Psychological Group Interventions for Reducing Distress Symptoms in Healthcare Workers: A Systematic Review.

Healthcare workers exposed to emergencies and chronic stressors are at high risk of developing mental health problems. This review synthesized existing studies of group psychological therapy to reduce distress symptoms in healthcare workers (i.e., as complex and heterogeneous emotional states, characterized by the presence of symptoms associated with post-traumatic stress disorder, burnout, anxiety, depression and moral injury). Searches were conducted using PRISMA guidelines and databases such as PubMed, PsycINFO, Medline and Web of Science, along with manual searches of reference lists of relevant articles. The search returned a total of 1071 randomized trials, of which 23 met the inclusion criteria. Of the total studies, nine were mindfulness interventions, seven were cognitive behavioural programmes, one was a programme based on acceptance and commitment therapy, one was an EMDR protocol and two focused on systemic and art therapy. Most studies aimed to reduce burnout, anxiety and depression; only three focused on post-traumatic stress disorder, and no studies were found that addressed moral injury. The results suggested that group interventions could be an effective tool to improve the mental health of healthcare workers and reduce their symptoms of distress, although many of the studies have methodological deficiencies. Limitations and future directions are discussed.

The network structure of psychopathological and resilient responses to the pandemic: A multicountry general population study of depression and anxiety.

Commonly identified patterns of psychological distress in response to adverse events are characterized by resilience (i.e., little to no distress), delayed (i.e., distress that increases over time), recovery (i.e., distress followed by a gradual decrease over time), and sustained (i.e., distress remaining stable over time). This study aimed to examine these response patterns during the COVID-19 pandemic. Anxiety and depressive symptom data collected across four European countries over the first year of the pandemic were analyzed (N = 3,594). Participants were first categorized into groups based on the four described patterns. Network connectivity and symptom clustering were then estimated for each group and compared. Two thirds (63.6%) of the sample displayed a resilience pattern. The sustained distress network (16.3%) showed higher connectivity than the recovery network (10.0%) group, p = .031; however, the resilient network showed higher connectivity than the delayed network (10.1%) group, p = .016. Regarding symptom clustering, more clusters emerged in the recovery network (i.e., three) than the sustained network (i.e., two). These results replicate findings that resilience was the most common mental health pattern over the first pandemic year. Moreover, they suggest that high network connectivity may be indicative of a stable mental health response over time, whereas fewer clusters may be indicative of a sustained distress pattern. Although exploratory, the network perspective provides a useful tool for examining the complexity of psychological responses to adverse events and, if replicated, could be useful in identifying indicators of protection against or vulnerability to future psychological distress.

ICD-11 prolonged grief disorder: Prevalence, predictors, and co-occurrence in a large representative sample.

The International Classification of Diseases has recently defined Prolonged Grief Disorder (PGD) with symptoms such as longing, worry, and intense emotional pain that exceed sociocultural norms more than 6 months after the loss. This study aims to (a) estimate the prevalence of this new diagnostic category, (b) identify its sociodemographic and loss-related predictors, and (c) assess the co-occurrence of PGD with other psychological disorders and substance abuse. A large representative sample of Spanish adults (N = 1498) participated. Several multivariate binary logistic regression and multivariate logistic regression models were used. Results showed a 9.95% prevalence in the total sample. Catholic beliefs were a positive predictor, while higher income and more time since loss significantly decreased the odds of PGD. PGD significantly increased the likelihood of anxiety, depression, somatisation, post-traumatic stress disorder, loneliness and substance use. Our study contributes to assessing the multicultural PGD validity, as our results from a large representative sample are comparable to those in other countries with the PGDS. Our findings have direct implications for the assessment and treatment of bereavement, identifying for practitioners variables that make individuals more vulnerable to PGD. Results highlighted the high co-occurrence of PGD with other psychological illnesses and increased drug use.

Effectiveness of trauma-informed care interventions at the organizational level: A systematic review.

