"Upheaval": Unpacking the dynamic balance between place attachment and social capital in disaster recovery.

A growing body of literature demonstrates that both place attachment and social capital play considerable, and likely interdependent, roles in disaster recovery. This paper contributes to our understanding of these constructs by presenting findings from a longitudinal, mixed-methods study of communities impacted by a home buyout program implemented in New York after Hurricane Sandy (N = 111). Results suggest a dynamic balance between place dependence, place identity, and bonding social capital, in which the relative importance of each construct can shift over time, and where losses in one of these areas may lead to cascading losses in the other areas. For buyout participants, increases in place dependence were associated with increases in bonding social capital, indicating that relocatees either regained both place dependence and bonding social capital in their new homes and communities, or they lost and did not regain both, depending on whether their new home and community met their emotional and functional needs sufficiently. For residents who remained in place, higher levels of place dependence were associated with losses in bonding social capital, reflecting the potential consequences of living in postdisaster limbo. Implications for future buyout research, policy, and practice are discussed.

COVID-19 Workplace Mitigation Strategies and Employee Leave Policies Implemented during the Height of the Pandemic, United States, Fall 2020 and 2021.

COVID-19 workplace mitigation strategies implemented within US businesses have been effective at preventing disease and protecting workers, but the extent of their use is not well understood. We examined reported COVID-19 workplace mitigation strategies by business size, geographic region, and industry using internet panel survey data from US adult respondents working full- or part-time outside the home (fall 2020, N = 1168) andfull- or part-time, inside or outside the home (fall 2021, N = 1778). We used chi-square tests to assess the differences in the strategies used (e.g., masking and COVID-19 screening) and ANOVA tests to examine the group differences on a mitigation strategies summative score. Fewer COVID-19 mitigation strategies were reported by respondents in fall 2021 (compared to fall 2020) across businesses of different sizes and regions. The participants in microbusinesses (1-10 employees) reported significantly (p < 0.05) lower mitigation scores than all other business sizes, and the respondents in these businesses were significantly less likely (p < 0.05) to have paid leave than those in enterprises with >10 employees. The healthcare and education sectors had the highest reported mean score of COVID-19 workplace mitigation strategies. Small and essential businesses are critical to the US economy. Insight is needed on their use of mitigation strategies to protect workers during the current and future pandemics.

Actionable research for understanding and addressing homelessness.

Homelessness results from an interaction of structural determinants and individual vulnerabilities, creating various pathways into homelessness and having multilevel impacts. Understanding and addressing homelessness requires research that not only takes an ecological perspective but also can be translated into action. Despite research demonstrating differing needs and experience among various subpopulations, particularly marginalized groups, homeless service systems often take a one-size-fits-all approach. Additionally, homeless service systems' prioritization of the most vulnerable and chronically homeless for permanent housing programs results in a service system that operates in a state of triage, with minimal attention to prevention efforts. This special issue highlights actionable research focused on preventing homelessness and addressing disparities among marginalized groups. Included articles target homelessness at multiple levels using a combination of qualitative, quantitative, and mixed-methods approaches. Embedded in community psychology values, this study focuses on prevention, leverages participatory methods, relies on diverse lived experiences, and explores community-based solutions.

Mindful awareness moderates the association between psychological inflexibility and distress variables: A cross-sectional investigation.

OBJECTIVE: Informed by the contextual behavioral science (CBS) model of behavioral health, the present cross-sectional study examined whether mindful awareness moderated the associations between psychological inflexibility and four distress variables. PARTICIPANTS: Cross-sectional data were collected from 402 ethnically diverse undergraduate college students from September 2015 to October 2015. METHODS: Participants competed an online self-report survey. RESULTS: Mindful awareness moderated the associations between psychological inflexibility and distress variables, with stronger associations for somatization and anxiety, and weaker associations for general distress and depression. Specifically, the strength of the positive associations between psychological inflexibility and these distress variables were substantially greater among those low in mindful awareness. CONCLUSION: These findings suggest that a greater degree of mindful awareness may buffer the effects of psychological inflexibility on distress variables, particularly somatization and anxiety. Theoretical and applied implications as well as limitations of the study are discussed.

