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Haack LM, Armstrong CC, Travis K, Aguilera A, Darrow SM. HealthySMS Text Messaging System Adjunct to Adolescent Group Cognitive Behavioral Therapy in the Context of COVID-19 (Let's Text!): Pilot Feasibility and Acceptability Study. JMIR Ment Health 2024; 11:e49317. [PMID: 38373030 PMCID: PMC10912989 DOI: 10.2196/49317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND The widespread occurrence and devastating impact of adolescent depression warrant health service research focused on feasible and acceptable digital health tools to supplement evidence-based intervention (EBI) efforts, particularly in the context of shelter-in-place guidelines disrupting youth socialization and service use in the wake of the COVID-19 pandemic. Given the promise of SMS text message interventions to enhance EBI engagement, our team developed the HealthySMS system as an adjunct to one of the most empirically supported interventions for adolescent depression: cognitive behavioral therapy (CBT) group services. The system sends daily SMS text messages requesting responses assessing mood, thoughts, and activities; weekly attendance reminder messages; daily tips about adherence (eg, a prompt for activity completion); and personalized responses based on participants' texts. OBJECTIVE This study aims to evaluate the feasibility and acceptability of HealthySMS in a real-world setting and explore potential mechanisms of change in EBI engagement, before evaluating the system's impact on adolescents' group CBT engagement and, ultimately, depression outcomes. METHODS Over the course of 2020, we invited all 20 adolescents receiving CBT group services for depression at an outpatient psychiatry clinic to enroll in our HealthySMS study; ultimately, 17 (85%) adolescents agreed to participate. We tracked participant initiation and engagement with the HealthySMS system as well as the content of SMS text message responses to HealthySMS. We also invited each participant to engage in a semistructured interview to gather additional qualitative inputs on the system. RESULTS All (n=17, 100%) research participants invited agreed to receive HealthySMS messages, and 94% (16/17) of the participants maintained use during the first month without opting out. We uncovered meaningful qualitative themes regarding the feasibility and acceptability of HealthySMS, as well as its potential impact on EBI engagement. CONCLUSIONS Taken together, the results of this pilot study suggest that HealthySMS adjunct to adolescent CBT group depression services is feasible and acceptable, as evidenced by high rates of HealthySMS initiation and low rates of dropout, as well as meaningful themes uncovered from participants' qualitative feedback. In addition, the findings provide evidence regarding iterative improvements to the HealthySMS system and research protocol, as well as potential mechanisms of change for enhanced EBI engagement and, ultimately, adolescent depression outcomes, which can be used in future effectiveness research.
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Affiliation(s)
- Lauren M Haack
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Courtney C Armstrong
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Kate Travis
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Adrian Aguilera
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
- School of Social Welfare, University of California Berkeley, Berkeley, CA, United States
| | - Sabrina M Darrow
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
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O'Hara SE, Paschall MJ, Grube JW, Ponicki WR. Did the association between alcohol outlet density and crime change during COVID shelter-in-place orders? Drug Alcohol Rev 2024; 43:454-464. [PMID: 38258462 PMCID: PMC10922690 DOI: 10.1111/dar.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION We investigated whether greater concentrations of on- and off-sale alcohol outlets were associated with crime and whether this association was moderated by COVID-19 shelter-in-place orders (SIP) that restricted on-premises consumption of alcohol. METHODS Crimes (2019-2020) and addresses of licenced alcohol outlets in a medium-sized California city were geocoded within census block groups (N = 61). On- and off-sale alcohol outlet density was calculated as licenced outlets/2.59 km2 (1 square mile). Multilevel negative binomial regression analyses were conducted to examine associations between alcohol outlet density and crime, and possible moderating effects of SIP, controlling for block group demographic characteristics and density of other retail businesses. RESULTS On-sale outlet density was positively associated with total crimes and Part 2 crimes, while off-sale outlet density was inversely associated with total crime and Part 2 crimes. Overall, SIP was not significantly associated with crime, but moderated the associations of on-sale density with total crime and Part 1 crimes such that reductions in crime during SIP were observed in higher density areas. The association of off-sale outlets with crime was not moderated by SIP policies. DISCUSSION AND CONCLUSION On-sale outlet density, but not off-sale density, appears to be associated with increased crime. The results further indicate that restrictions in hours and service imposed by SIP policies reduced crime in high on-sale outlet density areas. These findings reinforce the importance of regulating alcohol outlet density and hours of service, especially for on-sale outlets, as a crime reduction strategy.
