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Miller HN, Gallis JA, Berger MB, Askew S, Egger JR, Kay MC, Finkelstein EA, de Leon M, DeVries A, Brewer A, Holder MG, Bennett GG. Weight Gain Prevention Outcomes From a Pragmatic Digital Health Intervention With Community Health Center Patients: Randomized Controlled Trial. J Med Internet Res 2024; 26:e50330. [PMID: 38416574 PMCID: PMC11009856 DOI: 10.2196/50330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 02/07/2024] [Accepted: 02/26/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The prevalence of obesity and its associated comorbidities continue to rise in the United States. Populations who are uninsured and from racial and ethnic minority groups continue to be disproportionately affected. These populations also experience fewer clinically meaningful outcomes in most weight loss trials. Weight gain prevention presents a useful strategy for individuals who experience barriers to weight loss. Given the often-limited weight management resources available to patients in primary care settings serving vulnerable patients, evaluating interventions with pragmatic designs may help inform the design of comprehensive obesity care delivered in primary care. OBJECTIVE This study aims to evaluate the effectiveness of Balance, a 2-arm, 12-month pragmatic randomized controlled trial of a digital weight gain prevention intervention, delivered to patients receiving primary care within federally qualified community health centers. METHODS Balance was a 2-arm, 12-month pragmatic randomized controlled trial of a digital weight gain prevention intervention delivered to individuals who had a BMI of 25-40 kg/m2, spoke English or Spanish, and were receiving primary care within a network of federally qualified community health centers in North Carolina. The Balance intervention was designed to encourage behavioral changes that result in a slight energy deficit. Intervention participants received tailored goal setting and tracking, skills training, self-monitoring, and responsive health coaching from registered dietitians. Weight was measured at regular primary care visits and documented in the electronic health record. We compared the percentage of ≤3% weight gain in each arm at 24 months after randomization-our primary outcome-using individual empirical best linear unbiased predictors from the linear mixed-effects model. We used individual empirical best linear unbiased predictors from participants with at least 1 electronic health record weight documented within a 6-month window centered on the 24-month time point. RESULTS We randomized 443 participants, of which 223 (50.3%) participants were allocated to the intervention arm. At baseline, participants had a mean BMI of 32.6 kg/m2. Most participants were Latino or Hispanic (n=200, 45.1%) or non-Latino or Hispanic White (n=115, 26%). In total, 53% (n=235) of participants had at least 1 visit with weight measured in the primary time window. The intervention group had a higher proportion with ≤3% weight gain at 6 months (risk ratio=1.12, 95% CI 0.94-1.28; risk difference=9.5, 95% CI -4.5 to 16.4 percentage points). This difference attenuated to the null by 24 months (risk ratio=1.00, 95% CI 0.82-1.20; risk difference=0.2, 95% CI -12.1 to 11.0 percentage points). CONCLUSIONS In adults with overweight or obesity receiving primary care at a community health center, we did not find long-term evidence to support the dissemination of a digital health intervention for weight gain prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT03003403; https://clinicaltrials.gov/study/NCT03003403. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-019-6926-7.
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Affiliation(s)
- Hailey N Miller
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - John A Gallis
- Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Miriam B Berger
- Duke Digital Health Science Center, Duke University, Durham, NC, United States
| | - Sandy Askew
- Duke Digital Health Science Center, Duke University, Durham, NC, United States
| | - Joseph R Egger
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, United States
| | - Eric Andrew Finkelstein
- Duke-NUS Medical School Singapore, Duke Global Health Institute, Duke University, Durham, NC, United States
| | | | | | - Ashley Brewer
- Piedmont Health Services, Inc, Chapel Hill, NC, United States
| | - Marni Gwyther Holder
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Gary G Bennett
- Duke Digital Health Science Center, Duke University, Durham, NC, United States
- Trinity College of Arts & Sciences, Duke University, Durham, NC, United States
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Sánchez González ML, Cruz-Gonzalez M, Falgas-Bague I, Markle SL, Alegría M. Resilience of racial and ethnic minority older adults during the COVID-19 pandemic: The role of a prior disability prevention intervention. Am Psychol 2024; 79:241-253. [PMID: 37471006 PMCID: PMC10799164 DOI: 10.1037/amp0001177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Older adults from racially and ethnically diverse backgrounds and with preexisting mental illness have been disproportionately vulnerable to severe illness, disability, and death due to the adverse impacts of the COVID-19 pandemic. This study used a sample of older adults (60 +; N = 307) from a randomized clinical trial (Positive Minds-Strong Bodies [PMSB]) conducted between May 25, 2015, and March 5, 2019. Participants were recontacted to assess symptoms of anxiety, depression, general distress, and physical functioning during the COVID-19 pandemic between March 2, 2021, and July 18, 2022 (62.7% recontacting rate excluding ineligible participants; N = 165). We estimated an analysis of covariance model to evaluate whether or not prior differences between the PMSB intervention and enhanced usual care (EUC) groups continued to be observed at the COVID-19 follow-up. Results showed that, compared to EUC, participants who received the PMSB intervention reported fewer depression symptoms (Geriatric Depression Scale-15 scores) and greater physical functioning (Late-Life Functioning and Disability Instrument scores) at the COVID-19 follow-up. No significant differences were observed between the PMSB intervention and EUC groups on anxiety symptoms (Generalized Anxiety Disorder-7 scores) during the pandemic. Last, findings suggested that the lower depression symptoms and greater physical functioning observed after treatment completion were sustained, though not further improved, over time. These findings provide evidence that the PMSB intervention is a powerful intervention to promote resilience and prevent disability associated with major life stressors, such as the COVID-19 pandemic. Future research is needed to examine the underlying mechanisms of psychosocial and exercise training interventions that lead to lasting resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Irene Falgas-Bague
