Changes in work and life patterns associated with depressive symptoms during the COVID-19 pandemic: an observational study of health app (CALO mama) users

Working from home during COVID-19: boundary management tactics and energy resources management strategies reported by public service employees in a qualitative study

BACKGROUND

Increased working from home has imposed new challenges on public service employees, while also granting opportunities for job crafting. Grounding on the Job Demands-Resources model and Hobfoll's Conservation of Resources theory this exploratory research aims to investigate the work-nonwork balance of employees one and a half years after the outbreak of the COVID-19 pandemic. Therefore, the research focus lies on employees' job crafting strategies to optimize their working from home experience concerning boundary management and energy resource management.

METHODS

Twelve semi-structured telephone interviews were conducted with public service employees from different sectors in Germany. The experiences were content analyzed using the software MaxQDA and inductive and deductive categories were derived.

RESULTS

Boundary management comprised different strategies such as communicative (e.g., negotiating work time), physical (e.g., going to the garden), temporal (e.g., logging off in between the work day) and behavioral (e.g., prioritizing tasks) strategies. The job crafting strategies regarding energy management included preventing exhaustion (e.g. taking breaks), healthy cooking and energy management in case of sickness (e.g. deciding on sick leave).

CONCLUSIONS

This qualitative case study enriches research on job crafting by offering insights on boundary tactics and energy resources management strategies for remote working during the COVID-19 pandemic. The results point out different starting points for employees and decision makers, how a work-nonwork balance, energy management and thus employees' wellbeing may be increased when working from home in the future.

TRIAL REGISTRATION

The study design and methodology were approved by the Ethics Committee of the University of Cologne and the study was prospectively registered (Ref No. 21-1417_1).

Effects of working from home on lifestyle behaviors and mental health during the COVID-19 pandemic: A survey study

The COVID-19 outbreak has led to relevant changes in everyday life worldwide. One of these changes has been a rapid transition to and an increasing implementation of working from home (WH) modality. This study aimed to evaluate the impact of mandatory WH during the COVID-19 pandemic on lifestyle behaviors, Mediterranean diet adherence, body weight, and depression. An online cross-sectional survey was conducted in the early 2022 at the National Research Council of Italy using ad hoc questions and validated scales collecting information on physical activity, sedentary behavior, hobbies/pastimes, dietary habits including adherence to the Mediterranean diet, body weight, and depression during WH compared with before WH. 748 respondents were included in the study. An increased sedentary lifetime was reported by 48% of respondents; however, the subsample of workers who previously performed moderate physical activity intensified this activity. Body weight gain during WH was self-reported in 39.9% of respondents. Mediterranean diet adherence increased (p≪0.001) during WH compared with before WH. The average level of mental health did not record an overall variation; however, the proportion of subjects with mild and moderate depression increased (p = 0.006), while workers who reported values indicative of depression before the transition declared an improvement. These findings highlight health-related impact of WH during the COVID-19 pandemic that may inform future strategies and policies to improve employees' health and well-being.

Daily routine disruptions and psychiatric symptoms amid COVID-19: a systematic review and meta-analysis of data from 0.9 million individuals in 32 countries

BACKGROUND

There is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associations between daily routine disruptions and mental disorders amid the COVID-19 pandemic and factors that moderated the associations.

METHODS

PsycINFO, Web of Science, PubMed, and MEDLINE were systematically searched up to April 2023 (PROSPERO: CRD42023356846). Independent variables included regularity, change in frequency, and change in capability of different daily routines (i.e., physical activity, diet, sleep, social activities, leisure activities, work and studies, home activities, smoking, alcohol, combined multiple routines, unspecified generic routines). Dependent variables included symptoms and/or diagnoses of mental disorders (i.e., depression, anxiety, post-traumatic stress disorder, and general psychological distress).

