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Keyes B, McCombe G, Broughan J, Frawley T, Guerandel A, Gulati G, Kelly BD, Osborne B, O'Connor K, Cullen W. Enhancing GP care of mental health disorders post-COVID-19: a scoping review of interventions and outcomes. Ir J Psychol Med 2023; 40:470-486. [PMID: 35545971 DOI: 10.1017/ipm.2022.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Considerable literature has examined the COVID-19 pandemic's negative mental health sequelae. It is recognised that most people experiencing mental health problems present to primary care and the development of interventions to support GPs in the care of patients with mental health problems is a priority. This review examines interventions to enhance GP care of mental health disorders, with a view to reviewing how mental health needs might be addressed in the post-COVID-19 era. METHODS Five electronic databases (PubMed, PsycINFO, Cochrane Library, Google Scholar and WHO 'Global Research on COVID-19') were searched from May - July 2021 for papers published in English following Arksey and O'Malley's six-stage scoping review process. RESULTS The initial search identified 148 articles and a total of 29 were included in the review. These studies adopted a range of methodologies, most commonly randomised control trials, qualitative interviews and surveys. Results from included studies were divided into themes: Interventions to improve identification of mental health disorders, Interventions to support GPs, Therapeutic interventions, Telemedicine Interventions and Barriers and Facilitators to Intervention Implementation. Outcome measures reported included the Seven-item Generalised Anxiety Disorder Scale (GAD-7), the Nine-item Patient Health Questionnaire (PHQ-9) and the 'The Patient Global Impression of Change Scale'. CONCLUSION With increasing recognition of the mental health sequelae of COVID-19, there is a lack of large scale trials researching the acceptability or effectiveness of general practice interventions. Furthermore there is a lack of research regarding possible biological interventions (psychiatric medications) for mental health problems arising from the pandemic.
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Affiliation(s)
| | | | | | - Timothy Frawley
- UCD School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Allys Guerandel
- UCD School of Medicine, Dublin, Ireland
- Department of Psychiatry and Mental Health Research, St. Vincent's University Hospital, Dublin, Ireland
| | - Gautam Gulati
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Brendan D Kelly
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Brian Osborne
- Irish College of General Practitioners, Dublin, Ireland
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Rice KG, Arana F, Wetstone H, Aiello M, Durán B. Predicting and Moderating COVID-Fear and Stress among College Students in Argentina and the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6510. [PMID: 37569050 PMCID: PMC10418435 DOI: 10.3390/ijerph20156510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
The COVID-19 pandemic negatively affected mental health worldwide and college students were particularly vulnerable to its adverse effects. This longitudinal study was designed to highlight and compare the COVID experiences of college students in Argentina and the USA (N = 361). Specifically, we examined individual factors (gender, emotional regulation, and social support) assessed prior to the pandemic for their role as predictors or moderators of COVID-fear and psychological stress during the first months of the pandemic. The results supported measurement invariance for brief measures of COVID-fear and indicated that, overall, COVID-fear was highest during the second wave of the study (March-April 2020), lowest during the third wave (June 2020), and then rose again during the fourth wave (September 2020). Several interaction effects emerged, revealing important country-level differences in COVID-fear effects for the emotion regulation and social support factors. More so in the Argentina sample than in the USA sample, higher levels of social support at Time 1 were associated with increases in the effect of COVID-fear on stress among students. We discussed the implications of these and other findings for future cross-cultural pandemic-related stress studies.
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Affiliation(s)
- Kenneth G. Rice
- Ken Matheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30302, USA; (H.W.); (M.A.); (B.D.)
| | - Fernán Arana
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires C1052, Argentina;
- National Scientific and Technical Research Council (CONICET), Instituto de Investigaciones en Psicología, Buenos Aires C1033, Argentina
| | - Hannah Wetstone
- Ken Matheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30302, USA; (H.W.); (M.A.); (B.D.)
| | - Michelle Aiello
- Ken Matheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30302, USA; (H.W.); (M.A.); (B.D.)
| | - Barbara Durán
- Ken Matheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State University, Atlanta, GA 30302, USA; (H.W.); (M.A.); (B.D.)