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Sheri L Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital
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Hladek MD, Wilson DH, Shofner S, Gross AL, Buta B, Bandeen-Roche K, Schoenborn N. Resilient Adaptation Strategies: Unveiling Older Adults' Coping Dynamics Amidst the COVID-19 Pandemic. J Gerontol Nurs 2023; 49:32-39. [PMID: 38015152 DOI: 10.3928/00989134-20231108-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Older adults, who are particularly vulnerable to coronavirus disease 2019 (COVID-19), exhibit less stress and greater well-being than their younger peers. However, there have been no in-depth explorations of adaptive coping strategies among this population, nor has the role of frailty status been addressed. The current study examined stress and coping in 30 U.S. older adults (mean age = 81 years, range = 68 to 95 years) amidst the COVID-19 pandemic, uncovering themes of: (1) Pandemic Stresses: stresses experienced during the pandemic centered around social isolation and concern for others' well-being; (2) Resilience: older adults proved highly adaptable, with lifetime experience as a stress buffer; and (3) Silver Linings: older adults reported positive by-products, such as reconnecting with and a renewed appreciation for life and nature. Motivation for change and change itself centered around creating value and meaning in the present, especially around social isolation. Findings challenge existing ageist stereotypes, give insight into interventional design, and highlight the importance of ensuring infrastructural and societal support. [Journal of Gerontological Nursing, 49(12), 32-39.].
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Christodoulakis N, Abdelkader W, Lokker C, Cotterchio M, Griffith LE, Vanderloo LM, Anderson LN. Public Health Surveillance of Behavioral Cancer Risk Factors During the COVID-19 Pandemic: Sentiment and Emotion Analysis of Twitter Data. JMIR Form Res 2023; 7:e46874. [PMID: 37917123 PMCID: PMC10624214 DOI: 10.2196/46874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/28/2023] [Accepted: 09/15/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and its associated public health mitigation strategies have dramatically changed patterns of daily life activities worldwide, resulting in unintentional consequences on behavioral risk factors, including smoking, alcohol consumption, poor nutrition, and physical inactivity. The infodemic of social media data may provide novel opportunities for evaluating changes related to behavioral risk factors during the pandemic. OBJECTIVE We explored the feasibility of conducting a sentiment and emotion analysis using Twitter data to evaluate behavioral cancer risk factors (physical inactivity, poor nutrition, alcohol consumption, and smoking) over time during the first year of the COVID-19 pandemic. METHODS Tweets during 2020 relating to the COVID-19 pandemic and the 4 cancer risk factors were extracted from the George Washington University Libraries Dataverse. Tweets were defined and filtered using keywords to create 4 data sets. We trained and tested a machine learning classifier using a prelabeled Twitter data set. This was applied to determine the sentiment (positive, negative, or neutral) of each tweet. A natural language processing package was used to identify the emotions (anger, anticipation, disgust, fear, joy, sadness, surprise, and trust) based on the words contained in the tweets. Sentiments and emotions for each of the risk factors were evaluated over time and analyzed to identify keywords that emerged. RESULTS The sentiment analysis revealed that 56.69% (51,479/90,813) of the tweets about physical activity were positive, 16.4% (14,893/90,813) were negative, and 26.91% (24,441/90,813) were neutral. Similar patterns were observed for nutrition, where 55.44% (27,939/50,396), 15.78% (7950/50,396), and 28.79% (14,507/50,396) of the tweets were positive, negative, and neutral, respectively. For alcohol, the proportions of positive, negative, and neutral tweets were 46.85% (34,897/74,484), 22.9% (17,056/74,484), and 30.25% (22,531/74,484), respectively, and for smoking, they were 41.2% (11,628/28,220), 24.23% (6839/28,220), and 34.56% (9753/28,220), respectively. The sentiments were relatively stable over time. The emotion analysis suggests that the most common emotion expressed across physical activity and nutrition tweets was trust (69,495/320,741, 21.67% and 42,324/176,564, 23.97%, respectively); for alcohol, it was joy (49,147/273,128, 17.99%); and for smoking, it was fear (23,066/110,256, 20.92%). The emotions expressed remained relatively constant over the observed period. An analysis of the most frequent words tweeted revealed further insights into common themes expressed in relation to some of the risk factors and possible sources of bias. CONCLUSIONS This analysis provided insight into behavioral cancer risk factors as expressed on Twitter during the first year of the COVID-19 pandemic. It was feasible to extract tweets relating to all 4 risk factors, and most tweets had a positive sentiment with varied emotions across the different data sets. Although these results can play a role in promoting public health, a deeper dive via qualitative analysis can be conducted to provide a contextual examination of each tweet.
