1
|
Goodman SH, Boden-Albala B, Drum E, Ryan N, Gibbs B, Gutierrez D, Runnerstrom MG, Wing JJ. A rapid assessment of depressive and anxious symptoms among university students during the COVID-19 public health emergency: A repeated cross-sectional analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 39303079 DOI: 10.1080/07448481.2024.2400114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 07/04/2024] [Accepted: 08/25/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVES To identify potential associations between student characteristics and mental health symptoms during the early parts of the pandemic. PARTICIPANTS 3,883 students at a large public university on the West Coast of the United States. METHODS We conducted a repeated cross-sectional survey to assess health-protective behaviors, mental health, social support, and stigma resistance. The survey was administered in April 2020 and again in November/December 2020. Odds of mental health symptoms were estimated using multinomial logistic regression. RESULTS 39% of respondents reported anxious symptoms, 9% reported depressive symptoms, and 27% reported both anxious and depressive symptoms. AAPI had lower odds of reporting both anxious/depressive symptoms compared to whites (OR = 0.59; 95% CI:0.43-0.81). CONCLUSION Students reported elevated levels of psychological stress during the pandemic, yet our results may underestimate the actual odds due to stress brought on by COVID-19.
Collapse
Affiliation(s)
- Sara H Goodman
- Department of Pediatrics - Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA
| | - Bernadette Boden-Albala
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
- Department of Health, Society, and Behavior, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
- Department of Neurology, School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
- Department of Epidemiology, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
| | - Emily Drum
- Department of Health, Society, and Behavior, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
| | - Nessa Ryan
- Department of Health, Society, and Behavior, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
| | - Brooke Gibbs
- Department of Health, Society, and Behavior, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
| | - Desiree Gutierrez
- Department of Health, Society, and Behavior, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, California, USA
| | - Miryha Gould Runnerstrom
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington, USA
| | - Jeffrey J Wing
- College of Public Health, Division of Epidemiology, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
2
|
Boutilier AJ, Clark KD, Bosse JD, Jackman KB, Jewell J, Dawson-Rose C. Social-ecological barriers and facilitators to seeking inpatient psychiatric care among transgender and nonbinary people: A qualitative descriptive study. J Adv Nurs 2024. [PMID: 39206720 DOI: 10.1111/jan.16393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 07/18/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
AIM(S) To assess barriers and facilitators to seeking inpatient psychiatric treatment among transgender and nonbinary people. DESIGN Qualitative interview study. METHODS Semi-structured interviews were conducted from March 2019 to June 2022 with transgender and nonbinary people admitted to an inpatient psychiatric hospital in the United States during the past 5 years. Data were analysed using thematic analysis and constructed within a modified social-ecological model of stigma. Standards for Reporting Qualitative Research were used for this study. RESULTS Participants (N = 15) described barriers and facilitators across all three social-ecological levels. i) Individual themes included distrust of the mental healthcare system, feeling unsafe, loss of autonomy, minimizing one's own mental health needs, and feelings of accountability to others. ii) Interpersonal themes included: lack of support for transgender/nonbinary identity, limited transgender/nonbinary knowledge among mental healthcare professionals, and allyship. iii) Structural themes included: carceral setting, financial costs, and availability of non-profit treatment options. CONCLUSION Multi-level themes were identified as barriers and facilitators to seeking inpatient psychiatric care for transgender and nonbinary people, providing opportunities among inpatient settings to improve care delivery and engagement. Greater health equity can be achieved by addressing barriers to care. IMPLICATIONS Incorporating inclusive and affirming practices in inpatient psychiatric services presents an opportunity to reduce barriers to seeking care. IMPACT The present study describes the experiences of transgender and nonbinary people as they determine whether to voluntarily seek inpatient psychiatric treatment. This perspective allows nurses, health systems, and policymakers to integrate transgender and nonbinary people's needs to improve healthcare delivery. PATIENT/PUBLIC CONTRIBUTION Transgender and nonbinary participants were recruited in collaboration with community organizations. Members of the transgender and nonbinary community participated in study design development and analysis and were part of the study team.
Collapse
Affiliation(s)
- Ava J Boutilier
- School of Medicine, Queens University, Kingston, Ontario, Canada
- College of Liberal Arts, University of new Hampshire, Durham, New Hampshire, USA
| | - Kristen D Clark
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- College of Health and Human Services, Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA
| | - Jordon D Bosse
- College of Nursing, University of Rhode Island, South Kingstown, Rhode Island, USA
| | - Kasey B Jackman
- School of Nursing, Columbia University, New York, New York, USA
- New York-Presbyterian Hospital, New York, New York, USA
| | - Jaylyn Jewell
- College of Health and Human Services, Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA
| | - Carol Dawson-Rose
- Department of Community Health Systems, School of Nursing, University of California san Francisco, San Francisco, California, USA
| |
Collapse
|
3
|
Fitzgerald E, Pokhvisneva I, Patel S, Yu Chan S, Peng Tan A, Chen H, Pelufo Silveira P, Meaney MJ. Microglial function interacts with the environment to affect sex-specific depression risk. Brain Behav Immun 2024; 119:597-606. [PMID: 38670238 DOI: 10.1016/j.bbi.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
There is a two-fold higher incidence of depression in females compared to men with recent studies suggesting a role for microglia in conferring this sex-dependent depression risk. In this study we investigated the nature of this relation. Using GWAS enrichment, gene-set enrichment analysis and Mendelian randomization, we found minimal evidence for a direct relation between genes functionally related to microglia and sex-dependent genetic risk for depression. We then used expression quantitative trait loci and single nucleus RNA-sequencing resources to generate polygenic scores (PGS) representative of individual variation in microglial function in the adult (UK Biobank; N = 54753-72682) and fetal (ALSPAC; N = 1452) periods. The adult microglial PGS moderated the association between BMI (UK Biobank; beta = 0.001, 95 %CI 0.0009 to 0.003, P = 7.74E-6) and financial insecurity (UK Biobank; beta = 0.001, 95 %CI 0.005 to 0.015, P = 2E-4) with depressive symptoms in females. The fetal microglia PGS moderated the association between maternal prenatal depressive symptoms and offspring depressive symptoms at 24 years in females (ALSPAC; beta = 0.04, 95 %CI 0.004 to 0.07, P = 0.03). We found no evidence for an interaction between the microglial PGS and depression risk factors in males. Our results illustrate a role for microglial function in the conferral of sex-dependent depression risk following exposure to a depression risk factor.
Collapse
Affiliation(s)
- Eamon Fitzgerald
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Canada; Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada.
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Sachin Patel
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Shi Yu Chan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore
| | - Ai Peng Tan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Diagnostic Imaging, National University Health System, Singapore; Brain - Body Initiative, Agency for Science, Technology & Research (A*STAR), Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Canada; Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Brain - Body Initiative, Agency for Science, Technology & Research (A*STAR), Singapore.
| |
Collapse
|
4
|
Beccia AL, Zubizarreta D, Austin SB, Raifman JR, Chavarro JE, Charlton BM. Trajectories of Mental Distress Among US Women by Sexual Orientation and Racialized Group During the First Year of the COVID-19 Pandemic. Am J Public Health 2024; 114:511-522. [PMID: 38598758 PMCID: PMC11008304 DOI: 10.2105/ajph.2024.307601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Objectives. To describe longitudinal trends in the prevalence of mental distress across the first year of the COVID-19 pandemic (April 2020‒April 2021) among US women at the intersection of sexual orientation and racialized group. Methods. Participants included 49 805 cisgender women and female-identified people from the COVID-19 Sub-Study, a cohort of US adults embedded within the Nurses' Health Studies 2 and 3 and the Growing Up Today Study. We fit generalized estimating equation Poisson models to estimate trends in depressive and anxiety symptoms by sexual orientation (gay or lesbian, bisexual, mostly heterosexual, completely heterosexual); subsequent models explored further differences by racialized group (Asian, Black, Latine, White, other or unlisted). Results. Relative to completely heterosexual peers, gay or lesbian, bisexual, and mostly heterosexual women had a higher prevalence of depressive and anxiety symptoms at each study wave and experienced widening inequities over time. Inequities were largest for sexual minority women of color, although confidence intervals were wide. Conclusions. The COVID-19 pandemic may have exacerbated already-glaring mental health inequities affecting sexual minority women, especially those belonging to marginalized racialized groups. Future research should investigate structural drivers of these patterns to inform policy-oriented interventions. (Am J Public Health. 2024;114(5):511-522. https://doi.org/10.2105/AJPH.2024.307601).
Collapse
Affiliation(s)
- Ariel L Beccia
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Dougie Zubizarreta
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - S Bryn Austin
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Julia R Raifman
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Jorge E Chavarro
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| | - Brittany M Charlton
- Ariel L. Beccia is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Dougie Zubizarreta is with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. S. Bryn Austin is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Julia R. Raifman is with the Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston. Jorge E. Chavarro is with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Brittany M. Charlton is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston
| |
Collapse
|
5
|
Vincent W. Willingness to Use Digital Health Screening and Tracking Tools for Public Health in Sexual Minority Populations in a National Probability Sample: Quantitative Intersectional Analysis. J Med Internet Res 2024; 26:e47448. [PMID: 38457790 PMCID: PMC10960216 DOI: 10.2196/47448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Little is known about sexual minority adults' willingness to use digital health tools, such as pandemic-related tools for screening and tracking, outside of HIV prevention and intervention efforts for sexual minority men, specifically. Additionally, given the current cultural climate in the United States, heterosexual and sexual minority adults may differ in their willingness to use digital health tools, and there may be within-group differences among sexual minority adults. OBJECTIVE This study compared sexual minority and heterosexual adults' willingness to use COVID-19-related digital health tools for public health screening and tracking and tested whether sexual minority adults differed from each other by age group, gender, and race or ethnicity. METHODS We analyzed data from a cross-sectional, national probability survey (n=2047) implemented from May 30 to June 8, 2020, in the United States during the height of the public health response to the COVID-19 pandemic. Using latent-variable modeling, heterosexual and sexual minority adults were tested for differences in their willingness to use digital health tools for public health screening and tracking. Among sexual minority adults, specifically, associations with age, gender, and race or ethnicity were assessed. RESULTS On average, sexual minority adults showed greater willingness to use digital health tools for screening and tracking than heterosexual adults (latent factor mean difference 0.46, 95% CI 0.15-0.77). Among sexual minority adults, there were no differences by age group, gender, or race or ethnicity. However, African American (b=0.41, 95% CI 0.19-0.62), Hispanic or Latino (b=0.36, 95% CI 0.18-0.55), and other racial or ethnic minority (b=0.54, 95% CI 0.31-0.77) heterosexual adults showed greater willingness to use digital health tools for screening and tracking than White heterosexual adults. CONCLUSIONS In the United States, sexual minority adults were more willing to use digital health tools for screening and tracking than heterosexual adults. Sexual minority adults did not differ from each other by age, gender, or race or ethnicity in terms of their willingness to use these digital health tools, so no sexual orientation-based or intersectional disparities were identified. Furthermore, White heterosexual adults were less willing to use these tools than racial or ethnic minority heterosexual adults. Findings support the use of digital health tools with sexual minority adults, which could be important for other public health-related concerns (eg, the recent example of mpox). Additional studies are needed regarding the decision-making process of White heterosexual adults regarding the use of digital health tools to address public health crises, including pandemics or outbreaks that disproportionately affect minoritized populations.
Collapse
Affiliation(s)
- Wilson Vincent
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, United States
| |
Collapse
|
6
|
Mirzayi C, Westmoreland D, Stief M, Grov C. Depression and Anxiety Symptoms Among Cisgender Gay and Bisexual Men During the Onset of the COVID-19 Pandemic: Time Series Analysis of a US National Cohort Study. JMIR Public Health Surveill 2024; 10:e47048. [PMID: 38277213 PMCID: PMC10858417 DOI: 10.2196/47048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/08/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic in the United States in March 2020 caused a dramatic change in the way many people lived. Few aspects of daily life were left undisrupted by the pandemic's onset as well as the accompanying policies to control the spread of the disease. Previous research has found that the pandemic may have significantly impacted the mental health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals-potentially more so than other individuals. However, the pandemic did not affect all areas of the United States at the same time, and there may be regional variation in the impact of the onset of the pandemic on depressive symptoms among LGBTQ individuals. OBJECTIVE To assess regional variation of the impact of the pandemic, we conducted a time series analysis stratified by US geographic region to examine symptoms of depression and anxiety among a sample of primarily cisgender gay and bisexual men before and after the onset of the COVID-19 pandemic in the United States. METHODS In total, 5007 participants completed assessments as part of the Together 5000 study, an ongoing prospective cohort study. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire-4. Patient Health Questionnaire-4 scores were graphed as a function of days from March 15, 2020. Locally estimated scatterplot smoothing trend lines were applied. A sieve-bootstrap Mann-Kendall test for monotonic trend was conducted to assess the presence and direction of trends in the scatterplots. We then compared the observed trends to those observed for 1 year prior (2018-2019) to the pandemic onset using data collected from the same sample. RESULTS Significant positive trends were detected for the Northeast (P=.03) and Midwest (P=.01) regions of the United States in the 2020 assessment, indicating that symptoms of anxiety and depression were increasing in the sample in these regions immediately prior to and during the onset of the pandemic. In contrast, these trends were not present in data from the 2018 to 2019 assessment window. CONCLUSIONS Symptoms of anxiety and depression increased among the study population in the Northeast and Midwest during the beginning months of the COVID-19 pandemic, but similar increase was not observed in the South and West regions. These trends were also not found for any region in the 2018 to 2019 assessment window. This may indicate region-specific trends in anxiety and depression, potentially driven by the burden of the pandemic and policies that varied from region to region. Future studies should consider geographic variation in COVID-19 spread and policies as well as explore potential mechanisms by which this could influence the mental health of LGBTQ individuals.
Collapse
Affiliation(s)
- Chloe Mirzayi
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Drew Westmoreland
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Matthew Stief
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| |
Collapse
|
7
|
Dearolf MH, D’Angelo AB, Grov C. 'You have to trust their word': transmasculine experiences with sex partners and safety during the early COVID-19 outbreak. CULTURE, HEALTH & SEXUALITY 2024; 26:77-92. [PMID: 36929822 PMCID: PMC10505243 DOI: 10.1080/13691058.2023.2187093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The early months of the SARS-CoV2 pandemic exacerbated health disparities for vulnerable populations, including transgender (trans) communities, creating unique challenges for navigating sex and dating. This paper aims to expand upon the current literature regarding transmasculine populations by capturing their lived experiences during this critical time. We interviewed 20 assigned female sex at birth (AFAB) adults of the transmasculine spectrum - men, nonbinary, and transmasculine individuals - about their social and sexual experiences in the USA in May and June 2020. Transcripts were analysed using an inductive thematic approach. We found that sex drive decreased and uncertainty about health risks increased. Some participants found alternate ways to date and hook-up that reduced their COVID-19 risk, such as engaging in online sex (e.g. sexting, dating apps). Others expressed discomfort using virtual platforms for both personal/work and sexual lives, along with nuanced feelings around being objectified, compared to pornography, and fetishised as trans bodies. COVID-related shutdowns of queer spaces also amplified pre-existing concerns about interpersonal safety and rejection. When seeking new partners, participants sought behavioural characteristics that instilled trust. Future public health communications can take advantage of safety and sexual health strategies already present in trans communities to bolster wellbeing in trans lives.
Collapse
Affiliation(s)
- Michelle H. Dearolf
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Alexis B. D’Angelo
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| |
Collapse
|
8
|
Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med 2024; 54:43-66. [PMID: 37615061 DOI: 10.1017/s0033291723002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The onset of the COVID-19 pandemic raised concerns regarding population-wide impacts on mental health. Existing work on the psychological impacts of disaster has identified the potential for multiple response trajectories, with resilience as likely as the development of chronic psychopathology. Early reviews of mental health during the pandemic suggested elevated prevalence rates of multiple forms of psychopathology, but were limited by largely cross-sectional approaches. We conducted a systematic review of studies that prospectively assessed pre- to peri-pandemic changes in symptoms of psychopathology to investigate potential mental health changes associated with the onset of the pandemic (PROSPERO #CRD42021255042). A total of 97 studies were included, covering symptom clusters including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), fear, anxiety, depression, and general distress. Changes in psychopathology symptoms varied by symptom dimension and sample characteristics. OCD, anxiety, depression, and general distress symptoms tended to increase from pre- to peri-pandemic. An increase in fear was limited to medically vulnerable participants, and findings for PTSD were mixed. Pre-existing mental health diagnoses unexpectedly were not associated with symptom exacerbation, except in the case of OCD. Young people generally showed the most marked symptom increases, although this pattern was reversed in some samples. Women in middle adulthood in particular demonstrated a considerable increase in anxiety and depression. We conclude that mental health responding during the pandemic varied as a function of both symptom cluster and sample characteristics. Variability in responding should therefore be a key consideration guiding future research and intervention.
Collapse
Affiliation(s)
- Mary Blendermann
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tracie I Ebalu
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Eiko I Fried
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
9
|
Choudhury S, Yeh PG, Zajack-Garcia KL, Markham CM. Exploring Sexual Orientation Disparities Regarding the Interplay of Childhood Sexual Abuse, Self-Reported Diabetes Status, and Depression Among Adults in the United States. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:26-42. [PMID: 37846854 DOI: 10.1080/10538712.2023.2270518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
Previous research has revealed a strong link between the experience of childhood sexual abuse (CSA) and diabetes in adulthood. Moreover, research has shown that sexual minorities (SM) are exposed to adverse childhood experiences (ACEs) (i.e. CSA) and experience depression at higher rates than their heterosexual counterparts. Thus, it is imperative to further investigate the role of depression and the differential associations of exposure to ACEs with diabetes prevalence by sexual orientation. We explored sexual orientation disparities regarding the relationship between CSA and diabetes and examined the moderating role of depression. A total of 29,903 participants from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. Secondary data analysis was conducted using the survey data, and weighted logistic regression and moderation analysis were performed. Heterosexuals who experienced CSA (AOR = 1.25; p < .05) and SM who experienced CSA (AOR = 2.13; p < .05) reported higher odds of having diabetes. Among heterosexuals, depression (AOR = 1.38; p < .001) was significantly associated with having diabetes. Additionally, depression was a significant moderator among heterosexuals with and without CSA. Further understanding of the impact of ACEs on diabetes among specific subgroups of SM should be assessed in future studies.
Collapse
Affiliation(s)
- Sumaita Choudhury
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Paul G Yeh
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Kaitlyn L Zajack-Garcia
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Christine M Markham
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| |
Collapse
|
10
|
Carosella KA, Wiglesworth A, Bendezú JJ, Brower R, Mirza S, Mueller BA, Cullen KR, Klimes-Dougan B. Patterns of experience, expression, and physiology of stress relate to depressive symptoms and self-injurious thoughts and behaviors in adolescents: a person-centered approach. Psychol Med 2023; 53:7902-7912. [PMID: 37609891 PMCID: PMC10755230 DOI: 10.1017/s0033291723002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/24/2023] [Accepted: 06/30/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Preliminary evidence shows that discordance in stress experience, expression, and physiology (EEP) in adolescents is linked to depression, suicidal ideation (SI), non-suicidal self-injury (NSSI), and brain functioning. This study employs person-centered analysis to probe the relationship between stress responses, psychopathology, and neural patterns in female adolescents who are oversampled for engagement in NSSI. METHODS Adolescent females (N = 109, ages 12-17) underwent a social stress test from which self-report measures of stress experience, observer ratings of stress expression, and physiological metrics of stress (via salivary cortisol) were obtained. Multi-trajectory modeling was employed to identify concordant and discordant stress EEP groups. Depressive symptoms, SI and attempt, NSSI engagement, frontal and limbic activation to emotional stimuli, and resting state fronto-limbic connectivity were examined in the EEP groups derived from the multi-trajectory models. RESULTS Four groups were identified, three of which demonstrated relatively concordant EEP and one which demonstrated discordant EEP (High Experience-High Expression-Low Physiology). Further, replicating past research, the High Experience-High Expression-Low Physiology discordant group exhibited higher depressive symptoms, SI, suicide attempt, and NSSI episodes (only for sensitivity analyses based on past year) relative to other EEP groups. No significant group differences in brain functioning emerged. CONCLUSION Results indicate that within-person, multi-level patterns in stress responding capture risk for dysfunction including depression and self-injurious thoughts and behaviors. Further interrogating of system-level stress functioning may better inform assessment and intervention efforts.
Collapse
Affiliation(s)
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Jason José Bendezú
- Department of Psychology, The Pennsylvania State University, University Park Campus, University Park, PA, USA
| | - Rylee Brower
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Salahudeen Mirza
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Bryon A. Mueller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kathryn R. Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| |
Collapse
|
11
|
Ghabrial MA, Scheim AI, Chih C, Santos H, Adams NJ, Bauer GR. Change in Finances, Peer Access, and Mental Health Among Trans and Nonbinary People During the COVID-19 Pandemic. LGBT Health 2023; 10:595-607. [PMID: 37347954 PMCID: PMC10712362 DOI: 10.1089/lgbt.2022.0296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Purpose: Due to structural transphobia, trans and nonbinary (TNB) individuals were particularly vulnerable to the negative effects of social isolation and financial instability resulting from COVID-19. The present study examined the effect of change in finances and access to TNB peer gatherings on anxiety and depression during the COVID-19 pandemic. Methods: Participants were 18 years and older (mean = 30) and completed prepandemic baseline (Fall 2019) and pandemic follow-up (Fall 2020) surveys. Multivariable regressions examined associations between mental health and change in (1) finances and (2) access to TNB peer gatherings (in person or online). Results: Of 780 participants, 50% reported that the COVID-19 pandemic had a negative impact on personal income and 58.3% reported negative impact on access to TNB peer gatherings. Depression and anxiety symptoms increased from prepandemic to follow-up, and most participants were above measurement cutoffs for clinical levels at both time points. Change in finances and access to TNB peer gatherings interacted with prepandemic depression scores to predict depression symptoms during the COVID-19 pandemic. For participants with high prepandemic depression scores, financial stability predicted pandemic depression scores comparable to that predicted by negative financial change. No interaction was found between these variables when predicting anxiety symptoms during the COVID-19 pandemic. Conclusion: Findings underscore the influence of inequality and prepandemic mental health when considering the impact of COVID-19 on wellbeing. Results suggest need for multifaceted programs and services, including financial support and meaningful TNB community engagement, to address barriers to health equity posed by systematic gender oppression.
Collapse
Affiliation(s)
- Monica A. Ghabrial
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ayden I. Scheim
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Caiden Chih
- Mechanical and Industrial Engineering and University of Toronto, Toronto, Ontario, Canada
| | - Heather Santos
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Noah James Adams
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Transgender Professional Association for Transgender Health, Canada
| | - Greta R. Bauer
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Institute for Sexual and Gender Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| |
Collapse
|
12
|
Bleckmann C, Leyendecker B, Busch J. Sexual and Gender Minorities Facing the Coronavirus Pandemic: A Systematic Review of the Distinctive Psychosocial and Health-Related Impact. JOURNAL OF HOMOSEXUALITY 2023; 70:2741-2762. [PMID: 35576127 DOI: 10.1080/00918369.2022.2074335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual and gender minorities (SGM) constitute vulnerable groups in many countries. Thus, they might be affected to a different extent than heterosexual and cisgender individuals by the Coronavirus pandemic. This systematic review aimed to summarize the state of international research on the mental and physical health-related as well as socioeconomic effects of the Coronavirus pandemic on SGM individuals. Following the PRISMA protocol, we identified 35 publications, including different article formats. We considered minority stress theory and intersectionality in synthesizing the reviewed literature. Our key finding implicates that both minority- and pandemic-specific adversities have increased the vulnerabilities of SGM individuals during the Coronavirus pandemic. Minority-specific stressors include discrimination experiences, poorer mental and physical health, and fewer socioeconomic resources. Pandemic-specific challenges such as the deferral and delay of medication or school closing have exposed certain SGM subgroups (transgender individuals, young SGM) to particularly high risk. Moreover, the reviewed evidence suggests distinctive interactive effects of minority-specific stressors with pandemic-specific challenges (e.g., being forced to stay close to rejecting others during lockdown periods). A significant share of the included literature was US-based, while research from other countries remained scarce. The specific mechanisms still deserve to be better understood to protect SGM in future crises, especially during pandemics.
Collapse
Affiliation(s)
- Clara Bleckmann
- Child and Family Research, Ruhr-University Bochum, Bochum, Germany
| | | | - Julian Busch
- Child and Family Research, Ruhr-University Bochum, Bochum, Germany
- Center for Research on Education and School Development, TU Dortmund University, Dortmund, Germany
| |
Collapse
|
13
|
Hope VD, Timpson H, Porcellato L, Brett CE, Harrison R, Hunt A, Bigland C, Leavey C, Hay G, Saini P. Did the UK's COVID-19 restrictions during 2020 have a differential impact on the well-being of the LGBQ+ population: a mixed methods study. BMJ Open 2023; 13:e068818. [PMID: 37813541 PMCID: PMC10565157 DOI: 10.1136/bmjopen-2022-068818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 08/24/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE The social distancing measures governments implemented in response to the COVID-19 pandemic have had substantial impacts. For some communities, these impacts will be disproportionate, with those communities experiencing inequalities, marginalisation or discrimination facing specific challenges. Lesbian, gay, bisexual, queer and allied (LGBQ+) communities experience a range of well-being inequalities that may have been impacted by the pandemic. The study aimed to assess the comparative impact of the UK's response to COVID-19 on LGBQ+ communities. DESIGN A mixed-method explanatory sequential study of the general population using a cross-sectional online survey and semistructured interviews. SETTING Community, North West of England. PARTICIPANTS Adults aged 18 years and over; 1540 participated in the survey (192, 12%, LGBQ+) with 49 undergoing semistructured interviews (15 LGBQ+) during spring and summer of 2020. RESULTS Survey findings indicated that LGBQ+ people experienced similar positive and negative impacts to the rest of the population, but some negative impacts were more marked among the LGBQ+ community. LGBQ+ participants were more likely to disagree that 'the government considered the impact on people like you' when preparing guidance. They were significantly more likely to report being unable to access sufficient food and required medication, eating less healthily, exercising less regularly, experiencing poorer quality sleep and taking more pain medicine than usual. Interview data supported these differences; isolation, being unable to access social networks and concerns about health were commonly discussed by the LGBQ+ participants. Positive impacts, including better work-life balance, were similar across both groups. CONCLUSIONS The findings indicate LGBQ+ communities' wellbeing inequalities have been compounded by the social distancing restrictions, for example, by impacts on social networks increasing loneliness. Preparedness planning for future pandemics should include equality impact assessments for potential interventions.
Collapse
Affiliation(s)
- Vivian D Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Hannah Timpson
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Caroline E Brett
- School of Psychology, Liverpool John Moores University, Liverpool, UK
- School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Rebecca Harrison
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Anna Hunt
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Charlotte Bigland
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Conan Leavey
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Gordon Hay
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Pooja Saini
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
14
|
Parenteau AM, Boyer CJ, Campos LJ, Carranza AF, Deer LK, Hartman DT, Bidwell JT, Hostinar CE. A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience. Dev Psychopathol 2023; 35:1821-1842. [PMID: 36097815 PMCID: PMC10008755 DOI: 10.1017/s0954579422000499] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Social and economic inequality are chronic stressors that continually erode the mental and physical health of marginalized groups, undermining overall societal resilience. In this comprehensive review, we synthesize evidence of greater increases in mental health symptoms during the COVID-19 pandemic among socially or economically marginalized groups in the United States, including (a) people who are low income or experiencing homelessness, (b) racial and ethnic minorities, (c) women and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) communities, (d) immigrants and migrants, (e) children and people with a history of childhood adversity, and (f) the socially isolated and lonely. Based on this evidence, we propose that reducing social and economic inequality would promote population mental health and societal resilience to future crises. Specifically, we propose concrete, actionable recommendations for policy, intervention, and practice that would bolster five "pillars" of societal resilience: (1) economic safety and equity, (2) accessible healthcare, including mental health services, (3) combating racial injustice and promoting respect for diversity, equity, and inclusion, (4) child and family protection services, and (5) social cohesion. Although the recent pandemic exposed and accentuated steep inequalities within our society, efforts to rebuild offer the opportunity to re-envision societal resilience and policy to reduce multiple forms of inequality for our collective benefit.
Collapse
Affiliation(s)
- Anna M. Parenteau
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | - Chase J. Boyer
- Department of Human Ecology, University of California-Davis
| | | | | | - LillyBelle K. Deer
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | | | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, University of California-Davis
| | - Camelia E. Hostinar
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| |
Collapse
|
15
|
Connolly DJ, Eraslan E, Gilchrist G. Coronavirus (COVID-19) and sexualised drug use among men who have sex with men: a systematic review. Sex Health 2023; 20:375-384. [PMID: 37460309 DOI: 10.1071/sh23071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/27/2023] [Indexed: 10/12/2023]
Abstract
Drug-related harms, including harms from sexualised drug use (SDU), are disproportionately experienced by sexual and gender minority people, relative to their majority counterparts. Chemsex, a type of SDU practiced mainly by MSM, is associated with methamphetamine use and increased HIV seropositivity or risk of acquisition. Therefore, participants are at increased risk of immunocompromise. Existing evidence suggests that drug use increases following natural disasters. The impact of coronavirus disease 2019 (COVID-19) on chemsex is unknown. A PRISMA-adherent systematic review was conducted to synthesise reports of changes in the prevalence, frequency, or characteristics of drug use (and factors associated with these changes) following the onset of the COVID-19 pandemic. This report presents findings related to SDU/chemsex among MSM. A comprehensive search across nine databases, supplemented with backward-forward citation searching and contact with key opinion leaders, was conducted. Two reviewers carried out title-abstract screening, full-text screening, and data extraction. Following a final, single database search, nine studies were included in the narrative synthesis. More than half the sample were studies investigating HIV pre-exposure prophylaxis use. Twenty percent of participants in most studies reported chemsex participation. In four, participants reported a net increase or maintenance of chemsex participation during the pandemic and five reported a net decrease. Increased chemsex participation was associated with loneliness, cravings, and working during the pandemic. Decreased chemsex practice was associated with COVID-19-related fear. This synthesis suggests that chemsex practice continued, and for some MSM increased, throughout COVID-19 pandemic 'lockdowns'. This may have increased COVID-19 transmission and severity among potentially vulnerable MSM.
Collapse
Affiliation(s)
- Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Windsor Walk, London, UK
| | - Ece Eraslan
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Windsor Walk, London, UK
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Windsor Walk, London, UK
| |
Collapse
|
16
|
Peyer KL, Hogg JA, Carlson LM, Sa J. The relationship between physical activity, stress, and resilience in sexual and gender minority college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 37607032 DOI: 10.1080/07448481.2023.2248508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/29/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To assess the role of sexual orientation and gender identity in the relationship between physical activity (PA), stress and resilience. PARTICIPANTS A nationally-representative sample of students (n = 91,718) from United States postsecondary institutions. METHODS Students reported aerobic and strength training (ST) behaviors, stress, resilience, gender identity and sexual orientation. Moderated regressions examined the influence of gender identity and sexual orientation on the relationship between PA and stress or resilience. RESULTS Men and heterosexual students reported higher PA and resilience and lower stress than did women, gender minorities, and sexual minorities. Significant moderation was found for women, queer students, bisexual students, trans women and lesbians in the various models. CONCLUSIONS Gender minority and sexual minority students display poorer levels of PA and mental health than cisgender and heterosexual counterparts, but this relationship varies by identity group.
Collapse
Affiliation(s)
- Karissa L Peyer
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Jennifer A Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Lynette M Carlson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Jaesin Sa
- School of Health Promotion and Kinesiology, Texas Women's University, Denton, Texas, USA
| |
Collapse
|
17
|
Scarfe ML, Belisario K, Gillard J, De Jesus J, Frey BN, Van Ameringen M, McKinnon MC, Gohari MR, Busse JW, MacKillop J. Periodicity and severity of changes in depression and anxiety during the COVID-19 pandemic: Ten-wave longitudinal findings from an observational cohort study of community adults. Psychiatry Res 2023; 326:115267. [PMID: 37295351 PMCID: PMC10211253 DOI: 10.1016/j.psychres.2023.115267] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
AIMS Few multi-wave longitudinal studies have examined mental health changes across the coronavirus 2019 (COVID-19) pandemic. The current study examined: (a) overall changes in depression and anxiety over 10-waves of data collection; (b) subgroup moderators of changes; (c) clinical severity of the changes via minimally important differences (MIDs); and (d) correlates of clinically important changes. METHODS Using a longitudinal observational cohort design, 1412 non-clinical adults (Mage=36; 60% female) were assessed for depression and anxiety via the PHQ-9 and GAD-7 from October 2018 to April 2022 (3 pre-pandemic, 7 intra-pandemic waves; M retention = 92%). RESULTS Depression and anxiety exhibited significant intra-pandemic changes, reflecting initial increases, followed by decreases. Pre-pandemic severity moderated changes, with low severity participants exhibiting increases and high severity participants exhibiting non-significant change or decreases. For depression and anxiety, respectively, 10% and 11% exhibited MID increases, while 4% and 6% exhibited MID decreases. Divergent patterns were present by severity subgroup, with the lowest severity exhibiting higher rates of MID increases and the highest severity subgroup exhibiting higher rates of MID decreases. CONCLUSIONS These findings illuminate the periodicity of depression and anxiety during the COVID-19 pandemic and reveal an unexpected inverse relationship between increases and decreases based on pre-pandemic severity.
Collapse
Affiliation(s)
- Molly L Scarfe
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario L8P 3R2, Canada; St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario L8P 3R2, Canada; St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Jessica Gillard
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario L8P 3R2, Canada; St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Jane De Jesus
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario L8P 3R2, Canada; St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Benicio N Frey
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada
| | - Margaret C McKinnon
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada
| | - Mahmood R Gohari
- School of Public Health Sciences, University of Waterloo, Canada
| | - Jason W Busse
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Department of Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario L8P 3R2, Canada; Department of Psychology Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada; Homewood Research Institute, Guelph, Ontario, Canada.
| |
Collapse
|
18
|
Gattamorta KA, Vega G, Kania V. Impact of Living Arrangements of LGBTQ College Students During COVID-19. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2023; 61:251-265. [PMID: 38586549 PMCID: PMC10997324 DOI: 10.1080/19496591.2023.2186241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
This study examines the relationships between living arrangements and educational outcomes, access to LGBTQ affirming care, sexual and gender minority (SGM) stressors, and mental health. Bivariate analyses were implemented to examine relationships between living arrangements and academic outcomes, SGM stressors, access to care, and alcohol and substance use. Differences between undergraduate and graduate students are also reported. Students who continued living on campus were less likely to report increased family rejection, transphobia, and identity concealment.
Collapse
|
19
|
Godara M, Rademacher J, Hecht M, Silveira S, Voelkle MC, Singer T. Heterogeneous Mental Health Responses to the COVID-19 Pandemic in Germany: An Examination of Long-Term Trajectories, Risk Factors, and Vulnerable Groups. Healthcare (Basel) 2023; 11:1305. [PMID: 37174848 PMCID: PMC10177770 DOI: 10.3390/healthcare11091305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Abundant studies have examined mental health in the early periods of the COVID-19 pandemic. However, empirical work examining the mental health impact of the pandemic's subsequent phases remains limited. In the present study, we investigated how mental vulnerability and resilience evolved over the various phases of the pandemic in 2020 and 2021 in Germany. Data were collected (n = 3522) across seven measurement occasions using validated and self-generated measures of vulnerability and resilience. We found evidence for an immediate increase in vulnerability during the first lockdown in Germany, a trend towards recovery when lockdown measures were eased, and an increase in vulnerability with each passing month of the second lockdown. Four different latent trajectories of resilience-vulnerability emerged, with the majority of participants displaying a rather resilient trajectory, but nearly 30% of the sample fell into the more vulnerable groups. Females, younger individuals, those with a history of psychiatric disorders, lower income groups, and those with high trait vulnerability and low trait social belonging were more likely to exhibit trajectories associated with poorer mental well-being. Our findings indicate that resilience-vulnerability responses in Germany during the COVID-19 pandemic may have been more complex than previously thought, identifying risk groups that could benefit from greater support.
Collapse
Affiliation(s)
- Malvika Godara
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany; (J.R.); (S.S.); (T.S.)
| | - Jessie Rademacher
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany; (J.R.); (S.S.); (T.S.)
| | - Martin Hecht
- Department of Psychology, Helmut Schmidt University, 22043 Hamburg, Germany;
| | - Sarita Silveira
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany; (J.R.); (S.S.); (T.S.)
| | - Manuel C. Voelkle
- Institute of Psychology, Humboldt University of Berlin, 10117 Berlin, Germany;
| | - Tania Singer
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany; (J.R.); (S.S.); (T.S.)
| |
Collapse
|
20
|
Salerno JP, Doan L, Sayer LC, Drotning KJ, Rinderknecht RG, Fish JN. Changes in Mental Health and Well-Being Are Associated With Living Arrangements With Parents During COVID-19 Among Sexual Minority Young Persons in the U.S. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2023; 10:150-156. [PMID: 37283818 PMCID: PMC10241357 DOI: 10.1037/sgd0000520] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Sexual minority young persons may be at risk for compounding mental health effects of the COVID-19 pandemic due to their existing vulnerabilities for psychological inequities. Indeed, recent research has documented that sexual minority young persons are experiencing compounding psychiatric effects associated with the COVID-19 pandemic. Further, researchers and practitioners hypothesized that sexual minority youth and young adults may experience unique hardships related to their sexual and gender identities and familial conflict as a result of the COVID-19 pandemic and living arrangement changes with their parents and families. This study aims to investigate whether there are changes in sexual minority (and non-sexual minority) young adults' (SMYAs) mental health and wellbeing among those living with and living without their parents before and after the start of COVID-19. Among a cross-sectional sample of SMYAs (n=294; Mage=22 years; age range=18-26) and non-SMYAs (n=874; Mage=22 years; age range=18-26) defined by whether they were living with or living without their parents before and after the start of COVID-19, we retrospectively analyzed changes in psychological distress and wellbeing. SMYAs who returned to their parents' homes during post-onset of COVID-19 reported greater mental distress and lower wellbeing, followed by those who were living with their parents both before and after the start of COVID-19. Patterns were not consistent among non-SMYAs, and lower magnitudes of change were seen. There is a significant public health need for mental health services and family education resources for supporting SMYAs in the context of COVID-19 and beyond.
Collapse
Affiliation(s)
- John P. Salerno
- Department of Behavioral & Community Health, School of Public Health, University of Maryland, College Park, Maryland, United States, 4200 Valley Drive, Suite 1234, College Park, MD, USA 20742
| | - Long Doan
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - Liana C. Sayer
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - Kelsey J. Drotning
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - R. Gordon Rinderknecht
- Max Planck Institute for Demographic Research, Laboratory of Digital and Computational Demography, Rostock, Germany
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, United States, 4200 Valley Drive, Suite 1234, College Park, MD, USA 20742
| |
Collapse
|
21
|
Tessier AJ, Moyen A, Lawson C, Rappaport A, Yousif H, Fleurent-Grégoire C, Lalonde-Bester S, Brazeau AS, Chevalier S. Lifestyle Behaviour Changes and Associated Risk Factors During the COVID-19 Pandemic: results of the Canadian COVIDiet Online Cohort Study. JMIR Public Health Surveill 2023; 9:e43786. [PMID: 36848226 PMCID: PMC10131911 DOI: 10.2196/43786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and related lockdowns have impacted lifestyle behaviours including eating habits and physical activity; yet few studies identified emerging patterns of such changes and associated risk factors. OBJECTIVE To identify patterns of weight and lifestyle behaviour change, and potential risk factors, resulting from the pandemic in Canadian adults. METHODS Analyses were conducted on 1,609 adults (18-89 y; 90.1% women; 81.8% White) of the Canadian COVIDiet study baseline data (May-Dec 2020). Self-reported current and pre-pandemic weight, physical activity, smoking status, perceived eating habits, alcohol intake and sleep quality were collected by online questionnaires. Based on these 6 indicator variables, latent class analysis (LCA) was used to identify lifestyle behaviour change patterns. Associations with potential risk factors including age, gender, ethnicity, education, income, chronic diseases, body image perception, and changes in stress level, living situation and work arrangement were examined with logistic regressions. RESULTS Participants' mean BMI was 26.1 ± 6.3 kg/m2; 60.9% had >= bachelor's degree. Since the pandemic, 35% had decreased income and 49% changed work arrangement. Most participants reported unchanged weight, sleep quality, physical activity level, smoking and alcohol consumption, yet 44% reported a perceived decrease in eating habits quality. From LCA, 2 classes of lifestyle behaviour change emerged; "healthy" and "less healthy" (probability: 0.605 and 0.395; BIC=15574.3, entropy=4.8). "Healthy" class participants more frequently reported unchanged weight, sleep quality, smoking and alcohol intake, unchanged/improved eating habits and increased physical activity. The "less healthy" class reported significant weight gain, deteriorated eating habits and sleep quality, unchanged/increased alcohol intake and smoking, and decreased physical activity. Among risk factors, body image dissatisfaction OR=8.8, 95%CI (5.3-14.7), depression OR=1.8, 95%CI (1.3, 2.5), increased stress level OR=3.4, 95%CI (2.0, 5.8) and of gender minority identity OR=5.5, 95% CI (1.3-22.3) were associated with adopting "less healthy" behaviours in adjusted models. CONCLUSIONS The COVID-19 pandemic appeared to have influenced lifestyle behaviours unfavorably in some, but favorably in others. Body image perception, change in stress level and gender identity were factors associated with behaviour change patterns; whether these will sustain overtime remains to be studied. Findings provide insights to develop strategies in supporting adults with poorer mental well-being in the post-pandemic context and promoting healthful behaviours during future disease outbreaks. CLINICALTRIAL This study was registered on ClinicalTrials.gov (NCT04407533).
Collapse
Affiliation(s)
| | - Audrey Moyen
- McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, CA
| | - Claire Lawson
- McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, CA
| | - Aviva Rappaport
- McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, CA
| | - Hiba Yousif
- McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, CA
| | | | | | | | | |
Collapse
|
22
|
McKenna VS, Gustin RL, Hobek AL, Howell RJ, Dickinson TE, Shanley SN, Patel TH. Factors Related to Treatment Attendance for Patients Seeking Gender-Affirming Voice Therapy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:216-233. [PMID: 36584326 DOI: 10.1044/2022_ajslp-22-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate factors related to treatment attendance for patients seeking gender-affirming voice therapy (GAVT). METHOD We completed retrospective chart reviews of 50 patients (43 transgender women, three transgender men, four nonbinary patients; aged 18-67 years, M = 34.92 years, SD = 12.32 years) referred for GAVT at a Midwest outpatient center from 2016 to 2021. Data extraction included patient demographics, therapy visit specifics (e.g., number of sessions attended, treatment completion status, and in-person vs. virtual visits) and treatment timing (in relation to the onset of the COVID-19 pandemic), and psychosocial and socioeconomic information. RESULTS There was no impact of treatment-timing relative to the onset of the pandemic on any attendance measure; however, patients were 1.9 times more likely to complete therapy with each virtual telehealth session attended. Individual factors of outside social support and hormone replacement therapy were positively related to the number of therapy sessions attended, whereas insurance provider and employment status were related to therapy completion. CONCLUSIONS Telehealth attendance during the COVID-19 pandemic was positively associated with GAVT completion. Future research should investigate psychosocial and socioeconomic factors to understand how to identify patients at risk for poor treatment adherence and facilitate access to clinical care.
Collapse
Affiliation(s)
- Victoria S McKenna
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Biomedical Engineering, University of Cincinnati, OH
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Renee L Gustin
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Amy L Hobek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Rebecca J Howell
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, OH
| | - Tara E Dickinson
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Savannah N Shanley
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Tulsi H Patel
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| |
Collapse
|
23
|
Ponjoan A, Jacques-Aviñó C, Medina-Perucha L, Romero V, Martí-Lluch R, Alves-Cabratosa L, Ramos R, Berenguera A, Garcia-Gil MDM. Axes of social inequities in COVID-19 clinical trials: A systematic review. Front Public Health 2023; 11:1069357. [PMID: 36891333 PMCID: PMC9987589 DOI: 10.3389/fpubh.2023.1069357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results). Methods We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them. Results Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health. Conclusions Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
Collapse
Affiliation(s)
- Anna Ponjoan
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Constanza Jacques-Aviñó
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Laura Medina-Perucha
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Victor Romero
- Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain
| | - Ruth Martí-Lluch
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lia Alves-Cabratosa
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
| | - Rafel Ramos
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Department of Medical Sciences, School of Medicine, Universitat de Girona, Girona, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain.,Department of Nursing, Universitat de Girona, Girona, Spain
| | - María Del Mar Garcia-Gil
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
| |
Collapse
|
24
|
Adzrago D, Sulley S, Tagoe I, Odame E, Mamudu L, Williams F. Association between COVID-19 pandemic declaration and depression/anxiety among U.S. adults. PLoS One 2022; 17:e0279963. [PMID: 36584212 PMCID: PMC9803300 DOI: 10.1371/journal.pone.0279963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although studies have investigated the impact of the COVID-19 on mental health, few studies have attempted to compare the prevalence of depression/anxiety symptoms among U.S. adults before and after the COVID-19 pandemic declaration. We examined the prevalence and association between depression/anxiety symptoms and COVID-19 pandemic declaration among U.S. adult population and subgroups. METHODS A nationally representative cross-sectional study of the Health Information National Trends Survey (HINTS 5, Cycle 4) assessing health-related information and behaviors in U.S. adults aged ≥18 years from February through June 2020. The primary dependent variable was current depression/anxiety derived from Patient Health Questionnaire-4. The main independent variable was responses before and after the COVID-19 pandemic declaration in addition to sexual identity heterosexual identity, /race/ethnicity and rural-urban commuting areas. Covariates were sociodemographic factors, and health risk behaviors. Weighted percentages, multivariable logistic regression, and Chi-square tests were used to establish the prevalence and association between current depression/anxiety and the independent variables and covariates. RESULTS A total of 3,865 participants completed the survey and included 35.3% of the participants before the COVID-19 pandemic declaration. Most of the sample were aged 50-64 years [33.0%]; males [51.0%]; and non-Hispanic Whites [70.1%]). The post-pandemic declaration included participants, aged 35-49 years [27.0%]; females [52.6%]; and non-Hispanic Whites [59.6%]). The prevalence of depression/anxiety was higher after the COVID-19 pandemic declaration (32.2%) than before the declaration (29.9%). Higher risks of depression/anxiety symptoms after the declaration were associated with being a sexual minority ([adjusted odds ratio] AOR, 2.91 [95% confidence interval (CI), 1.38-6.14]) and having fair/poor general health (AOR, 2.91 [95% CI, 1.76-4.83]). The probability of experiencing depression/anxiety symptoms after the declaration was highest among homosexuals/lesbians/gays (65.6%) compared to bisexuals (39.6%), and heterosexuals (30.1%). CONCLUSIONS In this study, young adults, non-Hispanic Whites, and those with fair/poor general health had a higher burden of depression/anxiety symptoms after the pandemic declaration. The development of psychological support strategies to promote wellbeing during the pandemic may reduce psychological distress in the population, especially among at-risk populations.
Collapse
Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, Houston, Texas, United States of America
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC, United States of America
| | - Ishmael Tagoe
- School of Population Health, University of Toledo, Toledo, Ohio, United States of America
| | - Emmanuel Odame
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, California, United States of America
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
25
|
Gill EK, McQuillan MT. LGBTQ+ Students' Peer Victimization and Mental Health before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11537. [PMID: 36141809 PMCID: PMC9517503 DOI: 10.3390/ijerph191811537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Given the well-established health disparities between lesbian, gay, bisexual, transgender, queer, and gender-expansive (LGBTQ+) and cisgender, straight youth, scholars predicted the COVID-19 pandemic would disproportionately impact LGBTQ+ students. Yet, few studies have described changes in LGBTQ+ students' school experiences and well-being during the pandemic. Using survey data from 40,904 middle and high school students, we examined changes from before (2018) to during (2021) the pandemic in peer victimization, anxiety, and suicide attempts. We conducted bivariate and multivariate regression analyses to assess changes between the two time points among LGBTQ+ and cisgender, straight students. We found LGBTQ+ students experienced more peer victimization, anxiety, and suicide attempts at both points, before and during the pandemic, than cisgender, straight youth. However, LGBTQ+ students reported increased anxiety, decreased peer victimization, and decreased suicide attempts in 2021, during the pandemic, compared to pre-pandemic 2018 reports. These findings suggest pandemic-related school disruptions may have provided LGBTQ+ students some relief from the harmful effects of poor, in-person school climates.
Collapse
Affiliation(s)
- Erin K. Gill
- Department of Educational Leadership and Policy Analysis, University of Wisconsin-Madison, Madison, WI 53706, USA
| | | |
Collapse
|
26
|
Dal Santo T, Sun Y, Wu Y, He C, Wang Y, Jiang X, Li K, Bonardi O, Krishnan A, Boruff JT, Rice DB, Markham S, Levis B, Azar M, Neupane D, Tasleem A, Yao A, Thombs-Vite I, Agic B, Fahim C, Martin MS, Sockalingam S, Turecki G, Benedetti A, Thombs BD. Systematic review of mental health symptom changes by sex or gender in early-COVID-19 compared to pre-pandemic. Sci Rep 2022; 12:11417. [PMID: 35794116 PMCID: PMC9258011 DOI: 10.1038/s41598-022-14746-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/13/2022] [Indexed: 01/12/2023] Open
Abstract
Women and gender-diverse individuals have faced disproportionate socioeconomic burden during COVID-19. There have been reports of greater negative mental health changes compared to men based on cross-sectional research that has not accounted for pre-COVID-19 differences. We compared mental health changes from pre-COVID-19 to during COVID-19 by sex or gender. MEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), Web of Science Core Collection: Citation Indexes, China National Knowledge Infrastructure, Wanfang, medRxiv (preprints), and Open Science Framework Preprints (preprint server aggregator) were searched to August 30, 2021. Eligible studies included mental health symptom change data by sex or gender. 12 studies (10 unique cohorts) were included, all of which reported dichotomized sex or gender data. 9 cohorts reported results from March to June 2020, and 2 of these also reported on September or November to December 2020. One cohort included data pre-November 2020 data but did not provide dates. Continuous symptom change differences were not statistically significant for depression (standardized mean difference [SMD] = 0.12, 95% CI -0.09-0.33; 4 studies, 4,475 participants; I2 = 69.0%) and stress (SMD = - 0.10, 95% CI -0.21-0.01; 4 studies, 1,533 participants; I2 = 0.0%), but anxiety (SMD = 0.15, 95% CI 0.07-0.22; 4 studies, 4,344 participants; I2 = 3.0%) and general mental health (SMD = 0.15, 95% CI 0.12-0.18; 3 studies, 15,692 participants; I2 = 0.0%) worsened more among females/women than males/men. There were no significant differences in changes in proportions above cut-offs: anxiety (difference = - 0.05, 95% CI - 0.20-0.11; 1 study, 217 participants), depression (difference = 0.12, 95% CI -0.03-0.28; 1 study, 217 participants), general mental health (difference = - 0.03, 95% CI - 0.09-0.04; 3 studies, 18,985 participants; I2 = 94.0%), stress (difference = 0.04, 95% CI - 0.10-0.17; 1 study, 217 participants). Mental health outcomes did not differ or were worse by small amounts among women than men during early COVID-19.
Collapse
Affiliation(s)
- Tiffany Dal Santo
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Yutong Wang
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Xiaowen Jiang
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Kexin Li
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Olivia Bonardi
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, QC, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Amina Tasleem
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Anneke Yao
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Ian Thombs-Vite
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Michael S Martin
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Correctional Service of Canada, Ottawa, ON, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
- Department of Medicine, McGill University, Montréal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada.
- Department of Psychiatry, McGill University, Montréal, QC, Canada.
- Department of Psychology, McGill University, Montréal, QC, Canada.
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.
- Department of Medicine, McGill University, Montréal, QC, Canada.
- Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.
- Biomedical Ethics Unit, McGill University, Montréal, QC, Canada.
| |
Collapse
|
27
|
Hussain N, Li B. Mental Health Survey of Social Entrepreneurs During COVID-19: A Study From Pakistan. Front Psychiatry 2022; 13:849085. [PMID: 35815010 PMCID: PMC9260419 DOI: 10.3389/fpsyt.2022.849085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background COVID-19 is widely considered one of the worst pandemics in history, resulting in worldwide lockdowns, social isolation, unemployment, and economic recession. With the prolongation of COVID-19, numerous people experience stress, depression, and other mental health challenges. Recently, several studies have been documented in the literature on mental health issues among students (related to medical or other fields), teachers, medical personnel, and nurses in the wake of the COVID-19 pandemic. However, social entrepreneurs (SEs) have received insufficient attention. This study aims to conduct an online survey in Pakistan's five major cities to investigate more about the mental health status of social entrepreneurs. Materials and Methods An online survey which included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) was employed to collect data. The data analyses were carried out employing descriptive statistics, chi-square test, and multiple regression analyses. Results A total of 840 social entrepreneurs from Pakistan participated in the survey. Among these, 366 (43.6%) were female and 474 (56.4%) were male. The findings revealed that 709 (84%) social entrepreneurs were suffering from depression symptoms, and 600 (80%) were suffering from anxiety symptoms. The majority of social entrepreneurs with depression (N = 546) and anxiety (N = 567) had mild and moderate stages. In addition, optional open-ended questions were asked from SE participants that help to understand their perception and response to the COVID-19 pandemic. Conclusion The study concluded that several SEs in major cities of Pakistan were experiencing depression and anxiety symptoms. Based on data analysis, male SEs were highly suffering from depression and anxiety than female SEs. Limited resources and changes in customers' behavior were one of the major problems that lead SEs to depression and anxiety during the COVID-19 epidemic. In addition, SEs revealed that the lack of a social business execution policy is the most distressing factor for them. Therefore, a local government must take rigorous precautionary measures to prevent mental health issues among social entrepreneurs. Moreover, the Government of Pakistan needs to adopt supportive policies to assist social entrepreneurs in stressful circumstances.
Collapse
Affiliation(s)
- Nida Hussain
- Business School, Zhengzhou University, Zhengzhou, China
- Yunus Social Business Center, Zhengzhou University, Zhengzhou, China
| | - Baoming Li
- Business School, Zhengzhou University, Zhengzhou, China
- Yunus Social Business Center, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
28
|
López-Sáez MÁ, Platero RL. Spanish youth at the crossroads of gender and sexuality during the COVID-19 pandemic. EUROPEAN JOURNAL OF WOMEN'S STUDIES 2022. [PMCID: PMC8795754 DOI: 10.1177/13505068221076319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examines some of the perceptions amongst Spanish LGBTQ+ youth during the first wave of the COVID-19 pandemic and the subsequent confinement and lockdown measures, between March and May 2020. During this time, many of these young people were forced to return to their family homes and restrict their social relations. This new situation often exposed them to forms of violence from which there was no escape, with negative consequences for their psychosocial health. The study evaluates the correlations between perceived social support, burdensomeness, thwarted belongingness and the people with whom LGBTQ+ youth lived during confinement. A descriptive and multivariate analysis of variance (MANOVA) and bivariate correlations is used to examine the responses of 394 LGBTQ+ youth, between 17 and 21 years of age, residing in Spain. Overall, the study finds that gender is key when explaining the differences between the experiences of LGBTQ+ youth, with women and non-binary individuals experiencing a greater perception of stigma in the places where they lived during the lockdown. Moreover, trans men and women and non-binary individuals reported receiving less support and a greater feeling of burdensomeness then the other participants. These results suggest that LGBTQ+ youth must be given special consideration during times of crisis, like the COVID-19 pandemic, and may benefit from intervention with an intersectional and transfeminist perspective.
Collapse
|
29
|
Tucker JS, Dunbar MS, Perez LG, Seelam R, Troxel WM, Davis JP, D’Amico EJ. Young Adults' Perceived Impact of COVID-19 Pandemic on Sleep and Other Functioning: Does It Differ for Sexual/Gender and Racial/Ethnic Minorities? Behav Sleep Med 2022; 20:294-303. [PMID: 35642294 PMCID: PMC9162434 DOI: 10.1080/15402002.2022.2075366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Since the beginning of the COVID-19 pandemic, there has been concern that the pandemic and associated mitigation efforts would have a particularly adverse effect on communities that are marginalized. This study examined disparities in the perceived impacts of the pandemic on sleep, mental and physical health, social functioning, and substance use among young adults based on sexual/gender minority (SGM) status and race/ethnicity. METHOD Participants were 2,411 young adults (mean age = 23.6) surveyed between July 2020-July 2021. A linear regression analysis tested SGM and racial/ethnic group differences on 17 outcomes. RESULTS Most young adults reported little-to-no effect of the pandemic on sleep or other indicators of health and functioning. However, SGM young adults reported more adverse effects than non-SGM young adults on their sleep and most other outcomes. Hispanic young adults reported shorter sleep duration - but less pandemic-related depression, loneliness, and relationship problems - compared to non-Hispanic white young adults. We found no evidence that young adults with multiple minority statuses had especially poor pandemic-related outcomes. CONCLUSIONS While most young adults did not perceive much impact of the pandemic, results highlight disparities across certain demographic subgroups that may need to be addressed through targeted interventions and close monitoring for long-term effects.
Collapse
Affiliation(s)
| | - Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | | | | | - Wendy M. Troxel
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California
| | | |
Collapse
|
30
|
Clark KD, Lunn MR, Sherman ADF, Bosley HG, Lubensky ME, Obedin-Maliver J, Dastur Z, Flentje A. COVID-19 News and Its Association with the Mental Health of Sexual and Gender Minority Adults: A Cross-Sectional Study. JMIR Public Health Surveill 2022; 8:e34710. [PMID: 35486805 PMCID: PMC9153913 DOI: 10.2196/34710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/14/2022] [Accepted: 04/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background Sexual and gender minority (SGM; people whose sexual orientation is not heterosexual or whose gender identity varies from what is traditionally associated with the sex assigned to them at birth) people experience high rates of trauma and substantial disparities in anxiety and posttraumatic stress disorder (PTSD). Exposure to traumatic stressors such as news related to COVID-19 may be associated with symptoms of anxiety and PTSD. Objective This study aims to evaluate the relationship of COVID-19 news exposure with anxiety and PTSD symptoms in a sample of SGM adults in the United States. Methods Data were collected between March 23 and August 2, 2020, from The PRIDE Study, a national longitudinal cohort study of SGM people. Regression analyses were used to analyze the relationship between self-reported news exposure and symptoms of anxiety using the Generalized Anxiety Disorder-7 and symptoms of COVID-19–related PTSD using the Impact of Events Scale-Revised. Results Our sample included a total of 3079 SGM participants. Each unit increase in COVID-19–related news exposure was associated with greater anxiety symptoms (odds ratio 1.77, 95% CI 1.63-1.93; P<.001) and 1.93 greater odds of PTSD (95% CI 1.74-2.14; P<.001). Conclusions Our study found that COVID-19 news exposure was positively associated with greater symptoms of anxiety and PTSD among SGM people. This supports previous literature in other populations where greater news exposure was associated with poorer mental health. Further research is needed to determine the direction of this relationship and to evaluate for differences among SGM subgroups with multiple marginalized identities.