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Stewart I, Welch C, An L, Resnicow K, Pennebaker J, Mihalcea R. Expressive Interviewing Agents to Support Health-Related Behavior Change: Randomized Controlled Study of COVID-19 Behaviors. JMIR Form Res 2023; 7:e40277. [PMID: 37074948 PMCID: PMC10395645 DOI: 10.2196/40277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Expressive writing and motivational interviewing are well-known approaches to help patients cope with stressful life events. Although these methods are often applied by human counselors, it is less well understood if an automated artificial intelligence approach can benefit patients. Providing an automated method would help expose a wider range of people to the possible benefits of motivational interviewing, with lower cost and more adaptability to sudden events like the COVID-19 pandemic. OBJECTIVE This study presents an automated writing system and evaluates possible outcomes among participants with respect to behavior related to the COVID-19 pandemic. METHODS We developed a rule-based dialogue system for "Expressive Interviewing" to elicit writing from participants on the subject of how COVID-19 has impacted their lives. The system prompts participants to describe their life experiences and emotions and provides topic-specific prompts in response to participants' use of topical keywords. In May 2021 and June 2021, we recruited participants (N=151) via Prolific to complete either the Expressive Interviewing task or a control task. We surveyed participants immediately before the intervention, immediately after the intervention, and again 2 weeks after the intervention. We measured participants' self-reported stress, general mental health, COVID-19-related health behavior, and social behavior. RESULTS Participants generally wrote long responses during the task (53.3 words per response). In aggregate, task participants experienced a significant decrease in stress in the short term (~23% decrease, P<.001) and a slight difference in social activity compared with the control group (P=.03). No significant differences in short-term or long-term outcomes were detected between participant subgroups (eg, male versus female participants) except for some within-condition differences by ethnicity (eg, higher social activity among African American people participating in Expressive Interviewing vs participants of other ethnicities). For short-term effects, participants showed different outcomes based on their writing. Using more anxiety-related words was correlated with a greater short-term decrease in stress (r=-0.264, P<.001), and using more positive emotion words was correlated with a more meaningful experience (r=0.243, P=.001). As for long-term effects, writing with more lexical diversity was correlated with an increase in social activity (r=0.266, P<.001). CONCLUSIONS Expressive Interviewing participants exhibited short-term, but not long-term, positive changes in mental health, and some linguistic metrics of writing style were correlated with positive change in behavior. Although there were no significant long-term effects observed, the positive short-term effects suggest that the Expressive Interviewing intervention could be used in cases in which a patient lacks access to traditional therapy and needs a short-term solution. TRIAL REGISTRATION Clincaltrials.gov NCT05949840; https://www.clinicaltrials.gov/study/NCT05949840.
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Affiliation(s)
- Ian Stewart
- School of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Charles Welch
- Department of Mathematics and Computer Science, University of Marburg, Marburg, Germany
| | - Lawrence An
- Center for Health Communications Research, University of Michigan, Ann Arbor, MI, United States
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - James Pennebaker
- Department of Psychology, University of Texas at Austin, Austin, TX, United States
| | - Rada Mihalcea
- School of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, United States
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Sullivan M, Huberty J, Chung Y, Stecher C. Mindfulness Meditation App Abandonment During the COVID-19 Pandemic: An Observational Study. Mindfulness (N Y) 2023; 14:1-18. [PMID: 37362188 PMCID: PMC10158687 DOI: 10.1007/s12671-023-02125-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 06/28/2023]
Abstract
Objectives Mindfulness meditation apps are used by millions of adults in the USA to improve mental health. However, many new app subscribers quickly abandon their use. The purpose of this study was to determine the behavioral, demographic, and socioeconomic factors associated with the abandonment of meditation apps during the COVID-19 pandemic. Method A survey was distributed to subscribers of a popular meditation app, Calm, at the start of the COVID-19 pandemic in March 2020 that assessed meditation app behavior and meditation habit strength, as well as demographic and socioeconomic information. App usage data were also collected from the start of each participant's subscription until May 2021. A total of 3275 respondents were included in the analyses. Participants were divided into three cohorts according to their subscription start date: (1) long-term subscribers (> 1 year before pandemic start), (2) pre-pandemic subscribers (< 4 months before pandemic start), and (3) pandemic subscribers (joined during the pandemic). Results Meditating after an existing routine was associated with a lower risk of app abandonment for pre-pandemic subscribers (hazard ratio = 0.607, 95% CI: 0.422, 0.874; p = 0.007) and for pandemic subscribers (hazard ratio = 0.434, 95% CI: 0.285, 0.66; p < 0.001). Additionally, meditating "whenever I can" was associated with lower risk of abandonment among pandemic subscribers (hazard ratio = 0.437, 95% CI: 0.271, 0.706; p < 0.001), and no behavioral factors were significant predictors of app abandonment among the long-term subscribers. Conclusions These results show that combining meditation with an existing daily routine was a commonly utilized strategy for promoting persistent meditation app use during the COVID-19 pandemic for many subscribers. This finding supports existing evidence that pairing new behaviors with an existing routine is an effective method for establishing new health habits. Preregistration This study is not pre-registered.