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Affiliation(s)
- Nicolette Christodoulakis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Wael Abdelkader
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Cynthia Lokker
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Michelle Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Population Health and Value Based Health Systems, Ontario Health, Toronto, ON, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, ON, Canada
- School of Occupational Therapy, Western University, London, ON, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Kibe LW, Bosah A, Schrode KM, Kuo Y, Shaheen M, Adinkra E, Sanchez H, Bazargan M. Assessing Food Access, Exercise, and Dietary History among Older African American Parishioners During the COVID-19 Pandemic (C-FED Study): Design, Opportunities, Challenges, and Lessons Learned. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01657-8. [PMID: 37336866 DOI: 10.1007/s40615-023-01657-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Unhealthy diets and inadequate exercise are associated with chronic health conditions and excess mortality. Older African Americans do not meet dietary and exercise guidelines, and this may have worsened during the COVID-19 pandemic due to individual and environmental factors, including food insecurity. Studies evaluating these dynamics are essential for developing interventions. This narrative details a study protocol and data collection experiences during the pandemic. METHODS Participants > 55 years African American old completed detailed food frequency, exercise, and food access questionnaires between October 2020 and July 2021. Observations of the study administrators (authors of this manuscript) for the duration of the study are presented. Details on the study design and reflections on the opportunities, challenges, and lessons learned are summarized. Future manuscripts will report data analysis of study findings. RESULTS A total of 123 older African American adults participated in the study, and 118 (70% female) completed all three questionnaires. More than 50% of the participants had at least two primary chronic conditions. About 85% were fully vaccinated against COVID-19. Applying community-based participatory approaches, leveraging partnerships, and exercising flexibility approaches were pivotal to successfully implementing the study protocol. CONCLUSIONS Despite challenges related to the COVID-19 pandemic, detailed data on older African American adults' diet and exercise habits were obtained. Our study design and experiences will benefit future researchers. More importantly, results from our study will inform interventions and policies aimed at minimizing consequences associated with poor diet and exercise habits during the pandemic among this vulnerable population.
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Affiliation(s)
- Lucy W Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA.
| | - Adaobi Bosah
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
| | - Katrina M Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Yufu Kuo
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Edward Adinkra
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Humberto Sanchez
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, 90059, USA
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Alves ÁE, Canaan MM, Baruqui Junior AM, Barros FC, Andrade EF, Castelo PM, Pereira LJ. Metabolic control of diabetic patients assisted by private and public health care systems during the COVID-19 pandemic: A retrospective cohort study. Prim Care Diabetes 2023; 17:242-249. [PMID: 37031080 PMCID: PMC10070783 DOI: 10.1016/j.pcd.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/04/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023]
Abstract
AIMS We sought to analyze the impacts of social restriction measures imposed by the pandemic COVID-19 on the control of metabolic parameters in diabetic patients. METHODS We accessed the medical records of patients who underwent clinical follow-up in the public and private health systems between July 2019 and June 2021. The sample consisted of 288 patients (111 adults and 177 older individuals). A two-way ANOVA mixed model was used to test the effects of intra- (time: baseline and after 24 months) and inter-subject factors. Linear regression analysis was used to predict the difference in body weight considering age, sex, HbA1c, health care system and insulin use. RESULTS Among adults, we observed an increase in body weight and LDL-c levels, especially for insulin users (p ≤ 0.05). Adults assisted by the public health care system showed higher HbA1c levels (p = 0.001). Among older individuals using insulin, blood glucose levels decreased (p = 0.019). Body weight decreased in those assisted by the private system (p = 0.005), while glycemia decreased for patients assisted by both health care systems (p = 0.043). The linear regression model confirmed that the increase in body weight was more pronounced in adults than in older individuals. CONCLUSION The social restriction measures imposed by the pandemic affected the metabolic control of diabetic patients, especially adults assisted by the public health care system.
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Affiliation(s)
| | - Marcelo Martins Canaan
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil
| | | | | | - Eric Francelino Andrade
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Luciano José Pereira
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil.
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Monroe-Lord L, Harrison E, Ardakani A, Duan X, Spechler L, Jeffery TD, Jackson P. Changes in Food Consumption Trends among American Adults since the COVID-19 Pandemic. Nutrients 2023; 15:nu15071769. [PMID: 37049609 PMCID: PMC10096875 DOI: 10.3390/nu15071769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
The quality and quantity of food consumption have changed due to the COVID-19 pandemic. In this study, we examined how the COVID-19 pandemic has changed the consumption of different food groups in order to close the research gap by providing current evidence that reflects a later stage of the pandemic compared to other circulating research conducted at earlier stages. Data collection for this cross-sectional study was performed via an online Qualtrics survey from 10,050 adults aged 40-100 years. Nutritional status was measured using the 24-item short-form Dietary Screening Tool (DST) twice: before and since the COVID-19 pandemic. The DST questions were categorized based on MyPlate items, along with fat, sugar, and sweet items, as well as nutritional supplement intake. In addition, the total DST score was calculated for each participant, which categorized them into one of three groups: "at risk", "possible risk", and "not at risk". The results revealed that the consumption of grains, fruit, lean protein, and dairy decreased significantly, while the consumption of fat, sugar, and sweet items increased significantly due to COVID-19. The biggest decreases in consumption of food subcategories were related to whole grain bread and cereal, followed by fruit as a snack, in comparison with other types of grain and fruit. No changes in the consumption of vegetables, processed meat, or supplement intake were seen. The total DST score showed that, before and since COVID-19, the overall nutrition status of adult Americans has been at risk. In addition, of those participants who were not at risk before COVID-19, 28.5% were either at risk or at possible risk since COVID-19; moreover, of those participants who were at possible risk before COVID-19, 21% were at risk since COVID-19. As a good nutritional status can reduce the risk of severe illness or even mortality rate in times of crisis, the findings of this study can help policymakers and health educators to develop heath-protecting behavior sessions against future pandemics to manage crises.