Due to the recognition of the high prevalence and widespread effects of trauma, trauma-informed care (TIC) framework has emerged to address its impact and prevent retraumatization in the systems of care. Since organizational support has been identified as crucial in TIC implementation and sustainability, this systematic review assessed the status quo of TIC interventions which explicitly incorporate an organizational component. Our search yielded 880 articles, and 15 met the inclusion criteria. All the studies were carried out in the United States, more than half in mental health and Child Welfare Services, through longitudinal designs with no randomization or control group. All the studies utilized one to six organizational components, the most frequent related to presence of a defined leadership, procedures against retraumatization and provision of strength-based services. A wide variety of measures were used to assess the effectiveness of TIC interventions, with staff perceptions and safety management indicators being the most frequently used. In summary, the review indicates a positive trend in relation to the effectiveness of the interventions included in the study, with an improved functioning of beneficiaries, enhanced accessibility, and quality of services. However, the low quality and high heterogeneity of the studies make it difficult to draw conclusions with certainty. Therefore, the primary endeavor in TIC research is to provide more solid evidence. Partnerships between academic and community stakeholders will be of high value in this process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Paranoid beliefs and conspiracy mentality are associated with different forms of mistrust: A three-nation study.

Paranoia and conspiracy are terms typically used interchangeably. However, although the underlying content of these types of beliefs might be similar (e.g., seeing others as powerful and threatening), recent research suggests that these constructs differ in important ways. One important feature shared by both constructs is excessive mistrust but this aspect might play different roles in each belief system. In this study we explored the strength of associations of different trust predictors (i.e., trust in institutions, trust in sources of information, perceptual trust, and interpersonal trust) between conspiracy mentality and paranoid beliefs. We tested this association in a large representative multinational sample (United Kingdom n = 2025; Spain n = 1951; and Ireland n = 1041). Confirmatory factor analysis supported a two-factor model of conspiracy and paranoid beliefs in each nation sample. Path and equality of constraints analysis revealed that paranoia was more strongly associated with perceptual mistrust (bias towards mistrusting unfamiliar faces) whereas conspiracy was more strongly associated with mistrust in political institutions. Although interpersonal mistrust and trust in social sources of information were associated significantly with conspiracy their association with paranoid beliefs was stronger. These findings clarify the role of different trust processes in both belief systems. Limitations of this study are discussed.

The mediating role of controllability appraisals and coping strategies on adaptive functioning after job loss: a path model.

Job loss is a stressful event that increases the risk of experiencing depression and anxiety, especially during the initial months of unemployment. This study examined differences in psychological symptoms and resilient functioning accounted by employment status. The results pointed out that recently unemployed compared to currently employed individuals had lower levels of perceived controllability and resilience as well as higher levels of depression and anxiety. Path analyses showed that lower controllability appraisals at wave 1 of recently unemployed compared to employed individuals, in turn, predicted a lower use of active coping and reappraisal at wave 2, with the latter further accounting for lower levels in resilience. Higher use of distraction further mediated the relation between employment status and higher levels of depression and anxiety symptoms. Our findings demonstrate the importance of controllability appraisals and coping strategies used to promote adaptive psychological functioning following job loss.

The network structure of paranoia dimensions and its mental health correlates in the general population: The core role of loneliness.

Paranoid ideas are the most common abnormal beliefs in the schizophrenia spectrum, are also prevalent in non-clinical populations, and are highly correlated with other mental health problems such as anxiety, depression and low levels of well-being. Two previous studies with the same British population sample used confirmatory factor analysis and network analysis to show that the spectrum of paranoid beliefs is made up of four factors or dimensions (i.e., interpersonal sensitivity, mistrust, ideas of reference and ideas of persecution). The aims of this study are: 1) to explore the distribution and the structure of paranoid beliefs in a Spanish general population by applying the network approach and 2) to use network analysis to explore for the first time whether specific domains of paranoid ideation (i.e., dimensions) are specifically associated with mental health correlates such as depression, anxiety, loneliness, and well-being. We found a continuous distribution of paranoid beliefs among the 1328 individuals constituting the sample (e.g., 29,2 % did not endorse any items, 4.6 % endorsed half of the items, while 0.8 % endorsed all paranoid items). Paranoid ideas form three dimensions; interpersonal sensitivity, mistrust, and ideas of persecution (ideas of reference did not form a separate factor). The network model showed that loneliness has a pivotal role in connecting paranoid ideation with general psychopathology measures (i.e., depression, anxiety, loneliness and well-being). Research and clinical implications derived from our findings are also discussed.

Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic.

BACKGROUND: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country. METHOD: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models. RESULTS: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning. CONCLUSIONS: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

The role of insecure attachment and psychological mechanisms in paranoid and depressive symptoms: An exploratory model.