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Affiliation(s)
- Mariah Sullivan
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004 USA
| | | | - Yunro Chung
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004 USA
| | - Chad Stecher
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004 USA
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Valizadeh L, Zamanzadeh V, Namdar Areshtanab H, Avazeh M, Babaei N. Stress management protocol for nurses working in the COVID-19 wards. Heliyon 2023; 9:e15770. [PMID: 37124336 PMCID: PMC10125915 DOI: 10.1016/j.heliyon.2023.e15770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/12/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences. Methods This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion. Results Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items. Conclusion This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.
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Affiliation(s)
- Leila Valizadeh
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Marziyeh Avazeh
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasib Babaei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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6
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Stecher C, Cloonan S, Linnemayr S, Huberty J. Combining Behavioral Economics-Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e39930. [PMID: 37115610 PMCID: PMC10182474 DOI: 10.2196/39930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 02/20/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Chronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person interventions; however, to date, poor app-based intervention adherence has limited the efficacy of these mobile health tools. Anchoring, or pairing, a new behavior with an existing routine has been shown to effectively establish habits that are maintained over time, but this strategy typically only works for those with high initial motivation and has yet to be tested for maintaining meditation with a mobile app. OBJECTIVE This study will test novel combinations of behavioral economics-based incentives with the anchoring strategy for establishing and maintaining adherence to an effective dose of meditation with a mobile app. METHODS This 16-week study will use a 5-arm, parallel, partially blinded (participants only), randomized controlled design. We will implement a fractional factorial study design that varies the use of self-monitoring messages and financial incentives to support participants' use of their personalized anchoring strategy for maintaining adherence to a ≥10 minute-per-day meditation prescription during an 8-week intervention period, followed by an 8-week postintervention observation period. Specifically, we will vary the use of self-monitoring messages of either the target behavior (ie, meditation tracking) or the outcome associated with the target behavior (ie, mood symptom tracking). We will also vary the use of financial incentives conditional on either meditation at any time of day or meditation performed at approximately the same time of day as participants' personalized anchors. RESULTS Continuous meditation app use data will be used to measure weekly meditation adherence over the 16-week study period as a binary variable equal to 1 if participants complete ≥10 minutes of meditation for ≥4 days per week and 0 otherwise. We will measure weekly anchoring plan adherence as a binary variable equal to 1 if participants complete ≥10 minutes of meditation within +1 or -1 hour of the timing of their chosen anchor on ≥4 days per week and 0 otherwise. In addition to these primary measures of meditation and anchoring plan adherence, we will also assess the secondary measures of stress, anxiety, posttraumatic stress disorder, sleep disturbance, and meditation app habit strength at baseline, week 8, and week 16. CONCLUSIONS This study will fill an important gap in the mobile health literature by testing novel intervention approaches for establishing and maintaining adherence to app-based mindfulness meditation. If successful, this study will identify an accessible and scalable stress self-management intervention that can help combat stress in the United States. TRIAL REGISTRATION ClinicalTrials.gov NCT05217602; https://clinicaltrials.gov/ct2/show/NCT05217602. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39930.
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Affiliation(s)
- Chad Stecher
- Arizona State University, Phoenix, AZ, United States
| | - Sara Cloonan
- Arizona State University, Phoenix, AZ, United States
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7
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Walker SL, Viaña JN. Mindful mindfulness reporting: Media portrayals of scientific evidence for meditation mobile apps. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2023:9636625221147794. [PMID: 36734473 DOI: 10.1177/09636625221147794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Promoting mental health is a major global challenge. As mindfulness meditation apps can help maintain and restore good mental health, it is important to understand how their efficacy and safety are portrayed in the media. This study systematically evaluates whether evidence from academic research is used to communicate the health effects of two popular mindfulness apps, Calm and Smiling Mind. A scoping review mapped research findings from 16 relevant articles, and a media analysis examined the types of evidence used in news reporting. Analysing 105 news articles revealed that 98% did not use evidence from academic research on app-based meditation to support health claims. Only 28.5% of articles included advice from a health expert, and 9.5% mentioned potential risks and alternative treatments. Stronger evidence-based reporting on the health effects of mindfulness apps is needed to enable people to make more informed decisions for their health and wellbeing.
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Affiliation(s)
| | - John Noel Viaña
- Australian National University, Australia; Commonwealth Scientific and Industrial Research Organisation, Australia
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8
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Pozza A, Giangrasso B, Baldo D, Fort A, Millozzi G, Iocca F, Angelo NL, Pugi D, Gualtieri G, Lorenzi L, Gioia F, Bocci Benucci S, Fioravanti G, Coluccia A, Ferretti F, Casale S. Mobile opportunity against stress: Open study protocol on the effectiveness of a mobile platform for stress self-management in the post-pandemic era. Front Psychol 2023; 13:917574. [PMID: 36755986 PMCID: PMC9901297 DOI: 10.3389/fpsyg.2022.917574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Barbara Giangrasso
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - David Baldo
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Ada Fort
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | | | - Francesco Iocca
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Nicole Loren Angelo
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Daniele Pugi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | | | - Lore Lorenzi
- Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | - Francesca Gioia
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Sara Bocci Benucci
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
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Porter N, Jason LA. Mindfulness Meditation Interventions for Long COVID: Biobehavioral Gene Expression and Neuroimmune Functioning. Neuropsychiatr Dis Treat 2022; 18:2599-2626. [PMID: 36387947 PMCID: PMC9653042 DOI: 10.2147/ndt.s379653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Some individuals infected with SARS CoV-2 have developed Post-Acute Sequelae of SARS CoV-2 infection (PASC) or what has been referred to as Long COVID. Efforts are underway to find effective treatment strategies for those with Long COVID. One possible approach involves alternative medical interventions, which have been widely used to treat and manage symptoms of a variety of medical problems including post-viral infections. Meditation has been found to reduce fatigue and unrefreshing sleep, and for those with post-viral infections, it has enhanced immunity, and reduced inflammatory-driven pathogenesis. Our article summarizes the literature on what is known about mindfulness meditation interventions, and reviews evidence on how it may apply to those with Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Evidence is reviewed suggesting effective and sustainable outcomes may be achieved for symptomatology and underlying pathology of post-viral fatigue (PASC and ME/CFS).
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Affiliation(s)
- Nicole Porter
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
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Meiyi Z, Liu Y. Impact of fear of COVID-19 on students' performance, moderating role of mindfulness: HSK students' perception-based view. Front Public Health 2022; 10:967125. [PMID: 36420013 PMCID: PMC9677726 DOI: 10.3389/fpubh.2022.967125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/12/2022] [Indexed: 11/09/2022] Open
Abstract
COVID-19 created difficulties and problems in almost everyone's daily life routine. Educational institutions too had to reschedule their academic activities. This shift caused attitudinal and behavioral changes in students' learning patterns. Using stress theory, the present study tries to determine the association of fear of COVID-19 with students' performance. In addition, the present study also attempts to check the impact of fear of COVID-19 on anxiety. Further, this study tries to find the association of anxiety with students' performance. This study also attempts to determine the mediating role of anxiety and the moderating role of mindfulness. For empirical investigation, the current study collected data from 320 HSK students from different colleges and universities in China. The present study applied partial least square structural equation modeling for the empirical investigation of hypotheses by using Smart-PLS software. The present study's findings confirmed that fear of COVID-19 negatively affects students' performance, and it positively correlates with anxiety. The study's outcomes revealed that anxiety negatively affects students' performance. The outcomes also confirmed that anxiety negatively mediates the relationship between fear of COVID-19 and students' performance. The present study's findings acknowledged that mindfulness does not moderate the relationship between fear of COVID-19 and student performance and has a positive moderation between anxiety and student performance. The present study offers important practical, theoretical, and managerial implications.
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Affiliation(s)
- Zhang Meiyi
- School of International Education, Shandong University of Finance and Economics, Jinan, China
| | - Yang Liu
- Department of General Courses, Shanghai Information Technology College, Shanghai, China
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11
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Xiang E, Zhang X, Raza SA, Oluyomi A, Amos CI, Badr H. Risk and resilience in couple's adjustment to the COVID-19 pandemic. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2022; 39:3252-3274. [PMID: 38603302 PMCID: PMC9047666 DOI: 10.1177/02654075221094556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The COVID-19 pandemic's global scope and resulting social distancing measures have caused unprecedented economic, lifestyle, and social impacts to personal and relationship well-being. While lockdowns have prompted individuals to increase reliance on intimate partners for support, stressful external contexts can also interfere with partners' capacity to request and provide support, resulting in relationship dissatisfaction and even dissolution. Guided by a risk and resilience framework, this study examined the impact of perceived stress, social contextual factors, and dyadic coping on self-reported relationship satisfaction changes during the initial United States COVID-19 lockdown period. Participants were adults in romantic relationships who completed an online survey between April 13 and June 8, 2020. Overall, survey respondents (N = 1106) reported higher perceived stress levels than established population norms, and small but significant decrements in relationship satisfaction. Multivariable models revealed that higher perceived stress levels were associated with lower relationship satisfaction levels. Additionally, dyadic coping was found to moderate the impact of perceived stress on relationship satisfaction (B = .05, 95% CI = .02- .07), suggesting that engaging in dyadic coping buffered individuals from adverse effects of perceived stress on their relationships. Findings emphasize heightened stress experienced by individuals during the pandemic, potential detrimental effects of stress on couple relationships, and suggest dyadic coping may help buffer couples from adverse effects of the pandemic on their relationships. As such, dyadic coping may be an important target for future interventions designed to assist couples during the ongoing pandemic and future pandemics/natural disasters.