Health outcomes and healthcare utilization of Native Hawaiians and other Pacific Islanders living with HIV in Hawai'i: A mixed-methods study.

OBJECTIVES: Past research shows mixed outcomes in terms of HIV-related disparities among Native Hawaiians and Pacific Islanders (NHOPI). This study investigates HIV-related disparities among NHOPI living with HIV in Hawai'i. DESIGN: An explanatory sequential design was utilized. The quantitative portion analyzed survey data from a statewide Ryan White Needs Assessment (N = 398) to examine the differences in viral suppression and satisfaction with care between NHOPI and other ethnic groups. Utilizing the behavioral model for vulnerable populations (BMVP), semi-structured interviews (N = 16) were conducted next to explain what factors play a role in satisfaction with care and viral suppression when it comes to NHOPI living with HIV in Hawai'i. RESULTS: Among the 398 participants 13% were NHOPI. NHOPI were more likely to have a viral load of ≥10,000 copies/mL compared to those who didn't identify as NHOPI. However, there were no significant differences for other viral load levels (20-199 or 200-9999), and only 20 participants (5.2%) had a viral load of 10,000 copies/mL or more. No significant ethnic differences were found in satisfaction with medical care. In the qualitative phase, factors from all domains of the BMVP were represented within the four themes identified: (1) Care coordination is essential- with AIDs service organizations taking the lead; (2) HIV care, as well as overall health, is defined by the effectiveness of medication; (3) Initial diagnosis is a critical moment for intervention; and (4) Aspects of culture are intangible. CONCLUSION: Among NHOPI in Hawai'i who are engaged in case management, there appears to be no substantial disparities in either viral load or satisfaction with care compared to other ethnic groups. Despite this, qualitative findings provide insights on how ethnicity and culture may still be playing a role. Addressing all domains of the BMVP is crucial to addressing this.

National and State Trends in Anxiety and Depression Severity Scores Among Adults During the COVID-19 Pandemic - United States, 2020-2021.

Recent studies indicate an increase in the percentage of adults who reported clinically relevant symptoms of anxiety and depression during the COVID-19 pandemic (1-3). For example, based on U.S. Census Bureau Household Pulse Survey (HPS) data, CDC reported significant increases in symptoms of anxiety and depressive disorders among adults aged ≥18 years during August 19, 2020-February 1, 2021, with the largest increases among adults aged 18-29 years and among those with less than a high school education (1). To assess more recent national trends, as well as state-specific trends, CDC used HPS data (4) to assess trends in reported anxiety and depression among U.S. adults in all 50 states and the District of Columbia (DC) during August 19, 2020-June 7, 2021 (1). Nationally, the average anxiety severity score increased 13% from August 19-31, 2020, to December 9-21, 2020 (average percent change [APC] per survey wave = 1.5%) and then decreased 26.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -3.1%). The average depression severity score increased 14.8% from August 19-31, 2020, to December 9-21, 2020 (APC = 1.7%) and then decreased 24.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -2.8%). State-specific trends were generally similar to national trends, with both anxiety and depression scores for most states peaking during the December 9-21, 2020, or January 6-18, 2021, survey waves. Across the entire study period, the frequency of anxiety and depression symptoms was positively correlated with the average number of daily COVID-19 cases. Mental health services and resources, including telehealth behavioral services, are critical during the COVID-19 pandemic.

Investigating the Impact of Job Loss and Decreased Work Hours on Physical and Mental Health Outcomes Among US Adults During the COVID-19 Pandemic.

OBJECTIVE: To investigate associations between adverse changes in employment status and physical and mental health among US adults (aged 18 years or older) during the COVID-19 pandemic. METHODS: Data from participants (N = 2565) of a national Internet panel (June 2020) were assessed using path analyses to test associations between changes in self-reported employment status and hours worked and physical and mental health outcomes. RESULTS: Respondents who lost a job after March 1, 2020 (vs those who did not) reported more than twice the number of mentally unhealthy days. Females and those lacking social support had significantly worse physical and mental health outcomes. Participants in the lowest, pre-pandemic household income groups reported experiencing worse mental health. CONCLUSIONS: Results demonstrate the importance of providing economic and social support services to US adults experiencing poor mental and physical health during the COVID-19 pandemic.

Associations between social determinants of health, perceived discrimination, and body mass index on symptoms of depression among young African American mothers.

PURPOSE: The association between symptoms of depression and risks for cardiovascular disease (CVD) remains equivocal for African American (AA) mothers. We examined the association between social determinants of health (perceived discrimination), and cardiovascular risk (BMI) on symptoms of depression in a sample of young AA mothers. METHODS: Secondary data from 219 adult AA mothers between the ages of 21 and 46 with an average BMI of 29.8 and yearly family income of $14,999 were analyzed using a latent growth model that evaluated four time points to assess changes in symptoms of depression. RESULTS: Initial BMI was significantly associated with initial symptoms of depression (b = 0.12, p = .019). Perceived discrimination (unfair treatment) was associated with higher initial symptoms of depression (b = 1.14, p = .017). CONCLUSION: The findings suggest that elevated BMI and perceived discrimination are associated with higher reported symptoms of depression among young, socioeconomically disadvantaged AA mothers. These results advance the scientific understanding of young AA mothers' risk for symptoms of depression and CVD by elucidating the impact of perceived discrimination and social experiences on mental health. Further studies of SDoH and CVD risk factors and perceived racism and depression are needed to shed light on the long-term mental health impact on AA mothers and their children.

Theory-based Behavioral Predictors of Self-reported Use of Face Coverings in Public Settings during the COVID-19 Pandemic in the United States.

BACKGROUND: Investigating antecedents of behaviors, such as wearing face coverings, is critical for developing strategies to prevent SARS-CoV-2 transmission. PURPOSE: The purpose of this study was to determine associations between theory-based behavioral predictors of intention to wear a face covering and actual wearing of a face covering in public. METHODS: Data from a cross-sectional panel survey of U.S. adults conducted in May and June 2020 (N = 1,004) were used to test a theory-based behavioral path model. We (a) examined predictors of intention to wear a face covering, (b) reported use of cloth face coverings, and (c) reported use of other face masks (e.g., a surgical mask or N95 respirator) in public. RESULTS: We found that being female, perceived importance of others wanting the respondent to wear a face covering, confidence to wear a face covering, and perceived importance of personal face covering use was positively associated with intention to wear a face covering in public. Intention to wear a face covering was positively associated with self-reported wearing of a cloth face covering if other people were observed wearing cloth face coverings in public at least "rarely" (aOR = 1.43), with stronger associations if they reported "sometimes" (aOR = 1.83), "often" (aOR = 2.32), or "always" (aOR = 2.96). For other types of face masks, a positive association between intention and behavior was only present when observing others wearing face masks "often" (aOR = 1.25) or "always" (aOR = 1.48). CONCLUSIONS: Intention to wear face coverings and observing other people wearing them are important behavioral predictors of adherence to the CDC recommendation to wear face coverings in public.

Intimate Partner Violence Among Chinese Transwomen: Associations With Sexual Risk Behaviors and HIV Testing.

BACKGROUND: Intimate partner violence (IPV) is an emerging risk factor for HIV infection. Given the high vulnerability of and limited research on transwomen in China, we described IPV, sexual risk behaviors, HIV, and sexually transmitted infection (STIs) testing rates and results, and investigated the pathways that link IPV to HIV infection among this population. METHODS: We conducted a cross-sectional survey and collected blood samples for HIV and syphilis testing among transwomen in Shanghai, China (n = 199). With logistic regression, we examined sexual risk behaviors and HIV/STI testing history among participants with and without IPV experience. RESULTS: More than half of the respondents reported IPV (57.3%), and the prevalence of unprotected sex ranged from 51.9% (with sex workers) to 87.8% (oral sex); 85.9% had ever tested for HIV and 49.3% for other STIs. Self-reported positivity results were as follows: HIV (2.3%), herpes simplex virus type 2 (8.3%), gonorrhea (18.8%), and syphilis (17.8%). Laboratory-confirmed positivity values were 5.0% for HIV and 6.5% for syphilis. Respondents with a history of IPV were significantly less likely to report HIV testing in the past 12 months (adjusted odds ratio, 0.20; 95% confidence interval, 0.10-0.38). CONCLUSIONS: Transwomen self-reported a high prevalence of IPV, which was related to a lower probability of HIV testing. The prevalence of HIV and other STIs was lower than reported in previous studies of Chinese transwomen, whereas the HIV/STI testing rates were higher. Findings suggest transwomen in China are at risk for IPV and need enhanced HIV prevention services to promote HIV testing in an IPV setting.

Understanding the Role of Mental Health Clubhouses in Promoting Wellness and Health Equity Using Pilinaha-An Indigenous Framework for Health.

Individuals with severe mental illness need to be engaged in defining their own vision of wellness to promote equity and reduce disparities. This photovoice study helps define what wellness is and how it is achieved in mental health Clubhouses in Hawai'i. Results from a photovoice study with 43 members and staff were analyzed using Pilinaha, a Native Hawaiian framework for health. Pilinaha envisions health through connection to place, community, past and future, and one's better self. Within Clubhouses, connection to place included connection to 'aina (land) and the access to a safe space. Connection to community occurred through reciprocal social support, which developed kuleana (responsibility), and a sense of 'ohana (family) for many members who were previously isolated. Connection to one's better self-involved positive identity change, development of hope, and pursuing opportunities within and outside the Clubhouse. Connection to past and future was described through individual narratives, remembering members who had died, and connection to cultural traditions. Overall, wellness was conceptualized as the ability to work toward dreams, engage in cultural practice, and feel accepted, respected, and valued-to be treated with aloha. Findings provide a culturally responsive perspective on wellness and illustrate the value of Clubhouses as a space for mental health recovery and transformative change.

Factors Associated with Cloth Face Covering Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020.

On April 3, 2020, the White House Coronavirus Task Force and CDC announced a new behavioral recommendation to help slow the spread of coronavirus disease 2019 (COVID-19) by encouraging the use of a cloth face covering when out in public (1). Widespread use of cloth face coverings has not been studied among the U.S. population, and therefore, little is known about encouraging the public to adopt this behavior. Immediately following the recommendation, an Internet survey sampled 503 adults during April 7-9 to assess their use of cloth face coverings and the behavioral and sociodemographic factors that might influence adherence to this recommendation. The same survey was administered 1 month later, during May 11-13, to another sample of 502 adults to assess changes in the prevalence estimates of use of cloth face coverings from April to May. Within days of the release of the first national recommendation for use of cloth face coverings, a majority of persons who reported leaving their home in the previous week reported using a cloth face covering (61.9%). Prevalence of use increased to 76.4% 1 month later, primarily associated with increases in use among non-Hispanic white persons (54.3% to 75.1%), persons aged ≥65 years (36.6% to 79.2%), and persons residing in the Midwest (43.7% to 73.8%). High rates were observed in April and by May, increased further among non-Hispanic black persons (74.4% to 82.3%), Hispanic or Latino persons (77.3% to 76.2%), non-Hispanic persons of other race (70.8% to 77.3%), persons aged 18-29 years (70.1% to 74.9%) and 30-39 years (73.9% to 84.4%), and persons residing in the Northeast (76.9% to 87.0%). The use of a cloth face covering was associated with theory-derived constructs that indicate a favorable attitude toward them, intention to use them, ability to use them, social support for using them, and beliefs that they offered protection for self, others, and the community. Research is needed to understand possible barriers to using cloth face coverings and ways to promote their consistent and correct use among those who have yet to adopt this behavior.

A state of emergency: Dominant cultural narratives on homelessness in Hawai'i.

This exploratory study aimed to identify the dominant cultural narratives on homelessness in Hawai'i-an area of the United States that has seen a precipitous increase in homelessness amid overall national decline. Because media is a primary way in which these narratives are created, solidified, and perpetuated, this study sought to understand the role the local media played in constructing homelessness narratives during this homelessness "crisis." This study used thematic content analysis of a random sample of 648 articles of Hawai'i media coverage between 2012 and 2017. The analysis found that media coverage of homelessness in Hawai'i emphasized structural-level causes and solutions, while simultaneously relying on stereotypes and stigmatizing characteristics. However, coverage became more complex over time and was open to revision based on new information. This study suggests that media could be a viable target of interventions seeking to produce healthy and accurate narratives.

HIV and Aging in Mainland China: Implications for Control and Prevention Research.

PURPOSE OF REVIEW: The last 15 years have witnessed a dramatic change in HIV-related epidemiology amidst improvements in treatment and care in China. With proper treatment, HIV is now considered a chronic disease. As a consequence, many people living with HIV (PLWH) now present age-related comorbidities. We reviewed 13 topical issues concerning the epidemiology of aging with HIV in mainland China. RESULTS: Many of aging-related issues associated with the biological and physical aspects of living with HIV addressed in mainland China are consistent with the global literature. Greater prevalence of age-related comorbidities among PLWH was observed. Beyond biological mechanisms associated with HIV infection and traditional risk factors, other factors play a vital role in the aging process among PLWH. A stronger focus on screening, prevention, and management of non-HIV co-morbidities among PLWH is now warranted. Macro-social factors need to be integrated into next generation of clinical and/or behavioral HIV research to inform disease progression and management as well as prevention.

Preparing Teens to Stay Safe and Healthy on the Job: a Multilevel Evaluation of the Talking Safety Curriculum for Middle Schools and High Schools.

US adolescents experience a higher rate of largely preventable job-related injuries compared with adults. Safety education is considered critical to the prevention of these incidents. This study evaluates the effectiveness of a foundational curriculum from the National Institute for Occupational Safety and Health (NIOSH), Talking Safety, to change adolescents' workplace safety and health knowledge, attitude, subjective norm, self-efficacy, and behavioral intention to engage in workplace safety actions. The study also examines the impact of teacher fidelity of curriculum implementation on student outcomes. A multilevel evaluation, based on a modified theory of planned behavior, was conducted in 2016 with 1748 eighth-graders in Miami-Dade, Florida. Post-intervention, students had statistically significant increases (p < .05) in mean scores across outcomes: workplace safety knowledge (34%), attitude (5%), subjective norm (7%), self-efficacy (7%), and behavioral intention (7%). Consistent with theory, gains in attitude (b = 0.25, p < .001), subjective norm (b = 0.07, p < .01), and self-efficacy (b = 0.55, p < .001) were associated with gains in behavioral intention. Higher levels of implementation fidelity were associated with significant gains across outcome measures: knowledge (b = 0.60, p < .001), attitude (b = 0.08, p < .01), subjective norm (b = 0.04, p < .001), self-efficacy (b = 0.07, p < .01) and behavioral intention (b = 0.07, p < .01). Findings demonstrate the effectiveness of Talking Safety, delivered with fidelity, at positively changing measured outcomes, and provide support for using this curriculum as an essential component of any school-based, injury prevention program for young workers.

Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older.

BACKGROUND: Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for older US adults. RESEARCH DESIGN: Data were from the Medicare Health Outcomes Survey Cohort 15 (baseline survey in 2012, follow-up survey 2014, with mortality follow-up through January 31, 2015). We included individuals aged 65 years and older (n=96,481). We estimated mean QALY throughout the remainder of the lifetime according to the occurrence of these conditions. RESULTS: The age-adjusted QALY was 5.8 years for men and 7.8 years for women. Over 90% respondents reported at least 1 condition and 72% reported multiple conditions. Respondents with depression and congestive heart failure had the lowest age-adjusted QALY (1.1-1.5 y for men and 1.5-2.2 y for women), whereas those with hypertension, arthritis, and sciatica had higher QALY (4.2-5.4 and 6.4-7.2 y, respectively). Having either depression or congestive heart failure and any 1 or 2 of the other 13 conditions was associated with the lowest QALY among the possible dyads and triads of chronic conditions. Dyads and triads with hypertension or arthritis were more prevalent, but had higher QALY. CONCLUSIONS: Understanding the burden of disease for common chronic conditions and for combinations of these conditions is useful for delivering high-quality primary care that could be tailored for individuals with combinations of chronic conditions.