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Affiliation(s)
- Lillie Monroe-Lord
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC 20008, USA
| | | | - Azam Ardakani
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC 20008, USA
| | - Xuejling Duan
- Data Analytics, McDaniel College, 2 College Hill, Westminster, MD 21157, USA
| | - Lily Spechler
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC 20008, USA
| | - Tia D Jeffery
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC 20008, USA
| | - Phronie Jackson
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC 20008, USA
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McBain RK, Cantor J, Pera MF, Breslau J, Bravata DM, Whaley CM. Mental Health Service Utilization Rates Among Commercially Insured Adults in the US During the First Year of the COVID-19 Pandemic. JAMA Health Forum 2023; 4:e224936. [PMID: 36607697 PMCID: PMC9857246 DOI: 10.1001/jamahealthforum.2022.4936] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Importance The COVID-19 pandemic has been associated with an elevated prevalence of mental health conditions and disrupted mental health care throughout the US. Objective To examine mental health service use among US adults from January through December 2020. Design, Setting, and Participants This cohort study used county-level service utilization data from a national US database of commercial medical claims from adults (age >18 years) from January 5 to December 21, 2020. All analyses were conducted in April and May 2021. Main Outcomes and Measures Per-week use of mental health services per 10 000 beneficiaries was calculated for 5 psychiatric diagnostic categories: major depressive disorder (MDD), anxiety disorders, bipolar disorder, adjustment disorders, and posttraumatic stress disorder (PTSD). Changes in service utilization rates following the declaration of a national public health emergency on March 13, 2020, were examined overall and by service modality (in-person vs telehealth), diagnostic category, patient sex, and age group. Results The study included 5 142 577 commercially insured adults. The COVID-19 pandemic was associated with more than a 50% decline in in-person mental health care service utilization rates. At baseline, there was a mean (SD) of 11.66 (118.00) weekly beneficiaries receiving services for MDD per 10 000 enrollees; this declined by 6.44 weekly beneficiaries per 10 000 enrollees (β, -6.44; 95% CI, -8.33 to -4.54). For other disorders, these rates were as follows: anxiety disorders (mean [SD] baseline, 12.24 [129.40] beneficiaries per 10 000 enrollees; β, -5.28; 95% CI, -7.50 to -3.05), bipolar disorder (mean [SD] baseline, 3.32 [60.39] beneficiaries per 10 000 enrollees; β, -1.81; 95% CI, -2.75 to -0.87), adjustment disorders (mean [SD] baseline, 12.14 [129.94] beneficiaries per 10 000 enrollees; β, -6.78; 95% CI, -8.51 to -5.04), and PTSD (mean [SD] baseline, 4.93 [114.23] beneficiaries per 10 000 enrollees; β, -2.00; 95% CI, -3.98 to -0.02). Over the same period, there was a 16- to 20-fold increase in telehealth service utilization; the rate of increase was lowest for bipolar disorder (mean [SD] baseline, 0.13 [16.72] beneficiaries per 10 000 enrollees; β, 1.40; 95% CI, 1.04-1.76) and highest for anxiety disorders (mean [SD] baseline, 0.20 [9.28] beneficiaries per 10 000 enrollees; β, 9.12; 95% CI, 7.32-10.92). When combining in-person and telehealth service utilization rates, an overall increase in care for MDD, anxiety, and adjustment disorders was observed over the period. Conclusions and Relevance In this cohort study of US adults, we found that the COVID-19 pandemic was associated with a rapid increase in telehealth services for mental health conditions, offsetting a sharp decline in in-person care and generating overall higher service utilization rates for several mental health conditions compared with prepandemic levels.
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Tsekoura M, Fousekis K, Roukounaki M, Giannoulatou E, Kolokithas G, Sakellaropoulou Α, Gridelas A, Kastrinis A, Billis E, Tsepis E. Investigation of Physical Activity Levels and Associated Factors of Greek Older Adults During COVID-19 Pandemic: A Community-Based Cross-Sectional Study. Adv Exp Med Biol 2023; 1425:353-358. [PMID: 37581809 DOI: 10.1007/978-3-031-31986-0_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The purpose of this cross-sectional study was to investigate the self-reported impact of the COVID-19 pandemic on physical activity (PA), anxiety, and depression amongst Greek older adults. Participants were older adults (>60 years) recruited from community centers of Achaia (Open Care Centers for Older Adults), in Western Greek mainland during the period of December 2020-March 2021. The information was gathered through telephone interviews. Questions on social demographics, health history, diagnosis, quarantine, and hospitalization were asked, as well as impact of the pandemic health status and physical activity behavior. The level of PA was assessed via the International Physical Activity Questionnaire (IPAQ) questionnaire, while anxiety and depression via the Hospital and Anxiety and Depression Scale (HADS). The study protocol was approved by the Ethical Committee of the University of Patras. Four-hundred eleven (411) older adults (306 women, 105 men; mean age of 72.47 ± 6.89 years years) completed the survey. About half of the sample (n = 179; 43.5%) reported a decrease in physical activity due to the pandemic and social isolation restrictions. From the total sample, 211 older adults (51.3%) recorded fear of COVID-19 infection and 9 participants (2.1%) reported to have been diagnosed with the COVID-19 infection. The findings of this study demonstrated that PA was associated with place of living (r = 0.55; p ≤ 0.001), incidence of falls (r = 0.45; p ≤ 0.001), COVID-19 infection (r = 0.6; p ≤ 0.001), fear of COVID-19 infection (r = 0.45; p ≤ 0.05), and anxiety (r = 0.5; p ≤ 0.001). In summary, a decline in PA due to COVID-19 pandemic was reported by the majority of Greek older adults. Results of the present study show that the COVID-19 pandemic may have induced PA behavior changes in many older adults, which may accelerate their risk of developing frailty, sarcopenia, and disability. Interventions to improve PA in older adults should take into account social and community factors and should be key components of current and future pandemic plans, particularly for vulnerable groups.
