-sectional analysis of a prospective cohort study.

BACKGROUND: Early in the COVID-19 pandemic, the South Asian community in the Greater Toronto Area (GTA) was identified as having risk factors for exposure and specific barriers to accessing testing and reliable health information, rendering them particularly vulnerable to SARS-CoV-2 infection. We sought to investigate the burden of SARS-CoV-2 infection among South Asian people in the GTA, and to characterize the demographic characteristics, risk perceptions and trusted sources of health information in this group. METHODS: We conducted a cross-sectional analysis from the baseline assessment of participants in a prospective cohort study. Participants from the GTA were enrolled from Apr. 14 to July 28, 2021. Seropositivity for antispike and antinucleocapsid antibodies was determined from dried blood spots, and estimates of seropositivity were age and sex standardized to the South Asian population in Ontario. Demographic characteristics, risk perceptions and sources of COVID-19 information were collected via questionnaire and reported descriptively. RESULTS: Among the 916 South Asian participants enrolled (mean age 41 yr), the age- and sex-standardized seropositivity was 23.6% (95% confidence interval 20.8%-26.4%). Of the 693 respondents to the questionnaire, 228 (32.9%) identified as essential workers, and 125 (19.1%) reported living in a multigenerational household. A total of 288 (49.4%) perceived that they were at high COVID-19 risk owing to their geographic location, and 149 (34.3%) owing to their type of employment. The top 3 most trusted sources of information related to COVID-19 included health care providers and public health, traditional media sources and social media. INTERPRETATION: By the third wave of the COVID-19 pandemic, about one-quarter of a sample of South Asian individuals in Ontario had serologic evidence of prior SARS-CoV-2 infection. Insight into factors that put certain populations at risk can help future pandemic planning and disease control efforts.

Parental mental health and child anxiety during the COVID-19 pandemic in Latin America.

This study examined parents' (N = 10,141, 64% women) reports of their and their childrens' depression, anxiety, and stress in Brazil, Mexico, Colombia and Argentina. The data come from the COVID-19 Family Life Study (Ben Brik, 2020) and cohort recruited between April and December 2020. Participants completed online surveys that included the DASS-21 and the Revised Children's Manifest Anxiety Scale. Our findings indicate that socio-economically disadvantaged families fared worse in mental health during the early phases of the COVID-19 pandemic compared with families with more social and economic resources. Mothers reported higher anxiety, depression, and stress compared with fathers. Parents of adolescents and adolescents fared worse than did families with younger children. Parental physical activity was associated with better parent and child mental health of anxiety symptoms. We discuss the need to address the adverse impacts of the COVID-19 pandemic on mental health in families in Latin America via coordinated mental health and psychosocial support services that are integrated into the pandemic response currently and after the pandemic subsides.

Cohort profile: The UK COVID-19 Public Experiences (COPE) prospective longitudinal mixed-methods study of health and well-being during the SARSCoV2 coronavirus pandemic.

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic.