Combining social network and activity space data for health research: tools and methods

How is the COVID-19 pandemic impacting our life, mental health, and well-being? Design and preliminary findings of the pan-Canadian longitudinal COHESION study

BACKGROUND

With the advent of the COVID-19 pandemic, in-person social interactions and opportunities for accessing resources that sustain health and well-being have drastically reduced. We therefore designed the pan-Canadian prospective COVID-19: HEalth and Social Inequities across Neighbourhoods (COHESION) cohort to provide a deeper understanding of how the COVID-19 pandemic context affects mental health and well-being, key determinants of health, and health inequities.

METHODS

This paper presents the design of the two-phase COHESION Study, and descriptive results from the first phase conducted between May 2020 and September 2021. During that period, the COHESION research platform collected monthly data linked to COVID-19 such as infection and vaccination status, perceptions and attitudes regarding pandemic-related measures, and information on participants' physical and mental health, well-being, sleep, loneliness, resilience, substances use, living conditions, social interactions, activities, and mobility.

RESULTS

The 1,268 people enrolled in the Phase 1 COHESION Study are for the most part from Ontario (47%) and Quebec (33%), aged 48 ± 16 years [mean ± standard deviation (SD)], and mainly women (78%), White (85%), with a university degree (63%), and living in large urban centers (70%). According to the 298 ± 68 (mean ± SD) prospective questionnaires completed each month on average, the first year of follow-up reveals significant temporal variations in standardized indexes of well-being, loneliness, anxiety, depression, and psychological distress.

CONCLUSIONS

The COHESION Study will allow identifying trajectories of mental health and well-being while investigating their determinants and how these may vary by subgroup, over time, and across different provinces in Canada, in varying context including the pandemic recovery period. Our findings will contribute valuable insights to the urban health field and inform future public health interventions.

Association of neighborhood recreational facilities and depressive symptoms among Chinese older adults

OBJECTIVES

Neighborhood recreation facilities has been associated with depression that commonly tested with cross-sectional data. This study used longitudinal data to test the effect of neighborhood recreation facilities on the trajectory of depressive symptoms among Chinese older adults.

METHODS

Data was derived from the 2014, 2016 and 2018 China Longitudinal Aging Social Survey (CLASS). Depressive symptoms among older adults were obtained using the CES-D scale. The three-level linear growth model of "time point - individual - community" was conducted to test the association between neighborhood recreation facilities and depressive symptoms.

RESULTS

This study consisted of 3,804 respondents living in 333 communities. It was found that community fitness facilities had a significant effect on depressive symptoms in older adults ([Formula: see text]=-1.212, [Formula: see text]0.001). A supportive community fitness environment can effectively slow down the rate of increase in depressive symptoms among older adults ([Formula: see text]=-0.415, [Formula: see text]0.01). In subgroup analysis, fitness facilities were the important predictor for people in youngest-old group ([Formula: see text]=-1.247, [Formula: see text]0.01) and outdoor activity space was a protective predictor for oldest-old people's depressive symptoms ([Formula: see text]=-0.258, [Formula: see text]0.05).

CONCLUSIONS

This study demonstrated an association between neighborhood recreation facilities and depressive symptoms in older adults and found the age difference of this effect. Public health department need pay more attention to neighborhood environment construction to promote healthy aging.

Micro urban spaces and mental well-being: Measuring the exposure to urban landscapes along daily mobility paths and their effects on momentary depressive symptomatology among older population

The urban environment plays an important role for the mental health of residents. Researchers mainly focus on residential neighbourhoods as exposure context, leaving aside the effects of non-residential environments. In order to consider the daily experience of urban spaces, a people-based approach focused on mobility paths is needed. Applying this approach, (1) this study investigated whether individuals' momentary mental well-being is related to the exposure to micro-urban spaces along the daily mobility paths within the two previous hours; (2) it explored whether these associations differ when environmental exposures are defined considering all location points or only outdoor location points; and (3) it examined the associations between the types of activity and mobility and momentary depressive symptomatology. Using a geographically-explicit ecological momentary assessment approach (GEMA), momentary depressive symptomatology of 216 older adults living in the Ile-de-France region was assessed using smartphone surveys, while participants were tracked with a GPS receiver and an accelerometer for seven days. Exposure to multiple elements of the streetscape was computed within a street network buffer of 25 m of each GPS point over the two hours prior to the questionnaire. Mobility and activity type were documented from a GPS-based mobility survey. We estimated Bayesian generalized mixed effect models with random effects at the individual and day levels and took into account time autocorrelation. We also estimated fixed effects. A better momentary mental wellbeing was observed when residents performed leisure activities or were involved in active mobility and when they were exposed to walkable areas (pedestrian dedicated paths, open spaces, parks and green areas), water elements, and commerce, leisure and cultural attractors over the previous two hours. These relationships were stronger when exposures were defined based only on outdoor location points rather than all location points, and when we considered within-individual differences compared to between-individual differences.

Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec

While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.