RESULTS

Fifty-three eligible studies (51 independent samples, 910,503 respondents) were conducted in five continents. Daily routine disruptions were positively associated with depressive symptoms (r = 0.13, 95% CI = [0.06; 0.20], p < 0.001), anxiety symptoms (r = 0.12, 95% CI = [0.06; 0.17], p < 0.001), and general psychological distress (r = 0.09, 95% CI = [0.02; 0.16], p = 0.02). The routine-symptom associations were significant for physical activity, eating, sleep, and smoking (i.e., type), routines that were defined and assessed on regularity and change in capability (i.e., definition and assessment), and routines that were not internet-based. While the positive associations remained consistent across different sociodemographics, they were stronger in geo-temporal contexts with greater pandemic severity, lower governmental economic support, and when the routine-symptom link was examined prospectively.

CONCLUSIONS

This is one of the first meta-analytic evidence to show the positive association between daily routine disruptions and symptoms of mental disorders among large populations as COVID-19 dynamically unfolded across different geo-temporal contexts. Our findings highlight the priority of behavioral adjustment for enhancing population mental health in future large-scale disasters like COVID-19.

A Smartphone-Based Shopping Mall Walking Program and Daily Walking Steps

Importance

Because shopping malls are considered safe places for walking, several mall walking programs have been developed. Research on the association between the use of walking programs and the number of daily steps taken is limited.

Objective

To evaluate the association between use of a smartphone-based shopping mall walking program and daily steps taken after the COVID-19 pandemic.

Design, Setting, and Participants

This cohort study evaluated a nationwide longitudinal data set of 217 344 registered smartphone app users at least 18 years of age residing in Japan. Daily step counts were collected from January 1 to December 31, 2021.

Exposures

The mall walking program Mall Challenge integrated a global positioning system with a smartphone app's incentive system to reward achieving a goal of 1000 daily steps with lottery-based coupons to win from 0 to 500 shopping points (1 point equaled 1 yen or approximately US $0.01).

Main Outcomes and Measures

Daily step records were collected from the smartphone app's walking program and adjusted for gender and age. Multilevel analyses using mixed-effect linear regression models were used to estimate the coefficients for the association between daily participation in the walking program and daily step counts. Cross-level interaction terms of age and gender by walking program participation were included in one model.

Results

Among the 217 344 registered mall app users (23 638 110 daily step records; 154 616 [71.1%] women; 18 014 [8.3%] participants 65 years or older, and 199 330 [91.7%] adults younger than 65 years), the mean (SD) daily steps were 7415 (4686) on walking program participation days and 5281 (4339) on days without participation in the program. Walking program participation days were associated with 1219 additional daily steps (95% CI, 1205-1232) compared with nonparticipation days after adjusting for gender and age. By geographic region, participation in the walking program was associated with 1130 (95% CI, 1113-1146) more steps in rural malls, 1403 (95% CI, 1379-1428) more steps in suburban malls, and 1433 (95% CI, 1408-1457) more steps in urban malls than nonparticipation. Moreover, participation in the walking program was associated with 1422 (95% CI, 1405-1439) more steps in large malls and 1059 (95% CI, 1041-1077) more steps in small malls compared with nonparticipation. Regarding cross-level interactions, women were associated with walking 728 (95% CI, 698-758) more steps than men, and older adults were associated with walking 228 (95% CI, 183-273) more steps than younger adults on walking program participation days.

Conclusions and Relevance

This cohort study found that the use of a smartphone-based mall walking program combined with physical shopping mall facilities and lottery-based digital incentive coupons may motivate people to increase their daily number of walking steps.

Daily step counts before, during, and after COVID-19 pandemic: a smartphone-tracking study of university students in Egypt and Saudi Arabia

BACKGROUND

COVID-19 pandemic has drastically changed people's lifestyles and daily routines around the world. This study aimed to investigate changes in daily step counts - as an indicator of physical activity - before, during, and after the pandemic among university students in Egypt and Saudi Arabia and to identify regional and gender factors that may have influenced physical activity during these periods.

METHODS

A total of 1273 university students from Egypt (Assiut University and Zagazig University) and Saudi Arabia (Taif University, King Faisal University, and Imam AbdulRahman Bin Faisal University) provided valid data on their daily step counts recorded by a smartphone application (iPhone Health App) from January 2019 to December 2021. The data was divided and averaged based on three periods: the pre-pandemic year (January to December 2019), the first pandemic year (January to December 2020), and the second pandemic year (January to December 2021).