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Affiliation(s)
- Ellen Xiang
- Baylor College of
Medicine, Houston, TX, USA
| | | | | | | | | | - Hoda Badr
- Baylor College of
Medicine, Houston, TX, USA
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12
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Vazquez CE, Hess KE, McBride MJ, Cubbin C, Bearman SK, Calzada EJ. Impact of COVID social distancing measures on eating and exercise behaviors among a sample of Hispanic parents of young children in the United States. J Public Health Res 2022; 11:22799036221132389. [PMID: 36337260 PMCID: PMC9634197 DOI: 10.1177/22799036221132389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background: In the United States, healthy behaviors, such as eating fruits/vegetables and
exercise, are well below recommended levels, particularly for Hispanics. The
COVID pandemic may have exacerbated existing health behavior disparities.
The current study examines the impact of COVID social distancing measures on
Hispanic parents’ eating and exercise behaviors, and how the impact may
differ by socioeconomic status (SES) and distress levels. Design and methods: This cross-sectional logistic regression study utilized data from a sample of
Hispanic parents in Texas (n = 237). COVID-related
questions were collected in Summer 2020. Dependent variables included
self-reported changes in exercise and eating behaviors due to the pandemic
(i.e. got better or got worse). Primary independent variables included
family-SES, neighborhood-SES, and distress due to COVID. Results: More than half (60%) of parents reported that their eating and exercise
behaviors worsened. Results showed a significant relationship between
distress due to COVID and both dependent variables; changes in eating
(OR = 1.38, 95% CI [1.20, 1.58]) and changes in exercise (OR = 1.28, 95% CI
[1.11, 1.48]). There were no observed differences by SES. Conclusions: Results suggest distress due to COVID was associated with worsening of eating
and exercise behaviors, regardless of SES. The direction of the relationship
between distress and healthy eating and exercise behaviors requires further
attention.
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Affiliation(s)
- Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Katherine E Hess
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Megan J McBride
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Esther J Calzada
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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13
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Hübner T, Wolfgang T, Theis AC, Steber M, Wiedenmann L, Wöckel A, Diessner J, Hein G, Gründahl M, Kämmerer U, Kittel-Schneider S, Bartmann C. The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic. Reprod Health 2022; 19:189. [PMID: 36064560 PMCID: PMC9444078 DOI: 10.1186/s12978-022-01493-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 08/16/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. METHODS Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). RESULTS In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. CONCLUSION Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic. Clinical trial registration DRKS00022506.
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Affiliation(s)
- Theresa Hübner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.
| | - Tanja Wolfgang
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ann-Catrin Theis
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Magdalena Steber
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Lea Wiedenmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Joachim Diessner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Grit Hein
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Marthe Gründahl
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Catharina Bartmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
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14
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Complementary and Alternative Medicine for Long COVID: Scoping Review and Bibliometric Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7303393. [PMID: 35966751 PMCID: PMC9371860 DOI: 10.1155/2022/7303393] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/01/2022] [Indexed: 12/14/2022]
Abstract
Prolonged symptoms after the clearance of acute coronavirus disease 2019 (COVID-19) infection, termed long COVID, are an emerging threat to the post-COVID-19 era. Complementary and alternative medicine (CAM) interventions may play a significant role in the management of long COVID. The present study aimed to identify published studies on the use of CAM interventions for long COVID and provide an overview of the research status using bibliometric analysis. The present scoping review searched MEDLINE, Embase, and Cochrane Library from inception until November 2021 and identified published studies on CAM interventions for long COVID. A narrative analysis of the study types and effectiveness and safety of the CAM interventions are presented and a bibliometric analysis of citation information and references of the included publications were analyzed using the Bibliometrix package for R. An electronic database search identified 16 publications (2 clinical studies and 14 study protocols of systematic reviews or clinical studies) that were included in the present study. Dyspnea or pulmonary dysfunction, quality of life, olfactory dysfunction, and psychological symptoms after COVID-19 infection were assessed in the included publications. The two clinical studies suggested that Chinese herbal medications were effective in relieving symptoms of pulmonary dysfunction. Bibliometric analysis revealed the current trend of research publication in this area was driven by study protocols written by Chinese, Korean, and Indian authors. Thus, the present scoping review and bibliometric analysis revealed that there are few studies published about the use of CAM for long COVID and long-term management for COVID-19 survivors. Original studies on CAM interventions, including randomized controlled trials and systematic reviews, are required to actively support evidence for their use in the management of long COVID. PROSPERO registration: this trial is registered with CRD42021281526.