Collapse
Affiliation(s)
- Kristen D Clark
- Department of Nursing, University of New Hampshire, 4 Library Way, Durham, US
| | - Mitchel R Lunn
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, US.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, US
| | | | - Hannah G Bosley
- Department of Psychiatry, University of California San Francisco, San Francisco, US
| | - Micah E Lubensky
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, US
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, US.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, US
| | - Zubin Dastur
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, US
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, US.,Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, US
| |
Collapse
|
31
|
Lipperman-Kreda S, Sanders E, Kaner E, Antin TM. Understanding the Impact of COVID-19 on Tobacco and Nicotine Use among Young Adults Identified as Sexual and Gender Minorities: A Mixed Methods Approach. DRUGS (ABINGDON, ENGLAND) 2022; 29:289-296. [PMID: 36051858 PMCID: PMC9426672 DOI: 10.1080/09687637.2022.2063711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 04/17/2023]
Abstract
We investigated the perceived impact of COVID-19 on changes in tobacco and nicotine (NT) use among sexual and gender minority (SGM) young adults. We used a mixed methods approach that included closed- and open-ended survey questions and in-depth interviews. Participants were 53 SGM young adults in California who reported current or past cigarette smoking. Of study participants, 63% (n=33) reported any changes in their NT use, and of those, 60% reported initial increase of NT use. Content analysis of an open-ended survey question revealed three reported reasons for changes in NT use: (1) changes in routine activities (27%), (2) stress (46%), and (3) health (24%). Thematic analysis of qualitative interviews identified several related themes: (1) in discussions of increased NT use, stress and boredom/free time were important aspects of changes to daily routines, (2) fluctuations in NT use behaviors occurred over time, (3) reasons for NT changes were multiple and intertwined, and (4) NT use changes were shaped by experiences related to intersectional forms of structural and social stigmatization. Results reveal the dynamic and complex ways in which participants described their pandemic-related changes in NT use-nuance that is crucial for compassionate and participant-centered approaches to tobacco prevention and cessation.
Collapse
Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA, USA 94704
- Center for Critical Public Health @ the Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211 Alameda, CA USA 94501
| | - Emile Sanders
- Center for Critical Public Health @ the Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211 Alameda, CA USA 94501
| | - Emily Kaner
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA, USA 94704
- Center for Critical Public Health @ the Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211 Alameda, CA USA 94501
| | - Tamar M.J Antin
- Center for Critical Public Health @ the Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211 Alameda, CA USA 94501
| |
Collapse
|
32
|
Daniels NF, Burrin C, Chan T, Fusco F. A Systematic Review of the Impact of the First Year of COVID-19 on Obesity Risk Factors: A Pandemic Fueling a Pandemic? Curr Dev Nutr 2022; 6:nzac011. [PMID: 35415391 PMCID: PMC8989548 DOI: 10.1093/cdn/nzac011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/24/2022] [Indexed: 11/14/2022] Open
Abstract
Obesity is increasingly prevalent worldwide. Associated risk factors, including depression, socioeconomic stress, poor diet, and lack of physical activity, have all been impacted by the coronavirus disease 2019 (COVID-19) pandemic. This systematic review aims to explore the indirect effects of the first year of COVID-19 on obesity and its risk factors. A literature search of PubMed and EMBASE was performed from 1 January 2020 to 31 December 2020 to identify relevant studies pertaining to the first year of the COVID-19 pandemic (PROSPERO; CRD42020219433). All English-language studies on weight change and key obesity risk factors (psychosocial and socioeconomic health) during the COVID-19 pandemic were considered for inclusion. Of 805 full-text articles that were reviewed, 87 were included for analysis. The included studies observed increased food and alcohol consumption, increased sedentary time, worsening depressive symptoms, and increased financial stress. Overall, these results suggest that COVID-19 has exacerbated the current risk factors for obesity and is likely to worsen obesity rates in the near future. Future studies, and policy makers, will need to carefully consider their interdependency to develop effective interventions able to mitigate the obesity pandemic.
Collapse
Affiliation(s)
| | - Charlotte Burrin
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Tianming Chan
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Francesco Fusco
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
33
|
Izdebski Z, Słowikowska-Hilczer J, Mazur J. The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074110. [PMID: 35409792 PMCID: PMC8998642 DOI: 10.3390/ijerph19074110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023]
Abstract
The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.
Collapse
Affiliation(s)
- Zbigniew Izdebski
- Department of Biomedical Aspects of Development and Sexology, Faculty of Education, Warsaw University, 00-561 Warsaw, Poland
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
| | | | - Joanna Mazur
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
| |
Collapse
|
34
|
Nowaskie DZ, Roesler AC. The impact of COVID-19 on the LGBTQ+ community: Comparisons between cisgender, heterosexual people, cisgender sexual minority people, and gender minority people. Psychiatry Res 2022; 309:114391. [PMID: 35032764 PMCID: PMC8743502 DOI: 10.1016/j.psychres.2022.114391] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 11/28/2022]
Abstract
There is a dearth of public health data and research focusing on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) populations during the coronavirus ("COVID") pandemic. This study evaluated how COVID has impacted health, social, and occupational areas of functioning of the LGBTQ+ community. A community survey was distributed via email by local LGBTQ+ community organizations between September and December 2020. Participants (cisgender, heterosexual people, n = 63; cisgender sexual minority people, n = 184; and gender minority people, n = 74) were asked how COVID has impacted their life circumstances (i.e., physical health, mental health, financial stability, meeting basic needs, and social connectedness). A multivariate analysis of covariance was tested with these groups, demographic and HIV serostatus variables as independent variables and covariates, and outcomes as dependent variables. Compared to cisgender, heterosexual people, significantly more cisgender sexual minority people reported worsening physical health, and significantly more gender minority people reported worsening of all outcomes. Significantly more gender minority people reported worsening financial stability than cisgender sexual minority people. COVID has contributed to a worsening of life circumstances among the LGBTQ+ community, especially for gender minority people. More research is needed to create proactive, equitable, culturally-focused responses and interventions to pandemics.
Collapse
Affiliation(s)
- Dustin Z. Nowaskie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States,Corresponding author. Department of Psychiatry, Indiana University School of Medicine 355 W. 16th St., #2364 Indianapolis, IN, United States 317-759-0926
| | - Anna C. Roesler
- Indiana University School of Medicine, Indianapolis, IN, Untied States
| |
Collapse
|
35
|
Grov C, Zohra F, Westmoreland DA, Mirzayi C, D'Angelo A, Stief M, Kulkarni S, Nash D, Carrico AW. Sex in the Era of COVID-19 in a U.S. National Cohort of Cisgender Men, Transgender Women, and Transgender Men Who Have Sex with Men: April-May 2020. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:343-354. [PMID: 34845579 PMCID: PMC8628839 DOI: 10.1007/s10508-021-02121-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/05/2021] [Accepted: 08/01/2021] [Indexed: 05/28/2023]
Abstract
Since the emergence of the COVID-19 pandemic, there has been an increasing body of research focused on the effects that measures like stay-at-home orders and social distancing are having on other aspects of health, including mental health and sexual health. Currently, there are limited extant data on the effects of the pandemic on sexual and gender minorities. Between April 15, 2020, and May 15, 2020, we invited participants in an ongoing U.S. national cohort study (Together 5000) to complete a cross-sectional online survey about the pandemic, and its effects on mental and sexual health and well-being (n = 3991). Nearly all (97.7%) were living in an area where they were told they should only leave their homes for essentials. Most (70.1%) reported reducing their number of sex partners as a result of the pandemic. Among the 789 participants prescribed HIV pre-exposure prophylaxis (PrEP), 29.9% said they stopped taking their PrEP entirely, and 14.2% started selectively skipping doses. For those who had been taking PrEP, discontinuing PrEP was associated with having no new sex partners (β = 0.90, 95% CI 0.40-1.40). Among the 152 HIV-positive participants, 30.9% said they were unable to maintain an HIV-related medical appointment because of the pandemic and 13.8% said they had been unable to retrieve HIV medications. Additionally, 35.3% of participants were experiencing moderate to severe anxiety because of the pandemic and 36.7% reported symptoms of depression. In a multivariable logistic regression, reporting a new sex partner in the prior 30 days was significantly associated with being aged 30 or older (vs. not, AOR = 1.21), being Black (AOR = 1.79) or Latinx (AOR = 1.40, vs. white), and being unsure if they had been in close contact with someone diagnosed with COVID-19 (AOR = 1.32, vs. no contact). It was unassociated with COVID-19-induced anxiety, depression, or knowing someone hospitalized with COVID-19. The pandemic has caused disruptions in sexual behavior (partner reduction) as well as difficulties navigating PrEP and HIV care continua. Findings will guide more comprehensive public health responses to optimize HIV prevention and treatment in the era of COVID-19.
Collapse
Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA.
- CUNY Institute for Implementation Science in Population Health, New York, USA.
| | - Fatima Zohra
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Drew A Westmoreland
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Chloe Mirzayi
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Alexa D'Angelo
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Matthew Stief
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Sarah Kulkarni
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | | |
Collapse
|
36
|
Hart EA, Rubin A, Kline KM, Fox KR. Disordered eating across COVID-19 in LGBTQ+ young adults. Eat Behav 2022; 44:101581. [PMID: 34896869 PMCID: PMC8655496 DOI: 10.1016/j.eatbeh.2021.101581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 01/06/2023]
Abstract
Emerging evidence suggests that the COVID-19 pandemic is negatively affecting mental health, especially for sexual and gender minority populations. Relatively little is known about the impact of the pandemic on disordered eating behaviors (DEB) for these populations. The aim of this study is to understand changes in DEB across COVID-19 within an LGBTQ+ sample, with a particular focus on differences across sexual and gender identities, and the impact of social support on these outcomes. In a sample of 830 LGBTQ+ adults with a past year history of DEB, most, but not all, participants reported that the frequency of and urge to engage in each DEB increased a little bit or a lot during COVID-19. Contrary to research showing more severe psychopathology and DEB among gender minorities (GM) compared to sexual minorities (SM), changes in DEB severity since COVID-19 were not significantly different between SM and GM participants. There were a few small and significant relationships between changes in average DEB severity and characteristics of interpersonal relationships, average quality of home relationships, and living with someone not affirming of one's identity. Results highlight that COVID-19 may have exacerbated DEB for SGM young adults, that these changes were not different across sexual versus gender minorities, and that these changes are weakly but significantly related to minority stressors.
Collapse
|
37
|
Robinson E, Sutin AR, Daly M, Jones A. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. J Affect Disord 2022; 296:567-576. [PMID: 34600966 PMCID: PMC8578001 DOI: 10.1016/j.jad.2021.09.098] [Citation(s) in RCA: 550] [Impact Index Per Article: 275.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/09/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increases in mental health problems have been observed during the COVID-19 pandemic. The objectives were to examine the extent to which mental health symptoms changed during the pandemic in 2020, whether changes were persistent or short lived, and if changes were symptom specific. METHODS Systematic review and meta-analysis of longitudinal cohort studies examining changes in mental health among the same group of participants before vs. during the pandemic in 2020. RESULTS Sixty-five studies were included. Compared to pre-pandemic outbreak, there was an overall increase in mental health symptoms observed during March-April 2020 (SMC = .102 [95% CI: .026 to .192]) that significantly declined over time and became non-significant (May-July SMC = .067 [95% CI: -.022 to .157]. Compared to measures of anxiety (SMC = 0.13, p = 0.02) and general mental health (SMC = -.03, p = 0.65), increases in depression and mood disorder symptoms tended to be larger and remained significantly elevated in May-July [0.20, 95% CI: .099 to .302]. In primary analyses increases were most pronounced among samples with physical health conditions and there was no evidence of any change in symptoms among samples with a pre-existing mental health condition. LIMITATIONS There was a high degree of unexplained heterogeneity observed (I2s > 90%), indicating that change in mental health was highly variable across samples. CONCLUSIONS There was a small increase in mental health symptoms soon after the outbreak of the COVID-19 pandemic that decreased and was comparable to pre-pandemic levels by mid-2020 among most population sub-groups and symptom types.