RESULTS

The results showed a significant decrease in daily steps from pre-pandemic to the first pandemic year, followed by an increase in the second pandemic year. However, daily step counts did not fully recover to pre-pandemic levels in male Egyptian and marginally in male Saudi participants. In both nationalities, female participants did not show a significant difference in daily steps between the pre-pandemic and second-pandemic years. Female Egyptian participants had significantly lower daily step counts than male Egyptian participants, and a gender difference in daily steps was also observed in Saudi female participants in the pre-pandemic and the second pandemic year but not during the first pandemic year.

CONCLUSION

These findings outline the need for strategies in Egypt and Saudi Arabia to promote physical activity and reduce sedentary behavior, especially among young women, to mitigate the negative consequences of COVID-19 and meet physical activity guidelines.

Exploring the relationship between working from home, mental and physical health and wellbeing: a systematic review

Background

Understanding the impact of working from home on health and wellbeing is of great interest to employers and employees alike, with a strong need for up-to-date guidance. The aim of this systematic review was to identify, appraise and synthesise existing research evidence that explores the impact of home working on health and wellbeing outcomes for working people and health inequalities in the population.

Methods

We conducted a systematic review of qualitative, quantitative and observational studies. We searched databases, reference lists and UK grey literature and completed citation searching of included papers. We extracted and tabulated key data from the included papers and synthesised narratively. Factors associated with the health and wellbeing of people working at home reported in the literature were displayed by constructing mind maps of each individual factor which had been identified. The findings were combined with an a priori model to develop a final model, which was validated in consultation with stakeholders.

Results

Of 96 studies which were found to meet the inclusion criteria for the review, 30 studies were published before the COVID-19 pandemic and a further 66 were published during the pandemic. The quality of evidence was limited by the study designs employed by the authors, with the majority of studies being cross-sectional surveys (n = 59). For the most part, for studies which collected quantitative data, measures were self-reported. The largest volume of evidence identified consisted of studies conducted during the COVID-19 pandemic which looked at factors which influence the relationship between working from home and measures relating to mental health and wellbeing. Fifteen studies which considered the potential for working at home to have different effects for different subgroups suggested that working at home may have more negative consequences during the COVID-19 pandemic for women and in particular, mothers. There was very little evidence on age (two studies), ethnicity (one study), education or income (two studies) in terms of moderating home working effects, and very limited evidence from before the COVID-19 pandemic. The concept of enforced working from home and having 'no choice' was reported in only one paper prior to the pandemic and two papers reporting on working from home as a result of COVID-19. However, the concept of lack of choice around working from home was implicit in much of the literature - even though it was not directly measured. There were no clear patterns of wellbeing measures which changed from positive to negative association (or vice versa) during the pandemic.

Limitations

The quality of the evidence base was very much limited by study designs, particularly for studies published during the COVID-19 pandemic, with the majority of studies consisting of data collected by cross-sectional surveys (often online). Due to the rapidly expanding nature of the evidence on this topic, it is possible that new studies were published after the final citation searches were conducted.

Discussion

The evidence base for the factors which influence the relationship between home working and health-related outcomes has expanded significantly as a result of the need for those whose work could be done from home to work at home during the COVID-19 pandemic. Our findings suggest that there are factors relating to the external context, the role of employers and the circumstances of the employee which contribute to determining whether someone works at home and what the associated impacts on health and wellbeing may be. Learning from the COVID-19 lockdown experience will be important to inform future policy on home and hybrid working.

Future work

There is a need for better-quality studies of the health impact of home working, in particularly studies which recruit a range of participants who are representative of the working population and which are designed to minimise sampling/recruitment biases and response biases.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (project reference 18/93 PHR Public Health Review Team) and will be published in full in Public Health Research; Vol. 11, No. 4. See the NIHR Journals Library website for further project information. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Study registration

This study is registered as PROSPERO 2021 CRD42021253474.

Home working and social and mental wellbeing at different stages of the COVID-19 pandemic in the UK: Evidence from 7 longitudinal population surveys

BACKGROUND

Home working has increased since the Coronavirus Disease 2019 (COVID-19) pandemic's onset with concerns that it may have adverse health implications. We assessed the association between home working and social and mental wellbeing among the employed population aged 16 to 66 through harmonised analyses of 7 UK longitudinal studies.

