Mental well-being and physical activity of young people experiencing homelessness before and during COVID-19 lockdown: A longitudinal study

The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review

Objective: The homeless population experiences inequality in health compared with the general population, which may have widened during the COVID-19 pandemic. However, the impact of being homeless on the outcomes of COVID-19 is uncertain. This systematic review aimed to analyse the impact of experiencing homelessness on the clinical outcomes of COVID-19, including the effects on health inequalities. Methods: A review protocol was developed and registered in PROSPERO (PROSPERO registration 2022 CRD42022304941). Nine databases were searched in November 2022 to identify studies on homeless populations which contained primary research on the following outcomes of COVID-19: incidence, hospitalisation, mortality, long COVID, mental wellbeing, and evidence of inequalities. Included studies were summarised with narrative synthesis. Results: The searches yielded 8,233 initial hits; after screening, 41 studies were included. Overall, evidence showed that those in crowded living settings had a higher risk of COVID-19 infection compared to rough sleepers and the general population. The homeless population had higher rates of hospitalisation and mortality than the general population, lower vaccination rates, and suffered negative mental health impacts. Conclusion: This systematic review shows the homeless population is more susceptible to COVID-19 outcomes. Further research is needed to determine the actual impact of the pandemic on this population, and of interventions to mitigate overall risk, given the low certainty of findings from some of the low-quality evidence available. In addition, further research is required to ascertain the impact of long COVID on those experiencing homelessness, since the present review yielded no studies on this topic.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

Young Adults with Lived Foster Care Experience Who Later Experience Houselessness: an Exploratory Latent Class Analysis

Young adults with lived experience in out-of-home care during childhood report later experiences of housing instability as common. Existing literature identifies a host of factors compounding an individual's risk of experiencing houselessness, but research has yet to explore constellations of characteristics which describe youth formerly in care who later become unhoused. This exploratory study leverages a public-private data linkage collaborative to integrate and de-identify child welfare data extracted from a Rocky Mountain state's administrative database and houselessness service utilization data from a regional provider in a large metro area of the state. Linkage and sampling yielded a final sample of 285 youth (ages 18 to 24) formerly in foster care who accessed houselessness services between December 2018 and March 2020 and who had signed required consents. A 22-measure latent class analysis identified three characteristic groups: intensive youth corrections involvement and emancipation from the child welfare system (32% of sample); family-based challenges, neglect, and more moderate youth corrections involvement (41% of sample); and youth behavior and substance use challenges along with family reunification before accessing houselessness services (26%). We found that young women and Black, Indigenous, and people of color were disproportionately represented in the sample compared to the state's population of youth in out-of-home care. Youth with long histories of child welfare placement were a majority of the sample. Implications are discussed. Data-sharing barriers must be addressed to facilitate further research aimed at understanding houselessness within this population.

Sedentary Behaviour and Physical Activity Levels during Second Period of Lockdown in Chilean’s Schoolchildren: How Bad Is It?

Objective. The objective of this study was to compare the levels of sedentary behaviour and physical activity in relation to sociodemographic variables of Chilean schoolchildren before and during the COVID-19 pandemic. Methods. This retrospective study considered a non-random sample of 83 boys and 232 girls, and their respective parents, who attended public schools (n = 119) and private schools (n = 196) in Chile. A self-report instrument was applied that included sociodemographic variables, sedentary behaviour (SB), and physical activity (PA) in the second period of the pandemic in 2021. Results. The main results show that pre-pandemic SB had significant differences when compared between sexes, except for television time. During the pandemic, there was no significant difference in television time or telephone time. There were no significant differences by sex before and during the pandemic. When comparing the SB scores, video game time in boys decreased (p < 0.001), as did video game time in girls (p < 0.001), and computer time in boys (p < 0.001) and girls (p < 0.001). Telephone time increased in boys (p < 0.001) and girls (p < 0.001), as did television time (p < 0.001). Likewise, PA increased in boys (Δ + 9.51min) and girls (Δ + 3.54 min) during the pandemic (p < 0.001). Conclusions. Both PA and SB underwent changes according to sex before and during the second period of the COVID-19 pandemic in Chilean schoolchildren.

