Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic

Many Vietnam War veterans who experienced military trauma still exhibit PTSD symptomatology. Little is known about how new stressful situations, like the COVID-19 pandemic, affect previously traumatized people or whether they will react differently to them. We explore whether military combat experiences in Vietnam affect veterans' perceived abilities to cope with COVID-19 and whether current PTSD symptoms and later-adulthood reengagement with trauma memories are related to coping. We examine the extent that current PTSD symptoms and trauma reengagement relate to preventive practices. Participants were part of a randomly sampled cohort of American Legionnaires who responded to two previous surveys (1984, 1998), were born 1945-1953 and deployed to Vietnam 1963-1973, thus representing an aging veteran population. A survey supplement assessed coping with the pandemic and adherence to public health guidelines. The response rate was 74% (N = 507); 422 (61.6%) completed the COVID-19 supplement. Military experiences were found to affect coping with 41.4% reporting they affected ability to cope with COVID-19. Medium- and high-combat veterans were more likely to report that military experience affected coping than low-combat (OR 2.4, 95% CI 1.51–3.96; 2.6, 95% CI 1.41–4.61, respectively). Those with high PTSD scores had 7.7-fold (95% CI 4.3–13.17) increased likelihood of reporting that their coping was affected, compared to low-PTSD scorers. Few adopted social distancing (4%), staying at home (17%), or ceasing usual activities (32%); high-combat veterans were least likely to stay home. Veterans who practiced handwashing, sanitizer use, mask-wearing, and surface disinfection had significantly higher PTSD scores than those who did not. Veterans with higher scores on the LOSS-SF scale associated more reengagement with trauma memories and were more likely to engage in personal preventive strategies. Analysis of open-ended responses supported these findings. We conclude that fifty years after returning from Vietnam, PTSD scores were high for high-combat veterans, suggestive of PTSD diagnosis. Military experiences affected coping with COVID both positively and negatively, and may have helped instill useful personal health behaviors. Veterans, especially those with PTSD symptomatology, may have special needs during stressful times, like the COVID-19 pandemic, affecting compliance with recommended practices, as well as their overall health and well-being.

Social Media Use and Misinformation Among Asian Americans During COVID-19

Social media has been crucial for seeking and communicating COVID-19 information. However, social media has also promulgated misinformation, which is particularly concerning among Asian Americans who may rely on in-language information and utilize social media platforms to connect to Asia-based networks. There is limited literature examining social media use for COVID-19 information and the subsequent impact of misinformation on health behaviors among Asian Americans. This perspective reviews recent research, news, and gray literature to examine the dissemination of COVID-19 misinformation on social media platforms to Chinese, Korean, Vietnamese, and South Asian Americans. We discuss the linkage of COVID-19 misinformation to health behaviors, with emphasis on COVID-19 vaccine misinformation and vaccine decision-making in Asian American communities. We then discuss community- and research-driven responses to investigate misinformation during the pandemic. Lastly, we propose recommendations to mitigate misinformation and address the COVID-19 infodemic among Asian Americans.

Bridging Community, History, and Culture in Personal Informatics Tools

A healthy diet and increased physical activity are essential for reducing the prevalence of cardiovascular disease and related deaths, a worldwide public health concern that disproportionately affects Black American communities. Still, Black Americans can face unique challenges meeting dietary and physical activity requirements due to inequities in access and quality of care, environmental and local factors, and difficulties in changing individual health behaviors. Personal informatics and self-tracking tools are one way of increasing awareness of health behaviors to motivate behavior change. However, there are still gaps in knowledge about what encourages different users to engage with personal informatics tools over time, particularly when used in collaborative, community-health settings. This paper contributes a nuanced understanding of fifteen participants' reasons for engaging in an existing community-based health education and behavior change program that combines collaborative self-tracking with culturally relevant content and social engagement to motivate heart-healthy behaviors. We illustrate participants' positive and negative experiences engaging in self-tracking and collaborative tasks during the program. We also discuss how participants envision that integrating technology might support or hinder participant engagement and the work of deploying community-based public health interventions. Finally, we discuss design implications for culturally informed, community-based personal informatics tools that engage Black American's in heart-healthy activities.

Twitter and Facebook posts about COVID-19 are less likely to spread misinformation compared to other health topics

The COVID-19 pandemic brought widespread attention to an “infodemic” of potential health misinformation. This claim has not been assessed based on evidence. We evaluated if health misinformation became more common during the pandemic. We gathered about 325 million posts sharing URLs from Twitter and Facebook during the beginning of the pandemic (March 8-May 1, 2020) compared to the same period in 2019. We relied on source credibility as an accepted proxy for misinformation across this database. Human annotators also coded a subsample of 3000 posts with URLs for misinformation. Posts about COVID-19 were 0.37 times as likely to link to “not credible” sources and 1.13 times more likely to link to “more credible” sources than prior to the pandemic. Posts linking to “not credible” sources were 3.67 times more likely to include misinformation compared to posts from “more credible” sources. Thus, during the earliest stages of the pandemic, when claims of an infodemic emerged, social media contained proportionally less misinformation than expected based on the prior year. Our results suggest that widespread health misinformation is not unique to COVID-19. Rather, it is a systemic feature of online health communication that can adversely impact public health behaviors and must therefore be addressed.

