Department of Psychological Sciences, University of Connecticut, Mansfield, CT, USA.
Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA.
J Gen Intern Med. 2020 Aug;35(8):2296-2303. doi: 10.1007/s11606-020-05898-9. Epub 2020 May 29.
IMPORTANCE: Documenting Americans' stress responses to an unprecedented pandemic and their degree of adherence to CDC guidelines is essential for mental health interventions and policy-making. OBJECTIVE: To provide the first snapshot of immediate impact of COVID-19 on Americans' stress, coping, and guideline adherence. DESIGN: Data were collected from an online workers' platform for survey research (Amazon's Mechanical Turk) from April 7 to 9, 2020. The current data represents the baseline of a longitudinal study. Best practices for ensuring high-quality data were employed. PARTICIPANTS: Individuals who are 18 years of age or older, living in the USA, and English-speaking were eligible for the study. Of 1086 unique responses, 1015 completed responses are included. SETTING: Population-based. MAIN OUTCOMES: Exposure to and stressfulness of COVID-19 stressors, coping strategies, and adherence to CDC guidelines. RESULTS: The sample was 53.9% women (n = 547), with an average age of 38.9 years (SD = 13.50, range = 18-88), most of whom were White (n = 836, 82.4%), non-Hispanic (n = 929, 91.5%), and straight/heterosexual (n = 895, 88.2%); 40% were currently married (n = 407), and 21.6% (n = 219) were caregivers. About half (50.5%) endorsed having at least "mostly" enough money to meet their needs. Respondents' locations across the USA ranged from 18.5% in the Northeast to 37.8% in the South. The most commonly experienced stressors were reading/hearing about the severity and contagiousness of COVID-19, uncertainty about length of quarantine and social distancing requirements, and changes to social and daily personal care routines. Financial concerns were rated most stressful. Younger age, female gender, and caregiver status increased risk for stressor exposure and greater degree of stressfulness. The most frequently reported strategies to manage stress were distraction, active coping, and seeking emotional social support. CDC guideline adherence was generally high, but several key social distancing and hygiene behaviors showed suboptimal adherence, particularly for men and younger adults. CONCLUSIONS AND RELEVANCE: Americans have high COVID-19 stress exposure and some demographic subgroups appear particularly vulnerable to stress effects. Subgroups less likely to adhere to CDC guidelines may benefit from targeted information campaigns. these findings may guide mental health interventions and inform policy-making regarding implications of specific public health measures.
重要性:记录美国人对史无前例的大流行病的应激反应,以及他们对疾病预防控制中心指南的遵守程度,对于心理健康干预和政策制定至关重要。 目的:提供 COVID-19 对美国人压力、应对和指南遵守程度的即时影响的第一份快照。 设计:数据来自 2020 年 4 月 7 日至 9 日在在线工作者平台(亚马逊的 Mechanical Turk)上进行的调查研究。目前的数据代表了一项纵向研究的基线。采用了确保高质量数据的最佳实践。 参与者:年龄在 18 岁及以上、居住在美国且讲英语的个人有资格参加这项研究。在 1086 个独特的回复中,有 1015 个完整的回复被纳入分析。 设置:基于人群。 主要结果:接触和感知 COVID-19 压力源的压力、应对策略以及遵守疾病预防控制中心指南的情况。 结果:样本中 53.9%为女性(n = 547),平均年龄为 38.9 岁(标准差 = 13.50,范围为 18-88),其中大多数为白人(n = 836,82.4%)、非西班牙裔(n = 929,91.5%)和异性恋/直人(n = 895,88.2%);40%的人目前已婚(n = 407),21.6%(n = 219)为照顾者。大约一半(50.5%)的人表示他们有足够的钱来满足自己的需求。受访者在美国各地的分布范围从东北部的 18.5%到南部的 37.8%。最常见的压力源包括阅读/听说 COVID-19 的严重程度和传染性、对隔离和社交距离要求的持续时间的不确定性,以及社交和日常个人护理常规的变化。经济问题被评为最具压力的问题。年轻、女性和照顾者身份增加了压力源暴露和压力程度的风险。报告的最常见的压力管理策略包括分散注意力、积极应对和寻求情感社会支持。疾病预防控制中心指南的遵守情况总体较高,但一些关键的社交距离和卫生行为显示出较差的遵守情况,尤其是对于男性和年轻成年人。 结论和相关性:美国人的 COVID-19 压力暴露较高,一些人口统计学亚组似乎特别容易受到压力的影响。不太可能遵守疾病预防控制中心指南的亚组可能受益于有针对性的信息宣传活动。这些发现可能指导心理健康干预,并为特定公共卫生措施的影响提供政策制定方面的信息。
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