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Affiliation(s)
- Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - K Fousekis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - M Roukounaki
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - E Giannoulatou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - G Kolokithas
- Department of Elderly, Open Care Centres for the Elderly, Social Organization Municipality of Patras, Patras, Greece
| | - Α Sakellaropoulou
- Department of Elderly, Open Care Centres for the Elderly, Social Organization Municipality of Patras, Patras, Greece
| | - An Gridelas
- Department of Elderly, Open Care Centres for the Elderly, Social Organization Municipality of Patras, Patras, Greece
| | - A Kastrinis
- Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - E Billis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - E Tsepis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
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Liu Y, Wang H, Hughes MC. Health Behaviors, Financial Difficulties, and Depressive Symptoms Among Older Adults Across Gender and Race During the COVID-19 Pandemic. Gerontol Geriatr Med 2023; 9:23337214231192820. [PMID: 37565025 PMCID: PMC10411279 DOI: 10.1177/23337214231192820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Background: COVID-19 deeply affected the health and well-being of older adults. This study examines health behavior change and the interrelationships between health behaviors, financial difficulties, and depressive symptoms among older adults across gender and race during the pandemic. Methods: Using Rounds 1, 5, and 10 of the National Health and Aging Trends Study (NHATS) linked with the NHATS COVID-19 dataset, our sample included Medicare beneficiaries aged 65 or older in the U.S. (N = 3,118). We modeled the interrelationships between health behaviors, financial difficulties, and depressive symptoms using a structural equation model. Results: Female participants reported less walking, more changes in eating habits, less sleeping, and less alcohol consumption during the pandemic than before the pandemic compared to male participants. Compared to White, Non-White participants showed higher proportions of experiencing financial difficulties, less walking, less vigorous activity, and changes in time spent eating and sleeping during than before the pandemic. Financial difficulties was positively associated with depressive symptoms and sedentary behavior. Active behavior was negatively associated with depressive symptoms, while sedentary behavior was positively associated with more depressive symptoms. Discussion: Health professionals should consider health behaviors and financial difficulties when intervening on depressive symptoms experienced by older adults since the pandemic.
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Affiliation(s)
- Yujun Liu
- Northern Illinois University, DeKalb, USA
| | - Heng Wang
- Rush University Medical Center, Chicago, IL, USA
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11
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Zhang Z, Wei W, Zhu T, Zhou M, Li Y. New Dimension on Quality of Life Differences among Older Adults: A Comparative Analysis of Digital Consumption in Urban and Rural Areas of China. Int J Environ Res Public Health 2022; 19:15203. [PMID: 36429922 PMCID: PMC9691223 DOI: 10.3390/ijerph192215203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to compare the variability in quality of life in the area of digital consumption among older adults in urban and rural China during the COVID-19 pandemic. This study proposed a low-cost mixed research method, and the methodology used a quantitative study of a large regional sample combined with a qualitative study of a small regional sample. Data for the large-scale area sample were obtained from the China family panel study (CFPS) dataset, and data for the small-scale regional sample were obtained from Nanjing, China. The quantitative analysis of the large-scale regional sample used the least squares regression analysis (OSL) and propensity score matching (PSM). The qualitative analysis of the small-scale regional sample used the selection optimization and compensation (SOC) model. The findings show that economic income is a direct driver of digital consumption. Digital consumption had a significant positive relationship with the quality of life for urban and rural older adults. In addition, the study established the semantic network relationships of the coping strategies of digital consumption of older adults and their drivers. Finally, the theoretical and practical implications of these findings are discussed in the context of other related studies.