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Affiliation(s)
- Sharon E O'Hara
- Prevention Research Center, Berkeley, USA
- School of Public Health, University of California, Berkeley, Berkeley, USA
| | | | - Joel W Grube
- Prevention Research Center, Berkeley, USA
- School of Public Health, University of California, Berkeley, Berkeley, USA
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Morris J, Morris B, Briars A. COVID shelter in place orders and mental health outcomes among college undergraduates. J Am Coll Health 2023; 71:2530-2537. [PMID: 34586019 DOI: 10.1080/07448481.2021.1978459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/09/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
ObjectiveThe purpose of this study is to examine the relationship , if any, COVID-19 shelter-in-place orders had on mental health outcomes for undergraduate students.ParticipantsThis study was comprised of 138 students, all of which were recruited from a single four-year college in the Midwest.MethodsA pre-/post-test comparative design was adopted and was leveraged to capture data regarding students' experiences before and after the shelter-in-place orders were enacted to determine if there was a marked effect between the pre-virus condition and the situation after stay at home orders went into effect.ResultsPaired sample t-test were conducted to determine whether the mental health outcomes of depression, anxiety and stress were significantly changed from before to after COVID-19 shelter in place disorders. While anxiety and stress scores were revealed no significant difference, significantly greater depression was revealed after COVID-19.ConclusionOverall, the results of this study highlight the need for colleges to be aware of the mental health toll that the pandemic and shelter-in-place orders may take on their students. Though this toll registered only directly in depression, there remains significant reasons to believe the situation may also affect stress and anxiety regardless of the absence of evidence for these factors in this study. There remains much to be done in assessing the ultimate impact of the pandemic on students' mental health.
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Affiliation(s)
- James Morris
- Psychology Department (Graduate Clinical Mental Health Counseling Program), Lewis University, Romeoville, Illinois, USA
| | - Brian Morris
- Office of Field Experience, National Louis University, Wheeling, Illinois, USA
| | - Antwanae Briars
- Graduate Mental Health Counseling, Lewis University, Romeoville, Illinois, USA
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Bulterys PL, Leung NY, Saleem A, Budvytiene I, Pinsky BA, Banaei N. Postpandemic Effects of COVID-19 Shelter-in-Place Orders on the Gastrointestinal Pathogen Landscape. J Clin Microbiol 2023; 61:e0038523. [PMID: 37466426 PMCID: PMC10446857 DOI: 10.1128/jcm.00385-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Philip L. Bulterys
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Nicole Y. Leung
- Stanford University School of Medicine, Stanford, California, USA
| | - Atif Saleem
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Indre Budvytiene
- Clinical Virology Laboratory, Stanford University Medical Center, Stanford, California, USA
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, USA
- Clinical Virology Laboratory, Stanford University Medical Center, Stanford, California, USA
| | - Niaz Banaei
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, USA
- Clinical Microbiology Laboratory, Stanford University Medical Center, Stanford, California, USA
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Kristina Wharton M, Balassone A, Thomas S, Treffers R, Paschall MJ, Lam L, Lipperman-Kreda S. Covid-19 Shelter-in-Place, Modified Reopening Orders, and Order Compliance Impact on Adolescent Alcohol Use and Drinking Contexts in California: A Longitudinal Analysis. Addict Behav 2023; 143:107707. [PMID: 36989700 PMCID: PMC10037914 DOI: 10.1016/j.addbeh.2023.107707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/19/2023] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
This study evaluated how Shelter-in-Place (SIP), modified reopening orders, and self-reported compliance with these orders have affected adolescent alcohol frequency and quantity of use across contexts during the COVID-19 pandemic. Materials and Methods: Differences-in-differences (DID) models and multi-level modeling analyses were conducted on longitudinal data collected as part of a larger study on alcohol among adolescents in California. 1,350 adolescents at baseline contributed 7,467 observations for a baseline and 5 six-month follow-up surveys. Analytic samples ranged from 3,577-6,245 participant observations based on models. Alcohol use outcomes included participant frequency (days) and quantity (number of whole drinks) of alcohol use in past 1-month and past 6-month periods. Context-specific alcohol use outcomes included past 6-month frequency and quantity of use at: restaurants, bars/nightclubs, outside, one’s own home, another’s home, and fraternities/sororities. Participant self-reported compliance with orders in essential business/retail spaces and at outdoor/social settings were also assessed. Results: Our DID results indicated that being under a modified reopening order was associated with decreases in past 6-month quantity of alcohol use (IRR=0.72, CI=0.56-0.93, p<0.05). Higher self-reported compliance with SIP orders related to social outdoor/social settings was associated with decreases in overall drinking frequency and quantity as well as decreased frequency and quantity of alcohol use in all contexts in the past six months. Compliance with SIP orders impacting essential businesses and retail spaces was associated with decreased frequency and quantity of use at other’s home and outdoors. Conclusions: Results suggest that SIP and modified reopening policies may not directly affect adolescent alcohol use or drinking contexts, and that individual compliance with such orders may be a protective factor for alcohol use.
