scholarly journals Older Black Americans and Depressive Symptoms During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1049-1049
Author(s):  
David Chae ◽  
Connor Martz ◽  
Kara Chung ◽  
Roland Thorpe ◽  
Karen Lincoln

Abstract Black Americans have experienced multiple health threats during the COVID-19 pandemic, including greater risk of infection compared to Whites. In addition, older adults are more susceptible to worse disease consequences including hospitalization and mortality compared to those who are younger. Racism and economic costs are additional public health crises during this time that have disproportionately impacted Black Americans. Using data from the Uncovering COVID-19 Experiences and Realities (UnCOVER) Study, we examined depressive symptoms in relation to: (1) worry/fear of COVID-19; (2) work loss among household members (being laid off, reduced work hours); and (3) vicarious racism, a particularly salient source of psychosocial stress during the COVID-19 pandemic, including hearing about or seeing acts of racism committed against other race group members. Participants were Black Americans aged 50 years or older (n=300) from five cities (Atlanta, Chicago, Los Angeles, New Orleans, and New York) from May-July 2020. Depression was assessed using the Patient-Reported Outcomes Measurement Information System Short Form. In multivariable linear regression models, all three public health threats were significantly associated with depressive symptoms. When in the model simultaneously, worry/fear of COVID-19 (b=0.30, SE=0.12, p<0.01) and vicarious racism (b=0.62, SE=0.15, p<0.001) showed positive associations; work loss was no longer statistically significant (b=0.62, SE=0.43, p=0.15). When added, the corresponding three-way interaction term was significant (b=0.12, SE=0.04, p<0.01). Synergistic epidemics (“syndemics”) among older Black Americans amplify mental health tolls. Multi-pronged public health strategies are required to address depression in this population.

2021 ◽  
Vol 42 (02) ◽  
pp. 117-135
Author(s):  
Courtney T. Byrd ◽  
Katherine L. Winters ◽  
Megan Young ◽  
Danielle Werle ◽  
Robyn L. Croft ◽  
...  

AbstractSchool-based guidelines often require that treatment focuses on minimizing or eliminating stuttered speech. The purpose of this study was to examine the benefits of explicit training in communication competencies to children who stutter without targeting stuttered speech. Thirty-seven children (ages 4–16) completed Camp Dream. Speak. Live., an intensive group treatment program which targets the psychosocial needs and communication of children who stutter. Outcome measures included the Overall Assessment of the Speaker's Experience of Stuttering (OASES), the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT), and the Patient Reported Measurement Information System (PROMIS) Pediatric Peer Relationships Short Form (PROMIS Peer Relationships) and Parent Proxy Peer Relationships Short Form (PROMIS Parent Proxy). Pre- and posttreatment public presentations were rated on nine core verbal and nonverbal communication competencies by a neutral observer. Similar to previous studies, participants demonstrated significant improvements in communication attitudes (OASES) and perceived ability to establish peer relationships (PROMIS Peer Relationships), particularly school-aged participants (ages 7–16). Participants also demonstrated significant improvement in eight of the nine communication competencies. Findings suggest that, in addition to the psychosocial gains of programs such as Camp Dream. Speak. Live., children who stutter benefit from explicit training in communication skills, and these gains are not dependent on the presence of stuttered speech.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
John Fastenau ◽  
Heather Rozjabek ◽  
Shanshan Qin ◽  
Lori McLeod ◽  
Lauren Nelson ◽  
...  

Abstract Background Physiological and behavioral factors including hunger, satiety, food intake, and cravings are health determinants contributing to obesity. Patient-reported outcome (PRO) measures focused on eating-related factors provide insight into the relationships between food choice and quantity, weight change, and weight-loss treatment for individuals living with obesity. The DAILY EATS is a novel 5-item, patient-reported measure evaluating key eating-related factors (Worst and Average Hunger, Appetite, Cravings, and Satiety). Methods Psychometric analyses, consistent with regulatory standards, were conducted to evaluate the DAILY EATS using data from two randomized trials that included individuals with severe obesity without diabetes (NCT03486392) and with severe obesity and type 2 diabetes (NCT03586830). Additional measures included Patient Global Impression of Status (PGIS) and Patient Global Impression of Change items, Impact of Weight on Quality of Life-Lite, Ease of Weight Management, and Patient-Reported Outcomes Measurement Information System Physical Function Short Form 8b and 10a. The reliability, validity, and responsiveness of the DAILY EATS were assessed, and a scoring algorithm and thresholds to interpret meaningful score changes were developed. Results Item-level analyses of the DAILY EATS supported computation of an Eating Drivers Index (EDI), comprising the related items Worst Hunger, Appetite, and Cravings. Internal consistency (Cronbach’s coefficient alphas ≥0.80) and test-retest reliability (coefficients > 0.7) of the EDI were robust. Construct validity correlation patterns with other PRO measures were as hypothesized, with moderate to strong significant correlations between the EDI and PGIS-Hunger (0.30 ≤ r ≤ 0.68), PGIS-Cravings (0.33 ≤ r ≤ 0.77) and PGIS-Appetite (0.52 ≤ r ≤ 0.77). Anchor- and distribution-based analyses support reductions ranging from 1.6 to 2.1 as responder thresholds for the EDI, representing meaningful within-person improvement. Conclusions The DAILY EATS individual items and the composite EDI are reliable, sensitive, and valid in evaluating the concepts of hunger, appetite, and cravings for use in individuals with severe obesity with or without type 2 diabetes.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052495
Author(s):  
Rebecca M Lovett ◽  
Lauren Opsasnick ◽  
Andrea Russell ◽  
Esther Yoon ◽  
Sophia Weiner-Light ◽  
...  

ObjectivesTo examine the prevalence of mental health symptoms during the first surge of COVID-19 in the USA, and their associations with COVID-19-related emotional distress, health self-management and healthcare utilisation.DesignCross-sectional analysis of wave 3 (1–22 May 2020) survey data from the ongoing Chicago COVID-19 Comorbidities (C3) study.SettingSeven academic and community health centres in Chicago, Illinois.Participants565 adults aged 23–88 with one or more chronic conditions completing at least one prior C3 study wave.Primary and secondary outcome measuresClinically relevant anxiety and depressive symptoms as measured using Patient-Reported Outcomes Measurement Information System short forms. Self-reported emotional and health-related responses to COVID-19 were measured through a combination of single-item questions and validated measures.ResultsRates of anxiety and depressive symptoms were 14% (81/563) and 15% (84/563), respectively. Anxiety and depressive symptoms were then each separately associated with greater worry about contracting COVID-19 (relative risk (RR) 2.32, 95% CI 1.52 to 3.53; RR 1.67, 95% CI 1.10 to 2.54), greater stress (RR 4.93, 95% CI 3.20 to 7.59; RR 3.01, 95% CI 1.96 to 4.61) and loneliness (RR 3.82, 95% CI 2.21 to 6.60; RR 5.37, 95% CI 3.21 to 8.98), greater avoidance of the doctor (RR 1.62, 95% CI 1.06 to 2.49; RR 1.54, 95% CI 1.00 to 2.36) and difficulty managing health (least square means (LS Means) 6.09, 95% CI 5.25 to 6.92 vs 4.23, 95% CI 3.70 to 4.75; LS Means 5.85, 95% CI 5.04 to 6.65 vs 4.22, 95% CI 3.70 to 4.75) and medications (LS Means 3.71, 95% CI 2.98 to 4.43 vs 2.47, 95% CI 2.02 to 2.92) due to the pandemic.ConclusionsIdentifying and addressing mental health concerns may be an important factor to consider in COVID-19 prevention and management among high-risk medical populations.


