Combining Theory and Research to Validate a Social Norms Framework Addressing Female Genital Mutilation

Female Genital Mutilation (FGM) is a harmful practice with no benefits and considerable harm to girls and women who undergo it. In 2016, the United Nations Joint Program to Eliminate FGM, funded the development and subsequent validation of a monitoring and evaluation framework to understand the relationship between social norms and practicing FGM. Evidence on the framework was gathered through a pilot study in Ethiopia. This paper uses cross-sectional quantitative data from the pilot to operationalize the framework and determine what factors are associated with practicing FGM. A total of 554 and 481 participants answered the question “Have you undergone FGM?” and “Do you know a family member who has undergone FGM?” respectively. Overall, 65% of participants said they had undergone FGM and 32% said they knew someone in their family who had undergone FGM. Predictors of not undergoing FGM included most progressive attitudes vs. less progressive attitudes about FGM and relationship to identity [OR: 1.9 (95% CI: 1.1–3.3)]; region [Afar vs. Addis Ababa: OR: 0.09 (95% CI: 0.02–0.5); Southern Nations Nationalities and People's Regions vs. Addis Ababa: OR: 0.1 (95% CI: 0.05–0.3)], being 36 years old and above vs. 10–19 years (OR: 0.2 (95% CI: 0.1 to 0.7)) and being single, never married vs. married or engaged (OR: 2.8 (95% CI: 1.1–7.0)]. Predictors of knowing a family member who has not undergone FGM included: Higher knowledge vs. lower knowledge [OR: 0.3 (95% CI: 0.1–0.5)]; if the family expected you to abandon FGM, you had a greater odds of knowing a family member who had not undergone FGM [43.6 (95% CI: 2.7–687.8)]; coming from Southern Nations, Nationalities and People's Region was associated with a lower odds of knowing a family member who had not undergone FGM [0.3 (95% CI: 0.1–0.6)]. Being a female influential vs. female caregiver was associated with a higher odds of knowing a family member who had not undergone FGM [2.9 (95% CI: 1.01–5.2)]. This paper has allowed us to validate a theory and research based social norms framework, specifically examining how social and behavior change communication can be used as a mechanism for shifting norms around a given harmful practice. Now that this model has been developed and validated, it is likely to provide a foundation to study the direct and indirect impacts of social norms programming on changing harmful practices, such as FGM.

Metabolic Syndrome in a Population of In-Patients with Schizophrenia in the Western Siberia

Background. The relevance of this work is due to the incomplete nature of existing studies on risk factors of metabolic syndrome (MS) in patients with schizophrenia. Aim: to study the MS prevalence in schizophrenia in-patients and their clinical, therapeutic and socio-demographic features. Patients and methods: 517 in-patients diagnosed with schizophrenia according to the ICD-10 criteria were examined. All patients underwent a structured clinical interview (SCID); measurement of waist circumference, blood pressure and assessment of biochemical parameters for verification of MS based on the criteria of the IDF (International Diabetes Fediration). An assessment of the severity of clinical and psychopathological symptoms was performed using the PANSS. Results: the prevalence of MS in in-patients with schizophrenia in the Western Siberia is similar to that reported in the literature. It was found that in-patients with schizophrenia and MS are characterized by a predominance of women and older age, as well as a large proportion of divorced, and a smaller proportion of never married. Women with MS were older, got longer duration of illness, and got later onset of disease than men with MS. The age of disease onset was significantly greater in patients with MS than in patients without MS. Atypical antipsychotics were more often used as the basic antipsychotic treatment in the group of patients with MS but this difference between the groups did not reach statistical significance. Conclusions: the main risk factors in patients with schizophrenia and MS coincide with risk factors of MS in general population. A later onset of the disease can act as an independent risk factor. The relationship and mutual influence of risk factors for the development of MS in patients with schizophrenia needs further study.