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Affiliation(s)
- M Kristina Wharton
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck St. Suite 601, Berkeley, CA 94704, USA; University of California - Berkeley, School of Public Health, Berkeley Way, Berkeley, CA 94704, USA.
| | - Anna Balassone
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck St. Suite 601, Berkeley, CA 94704, USA
| | - Sue Thomas
- Pacific Institute for Research and Evaluation, National Capital Region Center 4061 Powder Mill Road, Suite 350, Beltsville, MD 20705, USA
| | - Ryan Treffers
- Pacific Institute for Research and Evaluation, National Capital Region Center 4061 Powder Mill Road, Suite 350, Beltsville, MD 20705, USA
| | - Mallie J Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck St. Suite 601, Berkeley, CA 94704, USA
| | - Lee Lam
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck St. Suite 601, Berkeley, CA 94704, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck St. Suite 601, Berkeley, CA 94704, USA
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Perry L, Scheerens C, Greene M, Shi Y, Onion Z, Bayudan E, Stern RJ, Gilissen J, Chodos AH. Unmet health-related needs of community-dwelling older adults during COVID-19 lockdown in a diverse urban cohort. J Am Geriatr Soc 2023; 71:178-187. [PMID: 36273406 PMCID: PMC9874555 DOI: 10.1111/jgs.18098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Shelter-in-place orders during the COVID-19 pandemic created unmet health-related and access-related needs among older adults. We sought to understand the prevalence of these needs among community-dwelling older adults. METHODS We performed a retrospective chart review of pandemic-related outreach calls to older adults between March and July 2020 at four urban, primary care clinics: a home-based practice, a safety net adult medicine clinic, an academic geriatrics practice, and a safety net clinic for adults living with HIV. Participants included those 60 or older at three sites, and those 65 or older with a chronic health condition at the fourth. We describe unmet health-related needs (the need for medication refills, medical supplies, or food) and access-related needs (ability to perform a telehealth visit, need for a call back from the primary care provider). We performed bivariate and multivariate analyses to examine the association between unmet needs and demographics, medical conditions, and healthcare utilization. RESULTS Sixty-two percent of people had at least one unmet need. Twenty-six percent had at least one unmet health-related need; 14.0% needed medication refills, 12.5% needed medical supplies, and 3.0% had food insecurity. Among access-related needs, 33% were not ready for video visits, and 36.4% asked for a return call from their provider. Prevalence of any unmet health-related need was the highest among Asian versus White (36.4% vs. 19.1%) and in the highest versus lowest poverty zip codes (30.8% vs. 18.2%). Those with diabetes and COPD had higher unmet health-related needs than those without, and there was no change in healthcare utilization. CONCLUSIONS During COVID, we found that disruptions in access to services created unmet needs among older adults, particularly for those who self-identified as Asian. We must foreground the needs of this older population group in the response to future public health crises.