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15
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Devillers-Réolon L, Mascret N, Sleimen-Malkoun R. Online Mindfulness Intervention, Mental Health and Attentional Abilities: A Randomized Controlled Trial in University Students During COVID-19 Lockdown. Front Psychol 2022; 13:889807. [PMID: 35874414 PMCID: PMC9301203 DOI: 10.3389/fpsyg.2022.889807] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has led to worldwide restrictive measures, raising concerns about mental health in young adults who were not particularly vulnerable to the virus itself. This study investigated the impact of these restrictions on mental and cognitive health of university students, and tested the efficacy of a brief online mindfulness meditation intervention in countering psychological distress and improving attentional abilities. Ninety-six university students forced into remote learning due to COVID-19 pandemic restrictions and with no experience in meditation were randomly assigned to either a passive control group (n = 48) or to an experimental group (n = 48) following daily, for 17 days, an online mindfulness intervention (10–20 min per day). Due to drop-out, 38 participants in each group were finally analyzed. Pre- and post-tests assessed participants’ mental health (psychological well-being, depression, anxiety, stress) and attentional abilities. The analysis of baseline data in comparison with normative scores and pre-pandemic statistics confirmed the expected psychological distress, but it did not reveal any attentional deficits in our participants. Pre-post change scores analyses showed a reduction in stress (p = 0.006, ηp2 = 0.10), anxiety (p = 0.002, ηp2 = 0.13), and depression (p = 0.025, ηp2 = 0.07), and an improvement in well-being (p = 0.013, ηp2 = 0.12) in the experimental group, but not in the control group. In both groups, no significant effect was found on attentional abilities. Our results confirmed the psychological vulnerability of higher education students in the midst of the remote learning period during the second COVID-19 lockdown in France, while suggesting preservation of attentional functioning. Although the tested mindfulness intervention did not enhance the attentional abilities in already good performing students, it did promote their mental health. This study offers additional evidence on the feasibility and efficacy of mindfulness-based interventions in students during psychologically straining periods, like the COVID-19 pandemic.
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16
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Fazia T, Bubbico F, Nova A, Riggi E, Caimi G, Calgan B, Salvato G, Bruno S, Bottini G, Bernardinelli L. Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety. Front Psychol 2022; 13:914183. [PMID: 35859847 PMCID: PMC9289612 DOI: 10.3389/fpsyg.2022.914183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022] Open
Abstract
To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre–post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (β = −8.24 [95%CI −15.39; −1.09], p = 0.02) and WEMWBS (β = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.