Attachment theory is considered an important theoretical framework for understanding the ontogenesis of psychopathology. In this regard, insecure attachment styles have been associated with the development and maintenance of paranoid and depressive symptoms. Furthermore, different psychological processes (i.e., self-esteem and experiential avoidance) have been identified as mediating mechanisms between the relationship of insecure attachment and these symptoms. Nowadays, there is a more positive view in psychology focusing on factors that contribute to well-being, although little is known about the role of these psychological well-being variables as mediators between insecure attachment and psychopathology. For thus, the aim of this study was to test one explorative structural equation model of insecure attachment on paranoid and depressive symptoms through psychological mediating mechanisms to elucidate the processes involved in each of them. To evaluate the model, 141 individuals with severe psychiatric conditions participated in the study. The results revealed good model fit, highlighting that avoidant attachment has a direct and indirect effect on the symptoms, while anxious attachment has only an indirect effect through mediating mechanisms. On the other hand, lower levels of self-acceptance and environmental mastery have been identified as important processes associated with paranoid and depressive symptoms. However, less positive relationships were a significant mediating mechanism only for paranoid ideation symptoms. These results have important clinical implications by shedding light on the relationship between insecure attachment, paranoid and depressive symptoms, and the psychological mediating mechanisms involved in this relationship, which may be considered key variables in clinical treatments.

Design, content, and fieldwork procedures of the COVID-19 Psychological Research Consortium (C19PRC) Study - Wave 4.

OBJECTIVES: This paper outlines fieldwork procedures for Wave 4 of the COVID-19 Psychological Research Consortium (C19PRC) Study in the UK during November-December 2020. METHODS: Respondents provided data on socio-political attitudes, beliefs, and behaviours, and mental health disorders (anxiety, depression, and posttraumatic stress). In Phase 1, adults (N = 2878) were reinvited to participate. At Phase 2, new recruitment: (i) replenished the longitudinal strand to account for attrition; and (ii) oversampled from the devolved UK nations to facilitate robust between-country analyses for core study outcomes. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was representative of the baseline sample characteristics. RESULTS: In Phase 1, 1796 adults were successfully recontacted and provided full interviews at Wave 4 (62.4% retention rate). In Phase 2, 292 new respondents were recruited to replenish the panel, as well as 1779 adults from Wales, Scotland, and Northern Ireland, who were representative of the socio-political composition of the adult populations in these nations. The raking procedure successfully re-balanced the longitudinal panel to within 1% of population estimates for selected socio-demographic characteristics. CONCLUSION: The C19PRC Study offers a unique opportunity to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID-19 pandemic.

A multicomponent positive psychology group intervention for people with severe psychiatric conditions; a randomized clinical trial.

OBJECTIVE: The aim of this study was to examine the efficacy and effectiveness of a theory-driven multicomponent positive psychology intervention to improve well-being for individuals with severe psychiatric conditions (SPCs) in comparison with treatment as usual (TAU). This intervention moves away from the traditional psychiatric perspectives that focused on symptoms and deficits, promoting a broader view of outcomes such as noncritical self-acceptance, strengths, and positive relationships with others, among other things. METHOD: A two-arm randomized and outcome-blinded trial with pre-post and 6-month follow-up evaluations was conducted to assess the intervention. A total of 141 participants were allocated to either the experimental condition or the waiting list group receiving their TAU. A mixed-effect model was used to examine the efficacy of the intervention and a repeated-measures Student's t-test for the follow-up effectiveness analysis. RESULTS: The intervention protocol was highly acceptable for participants, showing very high participant satisfaction as well as good attendance and adherence rates. At the end of the group therapy, participants reported a significant improvement in self-acceptance and environmental mastery and, these changes were maintained in the follow-up assessment after 6 months. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The results of this randomized control trial provide further evidence supporting that positive psychology approaches can be a powerful complementary strategy to promote more comprehensive psychiatric rehabilitation services for people with SPCs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Wastewater-Based Epidemiology of Enteric Viruses and Surveillance of Acute Gastrointestinal Illness Outbreaks in a Resource-Limited Region.

Acute gastrointestinal illness (AGI) continues to be an important cause of morbidity and mortality among all ages. This study applied the principles of wastewater-based epidemiology for the preventive identification of potential outbreaks of acute viral gastroenteritis and hepatitis A by analyzing the presence of human enteric viruses in influents of small municipal wastewater treatment plants (WWTPs) handling domestic sewage, together with public health reports of acute diarrheal and hepatitis A disease in Costa Rica during 2013. Raw wastewater samples were collected during four seasonal periods with different rainfall levels. The presence of five human enteric viruses (rotavirus A, norovirus GI, norovirus GII, enterovirus, and hepatitis A virus) was studied by endpoint and real-time polymerase chain reaction in influents of five WWTPs. Cases of AGI were analyzed using historical public health reports of endemic levels and quartile ranges for each administrative and territorial area where the WWTPs are located and for its surrounding counties. A tendency for a higher rate of positive viral tests was present 1 week before an increase of AGI cases. Epidemiological weeks categorized as Outbreak (above the 75th percentile) and Success (below the 25th percentile) showed statistically significant differences in terms of positive viral test rates (Wilcoxon test, P = 0.05). Virological monitoring of wastewater in small WWTPs is an appropriate model for epidemiological surveillance of diarrheal and hepatitis A diseases in low- and middle-resource countries.