Housing First and Photovoice: Transforming Lives, Communities, and Systems.

This article presents findings from a community-based participatory evaluation of a Housing First program on the Island of O'ahu. In this study, clients in a Housing First program used Photovoice to evaluate the program and to advocate for progressive housing policies. Written together by members of the Housing First Photovoice group, this collaborative article describes the outcomes from both the Housing First program and the Photovoice project and demonstrates the ways in which participatory program evaluations can interact with client-driven programs like Housing First to produce a cumulative, transformative impact. Findings suggest that community psychologists hoping to re-engage with community mental health systems through enacting transformative change should consider taking a community-based participatory approach to program evaluation because increased client voice in community mental health programs and their evaluations can have far-reaching, transformative impacts for research, practice, and policy.

Associations Between Profiles of Communication About Aging and Quality of Life for Middle-Aged and Older American Adults.

The association between how middle-aged and older adults talk about aging and their quality of life was examined using latent profile analysis and regression techniques. Two-hundred eight-six adults with an average age of 52.82 (range: 45-77) completed an online questionnaire, which assessed participants' self-reported communication about aging, stress, health-related quality of life, and satisfaction with life. Controlling for social support and demographics, participants' profile of communication about aging was found to predict satisfaction with life, stress, and mental health but not general or physical health.

Describing Trajectories of Homeless Service Use in Hawai'i Using Latent Class Growth Analysis.

The State of Hawai'i, like many other areas across the United States, has large numbers of individuals and families experiencing homelessness, many of whom seek support through statewide shelters and services. This study explored the diversity of ways in which individuals and families moved through Hawai'i's homeless service system. Using administrative data, a cohort of new service users was tracked across time to trace the developmental trajectories of their homeless service use. The sample consisted of adults who had entered the service system for the first time in the fiscal year (FY) of 2010 (N = 4655). These individuals were then tracked through the end of FY 2014, as they used emergency shelter, transitional shelter, and outreach services. A latent class growth analysis was conducted and identified four distinct patterns of service use: low service use (n = 3966, 85.2%); typical transitional shelter use (n = 452, 9.7%); atypical transitional use (n = 127, 2.7%), and potential chronic service use (n = 110, 2.4%). Multinomial logistic regression models were then used to determine if select demographic, family, background experience (e.g., education, employment), or health variables were associated with class membership. The distinct profiles for class membership are discussed.

Measurement characteristics for two health-related quality of life measures in older adults: The SF-36 and the CDC Healthy Days items.

BACKGROUND: The Short Form Health Survey (SF-36) and the Centers for Disease Control and Prevention (CDC) Healthy Days items are well known measures of health-related quality of life. The validity of the SF-36 for older adults and those with disabilities has been questioned. OBJECTIVE: Assess the extent to which the SF-36 and the Centers for Disease Control and Prevention (CDC) Healthy Days items measure the same aspects of health; whether the SF-36 and the CDC unhealthy days items are invariant across gender, functional status, or the presence of chronic health conditions of older adults; and whether each of the SF-36's eight subscales is independently associated with the CDC Healthy Days items. METHODS: We analyzed data from 66,269 adult Medicare advantage members age 65 and older. We used confirmatory factor analyses and regression modeling to test associations between the CDC Healthy Days items and subscales of the SF-36. RESULTS: The CDC Healthy Days items were associated with the SF-36 global measures of physical and mental health. The CDC physically unhealthy days item was associated with the SF-36 subscales for bodily pain, physical role limitations, and general health, while the CDC mentally unhealthy days item was associated with the SF-36 subscales for mental health, emotional role limitations, vitality and social functioning. The SF-36 physical functioning subscale was not independently associated with either of the CDC Healthy Days items. CONCLUSIONS: The CDC Healthy Days items measure similar domains as the SF-36 but appear to assess HRQOL without regard to limitations in functioning.