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Affiliation(s)
- Laura Perry
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Charlotte Scheerens
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA,Department of Public Health and Primary careUniversiteit GentGhentBelgium,Institute for Lung Health, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Meredith Greene
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Ying Shi
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Zoe Onion
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Evamae Bayudan
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Rachel J. Stern
- Ambulatory CareVentura County Healthcare AgencyVenturaCaliforniaUSA
| | - Joni Gilissen
- Atlantic Fellowship for Equity in Brain HealthGlobal Brain Health InstituteSan FranciscoCaliforniaUSA,End‐of‐Life Care Research Group, Department of Family Medicine & Chronic CareVrije Universiteit Brussel (VUB)BrusselsBelgium
| | - Anna H. Chodos
- Department of Medicine, Division of GeriatricsUniversity of California San FranciscoSan FranciscoCaliforniaUSA,Institute for Lung Health, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
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Kyne D, Robledo C, Clark LC, Charak R, Salahuddin M, Morrow J. Social Connectedness, Physical Distancing, and Anxiety in Complying with Shelter-In-Place Orders and Advisories during the Once-In-A-Century COVID-19 Pandemic in the US: A Study of Social Media and Internet Users. Int J Environ Res Public Health 2022; 19:15282. [PMID: 36429999 PMCID: PMC9690252 DOI: 10.3390/ijerph192215282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), was first identified in Wuhan, China, in December 2019. As of 20 October 2020, the virus had infected 8,202,552 people, with 220,061 deaths in US, and in countries around the world, over 38 million people have become infected and over one million have died. The virus usually spreads via respiratory droplets from an infected person. At the time of compiling this paper, while countries around the world are still striving to find a "pharmaceutical intervention (PI)", including treatments and vaccines, they are left with only "non-pharmaceutical interventions (NPIs)", such as physical distancing, wearing masks, and maintaining personal hygiene. In the US, all 50 states, the District of Columbia, and five US territories issued mandatory stay-at-home orders between March 1 and 31 May 2020 to lower the risk of virus transmission. This study empirically examined how social connectedness and anxiety interact with shelter-in-place compliance and advisories during the pandemic. The study collected information from 494 adults using an online survey during April and July 2020.
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Affiliation(s)
- Dean Kyne
- Department of Sociology, College of Liberal Arts, University of Texas Rio Grande Valley (UTRGV), Edinburg, TX 78539, USA
| | - Candace Robledo
- Department of Population Health & Biostatistics, School of Medicine, University of Texas Rio Grande Valley (UTRGV), Edinburg, TX 78539, USA
| | - Loren Cliff Clark
- Department of Population Health & Biostatistics, School of Medicine, University of Texas Rio Grande Valley (UTRGV), Edinburg, TX 78539, USA
| | - Ruby Charak
- Department of Psychology, College of Liberal Arts, University of Texas Rio Grande Valley (UTRGV), Edinburg, TX 78539, USA
| | - Meliha Salahuddin
- School of Public Health Austin Campus, University of Texas Health Science Center at Houston (UTHealth), Austin, TX 78701, USA
| | - Jay Morrow
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Hutchinson ML, Nash KB, Abend NS, Moharir M, Wells E, Messer RD, Palaganas J, Helbig I, Wietstock SO, Suslovic W, Gonzalez AK, Kaufman MC, Press CA, Piantino J. Multicenter Study of the Impact of COVID-19 Shelter-In-Place on Tertiary Hospital-based Care for Pediatric Neurologic Disease. Neurohospitalist 2022; 12:218-226. [PMID: 35414846 PMCID: PMC8814588 DOI: 10.1177/19418744211063075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective To describe changes in hospital-based care for children with neurologic diagnoses during the initial 6 weeks following regional Coronavirus 2019 Shelter-in-Place orders. Methods This retrospective cross-sectional study of 7 US and Canadian pediatric tertiary care institutions included emergency and inpatient encounters with a neurologic primary discharge diagnosis code in the initial 6 weeks of Shelter-in-Place (COVID-SiP), compared to the same period during the prior 3 years (Pre-COVID). Patient demographics, encounter length, and neuroimaging and electroencephalography use were extracted from the medical record. Results 27,900 encounters over 4 years were included. Compared to Pre-COVID, there was a 54% reduction in encounters during Shelter-in-Place. COVID-SiP patients were younger (median 5 years vs 7 years). The incidence of encounters for migraine fell by 72%, and encounters for acute diagnoses of status epilepticus, infantile spasms, and traumatic brain injury dropped by 53%, 55%, and 56%, respectively. There was an increase in hospital length of stay, relative utilization of intensive care, and diagnostic testing (long-term electroencephalography, brain MRI, and head CT (all P<.01)). Conclusion During the initial 6 weeks of SiP, there was a significant decrease in neurologic hospital-based encounters. Those admitted required a high level of care. Hospital-based neurologic services are needed to care for acutely ill patients. Precise factors causing these shifts are unknown and raise concern for changes in care seeking of patients with serious neurologic conditions. Impacts of potentially delayed diagnosis or treatment require further investigation.