Associations Between Parents’ Health and Social Control Behaviors and Their Adolescent’s Self-Efficacy and Health Behaviors: Insights From the Family Life, Activity, Sun, Health, and Eating (FLASHE) survey

Background Parents can influence their children to live healthier lifestyles by modeling healthy behaviors and/or trying to persuade their children to engage in healthier activities. Adolescents and their parents tend to have similar eating and exercise patterns, but less is known about the simultaneous influence of parent’s health behavior and social control on adolescents’ self-efficacy and health behaviors, including whether their effect is moderated by parenting style. Purpose We examine the degree to which parents’ social control and health behaviors are associated with their adolescent’s self-efficacy and health behaviors, including whether parenting styles moderate these associations. Method We analyzed data from the Family Life, Activity, Sun, Health, and Eating project. Results We found that parents’ own health behaviors are positively and strongly associated with their adolescent’s health behaviors across four domains: fruit/vegetable consumption, junk food consumption, physical activity, and nonacademic screen time. We found positive, moderate-to-strong associations between parents’ use of social control and their adolescents’ fruit/vegetable and junk food consumption, small negative associations with screen time, and no associations with physical activity. The effects of social control for junk food consumption and screen time, however, depended on parents’ own behavior in those domains. Parent responsiveness moderated the relation between parents’ social control and their adolescent children’s self-efficacy and health behaviors. Conclusions The health behaviors parents model and their social control efforts are associated with their adolescents’ beliefs and behavior. Efforts to leverage parents as sources of influence must consider the context in which influence is enacted.

Feel to Heal: Negative Emotion Differentiation Promotes Medication Adherence in Multiple Sclerosis

Multiple Sclerosis (MS) is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation (NED), may be protective against enactment of maladaptive risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients (n = 27) newly diagnosed with MS (following McDonald criteria). Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness.

Do School-Level Factors Affect the Health Behaviors of High School Students in Korea?

We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students’ tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students’ health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools’ characteristics to equip all students with health awareness, regardless of socioeconomic status.

Childhood Disadvantage and Adult Functional Status: Do Early-Life Exposures Jeopardize Healthy Aging?

Objectives To examine whether childhood disadvantage is associated with later-life functional status and identify mediating factors. Methods Unique and additive effects of five childhood domains on functional status were assessed at baseline (2006) and over time (2006–2016) in a sample of 13,894 adults from the Health and Retirement Study (>50 years). Adult health behaviors and socioeconomic status (SES) were tested as mediators. Results Respondents exposed to multiple childhood disadvantages (OR = .694) as well as low childhood SES (OR = .615), chronic diseases (OR = .694), impairments (OR = .599), and risky adolescent behaviors (OR = .608) were less likely to be free of functional disability by baseline. Over time, these unique and additive effects of childhood disadvantage increased the hazard odds of eventually developing functional disability (e.g., additive effect: hOR = 1.261). Adult health behaviors and SES mediated some of these effects. Discussion Given the enduring effects of childhood disadvantage, policies to promote healthy aging should reduce exposure to childhood disadvantage.

I'm wearing a mask, but are they?: Perceptions of Self-Other Differences in COVID-19 Health Behaviors

As information about COVID-19 safety behavior changed, people had to judge how likely others were to protect themselves through mask-wearing and vaccination seeking. In a large, campus-wide survey, we assessed whether University of Kansas students viewed others' protective behaviors as different from their own, how much students assumed others would share their beliefs and behaviors, and which individual differences were associated with those estimations. Participants in our survey (N = 1,704; 81.04% white, 64.08% female) evaluated how likely they and others were to wear masks on the University of Kansas campus, wear masks off-campus, and seek a vaccine. They also completed measures of political preference, numeracy, and preferences for risk in various contexts. We found that participants estimated that others would be less likely to engage in health safety behaviors than themselves, but that their estimations of others were widely shared. In addition, of all the individual differences we assessed, political preference displayed the most consistent associations across health behaviors. Not only was false uniqueness ubiquitous across different forms of COVID-19 safety behavior, it was indeed false - estimates of others' health behavior were lower than their actual rates. Understanding this relationship could allow for more accurate norm-setting and normalization of mask-wearing and vaccination.

Knowledge, Attitude, and Practice on Health Behaviors Regarding Air Pollution from Burning Waste: A Cross-sectional Study Among Villagers in the North of Iran in 2020

Background: Incineration is a waste disposal technique employed to reduce the volume of waste, resulting in air pollution. Objectives: This study aimed to determine the knowledge, attitude, and practice on health behaviors among Rasht villagers regarding air pollution from burning waste. Methods: The present descriptive cross-sectional study was conducted among 260 rural households in Rasht. Data were collected using a questionnaire by interviewing participants. The participants were randomly selected and entered the study. Data were analyzed by SPSS version 16 using the t-test, one-way ANOVA, and Pearson correlation at a 95% confidence interval. the content validity index (CVI) and content validity ratio (CVR) were used to assess the instrument's validity. Cronbach's alpha coefficient was calculated to evaluate the questionnaire reliability. Results: The findings confirmed the optimal validity and reliability of the instrument used in the study. The participants' age range was 19 to 78, with a mean age of 43.87 ± 12.66 years. The practice had a significant positive correlation with knowledge (r = 0.216). The correlation between practice and attitude was positive but not statistically significant. Education and information on burning wastes had a substantial relationship with knowledge. Participants received 80%, 29.3%, and 66.7% of the maximum achievable scores for knowledge, attitude, and practice components in the questionnaire, respectively. Conclusions: The villagers' attitude in performing health behaviors regarding air pollution was not favorable, and there is a need to provide educational and behavioral interventions in this regard.