Collapse
Affiliation(s)
- Eric Robinson
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Liverpool L69 7ZA, UK.
| | - Angelina R Sutin
- Department of Psychology, Maynooth University, Co., Kildare, Ireland
| | - Michael Daly
- Department of Psychology, Maynooth University, Co., Kildare, Ireland
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Liverpool L69 7ZA, UK
| |
Collapse
|
38
|
Folayan MO, Ibigbami O, Aly NM, Zuñiga RAA, Abeldaño GF, Ara E, Ellakany P, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Popoola BO, Quadri MFA, Roque M, Okeibunor JC, Brown B, Nguyen AL. Associations between sexual orientation, financial security and relationships with family and peers during the COVID-19 pandemic in Nigeria. AAS Open Res 2021. [DOI: 10.12688/aasopenres.13296.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: This study aimed to determine whether factors associated with financial insecurity during the COVID-19 pandemic were associated with worsening relationships with family, peers and friends of sexual minorities living in Nigeria. Methods: Data were collected using an online survey conducted from 29th June to 31st December 2020. The outcome variable was the quality of relationship with family, friends and peers during the COVID-19 pandemic. The explanatory variables were the sexual orientation (lesbian, gay, bisexual, heterosexual), COVID-19 status, and financial security (job loss or reduced/lost wages because of the COVID-19 pandemic). Multilevel logistic regression analysis models with robust estimation were built and used to assess the association between the outcome and explanatory variables. The models were adjusted for sociodemographic profile (age, sex at birth, education status). Results: Being a sexual minority was associated with higher odds of worsened relationship with family (AOR: 1.49) and friends and peers (AOR: 2.38) during the pandemic. Having COVID-19 symptoms but not getting tested was significantly associated with higher odds of reporting worsening of the relationship with family (AOR: 1.69) and history of job loss (AOR: 1.68), while having formal education (p<0.05) was significantly associated with lower odds of reporting worsening of the relationship with family. The factors significantly associated with higher odds of reporting worsened relationship with friends and peers were testing positive for COVID-19 (AOR: 1.60), reduced wages (AOR: 1.24), and being older (AOR: 1.01). Attaining a college/university education was significantly associated with lower odds of worsened relationship with friends and peers (AOR: 0.31). Conclusions: The COVID-19 pandemic may increase the risk of negative disruptions in the relationships with family, friends and peers, especially for sexual minorities. National COVID-19 response programs should include plans to support those who face social disruption in managing the crisis.
Collapse
|
39
|
Riggle EDB, Drabble LA, Bochicchio LA, Wootton AR, Veldhuis CB, Munroe C, Hughes TL. Experiences of the COVID-19 Pandemic Among African American, Latinx, and White Sexual Minority Women: A Descriptive Phenomenological Study. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2021; 8:145-158. [PMID: 34746332 DOI: 10.1037/sgd0000510] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
From a systems perspective, the COVID-19 pandemic has caused global changes impacting the lives of individuals at all levels of interactions. Qualitative in-depth interviews were conducted with a sample of 18 African-American/Black, Hispanic/Latina/Latinx, and White sexual minority women (SMW) to explore experiences and adaptations during the COVID-19 pandemic. Interviews were analyzed using a descriptive phenomenological approach to understand how the complex and changing contexts of the pandemic impacted participants' lives. Analyses revealed participants were impacted in the context of their sexual identity in their experiences of coming out and being visible; creating social bubbles; their connection to the LGBTQ community; and dating. The pandemic, which took place concurrently with major political events including Black Lives Matter demonstrations and protests against police and White supremacist violence against people of color, resulted in additional impacts on Black and Latinx SMW related to safety, dialogues about race, and on-going systemic and cultural racism. Interviews also revealed general challenges in the areas of relationships, including with a partner and family; employment and the workplace; and interactions in public spaces. The findings underscore the importance of understanding the diverse range of experiences and impacts of the pandemic on SMW, including experiences related to their sexual identity and racial/racialized identity, as well as general experiences that may have additional consequences for SMW, and supports needed to help alleviate the negative impacts in the short and long-term.
Collapse
Affiliation(s)
- Ellen D B Riggle
- Department of Political Science and Department of Gender and Women's Studies, University of Kentucky, Lexington, KY
| | - Laurie A Drabble
- College of Health & Human Sciences, San José State University, San José, CA
| | | | - Angie R Wootton
- School of Social Welfare, University of California Berkeley, Berkeley, CA
| | | | | | - Tonda L Hughes
- School of Nursing & Department of Psychiatry, Columbia University, New York City, NY
| |
Collapse
|
40
|
Gender-Affirming Telepsychology During and After the COVID-19 Pandemic: Recommendations for Adult Transgender and Gender Diverse Populations. JOURNAL OF HEALTH SERVICE PSYCHOLOGY 2021; 47:181-189. [PMID: 34693297 PMCID: PMC8520334 DOI: 10.1007/s42843-021-00048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The implementation of telepsychology soared in response to the 2019 novel coronavirus (COVID-19) pandemic. For most health service psychologists, this surge preceded formal training in telepsychology. Transgender and gender diverse (TGD) individuals reported significant vulnerabilities and health disparities during the COVID-19 pandemic. To ensure the health and well-being of adult transgender and gender diverse individuals during the COVD-19 pandemic and beyond, it is critical to promote the delivery of gender-affirming telepsychology. This article highlights clinical issues observed by health service psychologists at a high-volume gender clinic during the COVID-19 pandemic. The authors provide anticipatory guidance and recommendations to promote gender-affirming telepsychology.
Collapse
|
41
|
McAuliffe C, Daly Z, Black J, Pumarino J, Gadermann A, Slemon A, Thomson KC, Richardson C, Jenkins EK. Examining the associations between food worry and mental health during the early months of the COVID-19 pandemic in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:843-852. [PMID: 34383262 PMCID: PMC8359635 DOI: 10.17269/s41997-021-00557-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/21/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Little is known about the association between mental health and diminished food worry during the COVID-19 pandemic. This paper examines worry about having enough food to meet household needs and its association with mental health during the early months of the pandemic in Canada. METHODS Data are drawn from the first round of a multi-round mental health monitoring survey. Online surveys were administered between May 14 and 29, 2020, to a nationally representative sample of Canadian adults (n = 3000). Logistic regression models were used to examine associations between food worry and mental health indicators (anxious/worried, depressed, worse mental health compared with pre-pandemic, and suicidal thoughts/feelings), after adjusting for socio-demographic characteristics and pre-existing mental health conditions. Fully adjusted models explored the impact of controlling for financial worry due to the pandemic in the previous 2 weeks. RESULTS Overall, 17.3% of the sample reported food worry due to the pandemic in the previous 2 weeks, with the highest prevalence found among those with a reported disability (29.3%), Indigenous identity (27.1%), or pre-existing mental health condition (25.3%). Compared with participants who did not report food worry, those who did had higher odds of reporting feeling anxious/worried (OR=1.36, 95% CI: 1.08-1.71) and suicidal thoughts/feelings (OR=1.87, 95% CI: 1.24-2.80) when controlling for socio-demographics, pre-existing mental health conditions, and financial worry. CONCLUSION This paper provides insights about the associations between food worry and mental health in Canada during the COVID-19 pandemic and indicates the need for improved policies and social supports to mitigate food worry and associated mental health outcomes.
Collapse
Affiliation(s)
- Corey McAuliffe
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Zach Daly
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Jennifer Black
- Food, Nutrition, and Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Javiera Pumarino
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Allie Slemon
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Kimberly C Thomson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily K Jenkins
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
| |
Collapse
|
42
|
Kumar N, Janmohamed K, Nyhan K, Forastiere L, Zhang WH, Kågesten A, Uhlich M, Sarpong Frimpong A, Van de Velde S, Francis JM, Erausquin JT, Larrson E, Callander D, Scott J, Minichiello V, Tucker J. Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review. Sex Transm Infect 2021; 97:402-410. [PMID: 33782145 PMCID: PMC8380886 DOI: 10.1136/sextrans-2020-054896] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/20/2021] [Accepted: 02/27/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally-including some with attention to HIV-none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes. METHODS A scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers' Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies. RESULTS We found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women's sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs). CONCLUSIONS Sexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.
Collapse
Affiliation(s)
- Navin Kumar
- Department of Sociology, Yale University, New Haven, Connecticut, USA
| | - Kamila Janmohamed
- Department of Sociology, Yale University, New Haven, Connecticut, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Laura Forastiere
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Wei-Hong Zhang
- School of Public Health, Free University of Brussels, Brussels, Belgium
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Anna Kågesten
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Sarah Van de Velde
- Department of Sociology, Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Joel M Francis
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Jennifer Toller Erausquin
- Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Elin Larrson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Deton Callander
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - John Scott
- School of Social Justice, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Victor Minichiello
- School of Social Justice, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
| | - Joseph Tucker
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
43
|
Maffly-Kipp J, Eisenbeck N, Carreno DF, Hicks J. Mental health inequalities increase as a function of COVID-19 pandemic severity levels. Soc Sci Med 2021; 285:114275. [PMID: 34365069 PMCID: PMC8417401 DOI: 10.1016/j.socscimed.2021.114275] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022]
Abstract
RATIONALE Current evidence suggests that mental health across the globe has suffered significantly during the COVID-19 global pandemic, and that disadvantaged communities are suffering these impacts more acutely. Lower income, female gender, and younger age have all been associated with worse psychopathology during COVID-19. OBJECTIVE AND METHODS The goal of this study was to determine whether these disparities are more pronounced in places where the pandemic is more severe. We analyzed self-report data and objective metrics from a large global sample (N = 11,227) in order to test the hypothesis that country-level severity of COVID-19 moderates the relationship between the target demographic variables (Subjective SES, gender and age) and psychopathology indicators. RESULTS Severity of the pandemic emerged as a significant moderator of the relationship between these demographic variables and mental health outcomes. This pattern was extremely consistent for Subjective SES and gender, but slightly more nuanced for age. CONCLUSION Overall, we interpreted our data as suggesting that mental health disparities are greater in countries with more severe COVID-19 outbreaks. These findings are critical for understanding the ways that the ongoing pandemic is affecting global mental health, and contribute to the broader literature surrounding collective trauma.
Collapse
Affiliation(s)
- Joseph Maffly-Kipp
- Department of Psychological and Brain Sciences, Texas A&M University, United states
| | - Nikolett Eisenbeck
- Department of Psychology, Universidad de Sevilla, Calle San Fernando, 4, 41004 Sevilla, Spain
| | - David F Carreno
- Department of Psychology, Universidad de Almería, Almería, Spain
| | - Joshua Hicks
- Department of Psychological and Brain Sciences, Texas A&M University, United states.
| |
Collapse
|
44
|
García-Reyna B, Castillo-García GD, Barbosa-Camacho FJ, Cervantes-Cardona GA, Cervantes-Pérez E, Esparza-Estrada I, Brancaccio-Pérez IV, Silva-González G, Fuentes-Orozco C, Pintor-Belmontes KJ, Guzmán-Ramírez BG, Navarro DR, Ibarrola-Peña JC, López VAS, Chejfec-Ciociano JM, Sapién-Fernández JH, González-Ojeda A, Cervantes-Guevara G. Anxiety and COVID-19: Coronavirus Anxiety Scale scores in medical and non-medical personnel in urban hospitals in Guadalajara. A cross-sectional survey study. DEATH STUDIES 2021; 46:581-589. [PMID: 34181508 DOI: 10.1080/07481187.2021.1936297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The world is facing the worst health crisis in modern history. In addition to general concerns about the effects of COVID-19 on health, hospital personnel are developing numerous mental health conditions. This cross-sectional survey study evaluated the prevalence and severity of anxiety caused by the COVID-19 pandemic using the Coronavirus Anxiety Scale (CAS) in 2136 hospital employees. For the employees who presented scores ranging from 1-20 (n = 1090, 51%), the CAS mean score was 4.22 (SD = 3.95). The mean score was higher in women than men. By work category, non-clinical hospital personnel presented the highest CAS scores.