Social network analysis to study health behaviours in adolescents: A systematic review of methods

PURPOSE

Our objectives were (i) to systematically review how SNA is used in studies investigating adolescent health behaviours (i.e., the purpose of using SNA, methods used for network data collection and analysis), and (ii) to develop methodological guidelines to help researchers use SNA in studies on adolescent health behaviours.

METHODS

Five databases were searched using keywords related to "social network analysis" and "adolescents". We extracted data from included articles pertaining to the choice of methods for network data collection and analysis. We used these data to develop a 5-step decision tree to help researchers make methodological decisions most appropriate to their research objectives.

RESULTS

A total of 201 articles were included. Most investigated tobacco (50%) or alcohol use (48%). SNA was used most often to examine processes related to peer selection or influence (37%) and/or to examine the effect of sociometric position on health behaviours (34%). 181 studies (90%) used a sociocentric approach for SNA, 16 studies (8%) used an egocentric approach, and 4 studies (2%) used both. We identified five decision-making steps in SNA including the choice of: (i) network boundary, (ii) SNA approach, (iii) methods for name generators, (iv) methods for name interpreters, and (iv) SNA indicators.

CONCLUSION

This study provides insights and guidance in a 5-step decision tree on practical and methodological considerations in using SNA to explore adolescent health behaviours.

Recruiting Participants for Population Health Intervention Research: Effectiveness and Costs of Recruitment Methods for a Cohort Study

Background

Public health research studies often rely on population-based participation and draw on various recruitment methods to establish samples. Increasingly, researchers are turning to web-based recruitment tools. However, few studies detail traditional and web-based recruitment efforts in terms of costs and potential biases.

Objective

This study aims to report on and evaluate the cost-effectiveness, time effectiveness, and sociodemographic representation of diverse recruitment methods used to enroll participants in 3 cities of the Interventions, Research, and Action in Cities Team (INTERACT) study, a cohort study conducted in Canadian cities.

Methods

Over 2017 and 2018 in Vancouver, Saskatoon, and Montreal, the INTERACT study used the following recruitment methods: mailed letters, social media (including sponsored Facebook advertisements), news media, partner communications, snowball recruitment, in-person recruitment, and posters. Participation in the study involved answering web-based questionnaires (at minimum), activating a smartphone app to share sensor data, and wearing a device for mobility and physical activity monitoring. We describe sociodemographic characteristics by the recruitment method and analyze performance indicators, including cost, completion rate, and time effectiveness. Effectiveness included calculating cost per completer (ie, a participant who completed at least one questionnaire), the completion rate of a health questionnaire, and the delay between completion of eligibility and health questionnaires. Cost included producing materials (ie, printing costs), transmitting recruitment messages (ie, mailing list rental, postage, and sponsored Facebook posts charges), and staff time. In Montreal, the largest INTERACT sample, we modeled the number of daily recruits through generalized linear models accounting for the distributed lagged effects of recruitment campaigns.

Results

Overall, 1791 participants were recruited from 3 cities and completed at least one questionnaire: 318 in Vancouver, 315 in Saskatoon, and 1158 in Montreal. In all cities, most participants chose to participate fully (questionnaires, apps, and devices). The costs associated with a completed participant varied across recruitment methods and by city. Facebook advertisements generated the most recruits (n=687), at a cost of CAD $15.04 (US $11.57; including staff time) per completer. Mailed letters were the costliest, at CAD $108.30 (US $83.3) per completer but served to reach older participants. All methods resulted in a gender imbalance, with women participating more, specifically with social media. Partner newsletters resulted in the participation of younger adults and were cost-efficient (CAD $5.16 [US $3.97] per completer). A generalized linear model for daily Montreal recruitment identified 2-day lag effects on most recruitment methods, except for the snowball campaign (4 days), letters (15 days), and reminder cards (5 days).

Conclusions

This study presents comprehensive data on the costs, effectiveness, and bias of population recruitment in a cohort study in 3 Canadian cities. More comprehensive documentation and reporting of recruitment efforts across studies are needed to improve our capacity to conduct inclusive intervention research.

Zimitsani Moto: Understanding the Malawi COVID-19 Response

The coronavirus disease 2019 (COVID-19) pandemic has unsettled societies and economies of people and countries all over the world. Malawi is no exception. As such, the COVID-19 pandemic is more than just a health crisis. Countries have responded by instituting lockdowns and other restrictive measures among the populace. These have, in turn, elicited negative responses and legal challenges; most of which are rights-based. The main challenge has been that of the restriction of individual and religious freedoms. It is, thus, no surprise that reactions against government decrees restricting religious gatherings in the wake of the pandemic have been challenged in the courts. We will explore the Malawian traditional religious concept of healing and wholeness, give a chronological outline of government decrees and the responses to the pandemic, and conclude with an analysis using some reflections on Ferdinand Tönnies concepts of Gemeinschaft and Gesellschaft and recollection of traditional religion and critique of the new evangelicalism leading to an understanding of the Malawian response to the pandemic.