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Affiliation(s)
- Melissa L. Hutchinson
- Department of Pediatrics, Neurology
Division, The Ohio State University College of
Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Kendall B. Nash
- Departments of Neurology and
Pediatrics, Division of Child Neurology, University of California, San
Francisco, Benioff Children’s Hospital San Francisco, San Francisco,
CA, USA
| | - Nicholas S. Abend
- Departments of Neurology and
Pediatrics, Children’s Hospital of Philadelphia
and the University of Pennsylvania, Philadelphia PA, USA
| | - Mahendranath Moharir
- Division of Neurology, Department
of Pediatrics, The Hospital for Sick Children and
University of Toronto, Ontario, Canada
| | - Elizabeth Wells
- Center for Neuroscience and
Behavioral Medicine, Children’s National Hospital and the
George Washington University School of Medicine and Health
Sciences, Washington, DC, USA
| | - Ricka D. Messer
- Department of Pediatrics, Section
of Child Neurology, University of Colorado, Aurora, CO, USA
| | - Jamie Palaganas
- Department of Pediatrics, Division
of Child Neurology, Weill Cornell Medicine, New York Presbyterian
Hospital, New York, NY, USA
| | - Ingo Helbig
- Division of Neurology, Children’s Hospital of
Philadelphia, Philadelphia PA, USA
| | - Sharon O. Wietstock
- The Epilepsy NeuroGenetics
Initiative (ENGIN), Department of Biomedical and Health Informatics (DBHi),
Department of Neurology, University of
Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - William Suslovic
- Department of Neurology, Children’s National
Hospital, Washington, DC, USA
| | - Alexander K. Gonzalez
- The Epilepsy NeuroGenetics
Initiative (ENGIN). Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of
Philadelphia, Philadelphia PA, USA 1
| | - Michael C. Kaufman
- The Epilepsy NeuroGenetics
Initiative (ENGIN). Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of
Philadelphia, Philadelphia PA, USA 1
| | - Craig A. Press
- Departments of Neurology and
Pediatrics, Children’s Hospital of Philadelphia
and the University of Pennsylvania, Philadelphia PA, USA
| | - Juan Piantino
- Department of Pediatrics, Section
of Child Neurology, Oregon Health & Science
University, Portland, OR, USA,Juan A. Piantino, Department of Pediatrics,
Section of Child Neurology, Oregon Health & Science University, MCR CDRC-P
707 SW Gaines St, Portland, OR 97239, USA.
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Best J, Stoker S, McDaniel D, Lerew S, Jawanda G, Krentz N, Speicher M, Siwiec R. Effects of easing shelter-in-place restrictions and the lingering COVID-19 pandemic on orthopaedic trauma at a community level 2 trauma center. OTA Int 2021; 4:e123. [PMID: 34746656 DOI: 10.1097/OI9.0000000000000123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/07/2021] [Indexed: 11/26/2022]
Abstract
Objectives: Evaluate the effect of easing “shelter-in-place” restrictions and coronavirus-2019 (COVID-19) cases on orthopaedic trauma encounters (OTEs) at a community level II trauma center. Methods: A retrospective analysis was conducted of OTEs from March-June of 2016 to 2020. Injuries were classified by high or low severity. Admission and surgical intervention rates were also compared year to year. Data were statistically analyzed and compared with external data for traffic counts near the hospital and COVID-19 cases in Michigan as well as a timeline for enacting and easing of shelter-in-place orders in the state of Michigan. Results: There was no difference in the number of OTEs May to June, 2020 compared with the average of those same months 2016 to 2019. March to June, 2020 showed no change in proportion of injury severity, admissions, or surgical interventions when compared with the average of March-June, 2016 to 2019, although the overall quantity of each was decreased in March and April. A significant negative correlation was found between the daily number of COVID-19 cases in Michigan and OTEs. Conclusions: The quantity of OTEs normalized to pre-COVID-19 levels in May and June of 2020 compared with 2016 to 2019 despite a previously documented 45.1% drop in March and April. A negative correlation was noted between the number of reported Michigan COVID-19 cases and volume of OTEs. There were no significant changes noted to admission rates or rates of surgical intervention on OTEs throughout the time period studied.