Context, design and conduct of the longitudinal COVID-19 psychological research consortium study-wave 3.

OBJECTIVES: The COVID-19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID-19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the 'parent' strand of the Consortium) during July-August 2020. METHODS: Adults (N = 2025) who participated in the baseline and/or first follow-up surveys were reinvited to participate in this survey, which assessed: (1) COVID-19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross-sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK. RESULTS: 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re-balanced the cross-sectional sample to within 1% of population estimates across selected socio-demographic characteristics. CONCLUSION: This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID-19 pandemic.

Self-Schemas and Self-Esteem Discrepancies in Subclinical Paranoia: The Essential Role of Depressive Symptoms.

Background : Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explicit self-esteem discrepancies in three non-clinical groups with different psychopathological traits and a control group. Methods: Participants with elevated trait-paranoia (n = 41), depressive symptoms (n = 34), a combination of both traits (n = 32), and a control group (n = 71) were assessed on implicit and explicit self-esteem, self-schemas, depression, and paranoia. A dimensional approach with the total sample (n = 208) was also used to complement the information provided by the group approach. Results: All groups presented similar and positive levels of implicit self-esteem. Trait-paranoia participants had similar levels of explicit self-esteem and self-schemas compared with the control group. However, the group with a combination of trait-paranoia and depressive symptoms showed the lowest levels of positive self-schemas and self-esteem. Furthermore, this group and the control group displayed implicit/explicit self-esteem discrepancies, although in opposite directions and with different implications. The dimensional approach revealed associations of trait-paranoia and depressive symptoms with poor explicit self-esteem and self-schemas but not with implicit self-esteem. Conclusions: Trait-paranoia participants showed different self-representations depending on whether depressive symptoms were present or not. The interaction between subclinical neurotic and psychotic traits entailed a detrimental self-representation that might increase the risk for psychopathology.

Psychological Adjustment in Spain during the COVID-19 Pandemic: Positive and Negative Mental Health Outcomes in the General Population.

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.

Post-Traumatic Growth and Stress-Related Responses During the COVID-19 Pandemic in a National Representative Sample: The Role of Positive Core Beliefs About the World and Others.

Given the need to understand both the negative and positive psychological consequences of the current global COVID-19 pandemic (Brewin et al. in Perspectives in Public Health 10.1177/1757913920957365 2020), the aim of this study was to test a cognitive model of post-traumatic symptoms (PTS) and post-traumatic growth (PTG) during confinement caused by the SARS-COV-2 epidemic. In line with cognitive models of trauma elaboration (Park in Psychological Bulletin 10.1037/a0018301), we included in our model some beliefs associated to the world (e.g., primal beliefs about a good world), to the self (e.g., death anxiety or orientation toward the future) and to others (e.g., suspiciousness or identification with humanity). To evaluate the explanatory model, a national representative sample of adults between the ages of 18 and 75 (N = 1951) was surveyed between 7th and 13th April, 2020, in the middle of a strict 7-week national confinement. Structural equation modelling yielded a very similar model to the one initially specified. The results highlight the role of both negative and positive core beliefs, which are pertinent to the current pandemic threat, in the appearance of PTS and PTG, respectively. In short, primal beliefs about a good world, openness to the future and identification with humanity were associated with PTG; while suspiciousness, intolerance of uncertainty, anxiety about death and also identification with humanity were associated with PTS and consequent impairment. This is an innovative study of different pathways to traumatic responses and growth during a pandemic. Future research is needed to replicate its findings.

A symptom-based definition of resilience in times of pandemics: patterns of psychological responses over time and their predictors.