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12
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Van Vleet B, Fuller HR, Hofmann B, Huseth-Zosel A. Untapped Insight: A Longitudinal Qualitative Analysis of Older Adults' Advice During the COVID-19 Pandemic. Innov Aging 2022; 6:igac071. [PMID: 36600809 PMCID: PMC9799044 DOI: 10.1093/geroni/igac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives Due to a lifetime of experience, older adults are uniquely positioned to contribute advice and insight to others during a historical, societal crisis such as the coronavirus disease 2019 (COVID-19) pandemic. This qualitative study explores the solicited advice older adults offered their peers, family members, and communities throughout the first year of the pandemic. Research Design and Methods A sample of 72 older adults aged 70-97 from Minnesota and North Dakota were asked what advice they would provide to others in June 2020 and again in April/May 2021. Participants were asked to provide advice on individual coping and how community members should support older adults during the pandemic, as well as how others should adjust after the pandemic. Responses were coded and developed into overarching themes. Results Older adults advised others during the pandemic to foster mental and physical well-being, develop positive life perspectives, and connect to others as strategies to cope through the pandemic. Participants advised that after the pandemic people should remain vigilant, return to normal, and emerge as better people. Advice targeted to meeting the needs of older adults during the pandemic included: adopt selfless attitudes, take intentional actions, and maintain balance. A longitudinal approach revealed that advice remained consistent over time, despite the circumstances caused by COVID-19 changing. Discussion and Implications Findings suggest that older adults utilize their life experiences and coping strategies as sources for drawing advice. These findings also suggest that older adults are sources of insight during crises. Future research should investigate additional advice older adults can offer and how willingly communities listen. Applied work should give older adults opportunities to provide far-reaching advice as well as develop interventions aimed at decreasing ageist perceptions of older adults in times of crisis.
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Affiliation(s)
- Bryce Van Vleet
- Address correspondence to: Bryce Van Vleet, BA, Human Development and Family Science, North Dakota State University, P.O. Box 6050, Fargo, ND 58108-6050, USA. E-mail:
| | - Heather R Fuller
- Department of Human Development and Family Science, North Dakota State University, Fargo, North Dakota, USA
| | - Brittany Hofmann
- Department of Human Development and Family Science & School of Business, North Dakota State University, Fargo, North Dakota, USA
| | - Andrea Huseth-Zosel
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
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13
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Romero JL, Lv Q. Global Impact of COVID-19 Pandemic on Physical Activity Habits of Competitive Runners: An Analysis of Wearable Device Data. Int J Environ Res Public Health 2022; 19:12933. [PMID: 36232233 PMCID: PMC9566411 DOI: 10.3390/ijerph191912933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic resulted in government restrictions that altered the lifestyle of people worldwide. Studying the impact of these restrictions on exercise behaviors will improve our understanding of the environmental factors that influence individuals' physical activity (PA). We conducted a retrospective analysis using an stringency index of government pandemic policies developed by Oxford University and digitally-logged PA data from more than 7000 runners collected using a wearable exercise-tracking device to compare the relationship between strictness of lockdowns and exercise habits on a global scale. Additionally, the time-of-day of PA globally, and activity-levels of PA in 14 countries, are compared between the pre-pandemic year of 2019 and the first pandemic year of 2020. We found that during the pandemic year there was a major shift in the time-of-day that runners exercised, with significantly more activity counts logged during standard working hours on workdays (p < 0.001) and fewer activities during the same time frame on weekends (p < 0.001). Of the countries examined, Italy and Spain had among the most strict lockdowns and suffered the largest decreases in activity counts, whereas France experienced a minimal decrease in activity counts despite enacting a strict lockdown with certain allowances. This study suggests that there are several factors affecting PA of dedicated runners, including government policy, workplace policy, and cultural norms.
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Wong LY, Francis SL, Genschel U, Arthur A, Xu F, Weidauer L, Monroe-Lord L, Ventura-Marra M, Sahyoun NR, Kendall C. A cross-sectional assessment of food practices, physical activity levels, and stress levels in middle age and older adults' during the COVID-19 pandemic. Z Gesundh Wiss 2022; 31:1-17. [PMID: 35968050 PMCID: PMC9362154 DOI: 10.1007/s10389-022-01742-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022]
Abstract
Aim This cross-sectional study examined how the COVID-19 pandemic impacted the food practices, physical activity (PA) levels, and stress levels of aging adults ages 40 years and older from seven states. It also explored to what extent the COVID-19 outcomes were affected by the social determinants of health (SDH). Subject and methods Respondents (n = 1250) completed an online survey. Descriptive statistics were used to analyze the sociodemographic attributes and COVID-19 responses while the multiple llinear regression (MLR) test evaluated to what extent the SDH variables measured were associated with the reported COVID-19 impacts food practices, PA levels, and stress levels. Results Respondents were mostly White (75.9%), married (58.7%), age 60 years and older (61.8%), with a high school education or higher (97.4%). Most of the respondents (85.8%) live in areas that respondents perceived as supportive of health and well-being opportunities for older adults. Nearly one-half of the respondents reported maintaining their pre-pandemic grocery shopping/food buying frequency (44.7%) and PA levels (48.1%). However, 48.6% reported being "somewhat or very stressed" due to the pandemic. Findings revealed that the COVID-19 impacts on food-buying, PA levels, and stress levels were significantly influenced by age, gender, race, education, location, community, nutritional risk, quality of life, food security, and income (p < 0.05). Conclusion These findings provide valuable information as we continue to confront the impact the COVID-19 pandemic has had on the health and well-being of aging adults. We can use this information to inform future public health programming interventions and opportunities.