METHODS AND FINDINGS

We estimated associations between home working and measures of psychological distress, low life satisfaction, poor self-rated health, low social contact, and loneliness across 3 different stages of the pandemic (T1 = April to June 2020 -first lockdown, T2 = July to October 2020 -eased restrictions, T3 = November 2020 to March 2021 -second lockdown) using modified Poisson regression and meta-analyses to pool results across studies. We successively adjusted the model for sociodemographic characteristics (e.g., age, sex), job characteristics (e.g., sector of activity, pre-pandemic home working propensities), and pre-pandemic health. Among respectively 10,367, 11,585, and 12,179 participants at T1, T2, and T3, we found higher rates of home working at T1 and T3 compared with T2, reflecting lockdown periods. Home working was not associated with psychological distress at T1 (RR = 0.92, 95% CI = 0.79 to 1.08) or T2 (RR = 0.99, 95% CI = 0.88 to 1.11), but a detrimental association was found with psychological distress at T3 (RR = 1.17, 95% CI = 1.05 to 1.30). Study limitations include the fact that pre-pandemic home working propensities were derived from external sources, no information was collected on home working dosage and possible reverse association between change in wellbeing and home working likelihood.

CONCLUSIONS

No clear evidence of an association between home working and mental wellbeing was found, apart from greater risk of psychological distress during the second lockdown, but differences across subgroups (e.g., by sex or level of education) may exist. Longer term shifts to home working might not have adverse impacts on population wellbeing in the absence of pandemic restrictions but further monitoring of health inequalities is required.

Relationship between Health Status and Daily Activities Based on Housing Type among Suburban Residents during COVID-19 Self-Isolation

COVID-19 significantly impacted residents' health status and daily activities in suburban residential areas. This study elucidated the relationship between health scores, daily activities, and housing types. The method was a questionnaire survey of 378 residents of suburban residential estates in Teraikedai, Kongo District, Japan, during the COVID-19 self-isolation period. Since the survey cohort was New Town, the suburban residential area identified by the Ministry of Land, Infrastructure, Transport and Tourism was targeted. The questions included participant demographics, the Basic Survey on Japanese Social Life, and the SF-12v2. The Tukey-Kramer HSD test and stepwise decreasing logistic regression were used for the statistical analysis of the responses. The COVID-19 self-isolation led to lower physical and mental health scores than usual, and the health scores of residents living in detached houses were better than those of residents in apartments, both those over the age of 65 and those under the age of 65. There was also a correlation between residents' daily activities and their health scores. For those aged under 65 years, the health scores of residents living in detached houses were significantly better than those living in apartments, indicating that daily activities such as sports and recreational hobbies may contribute to health scores.

A retrospective chart review of clinical profile of patients utilizing telepsychiatry services during COVID-19 pandemic at a tertiary care centre

Background

Telepsychiatry as a vehicle for delivering mental health services became evident due to outburst of mental health issues during coronavirus disease 2019 (COVID-19) pandemic and it was found useful in providing mental health care while maintaining social distancing norms and lockdown guidelines.

Aim

To study clinical profile and sociodemographic profile of patients utilizing telepsychiatry services during COVID-19 pandemic.

Materials and Methods

Total 70 old follow-up and 42 new patients were consulted on telepsychiatry, as per Indian Telepsychiatry Operational Guidelines 2020 given by NIMHANS, during 1st and 2nd wave of COVID-19 pandemic from June 2020 to May 2021. Sociodemographic and clinical data was extracted from all patients who utilized our telepsychiatry services in a semi-structured proforma for retrospective analysis using frequency tables.

Results

A total of 102 patients benefitted from our telepsychiatry services. Out of which, 66.7% were adults between 21 and 40 years, with slight female preponderance (55.9%) and majority (78.4%) participants living in urban areas. About 70.6% were graduates with 41.2% participants belonging to either private or public service. One-third of the participants were IT professionals. Around 59.8% participants had past history of psychiatric illness and 40.2% had new onset illness. The diagnostic distribution included depressive disorder (28.4%), anxiety disorder (26.4%), psychotic disorder (21.6%) and obsessive compulsive disorder (9.8%) and others (13.8).