Informal Care Provision and the Reduction of Economic Activity Among Mid-Life Carers in Great Britain – A Mixed-Methods Approach

Informal care provision is an integral part of the long-term care system. However, it has been shown to have negative effects on the carers’ economic activity, and understanding the mechanisms behind this is crucial for social policy design. This study provides new insight into mid-life carers’ decisions to reduce their economic activity through a convergent mixed-methods design. Quantitative analysis of a sample of 2,233 carers aged fifty from the National Child Development Study (NCDS) Wave 8 with follow up at age fifty-five, and qualitative analysis of in-depth interviews of forty-eight carers between 2008-2010, were used. The combined results indicate that being female, single never married, having financial issues, being an employee, and frequently meeting a parent are associated with economic activity reduction; the carers’ own perspectives further elucidate key factors, such as their value and identity, family structure, life course events, and care intensity, which affect their decisions.

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended to take booster doses and the remaining were COVID-19 vaccine booster hesitant. The vaccine-booster-hesitant group was more likely to be unvaccinated (62.6% vs. 12.9%) and did not intend to have their children vaccinated (86.1% vs. 27.5%) compared to their non-hesitant counterparts. A significantly higher proportion of booster dose hesitant individuals had very little to no trust in the COVID-19 vaccine information given by public health/government agencies (55% vs. 12%) compared to non-hesitant ones. The mean scores of vaccine confidence index and vaccine literacy were lower among the hesitant group compared to the non-hesitant group. Compared to the non-hesitant group, vaccine hesitant participants were single or never married (41.8% vs. 28.7%), less educated, and living in a southern region of the nation (40.9% vs. 33.3%). These findings underscore the need of developing effective communication strategies emphasizing vaccine science in ways that are accessible to individuals with lower levels of education and vaccine literacy to increase vaccination uptake.

Marital Histories and Late-Life Economic Security: Do Social Security Benefits Rules Perpetuate Disparities?

Disparities in late-life economic security persist along the lines of gender, marital status, race, and educational attainment. We propose that these disparities are partly due to the fact that Social Security benefits are structured such that never-married, divorced, and cohabiting persons, those who were widowed prematurely, or were in a dual-earner couple face benefit penalties. Drawing on data from the Wisconsin Longitudinal Study (WLS), a study that has followed men and women from age 18 (in 1957) through age 72 (in 2011), we examine disparities in Social Security earnings and poverty risk on the basis of gender and marital histories. Our results reveal a large disadvantage for divorced and never-married persons (relative to their married counterparts), with women and those divorced two or more times experiencing the largest toll. We discuss the implications of our results for revamping Social Security to better meet the needs of 21st century families.

Protective and Risk Factors of Depression Among Older Adults During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic adversely impacted the mental health of older adults. This study aims to explore the associations between protective/risk factors of depression during the pandemic and to examine the differences in these associations by marital status. Data from the Health and Retirement Study 2020 COVID-19 module, released in February, 2021, were used. The level of resilience during the pandemic was selected as a protective factor. The level of COVID-19 pandemic concern was selected as a risk factor. Among older adults aged 51 years and older, the weighted regression model found that higher levels of COVID-19 concern were associated with higher levels of depressive symptoms (p<0.05), whereas higher levels of resilience were associated with lower levels of depressive symptoms (p<0.05). Marital status moderated the association between COVID-19 concern and depressive symptoms. Never-married people were at higher risk of depressive symptoms than married people when COVID-19 concerns increased. It is important to enhance support for never-married people during the pandemic to protect their psychological well-being.

Young Australians living with parents: free and pay board as popular housing tenure choices

Young adults staying with parents is definitely a growing housing tenure in Australia. This paper, for the first time, unearths individual-level housing tenure choices of young Australians from the household-level data of owning/renting from the 2017 Household Income and Labour Dynamics in Australia survey. In addition to owner-occupation and private rental, the paper explores the influence of personal characteristics on two types of multigenerational co-residence: young adults who live with parents rent-free and pay board. The results show that, in Australia, young women are more independent in their housing tenure choices (i.e., owning and renting) in comparison to young men. There is a growing trend towards mature and high-earning young people living with parents for free, which might be explained by the aim of saving money to buy a house or investment property and also care arrangements for their elderly parents. Marital status has also a significant effect on housing tenure choices. Never married young adults prefer to live with parents either for free or pay board; while those divorced/separated or widowed prefer to rent privately to maintain their residential independency, after life circumstances changed. This study informs policy makers to provide more support to young adults in a fully or partly independent housing tenure (renting and paying board) in assisting them to climb up the housing career ladder—becoming a homeowner.