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Affiliation(s)
- Loo Yee Wong
- Department of Food Science and Human Nutrition, Iowa State University, 36 MacKay Hall, 2302 Osborn Drive, Ames, IA 50011-1078 USA
| | - Sarah L. Francis
- Department of Food Science and Human Nutrition, Iowa State University, 36 MacKay Hall, 2302 Osborn Drive, Ames, IA 50011-1078 USA
| | - Ulrike Genschel
- Department of Food Science and Human Nutrition, Iowa State University, 36 MacKay Hall, 2302 Osborn Drive, Ames, IA 50011-1078 USA
| | - Anna Arthur
- University of Kansas Medical Center, Kansas City, KS USA
| | - Furong Xu
- University of Rhode Island, Kingston, RI USA
| | - Lee Weidauer
- South Dakota State University, Brookings, SD USA
| | | | | | | | - Chandler Kendall
- Department of Food Science and Human Nutrition, Iowa State University, 36 MacKay Hall, 2302 Osborn Drive, Ames, IA 50011-1078 USA
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15
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Chen L, Liu L, Wu H, Peng Z, Sun Z. Change of Residents’ Attitudes and Behaviors toward Urban Green Space Pre- and Post- COVID-19 Pandemic. Land 2022; 11:1051. [DOI: 10.3390/land11071051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The COVID-19 pandemic has changed and influenced people’s attitudes and behaviors toward visiting green spaces. This paper aims to explore the association between residents’ health and urban green spaces (UGS) through an in-depth study of changes in residents’ use of UGS under the influence of the COVID-19 pandemic. The Wuhan East Lake Greenway Park was selected as the location for the field survey and in-depth interviews. At the same time, an online survey was also conducted (total number = 302) regarding participants’ physical and mental health and their attitude and behavior toward the UGS. A paired sample t-test and binary logistic regression were performed to investigate the association between participants’ health and UGS during COVID-19. The results show that: (1) the COVID-19 pandemic has primarily changed the leisure patterns of parks, with potential impacts on the physical and mental health of participants; (2) the purpose, frequency, timing, and preferred areas of participants’ park visits have changed to varying degrees after the pandemic, highlighting the important role and benefits of UGSs; (3) the physical and mental health of participants and urban development issues reflected by UGS use are prominent. This study reveals that awareness of the construction and protection of UGSs is an important prerequisite for ensuring the health of urban residents.
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16
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Lee DJ, Miller CA, Gambale A, Nisani M, Marra M, Leung ER, Chillianis D, Rodgers M. Survey of physical activity in persons with limb loss during the COVID-19 pandemic in the United States. Prosthet Orthot Int 2022; 46:220-226. [PMID: 35121718 DOI: 10.1097/pxr.0000000000000093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Physical activity has been shown to be fundamental in the prevention of numerous diseases and disorders. Achieving and maintaining physical activity levels can be particularly challenging in those with impairments, such as those experiencing a lower limb amputation. To slow the spread of the virus, COVID-19 lockdown mandates imposed by the US state governments may have inadvertent consequences on physical activity levels of those dependent on specific forms of exercise. Understanding how physical activity levels may have affected persons with limb loss can inform intervention strategies for this vulnerable population. OBJECTIVES Examine the effects of the COVID-19 pandemic on physical activity levels in persons with limb loss. STUDY DESIGN Mixed-method design. METHODS A 20-item logic web-based survey and semistructured interviews were administered to individuals who were 18 years or older, spoke English, and had a history of lower limb loss. Quantitative data were analyzed using SPSS v25, whereas qualitative data were analyzed using constant comparison to formulate themes. RESULTS There were a significant effect on the amount of physical activity minutes performed per day, a negative effect on the ability to exercise and participate in societal engagements, and a series of barriers to performing physical activity because of the pandemic. CONCLUSION Physical activity was reduced significantly in persons with limb loss during the COVID-19 pandemic. A combination of health concerns, fitness center closures, and social distancing mandates were the primary drivers behind the decrease in activity.
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Affiliation(s)
| | - Carol A Miller
- Philadelphia College of Osteopathic Medicine, Suwanee, GA
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17
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Chan CT, Ming K, Camp C, Saberi P. Sexual Behaviors, Substance Use, and Quality of Life Among Individuals Using PrEP in San Francisco During the COVID-19 Pandemic Shelter-In-Place Orders: A Cross-Sectional Survey. J Acquir Immune Defic Syndr 2022; 89:e39-e42. [PMID: 34974469 PMCID: PMC8881333 DOI: 10.1097/qai.0000000000002900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Carrie T Chan
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA
- Stanford Children's Health, Palo Alto, CA
| | - Kristin Ming
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
| | - Christina Camp
- Department of Community Health Systems Nursing, University of California San Francisco, San Francisco, CA
| | - Parya Saberi
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
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18
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Sithichoksakulchai S, Chen M, Chen K. Walking Promotes Physical Fitness of Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. Topics in Geriatric Rehabilitation 2022; 38:101-9. [DOI: 10.1097/tgr.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Zach S, Eilat-Adar S, Ophir M, Dotan A. Differences in the Association between Physical Activity and People's Resilience and Emotions during Two Consecutive Covid-19 Lockdowns in Israel. Int J Environ Res Public Health 2021; 18:ijerph182413217. [PMID: 34948825 PMCID: PMC8701463 DOI: 10.3390/ijerph182413217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022]
Abstract
Governments worldwide have imposed harsh restrictions for decreasing the Covid-19 pandemic and maintaining public health. Yet such limitations have impacted people's physical activity. This study examined relationships between changes in physical activity and resilience, emotions, and depression during two lockdowns in Israel. An online survey was completed twice by 135 participants during two consecutive lockdowns. The results indicate that resilience and positive emotions were higher, and negative emotions and depression were lower during the second lockdown compared to the first one-even though people spent less time performing physical activity in the later lockdown. Moreover, negative emotions significantly decreased among people who reported increased physical activity during the second lockdown [M = 2.2 (SD = 0.9) compared to M = 1.9 (SD = 0.8) on a scale of 1-5] and increased among those who reported a reduction in activity [M = 1.8 (SD = 0.7) compared to M = 2.2 (SD = 0.7)]. It could therefore be concluded that while the Israeli population's resilience is higher compared to other populations (who do not regularly deal with crisis situations), their increased physical activity was associated with better resilience and emotions and lower depression scores. Since lockdowns are an extreme yet often repeated phenomenon, it is important to understand the psychological implications of engaging in physical activity.