Conclusion

Telepsychiatry has emerged as an important consultation modality in this COVID-19 pandemic. Its future use seems promising, which will require mental health practitioners to develop their skills while interacting digitally, conducting assessments, and therapy.

Role of Multifaceted Social Relationships on the Association of Loneliness with Depression Symptoms: A Moderated Mediation Analysis

Strong relationship exists between loneliness and depression in older adults. However, the effect of multifaceted social relationships on the relationship between loneliness and depression has not been explored. The purpose of the current study was to find out how multifaceted social relationships affect the aforementioned processes. We investigated and evaluated the loneliness status, depression symptoms, social relationships, and demographic information of 1116 older adults aged ≥65 years living in rural Japan. The final 555 participants were included in the analysis. Statistical evidence showed a direct effect between loneliness and depression symptoms. Additionally, the mediation model found that social curiosity and participation acted as mediators between loneliness and depression symptoms. Further, independence and participation, independence, and feeling safe played a conditional moderating role in the model of loneliness-social curiosity-depression symptoms and loneliness-participation-depression symptoms, respectively. Interaction can be an individual moderator in the link between loneliness and depression symptoms without any mediator. The moderated mediation model suggests that social curiosity and participation could mediate the association between loneliness and depression symptoms. In this process, independence, participation, and feeling safe may act as moderators.

Ageing workers' mental health during COVID-19: a multilevel observational study on the association with the work environment, perceived workplace safety and individual factors

OBJECTIVES

The stress and anxiety associated with the predisposition of ageing workers to severe COVID-19 illness, once occupationally infected, jeopardise their mental health. This study aimed to investigate the association between individual level, work environment exposure factors and perceived workplace safety with a decline in mental health of ageing workers from different industry sectors.

DESIGN

Observational study, prevalence assessment of survey added to longitudinal cohort data.

SETTING

The Survey of Health, Ageing and Retirement in Europe (SHARE) from 27 countries in Europe and Israel participating in the COVID-19 survey (summer 2020) and having prepandemic waves' SHARE data.

PARTICIPANTS

Workers aged 50-70 (n=6449) who attended their workplaces at least partially after the pandemic broke out.

PRIMARY OUTCOME MEASURE

Perceived decline in mental health compared with preoutbreak status.

RESULTS

Multilevel analyses demonstrated that 24.5% (95% CI 23.5% to 25.5%) of ageing workers in Europe experienced mental health decline associated with national-level self-reported COVID-19 burden. Workplace safety perception was the strongest predictor, as each one-point increase in unsafe perception was associated with 60% of mental health decline (OR=1.6, 95% CI 1.47 to 1.74), explaining 30% of increased reported mental health symptoms of ageing workers. Safety perception mediates the mental health outcomes of the work environment, such as workplace contagion risk and work location. Female gender (OR=1.77, 95% CI 1.55 to 2.02), financial difficulties (OR=1.19, 95% CI 1.1 to 1.28), higher vulnerability index (comorbidities, age >60) (OR=1.11, 95% CI 1.05 to 1.18), pre-existing mental problems (OR=1.78, 95% CI 1.55 to 2.04) and increased national burden of COVID-19 (OR=1.01, 95% CI 1.0 to 1.02) were associated with declines in mental health, whereas exclusively working on-site was protective.

CONCLUSION

Vulnerable subgroups for mental health declines among ageing workers were revealed, which warrant their screening and employers' evaluation of workplace conditions of ageing workers to prevent mental health-related implications. Workplace interventions should aim to reduce work environment influences on infection risk and mental distress.