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Sobba W, Landry MJ, Cunanan KM, Marcone A, Gardner CD. Changes in Ultra-Processed Food Consumption and Lifestyle Behaviors Following COVID-19 Shelter-in-Place: A Retrospective Study. Foods 2021; 10:2553. [PMID: 34828834 DOI: 10.3390/foods10112553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/09/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023] Open
Abstract
Ultra-processed food (UPF) consumption poses a potential risk to public health and may be related to shelter-in-place orders. This study utilized the level of food processing as a lens by which to examine the relationships between diet, weight change, and lifestyle changes (including cooking, snacking, and sedentary activity) that occurred during regional shelter-in-place orders. This study used a cross-sectional, retrospective survey (n = 589) to assess baseline demographics, changes in lifestyle behaviors using a Likert scale, and changes in dietary behaviors using a modified food frequency questionnaire from mid-March to May 2020; data were collected in the California Bay Area from August to October 2020. Foods were categorized by level of processing (minimally processed, processed, and ultra-processed) using the NOVA scale. Stepwise multiple linear regression and univariate linear regression models were used to determine the associations between these factors. Increased snacking was positively associated with a change in the percent of the calories derived from UPF and weight gain (β = 1.0, p < 0.001; β = 0.8 kg, p < 0.001) and negatively associated with the share of MPF calories consumed (β = −0.9, p < 0.001). These relationships have public health implications as interventions designed around decreased snacking may positively impact diet and weight management and thereby mitigate negative health outcomes.
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Wang Y, Siesel C, Chen Y, Lopman B, Edison L, Thomas M, Adams C, Lau M, Teunis PFM. Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Georgia, USA, February 1-July 13, 2020. Emerg Infect Dis 2021; 27:2578-2587. [PMID: 34399085 PMCID: PMC8462336 DOI: 10.3201/eid2710.210061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The serial interval and effective reproduction number for coronavirus disease (COVID-19) are heterogenous, varying by demographic characteristics, region, and period. During February 1–July 13, 2020, we identified 4,080 transmission pairs in Georgia, USA, by using contact tracing information from COVID-19 cases reported to the Georgia Department of Public Health. We examined how various transmission characteristics were affected by symptoms, demographics, and period (during shelter-in-place and after subsequent reopening) and estimated the time course of reproduction numbers for all 159 Georgia counties. Transmission varied by time and place but also by persons’ sex and race. The mean serial interval decreased from 5.97 days in February–April to 4.40 days in June–July. Younger adults (20–50 years of age) were involved in most transmission events occurring during or after reopening. The shelter-in-place period was not long enough to prevent sustained virus transmission in densely populated urban areas connected by major transportation links.
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Chamie G, Marquez C, Crawford E, Peng J, Petersen M, Schwab D, Schwab J, Martinez J, Jones D, Black D, Gandhi M, Kerkhoff AD, Jain V, Sergi F, Jacobo J, Rojas S, Tulier-Laiwa V, Gallardo-Brown T, Appa A, Chiu C, Rodgers M, Hackett J, Kistler A, Hao S, Kamm J, Dynerman D, Batson J, Greenhouse B, DeRisi J, Havlir DV. Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Disproportionately Affects the Latinx Population During Shelter-in-Place in San Francisco. Clin Infect Dis 2021; 73:S127-S135. [PMID: 32821935 PMCID: PMC7499499 DOI: 10.1093/cid/ciaa1234] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
Background There is urgent need to understand the dynamics and risk factors driving ongoing SARS-CoV-2 transmission during shelter-in-place mandates. Methods We offered SARS-CoV-2 reverse transcription-PCR and antibody (Abbott ARCHITECT IgG) testing, regardless of symptoms, to all residents (≥4 years) and workers in a San Francisco census tract (population: 5,174) at outdoor, community-mobilized events over four days. We estimated SARS-CoV-2 point prevalence (PCR-positive) and cumulative incidence (antibody or PCR-positive) in the census tract and evaluated risk factors for recent (PCR-positive/antibody-negative) versus prior infection (antibody-positive/PCR-negative). SARS-CoV-2 genome recovery and phylogenetics were used to measure viral strain diversity, establish viral lineages present, and estimate number of introductions. Results We tested 3,953 persons: 40% Latinx; 41% White; 9% Asian/Pacific Islander; and 2% Black. Overall, 2.1% (83/3,871) tested PCR-positive: 95% were Latinx and 52% asymptomatic when tested. 1.7% of census tract residents and 6.0% of workers (non-census tract residents) were PCR-positive. Among 2,598 tract residents, estimated point prevalence of PCR-positives was 2.3% (95%CI: 1.2-3.8%): 3.9% (95%CI: 2.0-6.4%) among Latinx vs. 0.2% (95%CI: 0.0-0.4%) among non-Latinx persons. Estimated cumulative incidence among residents was 6.1% (95%CI: 4.0-8.6%). Prior infections were 67% Latinx, 16% White, and 17% other ethnicities. Among recent infections, 96% were Latinx. Risk factors for recent infection were Latinx ethnicity, inability to shelter-in-place and maintain income, frontline service work, unemployment, and household income &$50,000/year. Five SARS-CoV-2 phylogenetic lineages were detected. Conclusion SARS-CoV-2 infections from diverse lineages continued circulating among low-income, Latinx persons unable to work from home and maintain income during San Francisco’s shelter-in-place ordinance.