Background: It has been suggested that resilience is best conceptualized as healthy and stable functioning in the face of a potentially traumatic event. However, most research on this field has focused on self-reported resilience, and other patterns of response when facing adversity, in cross-sectional designs. Objective: Alternatively, we aimed to study changing patterns of psychological responses to the COVID-19 pandemic in the general population, based on patterns of symptoms, and factors contributing to those patterns. Method: A national representative sample of Spain (N = 1,628) responded to an internet-based survey at two assessment points, separated by 1 month (April and May 2020), during the official national confinement stage. Based upon whether participants exhibited absence/presence of distress (i.e., significant trauma-related, depression, or anxiety symptoms) at one or two of the assessment times, patterns of psychological responses were defined by categorizing individuals into one of the four categories: Resilience, Delayed distress, Recovered, and Sustained distress. Results: Analyses of the levels of disturbance associated with the symptoms provided support to that four-fold distinction of patterns of responses. Furthermore, resilience responses were the most common psychological response to the pandemic. Multinomial regression analyses revealed that the main variables increasing the probability of resilience to COVID-19 were being male, older, having no history of mental health difficulties, higher levels of psychological well-being and high identification with all humanity. Also, having low scores in several variables (i.e., anxiety and economic threat due to COVID-19, substance use during the confinement, intolerance to uncertainty, death anxiety, loneliness, and suspiciousness) was a significant predictor of a resilient response to COVID-19. Conclusion: Our findings are consistent with previous literature that conceptualizes resilience as a dynamic process. The clinical implications of significant predictors of the resilience and the rest of psychological patterns of response are discussed.

Antecedentes: Se ha sugerido que la mejor manera de conceptualizar la resiliencia es como un funcionamiento saludable y estable ante un evento potencialmente traumático. Sin embargo, la mayor parte de las investigaciones sobre la resiliencia y otras pautas de respuesta ante la adversidad se han centrado en el uso de cuestionarios de autoinforme de resiliencia en diseños transversales.Objetivo: Alternativamente, nuestro objetivo fue estudiar los cambios en los patrones de las respuestas psicológicas a la pandemia de COVID-19 en la población general y analizar de manera empírica las características que contribuyen a la respuesta resiliente.Métodos: Se utilizó una muestra nacional representativa española (N=1.628), que respondió a una encuesta realizada a través de Internet, en dos momentos de evaluación, separados por un mes, durante la etapa de confinamiento asociada a la pandemia (Abril y Mayo 2020). Se definieron los patrones de respuesta psicológica en función de la ausencia/presencia de malestar (v.g., síntomas significativos de estrés post-traumático, depresión y Ansiedad) en los dos momentos de evaluación, clasificando a los individuos en: resiliencia, malestar tardío, recuperación y malestar sostenido.Resultados: Análisis de los niveles de interferencia apoyaron estos cuatro de patrones dinámicos de respuesta psicológica. Además, la respuesta de resiliencia fue la más común frente a la pandemia. Un análisis de regresión multinomial indicó que los predictores de una mayor probabilidad de resiliencia fueron ser hombre, tener más edad, no tener antecedentes de salud mental, y altos niveles de identificación con la humanidad y de bienestar psicológico. Además, bajos niveles en otras variables (ansiedad y amenaza económica debida a la pandemia, consumo de sustancias durante el confinamiento, intolerancia a la incertidumbre, ansiedad ante la muerte, soledad, y desconfianza) fueron también predictores significativos de una respuesta de resiliencia psicológica al COVID-19.Conclusión: Nuestros hallazgos están en línea con la literatura previa que identifica la resiliencia como un patrón de respuesta común y un proceso dinámico. Se discuten las implicaciones clínicas de los predictores significativos de los cuatro diferentes patrones de respuesta.

Monitoring the psychological, social, and economic impact of the COVID-19 pandemic in the population: Context, design and conduct of the longitudinal COVID-19 psychological research consortium (C19PRC) study.

OBJECTIVES: The C19PRC study aims to assess the impact of the COVID-19 pandemic in the adult population of the UK, Republic of Ireland, and Spain. This paper describes the conduct of the first two waves of the UK survey (the "parent" strand of the Consortium) during March-April 2020. METHODS: A longitudinal, internet panel survey was designed to assess: (1) COVID-19 related knowledge, attitudes, and behaviors; (2) the occurrence of common mental health disorders as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Quota sampling (age, sex, and household income) was used to recruit a nationally representative sample of adults. RESULTS: Two thousand and twenty five adults were recruited at baseline, and 1406 were followed-up one-month later (69.4% retention rate). The baseline sample was representative of the UK population in relation to economic activity, ethnicity, and household composition. Attrition was predicted by key socio-demographic characteristics, and an inverse probability weighting procedure was employed to ensure the follow-up sample was representative of the baseline sample. CONCLUSION: The C19PRC study data has strong generalizability to facilitate and stimulate interdisciplinary research on important public health questions relating to the COVID-19 pandemic.