Working from home, work-time control and mental health: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil)

This cross-sectional study investigated the association between work-time control (WTC), independently and in combination with hours worked (HW), and four mental health outcomes among 2,318 participants of the Longitudinal Study of Adult Health (ELSA-Brasil) who worked from home during the COVID-19 pandemic. WTC was assessed by the WTC Scale, and mental health outcomes included depression, anxiety, stress (measured by the Depression, Anxiety and Stress Scale, DASS-21), and self-rated mental health. Logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs). Among women, long HW were associated with stress (OR = 1.56; 95% CI = 1.11–2.20) and poor self-rated mental health (OR = 1.64; 95% CI = 1.13–2.38), whereas they were protective against anxiety among men (OR = 0.59; 95% CI = 0.37–0.93). In both sexes, weak WTC was associated with all mental health outcomes. Among women, the long HW/weak WTC combination was associated with all mental health outcomes, and short HW/weak WTC was associated with anxiety and stress. Among men, long HW/strong WTC was protective against depression and stress, while short HW/strong WTC and short HW/weak WTC was associated with all mental health outcomes. In both sexes, weak WTC, independently and in combination with HW, was associated with all mental health outcomes. WTC can improve working conditions, protect against mental distress, and fosterwork-life balance for those who work from home.

Effect of Working from Home on the Association between Job Demands and Psychological Distress

Limited information is available regarding the association between workplace psychosocial factors and general mental health status among workers during the coronavirus disease 2019 pandemic. This study examined how working from home affected the association between job demands and psychological distress (PD). A cross-sectional online survey was conducted in December 2020 (N = 27,036). The dependent variable (PD) was assessed using the Kessler Psychological Distress Scale. Job demands were assessed using the Job Content Questionnaire. Working from home was determined by participants’ responses to the question, “Do you currently work from home?” We used a two-level regression analysis adjusted for prefecture. Each individual-level variable at Level 1 was nested into each prefecture at Level 2, stratified by working from home or not. Overall, 21.3% of participants worked from home. The interaction between working from home and job demands was significant. Job demands were positively associated with PD. The stratified analysis indicated that the associations were weaker among employees who worked from home compared with those among employees who did not. The association between job demands and PD may be weakened by working from home.

Worker Stress, Burnout, and Wellbeing Before and During the COVID-19 Restrictions in the United Kingdom

COVID-19 created a transformational shift in the working environment for much of the labour force, yet its impact on workers is unclear. This study uses longitudinal data to examine the wellbeing of 621 full-time workers assessed before (November 2019-February 2020) and during (May-June 2020) the first lockdown in the United Kingdom. We employ fixed effects analyses to investigate the impact of the restrictions and mandatory homeworking on cognitive, emotional, and psychological wellbeing. Within the sample, the rate of full-time homeworking increased from 2 to 74% between waves. We identify significant changes in 9 of the 15 measures assessed, with a general pattern of improvements in wellbeing during lockdown. Overall levels of stress, self-rated mental health, positive emotions and life and job satisfaction are not adversely affected by the restrictions. There is a reduction in the burnout symptoms of disengagement (-0.13 sd) and exhaustion (-0.20 sd) and in the frequency with which negative emotions are experienced at work (-0.15 sd). Workers feel more autonomous (+0.09 sd), closer to their co-workers (+0.10 sd), and more attached to their organisations (+0.19 sd). However, homelife satisfaction declines (-0.11 sd). These findings highlight the possibility that the COVID-19 pandemic and large-scale transition to homeworking was associated with unchanged or improved worker wellbeing. This study has important implications for governments and employers regarding a global shift to homeworking.

Pre-pandemic individual- and community-level social capital and depressive symptoms during COVID-19: A longitudinal study of Japanese older adults in 2019-21

During a pandemic, it is important to know whether social capital can mitigate the risk of mental disorders, given the restrictions on social interactions. However, evidence using longitudinal data is scarce. This study examined the association between pre-pandemic social capital and depressive symptoms during COVID-19 among older adults. We used longitudinal data from the Japan Gerontological Evaluation Study (JAGES), including 8291 participants aged 65 or older who were physically and cognitively independent and not depressed at baseline. We conducted baseline and follow-up mail surveys in ten municipalities in Japan from November 2019 to January 2020 (pre-pandemic period) and from November 2020 to February 2021 (pandemic period), respectively. We measured depressive symptoms using the 15-item Geriatric Depression Scale. Social capital was measured with three validated subscales, namely, civic participation, social cohesion, and reciprocity. We performed a multilevel logistic regression analysis to examine the association. A total of 1089 (13.1%) participants newly developed depressive symptoms during the pandemic. The logistic regression showed that pre-pandemic individual-level social cohesion (odds ratio = 0.79, 95% confidence interval: 0.73 to 0.86) and reciprocity (0.89, 0.82 to 0.96) and community-level reciprocity (0.93, 0.88 to 0.98) were negatively associated with the odds of depressive symptoms. Even after adjusting for declines in social capital during the pandemic, the observed associations of pre-pandemic social capital remained. Fostering social cohesion and reciprocity may increase resilience to mental disorders during a pandemic of infectious disease.

