Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study Bienestar de los veteranos canadienses durante la pandemia de COVID-19: Resultados transversales del estudio de bienestar de veteranos de COVID-19 COVID-19 疫情期间加拿大退伍军人的幸福感: 来自 COVID-19 退伍军人幸福感研究的横断面结果

Background The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded stressors resulting from disruptions to familial, social, and occupational domains, and were faced with changes in health-care delivery (e.g. telehealth). The objectives of this study are to assess (a) the mental health impact of COVID-19 and related life changes on the well-being of Veterans and (b) perceptions of and satisfaction with changes in health-care treatments and delivery during the pandemic. Methods A total of 1136 Canadian Veterans participated in an online survey. Participants completed questions pertaining to their mental health and well-being, lifestyle changes, and concerns relating to the COVID-19 pandemic, as well as experiences and satisfaction with health-care treatments during the pandemic. Results Results showed that 55.9% of respondents reported worse mental health functioning compared to before the pandemic. The frequency of probable posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, alcohol use disorder, and suicidal ideation were 34.2%, 35.3%, 26.8%, 13.0%, and 22.0%, respectively. Between 38.6% and 53.1% of respondents attributed their symptoms as either directly related to or exacerbated by the pandemic. Approximately 18% of respondents reported using telehealth for mental health services during the pandemic, and among those, 72.8% indicated a choice to use telehealth even after the pandemic. Conclusions This study found that Veterans experienced worsening mental health as a result of the COVID-19 pandemic. The use of telehealth services was widely endorsed by mental health treatment-seeking Veterans who transitioned to virtual care during the pandemic. Our findings have important clinical and programmeadministrator implications, emphasizing the need to reach out to support veterans, especially those with pre-existing mental health conditions and to enhance and maintain virtual care even post-pandemic. HIGHLIGHTS Over 50% of Veterans reported worse mental health compared to before the pandemic. Probable mental health conditions based on self-reports ranged from 13% to 35%. Nearly 1 in 5 Veterans surveyed reported using telehealth for mental health services during the pandemic.

Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study.

Background: The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded stressors resulting from disruptions to familial, social, and occupational domains, and were faced with changes in health-care delivery (e.g. telehealth). The objectives of this study are to assess (a) the mental health impact of COVID-19 and related life changes on the well-being of Veterans and (b) perceptions of and satisfaction with changes in health-care treatments and delivery during the pandemic. Methods: A total of 1136 Canadian Veterans participated in an online survey. Participants completed questions pertaining to their mental health and well-being, lifestyle changes, and concerns relating to the COVID-19 pandemic, as well as experiences and satisfaction with health-care treatments during the pandemic. Results: Results showed that 55.9% of respondents reported worse mental health functioning compared to before the pandemic. The frequency of probable posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, alcohol use disorder, and suicidal ideation were 34.2%, 35.3%, 26.8%, 13.0%, and 22.0%, respectively. Between 38.6% and 53.1% of respondents attributed their symptoms as either directly related to or exacerbated by the pandemic. Approximately 18% of respondents reported using telehealth for mental health services during the pandemic, and among those, 72.8% indicated a choice to use telehealth even after the pandemic. Conclusions: This study found that Veterans experienced worsening mental health as a result of the COVID-19 pandemic. The use of telehealth services was widely endorsed by mental health treatment-seeking Veterans who transitioned to virtual care during the pandemic. Our findings have important clinical and programmeadministrator implications, emphasizing the need to reach out to support veterans, especially those with pre-existing mental health conditions and to enhance and maintain virtual care even post-pandemic.