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Affiliation(s)
- Teresa Fazia
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Teresa Fazia
| | - Francesco Bubbico
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Andrea Nova
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Emilia Riggi
- SSD Epidemiologia e Screening CPO, Universital Hospital “Città della Salute e della Scienza di Torino”, Torino, Italy
| | - Giancarlo Caimi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Beril Calgan
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gerardo Salvato
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Cognitive Neuropsychology Centre, ASST “Grande Ospedale Metropolitano” Niguarda, Milan, Italy
| | | | - Gabriella Bottini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Cognitive Neuropsychology Centre, ASST “Grande Ospedale Metropolitano” Niguarda, Milan, Italy
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Berhe NM, Van de Velde S, Rabiee-Khan F, van der Heijde C, Vonk P, Buffel V, Wouters E, Van Hal G. Knowledge deficit and fear of COVID-19 among higher education students during the first wave of the pandemic and implications for public health: a multi-country cross-sectional survey. BMC Public Health 2022; 22:1144. [PMID: 35672723 PMCID: PMC9172614 DOI: 10.1186/s12889-022-13511-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public health measures such as physical distancing and distance learning have been implemented during the COVID-19 pandemic. COVID-19 related knowledge deficit can increase fear that leads to negative mental health and COVID-19, especially among adolescents. Therefore, our study aimed to assess COVID-19 related knowledge deficit and its association with fear among higher education (HE) students during the first wave of COVID-19. METHODS A cross-sectional survey, COVID-19 International Students Well-being Study (C-19 ISWS) was conducted in 133 Higher Education Institutions (HEIs) in 26 countries between April 27 and July 7, 2020. A stratified convenience sampling technique was used. Descriptive, bivariate, mixed-effect logistic regression analyses were conducted using R software. RESULTS Out of 127,362 respondents, 72.1% were female, and 76.5% did not report a previous history of confirmed COVID-19. The majority of those without the previous infection 81,645 (83.7%) were from 21 European countries while the rest 15,850 (16.3%) were from 5 non-European countries. The most frequent correct response to COVID-19 related knowledge questions among respondents was having the virus without having symptoms (94.3%). Compared to participants with good knowledge, the odds of being afraid of acquiring SARS-COV-2 infection among those with poor knowledge was 1.05 (95%CI:1.03,1.08) and the odds of being afraid of contracting severe COVID-19 was 1.36 (95%CI:1.31,1.40). CONCLUSION COVID-19 related knowledge was independently associated with both fear of acquiring SARS-COV-2 infection as well as contracting severe COVID-19. Our findings will serve as a basis for public health response for both the current and similar future pandemics by highlighting the need for addressing the COVID-19 knowledge deficit to fight the infodemic and prevent negative mental health outcomes.
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Affiliation(s)
- Neamin M. Berhe
- Department of Epidemiology, Medicine & Health Sciences Faculty, University of Antwerp, Antwerp, Belgium
| | - Sarah Van de Velde
- Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Fatemeh Rabiee-Khan
- Faculty of Health, Education & Life Sciences, Birmingham City University, Birmingham, UK
| | | | - Peter Vonk
- Department of Student Health Services, University of Amsterdam, Amsterdam, Netherlands
| | - Veerle Buffel
- Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Edwin Wouters
- Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Guido Van Hal
- Department of Social Epidemiology and Health Policy, University of Antwerp, Antwerp, Belgium
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18
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Laird B, Puzia M, Larkey L, Ehlers D, Huberty J. A Mobile App for Stress Management in Middle-Aged Men and Women (Calm): Feasibility Randomized Controlled Trial. JMIR Form Res 2022; 6:e30294. [PMID: 34989677 PMCID: PMC9132144 DOI: 10.2196/30294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/23/2021] [Accepted: 09/26/2021] [Indexed: 12/03/2022] Open
Abstract
Background Middle-aged adults (40-65 years) report higher stress levels than most other age groups. There is a need to determine the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in middle-aged adults with a focus on men, as previous meditation app–based studies have reported a low proportion of or even no male participants. Objective This study aims to (1) determine the feasibility (ie, acceptability and demand with a focus on men) of a consumer-based meditation app (Calm), to reduce stress among middle-aged adults reporting elevated stress levels, and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (anxiety, depressive symptoms, mindfulness, and general coping), health behaviors (physical activity and eating habits), and COVID-19 perceptions. Methods This feasibility randomized controlled trial evaluated an app-based meditation intervention in middle-aged adults (N=83) with elevated stress levels (ie, Perceived Stress Scale score ≥15) and limited or no previous experience with meditation. Participants were randomized to the intervention group (Calm app) or a control (educational podcasts; POD) group. Participants completed self-report assessments at baseline and postintervention (week 4). Feasibility was measured as acceptability and demand using Bowen framework. Feasibility and COVID-19 perceptions data were examined using descriptive statistics, and preliminary effects were evaluated using repeated measures analysis of variance. Results Participants were satisfied with Calm (27/28, 96%) and found it appropriate or useful (26/28, 93%). Most reported they would likely continue using the Calm app (18/28, 64%). More Calm users reported satisfaction, appropriateness or usefulness, and intent to continue app use than POD users. Calm users (n=33) completed a mean of 20 (SD 31.1) minutes of meditation on the days they meditated and 103 (SD 109.1) minutes of meditation per week. The average adherence rate to the prescribed meditation was 71% among Calm app users, compared to 62% among POD users. Recruitment rate of men was 35% (29/83). Of those randomized to Calm, 55% (15/29) were men, and retention among them was higher (14/15, 93%) than that among women (12/20, 60%). No significant within or between group differences were observed. Conclusions A 4-week, app-based mindfulness meditation intervention (Calm) may be feasible for middle-aged adults and a useful stress-management tool. Calm users expressed satisfaction with the app and felt it was appropriate and useful. Significant improvements in perceived stress and psychological outcomes or stress-related health behaviors were not observed. Even though men spent less time in meditation than women did and completed fewer weekly sessions, they were more likely to adhere to the prescription. Further research is needed for improving stress and stress-related outcomes among middle-aged adults with emphasis on the effects of mindfulness meditation apps for men. Trial Registration ClinicalTrials.gov NCT04272138; https://clinicaltrials.gov/ct2/show/NCT04272138