Collapse
Affiliation(s)
| | | | - Francisco José Barbosa-Camacho
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Guillermo Alonso Cervantes-Cardona
- Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Enrique Cervantes-Pérez
- Departamento de Nutrición Clínica, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
| | - Isaac Esparza-Estrada
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Irma Valeria Brancaccio-Pérez
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Gabriela Silva-González
- Departamento de Odontología para la Preservación de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Clotilde Fuentes-Orozco
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Kevin Josue Pintor-Belmontes
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Bertha Georgina Guzmán-Ramírez
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Dinorah Rodríguez Navarro
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Juan Carlos Ibarrola-Peña
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Veronica Alexandra Sánchez López
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Jonathan Matias Chejfec-Ciociano
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - José Héctor Sapién-Fernández
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Alejandro González-Ojeda
- Unidad de Investigación Biomédica 02, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Gabino Cervantes-Guevara
- Centro Universitario del Norte, Universidad de Guadalajara, Colotlan, Mexico
- Hospital Civil de Guadalajara "Fray Antonio Alcalde", Universidad de Guadalajara, Guadalajara, México
| |
Collapse
|
45
|
Morgan R, Baker P, Griffith DM, Klein SL, Logie CH, Mwiine AA, Scheim AI, Shapiro JR, Smith J, Wenham C, White A. Beyond a Zero-Sum Game: How Does the Impact of COVID-19 Vary by Gender? FRONTIERS IN SOCIOLOGY 2021; 6:650729. [PMID: 34212026 PMCID: PMC8239350 DOI: 10.3389/fsoc.2021.650729] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/24/2021] [Indexed: 06/13/2023]
Abstract
Epidemics and pandemics, like COVID-19, are not gender neutral. Much of the current work on gender, sex, and COVID-19, however, has seemed implicitly or explicitly to be attempting to demonstrate that either men or women have been hardest hit, treating differences between women and men as though it is not important to understand how each group is affected by the virus. This approach often leaves out the effect on gender and sexual minorities entirely. Believing that a more nuanced approach is needed now and for the future, we brought together a group of gender experts to answer the question: how are people of different genders impacted by COVID-19 and why? Individuals working in women's, men's, and LGBTQ health and wellbeing wrote sections to lay out the different ways that women, men, and gender and sexual minorities are affected by COVID-19. We demonstrate that there is not one group "most affected," but that many groups are affected, and we need to move beyond a zero-sum game and engage in ways to mutually identify and support marginalized groups.
Collapse
Affiliation(s)
- Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Peter Baker
- Global Action on Men’s Health, London, United Kingdom
| | - Derek M Griffith
- Founder and Director of the Center for Research on Men’s Health and Professor of Medicine, Health and Society, Vanderbilt University, Nashville, TN, United States
| | - Sabra L. Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- W. Harry Feinstone Department of Molecular Microbiology and Immunology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, Canada and Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
| | - Amon Ashaba Mwiine
- School of Women and Gender Studies, Makerere University, Kampala, Uganda
| | - Ayden I Scheim
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Janna R. Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Julia Smith
- Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Clare Wenham
- Department of Health Policy, London School of Economics and Political Science, Leeds, United Kingdom
| | - Alan White
- Emeritus Professor of Men’s Health, Leeds Beckett University, Leeds, United Kingdom
| |
Collapse
|
46
|
Walsh AR, Stephenson R. Positive and Negative Impacts of the COVID-19 Pandemic on Relationship Satisfaction in Male Couples. Am J Mens Health 2021; 15:15579883211022180. [PMID: 34088238 PMCID: PMC8182189 DOI: 10.1177/15579883211022180] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/16/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
Little is known about the impact of the coronavirus pandemic and control measures on gay, bisexual, and other men who have sex with men (GBMSM) couples. The goal of this study was to investigate individual-level relationship satisfaction during the COVID-19 pandemic in a sample of 209 coupled GBMSM in the United States. We analyzed reported happiness and feelings about a relationship's future and assessed the odds of changing relationship happiness and investment associated with pandemic-related life changes (pandemic-related employment change; COVID-19 illness; high-risk of severe illness), using logistic and multinomial logit models. Fifty-five percent of participants (N = 114) reported that their relationship happiness had not changed during the pandemic, but 30% (N = 62) reported increased relationship happiness. 25% (N = 53) reported they had become more invested in their relationship's future during the pandemic, and only one participant reported decreased investment. The odds of increased relationship investment was significantly associated with pandemic-related employment change (adjusted odds ratio (aOR), 95% confidence interval (CI): 2.19 [1.04, 4.61]) and increased sex during the pandemic (aOR: 4.38 [1.55, 12.41]). Those with a pandemic-related employment change also had significantly higher odds of increased relationship happiness than those without a change (aOR: 2.10 [1.01, 4.35]). COVID-19 cases that reported being at higher risk of serious COVID-19 disease had higher odds of decreased relationship happiness than high-risk non-cases (aOR: 6.58 [1.10, 39.39]). Additional research in this area is warranted to minimize the long-term impacts of the pandemic on coupled GBMSM.
Collapse
Affiliation(s)
- Alison R. Walsh
- Center for Sexuality and Health
Disparities, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations and
Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Rob Stephenson
- Center for Sexuality and Health
Disparities, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations and
Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA
| |
Collapse
|
47
|
Fish JN, Salerno J, Williams ND, Rinderknecht RG, Drotning KJ, Sayer L, Doan L. Sexual Minority Disparities in Health and Well-Being as a Consequence of the COVID-19 Pandemic Differ by Sexual Identity. LGBT Health 2021; 8:263-272. [PMID: 33887160 DOI: 10.1089/lgbt.2020.0489] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: The coronavirus disease 2019 (COVID-19) pandemic has accentuated long-standing population health disparities in the United States. We examined how the pandemic and its social consequences may differentially impact sexual minority adults, relative to heterosexual adults. Methods: Data are from a U.S. national sample of adults (n = 2996; 18.06%) collected from online panels from April to May 2020. We used eight indicators of well-being-mental health, physical health, quality of life, stress, loneliness, psychological distress, alcohol use, and fatigue-to assess the degree to which sexual identity subgroups (i.e., heterosexual, gay/lesbian, bisexual, and "other" sexual minority) varied in retrospective pre- and postpandemic onset indicators of well-being and whether groups varied in their rate of change from pre- and postpandemic onset. Results: The results showed consistent patterns of decline in well-being across sexual identity subgroups, although changes in mental health, physical health, quality of life, stress, and psychological distress were more robust among sexual minority adults in general, relative to heterosexual adults. Adjusted multivariate models testing differences in change in retrospective pre- and postpandemic onset found that well-being among bisexual men and women was most negatively impacted by the pandemic. Conclusion: The COVID-19 pandemic may have distinct health consequences for sexual minority adults in the United States. Our findings support and further legitimize calls for more comprehensive surveillance and cultural responsiveness in emergency preparedness as it relates to sexual minority people and the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jessica N Fish
- Department of Family Science and School of Public Health, University of Maryland, College Park, Maryland, USA
| | - John Salerno
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Natasha D Williams
- Department of Family Science and School of Public Health, University of Maryland, College Park, Maryland, USA
| | - R Gordon Rinderknecht
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Kelsey J Drotning
- Department of Sociology, College of Behavioral and Social Sciences, University of Maryland, College Park, Maryland, USA
| | - Liana Sayer
- Department of Sociology, College of Behavioral and Social Sciences, University of Maryland, College Park, Maryland, USA
| | - Long Doan
- Department of Sociology, College of Behavioral and Social Sciences, University of Maryland, College Park, Maryland, USA
| |
Collapse
|
48
|
Salerno JP, Shrader CH, Algarin AB, Lee JY, Fish JN. Changes in alcohol use since the onset of COVID-19 are associated with psychological distress among sexual and gender minority university students in the U.S. Drug Alcohol Depend 2021; 221:108594. [PMID: 33689965 PMCID: PMC8104058 DOI: 10.1016/j.drugalcdep.2021.108594] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Sexual and gender minority (SGM) young persons are experiencing compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. Given that 41% of all young persons are enrolled in universities, and the increased vulnerabilities faced by SGM young persons during the pandemic, it is imperative to understand the effects of alcohol use on mental health among SGM university students amid COVID-19. This study aims to examine the associations between changes in alcohol use since the start of COVID-19 and mental distress among SGM university students in the U.S., and to explore sex-stratified differences. METHODS A nonprobability cross-sectional sample of 509 SGM university students (Mage = 22.04 years, SD = 3.99) were retrospectively surveyed online between May-August 2020 and asked if their alcohol use had changed since the start of COVID-19. Statistical analyses explored the association between changes in alcohol use since the start of COVID-19 and mental distress. RESULTS Average psychological distress (M = 27.79, SD = 7.82) was relatively high as per existing research and established clinical cutoff scores. Roughly 32% had increased alcohol use since the start of COVID-19. Subsequently, greater alcohol use (p < .05) since the start of COVID-19 was associated with higher psychological distress among SGM university students, and among females but not males assigned at birth. CONCLUSIONS Higher education, medical, and behavioral health professionals should consider how to adapt their practice to address alcohol use and psychological burdens among SGM university students (especially females) who are facing health inequities during and beyond COVID-19, requiring SGM-affirmative care.
Collapse
Affiliation(s)
- John P. Salerno
- Department of Behavioral & Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1234, College Park, MD, 20742, USA,Corresponding author
| | - Cho-Hee Shrader
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, CRB 906, Miami, FL, 33136,USA.
| | - Angel B. Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive La Jolla, CA, 92093, USA
| | - Ji-Young Lee
- Northwestern University, Institute for Sexual and Gender Minority Health and Wellbeing, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1142, College Park, MD, 20742, USA
| |
Collapse
|
49
|
Tibubos AN, Otten D, Ernst M, Beutel ME. A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis. Front Psychiatry 2021; 12:712492. [PMID: 34603104 PMCID: PMC8484908 DOI: 10.3389/fpsyt.2021.712492] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/13/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Sex and gender are important modifiers of mental health and behavior in normal times and during crises. We investigated whether they were addressed by empirical, international research that explored the mental health and health behavior ramifications after the onset of the COVID-19 pandemic. Methods: We systematically searched the databases PsyArXiv, PubMed, PsycInfo, Psyndex, PubPsych, Cochrane Library, and Web of Science for studies assessing mental health outcomes (main outcomes) as well as potential risk and protective health behavior (additional outcomes) up to July 2, 2020. Findings: Most of the 80 publications fulfilling the selection criteria reflected the static difference perspective treating sex and gender as dichotomous variables. The focus was on internalizing disorders (especially anxiety and depression) burdening women in particular, while externalizing disorders were neglected. Sex- and gender-specific evaluation of mental healthcare use has also been lacking. With respect to unfavorable health behavior in terms of adherence to prescribed protective measures, men constitute a risk group. Interpretations: Women remain a vulnerable group burdened by multiple stresses and mental health symptoms. The neglect of sex- and gender-specific evaluation of aggression-related disorders, substance addiction, and mental healthcare use in the early stage represents a potentially dangerous oversight. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192026, PROSPERO 2020 CRD42020192026.
Collapse
Affiliation(s)
- Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Diagnostics in Healthcare and E-Health, University of Trier, Trier, Germany
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
50
|
Nelson KM, Gordon AR, John SA, Stout CD, Macapagal K. "Physical Sex Is Over for Now": Impact of COVID-19 on the Well-Being and Sexual Health of Adolescent Sexual Minority Males in the U.S. J Adolesc Health 2020; 67:756-762. [PMID: 33039273 PMCID: PMC7683377 DOI: 10.1016/j.jadohealth.2020.08.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aimed to explore how the COVID-19 pandemic and physical distancing measures have impacted the well-being and sexual health among adolescent sexual minority males (ASMM) during the initial phase of physical distancing mandates in the U.S. METHODS From March 27, 2020, to May 8, 2020, U.S. ASMM (N = 151; aged 14-17 years) completed the online baseline survey of a sexual health intervention trial. COVID-19-related closed- and open-ended questions were included. A mixed-methods approach assessed COVID-19-related changes in well-being and sexual health by outness with an accepting guardian. RESULTS The majority (57%) of participants reported being worried about COVID-19. Almost all (91%) were physically distancing. Participants noted that COVID-19 changed school, home, work, and family life. Participants highlighted that COVID-19 reduced their ability to socialize and had a deleterious effect on their mental health. In the past 3 months, participants reported seeing sexual partners in person less often, masturbating and viewing pornography more often, and sexting and messaging on men-seeking-men websites/phone applications about the same amount. Many described being physically distanced from sexual partners, and some noted an increase in their use of virtual ways to connect with partners (e.g., video chatting). There were no differences by outness with an accepting guardian in quantitative or qualitative responses. CONCLUSIONS These findings provide a snapshot of the initial effects of the COVID-19 pandemic among a convenience sample of U.S. ASMM and underscore the need to provide access to resources sensitive to their social, developmental, and sexual health needs during this crisis.
Collapse
Affiliation(s)
- Kimberly M. Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA,Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Steven A. John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Claire D. Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Katharyn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| |
Collapse
|