Antecedentes: Los impactos de la pandemia del COVID-19 han afectado de manera desproporcionada a diferentes grupos de la población. Los veteranos tienen más probabilidades de tener afecciones de salud mental preexistentes en comparación con la población canadiense en general, experimentar factores estresantes agravados como resultado de las interrupciones en los dominios familiares, sociales, y ocupacionales, y se enfrentan a cambios en la prestación de la atención médica (por ejemplo, telesalud). Los objetivos de este estudio son evaluar (a) el impacto en la salud mental del COVID-19 y los cambios de vida relacionados en el bienestar de los Veteranos y (b) las percepciones y la satisfacción con los cambios en los tratamientos y la entrega de la atención médica durante la pandemia.Métodos: Un total de 1136 veteranos canadienses participaron en una encuesta en línea. Los participantes completaron preguntas relacionadas con su salud mental y bienestar, cambios en el estilo de vida, e inquietudes relacionadas con la pandemia del COVID-19, así como experiencias y satisfacción con los tratamientos de atención médica durante la pandemia.Resultados: Los resultados mostraron que el 55,9% de los encuestados informaron un peor funcionamiento de la salud mental en comparación con antes de la pandemia. La frecuencia de probable trastorno de estrés postraumático, trastorno depresivo mayor, trastorno de ansiedad generalizada, trastorno por consumo de alcohol, e ideación suicida fue del 34,2%, 35,3%, 26,8%, 13,0% y 22,0%, respectivamente. Entre el 38,6% y el 53,1% de los encuestados atribuyeron sus síntomas como directamente relacionados con la pandemia o agravados por ella. Aproximadamente el 18% de los encuestados informó haber utilizado la telesalud para los servicios de salud mental durante la pandemia, y entre ellos, el 72,8% indicó que había optado por utilizar la telesalud incluso después de la pandemia.Conclusiones: Este estudio encontró que los Veteranos experimentaron un empeoramiento de la salud mental como resultado de la pandemia del COVID-19. El uso de los servicios de telesalud fue ampliamente respaldado por los Veteranos en busca de tratamiento de salud mental que hicieron la transición a la atención virtual durante la pandemia. Nuestros hallazgos tienen importantes implicaciones clínicas y para los administradores de programas, enfatizando la necesidad de ayudar a los veteranos, especialmente a aquellos con condiciones de salud mental preexistentes, y de mejorar y mantener la atención virtual incluso después de una pandemia.

Well-being of Canadian Armed Forces Veterans and Spouses of Veterans During the COVID-19 Pandemic: Protocol for a Prospective Longitudinal Survey.

BACKGROUND: The COVID-19 pandemic has resulted in significant changes to everyday life, including social distancing mandates, changes to health care, and a heightened risk of infection. Previous research has shown that Canadian Armed Forces (CAF) veterans are at higher risk of developing mental and physical health conditions. Veterans and their families may face unique social challenges that can compound with pandemic-related disruptions to negatively impact well-being. OBJECTIVE: This study aims to longitudinally characterize the mental health of CAF veterans and spouses of CAF veterans throughout the pandemic and to understand the dynamic influences of pandemic-related stressors on psychological health over time. METHODS: We employed a prospective longitudinal panel design using an online data collection platform. Study participation was open to all CAF veterans and spouses of CAF veterans residing in Canada. Participants were asked to complete a comprehensive battery of assessments representing psychological well-being, chronic pain, health care access patterns, physical environment, employment, social integration, and adjustment to pandemic-related lifestyle changes. Follow-up assessments were conducted every 3 months over an 18-month period. This study was approved by the Western University Health Sciences and Lawson Health Research Institute Research Ethics Boards. RESULTS: Baseline data were collected between July 2020 and February 2021. There were 3 population segments that participated in the study: 1047 veterans, 366 spouses of veterans, and 125 veterans who are also spouses of veterans completed baseline data collection. As of November 2021, data collection is ongoing, with participants completing the 9- or 12-month follow-up surveys depending on their date of self-enrollment. Data collection across all time points will be complete in September 2022. CONCLUSIONS: This longitudinal survey is unique in its comprehensive assessment of domains relevant to veterans and spouses of veterans during the COVID-19 pandemic, ranging from occupational, demographic, social, mental, and physical domains, to perceptions and experiences with health care treatments and access. The results of this study will be used to inform policy for veteran and veteran family support, and to best prepare for similar emergencies should they occur in the future. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34984.

The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study.

BACKGROUND: It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. METHODS: This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (≥80th percentile) within sex and ten-year age groups (e.g. 50-60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or out-patient setting as of July 26, 2020. Participants were classified as having died from COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. FINDINGS: There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. CONCLUSIONS: While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of dying from COVID-19. This suggests that prior gains in CRF could be protective against dying from COVID-19 should someone develop the virus.