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Affiliation(s)
- Gabriel Chamie
- University of California, San Francisco, San Francisco, California, USA
| | - Carina Marquez
- University of California, San Francisco, San Francisco, California, USA
| | - Emily Crawford
- University of California, San Francisco, San Francisco, California, USA.,Chan Zuckerberg Biohub, San Francisco, California, USA
| | - James Peng
- University of California, San Francisco, San Francisco, California, USA
| | - Maya Petersen
- University of California, Berkeley, Berkeley, California, USA
| | - Daniel Schwab
- College of the Holy Cross, Worcester, Massachusetts, USA
| | - Joshua Schwab
- University of California, Berkeley, Berkeley, California, USA
| | - Jackie Martinez
- University of California, San Francisco, San Francisco, California, USA
| | - Diane Jones
- Unidos en Salud/United in Health, San Francisco, California, USA
| | - Douglas Black
- University of California, San Francisco, San Francisco, California, USA
| | - Monica Gandhi
- University of California, San Francisco, San Francisco, California, USA
| | - Andrew D Kerkhoff
- University of California, San Francisco, San Francisco, California, USA
| | - Vivek Jain
- University of California, San Francisco, San Francisco, California, USA
| | - Francesco Sergi
- University of California, San Francisco, San Francisco, California, USA
| | - Jon Jacobo
- Latino Task Force for COVID-19, San Francisco, California, USA
| | - Susana Rojas
- Latino Task Force for COVID-19, San Francisco, California, USA
| | | | | | - Ayesha Appa
- University of California, San Francisco, San Francisco, California, USA
| | - Charles Chiu
- University of California, San Francisco, San Francisco, California, USA
| | | | | | | | - Amy Kistler
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Samantha Hao
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Jack Kamm
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | | | - Joshua Batson
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Bryan Greenhouse
- University of California, San Francisco, San Francisco, California, USA
| | - Joe DeRisi
- University of California, San Francisco, San Francisco, California, USA.,Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Diane V Havlir
- University of California, San Francisco, San Francisco, California, USA
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Daughton AR, Shelley CD, Barnard M, Gerts D, Watson Ross C, Crooker I, Nadiga G, Mukundan N, Vaquera Chavez NY, Parikh N, Pitts T, Fairchild G. Mining and Validating Social Media Data for COVID-19-Related Human Behaviors Between January and July 2020: Infodemiology Study. J Med Internet Res 2021; 23:e27059. [PMID: 33882015 PMCID: PMC8153035 DOI: 10.2196/27059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/08/2021] [Accepted: 04/17/2021] [Indexed: 01/29/2023] Open
Abstract
Background Health authorities can minimize the impact of an emergent infectious disease outbreak through effective and timely risk communication, which can build trust and adherence to subsequent behavioral messaging. Monitoring the psychological impacts of an outbreak, as well as public adherence to such messaging, is also important for minimizing long-term effects of an outbreak. Objective We used social media data from Twitter to identify human behaviors relevant to COVID-19 transmission, as well as the perceived impacts of COVID-19 on individuals, as a first step toward real-time monitoring of public perceptions to inform public health communications. Methods We developed a coding schema for 6 categories and 11 subcategories, which included both a wide number of behaviors as well codes focused on the impacts of the pandemic (eg, economic and mental health impacts). We used this to develop training data and develop supervised learning classifiers for classes with sufficient labels. Classifiers that performed adequately were applied to our remaining corpus, and temporal and geospatial trends were assessed. We compared the classified patterns to ground truth mobility data and actual COVID-19 confirmed cases to assess the signal achieved here. Results We applied our labeling schema to approximately 7200 tweets. The worst-performing classifiers had F1 scores of only 0.18 to 0.28 when trying to identify tweets about monitoring symptoms and testing. Classifiers about social distancing, however, were much stronger, with F1 scores of 0.64 to 0.66. We applied the social distancing classifiers to over 228 million tweets. We showed temporal patterns consistent with real-world events, and we showed correlations of up to –0.5 between social distancing signals on Twitter and ground truth mobility throughout the United States. Conclusions Behaviors discussed on Twitter are exceptionally varied. Twitter can provide useful information for parameterizing models that incorporate human behavior, as well as for informing public health communication strategies by describing awareness of and compliance with suggested behaviors.