469. The Mental Health Implications of Job Loss for Never-married Women During the COVID-19 Pandemic

Background The COVID-19 pandemic was associated with an array of social and economic events, influencing how the pandemic affected people of all genders. In particular, job losses surged during the COVID-19 pandemic, especially among women. We analyzed how the pandemic and rising job losses affected the mental health of unmarried women with and without children in order to identify possible health disparities, potential causal factors and opportunities for interventions. Methods Data were collected from Wave 3 (January 6-February 15, 2021) of the US Census COVID-19 Household Pulse online survey designed to measure the impact of COVID-19. Microdata files were downloaded from the Census website and included N=13,940 never-married female respondents aged 25-54 years old. Data were analyzed using χ2 tests, with z-tests for more granular between-group comparisons. Results When asked if they had felt anxiety in the past week, 31% of respondents without children in the household and 28% of those with children reported feeling anxiety nearly every day (p< .05). Among those who did not lose work during the pandemic, 24% of those without children felt anxiety nearly every day vs. 20% of those with children (p< .05). Among those who did experience pandemic-related job loss, 33% of those with children and 42% of those without children reported daily anxiety (p< .05). Conclusion Overall, COVID-19 job loss was associated with higher levels of anxiety for never-married adult women. Notably, respondents without children expressed significantly higher levels of anxiety than respondents with children, and this difference was even greater when comparing those who had lost jobs during the pandemic. Reasons are being further researched but may be related to mothers’ greater opportunities for social and community support, particularly when encountering difficult circumstances. These results have implications for the development of mental health programs serving women experiencing environmental stressors such as job loss, especially women without children who may not have the same mental health and community support. Disclosures All Authors: No reported disclosures

Depression-anxiety in Adult Population of Qatar during the First Year of COVID-19

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. This study intended to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77 % were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=1.69, p < 0.015), prior psychiatric history (OR=1.80, p=0.009), Social Media induced worries (OR=1.72, p=0.003), history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, similar national events and assist with early intervention to treat sufferers.

Social Participation and Survival in Widowed Persons: Results of the Taiwan Longitudinal Study on Aging

It has been considered that widowed persons have a higher risk of death. This study intended to explore whether social participation could improve this trend. A longitudinal study database was constructed to explore the trend of survival and its change with social participation in widowed persons. The Taiwan Longitudinal Study on Aging (TLSA), based on four consecutive waves of longitudinal follow-up data in 1999, 2003, 2007, and 2011 was linked with the National Death Registry from 1999 through 2012. In total, there were 1417 widowed persons and 4500 nonwidowed persons included in this study, excluding divorced and never-married people. The survival trend analysis was carried out with social participation as the main predictive factor stratified for comparative analysis. Our results showed that the widowed were older than the nonwidowed, were female-dominant, had a lower education level, were more economically stressed, and were less likely to engage in regular exercise, and thus showed generally poorer health; for example, being more vulnerable to having chronic diseases, disability with the Activities of Daily Living (ADL), cognitive impairment with the Short Portable Mental State Questionnaire (SPMSQ), and depression with The Center for Epidemiological Studies-Depression (CES-D). The death risk of the widowed was significantly higher than that of the nonwidowed, but the death trend for those with social participation was significantly lower than that of their counterparts in both the widowed and nonwidowed. After matching with gender and age for widowed persons, the widowed with social participation had a significantly lower risk of death (adjusted hazard ratio (HR), 0.83; 95% confidence interval (CI), 0.71–0.98) compared to the widowed without social participation. It was concluded that social participation can improve the death risk for the widowed, and it is worthily included in health promotion plans and social welfare services for widowed persons.