2018 ◽  
Vol 3 (2) ◽  
pp. 238146831879936 ◽  
Author(s):  
Fatima Al Sayah ◽  
Arto Ohinmaa ◽  
Jeffrey A. Johnson

Objective. To evaluate the performance of EQ-5D-5L (EuroQol Five-Dimension, Five-Level Questionnaire) and SF-12-v2 (12-item Medical Outcomes Health Survey–Short Form, Version 2) in screening for anxiety and depressive symptoms in adults with type 2 diabetes. Methods. Cross-sectional data from a population-based study of type 2 diabetes in Alberta, Canada, were used. Anxiety symptoms (using the 2-item Generalized Anxiety Disorder questionnaire) were categorized into absent (<3) versus present (≥3). Depressive symptoms (using the 8-item Patient Health Questionnaire) were categorized according to two severity cut-points: absent (<10) versus mild (≥10), and absent (<15) versus moderate-severe (≥15). The performance of the measures in screening for anxiety and depressive symptoms was evaluated using receiver operating curve (ROC) analysis. Results. Average age of participants ( N = 1,391) was 66.8 years (SD 10.2), and 47% were female. Seventeen percent of participants screened positive for mild and 5.9% for moderate-severe depressive symptoms, and 11.3% for anxiety symptoms. For comorbid symptoms, 8.6% screened positive for anxiety and any depressive symptoms, and 4.6% for anxiety and moderate-severe depressive symptoms. The EQ-5D-5L anxiety/depression dimension and the SF-12 mental composite summary score had the best performance in screening for anxiety (area under ROC: 0.89, 0.89, respectively), depressive symptoms (any: 0.88, 0.92; moderate-severe: 0.90, 0.90), and comorbid anxiety and depressive symptoms (any: 0.92, 0.91; moderate-severe: 0.92, 0.90). These were followed by SF-12 feeling downhearted/depressed item (range = 0.83–0.85), while the lowest performance was for the EQ-5D-5L index score (0.80–0.84) and the SF-12 mental health domain (0.81–0.82). Conclusion. The EQ-5D-5L and the SF-12 are suitable tools for screening for anxiety and depressive symptoms in adults with type 2 diabetes. These tools present a unique opportunity for a standardized approach for routine mental health screening within the context of routine outcome measurement initiatives, where screening is recommended.


2017 ◽  
Vol 2 (3) ◽  
pp. 188-195 ◽  
Author(s):  
Kathleen Morrisroe ◽  
Wendy Stevens ◽  
Molla Huq ◽  
Joanne Sahhar ◽  
Gene-Siew Ngian ◽  
...  

Background We aimed to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) in Australian systemic sclerosis (SSc) patients. Methods SSc patients, identified through the Australian Scleroderma Cohort Study database, completed two quality-of-life instruments concurrently, the PROMIS-29 and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The construct validity of the PROMIS-29 was assessed by the correlations between the PROMIS-29 and the SF-36 and Health Assessment Questionnaire Disability Index (HAQ-DI). Cronbach's alpha was used to test the internal reliability of all instruments in Australian SSc patients and non-parametric correlation, including Spearman's correlation, was used to test the construct validity of PROMIS-29 against the SF-36 and HAQ-DI. Results A total of 477 completed questionnaires were returned, equating to a response rate of 59.6%. The mean (±SD) age of respondents at the time of the survey was 64.1 (±11.1) years. They were predominantly female (87.4%), with limited disease subtype (lcSSc) (77.8%) and long disease duration from onset of first non-Raynaud's phenomenon symptom at the time of survey (10.9 ± 11.1 years). For the correlation analysis between the PROMIS-29 and the legacy instruments, all Spearman correlation coefficients were in the logical direction and highly significant suggesting that the PROMIS-29 is a good alternative to other validated measures of disease burden. Conclusions Our study indicates that the PROMIS-29 questionnaire is a valid instrument for measuring health-related quality of life in Australian females with lcSSc of long duration.


2020 ◽  
Vol 48 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Ying Ying Leung ◽  
Ana-Maria Orbai ◽  
Alexis Ogdie ◽  
Pil Hojgaard ◽  
Richard Holland ◽  
...  

Objective.Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.Methods.A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.Results.Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.Conclusion.Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.


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