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Affiliation(s)
- Sima Zach
- Correspondence: (S.Z.); (S.E.-A.); Tel.: +972-54-44-00029 or +972-09-8639307 (S.E.-A.)
| | - Sigal Eilat-Adar
- Correspondence: (S.Z.); (S.E.-A.); Tel.: +972-54-44-00029 or +972-09-8639307 (S.E.-A.)
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Abstract
The excellent stretchability and biocompatibility of flexible sensors have inspired an emerging field of plant wearables, which enable intimate contact with the plants to continuously monitor the growth status and localized microclimate in real-time. Plant flexible wearables provide a promising platform for the development of plant phenotype and the construction of intelligent agriculture via monitoring and regulating the critical physiological parameters and microclimate of plants. Here, the emerging applications of plant flexible wearables together with their pros and cons from four aspects, including physiological indicators, surrounding environment, crop quality, and active control of growth, are highlighted. Self-powered energy supply systems and signal transmission mechanisms are also elucidated. Furthermore, the future opportunities and challenges of plant wearables are discussed in detail.
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Affiliation(s)
- Chun-Chun Qu
- College of Engineering, China Agricultural University, Beijing, 100083, China
- State Key Laboratory of Plant Physiology and Biochemistry, Center for Crop Functional Genomics and Molecular Breeding, China Agricultural University, Beijing, 100083, China
- Sanya Institute of China Agricultural University, China Agricultural University, Hainan, 572000, China
| | - Xu-Yang Sun
- School of Medical Science and Engineering, Beihang University, Beijing, 100191, China
| | - Wen-Xiu Sun
- College of Engineering, China Agricultural University, Beijing, 100083, China
- State Key Laboratory of Plant Physiology and Biochemistry, Center for Crop Functional Genomics and Molecular Breeding, China Agricultural University, Beijing, 100083, China
| | - Ling-Xiao Cao
- College of Engineering, China Agricultural University, Beijing, 100083, China
| | - Xi-Qing Wang
- State Key Laboratory of Plant Physiology and Biochemistry, Center for Crop Functional Genomics and Molecular Breeding, China Agricultural University, Beijing, 100083, China
| | - Zhi-Zhu He
- College of Engineering, China Agricultural University, Beijing, 100083, China
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21
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Abstract
Food insecurity has emerged as a significant problem for older adults in the United States. Older adults with chronic conditions are particularly vulnerable, as they face a number of physical, psychological, social, and economic barriers related to food purchasing options. The purpose of the current article is to examine the significance of food insecurity in older adults with chronic disease, highlight the barriers and determinates that contribute to the problem, and offer interventions to impact the disparity of food insecurity in this population. [Journal of Gerontological Nursing, 47(12), 7-11.].
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22
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Johnson N, Bradley A, Klawitter L, Johnson J, Johnson L, Tomkinson GR, Hackney KJ, Stastny S, Ehlers DK, McGrath R. The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study. Geriatrics (Basel) 2021; 6:geriatrics6030068. [PMID: 34209416 PMCID: PMC8293040 DOI: 10.3390/geriatrics6030068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic. Methods: There were n = 13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth intervention during the COVID-19 pandemic. The didactic intervention contents were shared online, and participants worked with trained interviewers over the telephone to discuss physical activity. At baseline and post-intervention, the Multimedia Activity Recall for Children and Adults examined activity profiles, while accelerometry estimated time spent sedentary and in physical activity. Results: Relative to the baseline measures, there was an 88 min/day (95% confidence interval (CI): 39, 137) increase in computer time and 36 min/day (CI: 10, 62) reduction in time spent in active transport at post-intervention. Moderate-to-vigorous physical activity participation also increased by an estimated 2 min/day (CI: −21, 26) and 12 min/week (CI: −154, 180), but this trend was not statistically significant. Conclusion: We recommend that support be provided to older adults transitioning to telehealth, especially as migration to telehealth progresses.
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Affiliation(s)
- Nathaniel Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Adam Bradley
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Jane Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Lance Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Grant R. Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND 58202, USA;
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, SA 5501, Australia
| | - Kyle J. Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Sherri Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
| | - Diane K. Ehlers
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; (N.J.); (A.B.); (L.K.); (J.J.); (L.J.); (K.J.H.); (S.S.)
- Fargo VA Healthcare System, Fargo, ND 58102, USA
- Correspondence: ; Tel.: +1-701-231-7474; Fax: +1-701-231-8872
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