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Affiliation(s)
- Breanne Laird
- Arizona State University, Phoenix, AZ, United States
| | - Megan Puzia
- Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States
| | - Linda Larkey
- Arizona State University, Phoenix, AZ, United States
| | - Diane Ehlers
- University of Nebraska Medical Center, Omaha, NE, United States
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19
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Mosher Henke R. Knowing Well, Being Well: well-being born of understanding: Shifts in Health Behaviors Amid the COVID-19 Pandemic. Am J Health Promot 2021; 35:1162-1183. [DOI: 10.1177/08901171211055310a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Satre DD, Meacham MC, Asarnow LD, Fisher WS, Fortuna LR, Iturralde E. Opportunities to Integrate Mobile App-Based Interventions Into Mental Health and Substance Use Disorder Treatment Services in the Wake of COVID-19. Am J Health Promot 2021; 35:1178-1183. [PMID: 34652971 DOI: 10.1177/08901171211055314] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has heightened concerns about the impact of depression, anxiety, alcohol, and drug use on public health. Mobile apps to address these problems were increasingly popular even before the pandemic, and may help reach people who otherwise have limited treatment access. In this review, we describe pandemic-related substance use and mental health problems, the growing evidence for mobile app efficacy, how health systems can integrate apps into patient care, and future research directions. If equity in access and effective implementation can be addressed, mobile apps are likely to play an important role in mental health and substance use disorder treatment.
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Affiliation(s)
- Derek D Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Meredith C Meacham
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lauren D Asarnow
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Weston S Fisher
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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21
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Gordon JS, Sbarra D, Armin J, Pace TWW, Gniady C, Barraza Y. Use of a Guided Imagery Mobile App (See Me Serene) to Reduce COVID-19-Related Stress: Pilot Feasibility Study. JMIR Form Res 2021; 5:e32353. [PMID: 34546941 PMCID: PMC8491644 DOI: 10.2196/32353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 12/13/2022] Open
Abstract
Background The SARS-CoV-2 pandemic has led to concerns about mental health resulting from regional and national lockdowns, social isolation, job loss, and concern about disease exposure. Objective We describe results of the pilot feasibility study of the See Me Serene mHealth app. The app provides users with immersive, vivid, nature experiences to reduce stress and anxiety related to COVID-19 and other isolation. The goals of the study were to develop the See Me Serene app and test the feasibility and acceptability of study procedures, and explore the potential impact of the app on stress and anxiety. Methods We developed and tested the See Me Serene app and our study procedures for feasibility, and gathered preliminary data with a goal of 100 participants. The research was conducted in 2 phases: (1) development and internal testing of the app; and (2) feasibility and pilot testing with participants recruited online through earned media (eg, news stories), presentations at a university campus, and social media (eg, online sharing of earned media and presentations). The feasibility study employed a mixed methods, within-subjects, pre-/posttest design. At baseline and 30-day follow-up, we assessed stress-related variables via validated self-report measures and saliva samples for determination of cortisol concentrations. Results We met or surpassed all our feasibility benchmarks for recruitment (101 participants recruited), retention (91% [90/99] of 30-day assessment completed), and data collection (99 participants completed all baseline data; 85% [84/99] of salivary cortisol samples returned). Participants adhered to the intervention. On average, participants listened to 48.2 audio files over 30 days or approximately 1.6 audio files per day. Participants were satisfied with the app, with 87% (78/90) rating the app as helpful in dealing with stress and anxiety. The app showed the potential to reduce stress, anxiety, loneliness, and worry. We did not find significant differences (P=.41) in cortisol levels over time. Our findings suggest that future research is warranted to test the efficacy of the See Me Serene app with a representative, diverse sample. Conclusions There is a need for evidence-based and easily disseminable stress-reduction interventions. See Me Serene is a feasible intervention and has the potential to reduce stress related to COVID-19 and other forms of social isolation. More research on See Me Serene is warranted.
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Affiliation(s)
- Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - David Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Department of Family and Community of Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Thaddeus W W Pace
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Chris Gniady
- Department of Computer Science, University of Arizona, Tucson, AZ, United States
| | - Yessenya Barraza
- College of Nursing, University of Arizona, Tucson, AZ, United States
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