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Affiliation(s)
- Ashlynn R Daughton
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Courtney D Shelley
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Martha Barnard
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Dax Gerts
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Chrysm Watson Ross
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States.,Computer Science, University of New Mexico, Albuquerque, NM, United States
| | - Isabel Crooker
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Gopal Nadiga
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Nilesh Mukundan
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Nidia Yadira Vaquera Chavez
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States.,Computer Science, University of New Mexico, Albuquerque, NM, United States
| | - Nidhi Parikh
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Travis Pitts
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Geoffrey Fairchild
- Analytics, Intelligence, and Technology, Los Alamos National Laboratory, Los Alamos, NM, United States
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Stoker S, McDaniel D, Crean T, Maddox J, Jawanda G, Krentz N, Best J, Speicher M, Siwiec R. Effect of Shelter-in-Place Orders and the COVID-19 Pandemic on Orthopaedic Trauma at a Community Level II Trauma Center. J Orthop Trauma 2020; 34:e336-e342. [PMID: 32815848 PMCID: PMC7446991 DOI: 10.1097/bot.0000000000001860] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the effect of the COVID-19 pandemic and the "shelter-in-place" order on orthopaedic trauma presenting to a community level II trauma center. It is hypothesized that the overall number of orthopaedic trauma encounters (OTEs), the number of OTEs related to both high and low severity injuries, and the proportion of OTEs related to high severity versus low severity injuries decreased compared with previous years. METHODS A retrospective analysis was conducted of OTEs between 2016 and 2020. High and low severity OTEs were classified according to an algorithm created by the researchers. Data were statistically analyzed and compared with external data for traffic counts, motor vehicle accidents, and Transportation Security Administration checkpoints. RESULTS A 45.1% decrease (P = 0.0005) was seen in OTEs from March and April 2016-2019 compared with 2020. The decrease began approximately 12 days before the shelter-in-place order. There was a 58.8% decrease in high severity injuries with a fracture (P = 0.013) and a 42.9% decrease in low severities injuries (P = 0.0003). The proportion of high to low severity OTEs was unchanged. CONCLUSIONS The quantity of OTEs was significantly affected by the COVID-19 pandemic and Michigan shelter-in-place order. A decrease in both high and low severity OTEs was found; however, there was no statistically significant change in the ratio of high to low severity OTEs compared with previous years. Although it is difficult to determine what portion of the decrease in OTE is attributable to the shelter-in-place order versus the COVID-19 pandemic in general, data suggest both play a role. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.
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Affiliation(s)
- Steven Stoker
- Departments of Medical Education, and
- Orthopedics, McLaren Oakland, McLaren Healthcare, Pontiac, MI
| | - Dalton McDaniel
- Departments of Medical Education, and
- Orthopedics, McLaren Oakland, McLaren Healthcare, Pontiac, MI
| | - Trevor Crean
- Departments of Medical Education, and
- Orthopedics, McLaren Oakland, McLaren Healthcare, Pontiac, MI
| | - Joshua Maddox
- Departments of Medical Education, and
- Orthopedics, McLaren Oakland, McLaren Healthcare, Pontiac, MI
| | - Gurkirat Jawanda
- Departments of Medical Education, and
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI
| | - Neal Krentz
- Departments of Medical Education, and
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI
| | - Jacob Best
- Departments of Medical Education, and
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI
| | - Mark Speicher
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD; and
| | - Ryan Siwiec
- Departments of Medical Education, and
- Orthopedics, McLaren Oakland, McLaren Healthcare, Pontiac, MI
- Center for Advanced Orthopedics & Sports Medicine, Auburn Hills, MI
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