Trends and factors associated with change in COVID-19 vaccination intent among residents and staff in six Seattle homeless shelters, March 2020 to August 2021

Introduction

Achieving high COVID-19 vaccination coverage in homeless shelters is critical in preventing morbidity, mortality, and outbreaks, however, vaccination coverage remains lower among people experiencing homelessness (PEH) than the general population.

Methods

We conducted a cross-sectional study to retrospectively describe attitudes and identify factors associated with change in COVID-19 vaccination intent among shelter residents and staff during March 2020 - August 2021. To identify factors associated with change in COVID-19 vaccine intent becoming more positive overall compared to other attitudes, we utilized a Poisson model to calculate Risk Ratios with robust standard errors, adjusting for confounding by shelter site and demographic variables determined a priori.

Results

From July 12 - August 2, 2021, 97 residents and 20 staff participated in surveys across six shelters in Seattle King County, Washington. Intent to be vaccinated against COVID-19 increased from 45.3 % (n = 53) when recalling attitudes in March 2020 to 74.4 % (n = 87) as of August 2021, and was similar among residents and staff. Many participants (43.6 %, n = 51) indicated feeling increasingly accepting about receiving a COVID-19 vaccine since March 2020, while 13.7 % (n = 16) changed back and forth, 10.3 % (n = 12) became more hesitant, and 32.5 % (n = 38) had no change in intent. In the model examining the relationship between becoming more positive about receiving a COVID-19 vaccine compared to all other attitudes (n = 116), we found a 57.2 % increase in vaccine acceptability (RR 1.57; 95 % CI: 1.01, 2.45) among those who reported worsening mental health since the start of the pandemic.

Conclusions

Findings highlight opportunities to improve communication with residents and staff about COVID-19 vaccination and support a need for continued dialogue and a person-centered approach to understanding the sociocultural complexities and dynamism of vaccine attitudes at shelters.Clinical Trial Registry Number: NCT04141917.

The Role of Physical Activity in the Reduction of Generalised Anxiety Disorder in Young Adults in the Context of COVID-19 Pandemic

Physical activity is critically important not only for physical but also for mental health. Exercise may be a beneficial form of therapy for young adults with anxiety disorders. The global outbreak of the COVID-19 pandemic adversely affected the public, including young adults, in terms of their mental well-being and opportunities for physical activity. The study aimed to identify the influence of physical activity (PA) on generalised anxiety in young adults. It also assessed the changes which occurred in the level of PA and in generalised anxiety in young adults as a result of COVID-19 pandemic. A cross-sectional survey was carried out online with 506 young adults aged 18 to 34 years (=24.67 years ± 4.23 years). Respondents provided two answers to each question, i.e., information relating to the last 7 days during the pandemic (first hard lockdown), and to a period of 7 days before the pandemic (retrospective). The levels of physical activity were measured using 7-item International Physical Activity Questionnaire-Short Form (IPAQ-SF), whereas the level of generalised anxiety was assessed using the Generalised Anxiety Disorder 7 (GAD-7) questionnaire. During the pandemic there was a significant correlation between the level of generalised anxiety and the level of physical activity reported by the respondents (p = 0.048). A higher level of physical activity corresponded to lower level of generalized anxiety in young adults. During the pandemic, young adults spent significantly less time performing physical activity (8752.5 vs. 6174.6 metabolic equivalents (MET) min/week, p < 0.001), they spent more time engaging in sedentary behaviours (Me = 240 vs. Me = 300 min/day, p < 0.001), and they walked much less (from Me = 6930.0 (MET) min/week vs. 3861.0 (MET) min/week (44.29% decrease). Furthermore, after the outbreak of the pandemic the level of perceived generalised anxiety increased significantly (p < 0.001). Physical activity may play an important role in reducing anxiety disorder in young adults. During the COVID-19 pandemic young adults were significantly less involved in PA, which adversely affected their physical and mental condition. The importance of sufficient PA should be emphasised during this specific period, particularly among young adults.

What Types of Exercise Are Best for Emotional Intelligence and Logical Thinking?

The aim of our study was to determine whether EI and LT vs. intuitive thinking (CRT score) are related to participation in professional sports, independent exercise, and exercise at a gym/health center compared with no exercise. We selected 20 of the most popular types of exercise in Lithuania among respondents who exercise independently or at a gym/health center, and we ranked these types of exercise according to the participants' emotional intelligence and logical thinking. We studied 4545 women and 1824 men aged 18-74 years with a focus on whether emotional intelligence and logical thinking are related to type of exercise. Participation in any exercise was significantly related to emotional intelligence in men and women. Women in professional sports solved the lowest number of logic tasks. Women who exercise independently or at a gym/health center had better logical thinking than those who do not exercise. Among men, logical thinking was not associated with the type of exercise. We found the tendency for a negative correlation between EI and LT in the 20 most popular types of exercise. Emotional intelligence correlated positively with participation in MVPA. The highest emotional intelligence was in women who participate in dance or Pilates and in men who participate in martial arts, wrestling, boxing, or yoga. Logical thinking was the highest in men who participate in triathlon and in women who perform CrossFit. Men who practice martial arts or track and field and women who participate in cycling were in the top five for emotional intelligence and logical thinking.

A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe

Persons experiencing homelessness (PEH) are at heightened risk for infection, morbidity, and mortality from COVID-19. However, health consequences of the pandemic extend far beyond those directly caused by the virus. This scoping review aimed to explore the impacts of the COVID-19 pandemic on the health and well-being of PEH in North America and Europe. A systematic search of academic and grey literature was conducted in September 2021. To be included, studies had to include primary data related to the impact of the pandemic on health or well-being of PEH and be written in English. All potentially relevant references were independently screened by two reviewers, and minor conflicts were settled with input of a third reviewer. A total of 96 articles met criteria for inclusion. Data extraction was completed for all included studies, and findings synthesised and presented thematically. Numerous health impacts of the pandemic on PEH were identified, including SARS-CoV-2 infection, morbidity, mortality, and hospitalisation, fear of infection, access to housing, hygiene, PPE, food, as well as mental health, substance use, other health-related outcomes and treatment services. Gaps in the literature relating to persons using alcohol, access to mental health support, and violence were also identified. Implications for future research are discussed.

Prevalence and Risk Factors of Poor Sleep Quality in Collegiate Athletes during COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic has changed our lifestyle, sleep and physical activity habits. This study evaluated the prevalence of poor sleep quality, its disrupters, and the impact of the pandemic in collegiate athletes. We performed a cross-sectional study of collegiate athletes (N = 339, median age: 20 (IQR,19−21) years old, 48.5% female, 47% individual sports) who received a web-based questionnaire in April 2021. This survey included subject characteristics, chronotype, sleep disrupters, the changes due to the pandemic and sleep quality (Pittsburg Sleep Quality Index [PSQI]). A multivariate linear regression was performed to assess the relationship between sleep quality, gender, chronotype, sleep disrupters and the changes to training volume or sleep. Results showed a disrupted sleep quality in 63.7%. One in five students had a total sleep time under 6.5 h per night. Poor sleep quality was significantly correlated with nocturnal concerns related to the pandemic, evening chronotype, female gender, third year of study, caffeine consumption and lack of sleep routine (all p < 0.05). To conclude, poor sleep quality is common in collegiate athletes. Sleep disrupters remain prevalent in the lifestyle habits of this population and may have been exacerbated by changes related to the COVID-19 pandemic. Sleep hygiene should become a major aspect of sports education during the return to post-covid normality.