Effect of Anxiety About COVID-19 Infection in the Workplace on the Association Between Job Demands and Psychological Distress

Purpose: There is limited information about the association between workplace psychosocial factors and general worker mental health status during the COVID-19 pandemic. In the present study, we examined how anxiety about being infected by COVID-19 in the workplace affected the association between job demands and psychological distress (PD).

Method: A cross-sectional online survey was conducted in December 2020. The final analyzed sample was 27,036. The dependent variable of PD was assessed using the Kessler Psychological Distress Scale (K6). Job demands were assessed using the Job Content Questionnaire. Feelings of anxiety were assessed by participants' responses to the following question: “Do you feel anxiety about being infected by COVID-19 in the workplace?” We used a two-level regression adjusting for prefectural level: each individual-level variable at level 1 was nested into each prefecture at level 2, stratified by presence of anxiety.

Results: A total of 50.5% of participants felt anxious about being infected by COVID-19 in the workplace. The interaction between anxiety and job demands was significant. Job demands were positively associated with PD. In the stratified analysis, the associations were stronger among employees who experienced anxiety about COVID-19 infection in the workplace than among those who did not.

Conclusion: The association between job demands and PD may be strengthened by anxiety about COVID-19 infection in the workplace.

Association of Visual Display Terminal Usage with Self-Rated Health and Psychological Distress among Japanese Office Workers during the COVID-19 Pandemic

The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data of 7088 office workers from a web-based, self-administered survey conducted from 25 August 2020, to 30 September 2020, was used. Multiple logistic regression analysis was applied. Compared to those who used a VDT for 4–9 h for work, office workers who used a VDT for ≥10 h for work had poor SRH (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.13, 2.41) and severe psychological distress (OR: 2.23; 95% CI: 1.52, 3.28). VDT usage for less than 1 h (OR: 1.37, 95% CI: 1.12, 1.67) and 1–3 h (OR: 1.42, 95% CI: 1.12, 1.80) for work were also associated with severe psychological distress. Stratification analysis by age showed a significant association of VDT usage for work with poor SRH among 30–64-year-olds, while a U-shape association was found between VDT usage for work and psychological distress with the younger age group (15–29 years old). During the COVID-19 pandemic in Japan, the prolonged usage of VDT for work can deteriorate both general and psychological health, while moderate usage of VDT for work can reduce psychological distress.

Working from home and dietary changes during the COVID-19 pandemic: A longitudinal study of health app (CALO mama) users

It is plausible that the coronavirus disease pandemic and related changes in work and life patterns affected dietary patterns, but existing studies have limitations owing to a cross-sectional design. Using longitudinal data, we examined dietary changes in people due to the pandemic and work and life patterns. We conducted an online survey on changes in work and life patterns during the pandemic from April 30, 2020, to May 8, 2020, among users of a health app called CALO mama provided in Japan. We retrieved and linked the dietary data for 5929 participants from January 1, 2020, to May 13, 2020. Generalized linear mixed models were used to estimate the frequencies of food intake associated with the pandemic and work and life patterns. During the state of emergency, the frequency of intake of vegetables, beans, seaweeds, fish, meats, dairy products, and snacks increased, whereas alcohol intake decreased. Working from home was associated with increased intake of vegetables, fruits, dairy products, and snacks but decreased intake of seaweeds, meats, and alcohol. Time spent on childcare was associated with decreased intake of vegetables and fruits but increased intake of meats. Probable depressive symptoms were negatively associated with the frequency of food intake other than snacks and alcohol. We conclude that diet quality improved during the pandemic in general, but attention must be paid to overconsumption of snacks and negative factors such as increased burden of childcare and depression for healthy eating.