Vaccines against COVID-19 have been developed in unprecedented time. However, the effectiveness of any vaccine is dictated by the proportion of the population willing to be vaccinated. This ...observational population-based study examines intentions to be vaccinated against COVID-19 throughout the pandemic.
In November 2020, longitudinal data from a nationally representative sample of 7,547 U.S. adults enrolled in the Understanding America Study were analyzed using multinomial logistic regression. Participants reported being willing, undecided, and unwilling to get vaccinated against COVID-19 across 13 assessments conducted from April to October 2020. Public attitudes to vaccination against COVID-19 were also assessed on a 4-point Likert-type scale.
Willingness to vaccinate declined from 71% in April to 53.6% in October. This was explained by an increase in the percentage of participants undecided about vaccinating (from 10.5% to 14.4%) and the proportion of the sample unwilling to vaccinate (from 18.5% to 32%). The population subgroups most likely to be undecided/unwilling to vaccinate were those without a degree (undecided: RR=2.47, 95% CI=2.04, 3.00; unwilling: RR=1.92, 95% CI=1.67, 2.20), Black participants (undecided: RR=2.18, 95% CI=1.73, 2.74; unwilling: RR=1.98, 95% CI=1.63, 2.42), and female participants (undecided: RR=1.41, 95% CI=1.20, 1.65; unwilling: RR=1.29, 95% CI=1.14, 1.46). Participants who were older or were on higher incomes were least likely to be undecided or unwilling to vaccinate. Concerns about potential side effects of a vaccine were common.
Intentions to be vaccinated against COVID-19 have declined rapidly during the pandemic, and close to half of Americans are undecided or unwilling to be vaccinated.
Widespread uptake of COVID-19 vaccines will be essential to controlling the COVID-19 pandemic. Vaccines have been developed in unprecedented time and quantifying levels of hesitancy towards ...vaccination among the general population is of importance.
Systematic review and meta-analysis of studies using large nationally representative samples (n ≥ 1000) to examine the percentage of the population intending to vaccinate, unsure, or intending to refuse a COVID-19 vaccine when available. Generic inverse meta-analysis and meta-regression were used to pool estimates and examine time trends. PubMed, Scopus and pre-printer servers were searched from January-November 2020. Registered on PROSPERO (CRD42020223132).
Twenty-eight nationally representative samples (n = 58,656) from 13 countries indicate that as the pandemic has progressed, the percentage of people intending to vaccinate decreased and the percentage of people intending to refuse vaccination increased. Pooled data from surveys conducted during June-October suggest that 60% (95% CI: 49% to 69%) intend to vaccinate and 20% (95% CI: 13% to 29%) intend to refuse vaccination, although intentions vary substantially between samples and countries (I2 > 90%). Being female, younger, of lower income or education level and belonging to an ethnic minority group were consistently associated with being less likely to intend to vaccinate. Findings were consistent across higher vs. lower quality studies.
Intentions to be vaccinated when a COVID-19 vaccine becomes available have been declining across countries and there is an urgent need to address social inequalities in vaccine hesitancy and promote widespread uptake of vaccines as they become available.
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Objectives
It has been shown that psychological distress rose rapidly as the COVID‐19 pandemic emerged and then recovered to pre‐crisis levels as social lockdown restrictions were eased in the United ...States. The aim of the current study was to investigate psychosocial and behavioural factors that may explain the rise and fall of distress during the initial months of the COVID‐19 crisis.
Design
This study examined six waves of longitudinal nationally representative data from the Understanding America Study (UAS) collected between March and June 2020 (N = 7,138, observations = 34,125).
Methods
Mediation analysis was used to identify whether changes in distress (PHQ‐4) during the COVID‐19 pandemic were explained by the following factors: perceived infection risk and risk of death, perceived financial risks, lifestyle changes resulting from the virus, perceived discrimination related to the virus, and changes in substance use and employment status.
Results
All mediating factors played a role in explaining changes in distress and together accounted for 70% of the increase in distress between 10‐18 March and 1‐14 April and 46.4% of the decline in distress between 1‐14 April and early June 2020. Changes in perceived health risks were most important in explaining changes in distress followed by changes in lifestyle and the perceived financial risks associated with COVID‐19.
Conclusions
This study provides longitudinal population‐based evidence detailing the mediating factors explaining changes in distress during the COVID‐19 crisis. Perceived health risks associated with the virus may play a key role in explaining rising and falling levels of psychological distress during the COVID‐19 pandemic.
•A significant but small increase in mental health symptoms early in the pandemic.•Overall, mental health symptoms comparable to pre-pandemic levels by mid-2020.•Larger rises for depressive symptoms ...and those with existing poor physical health.•Overall, in 2020 there was resilience in mental health during the COVID pandemic.
Increases in mental health problems have been observed during the COVID-19 pandemic. The objectives were to examine the extent to which mental health symptoms changed during the pandemic in 2020, whether changes were persistent or short lived, and if changes were symptom specific.
Systematic review and meta-analysis of longitudinal cohort studies examining changes in mental health among the same group of participants before vs. during the pandemic in 2020.
Sixty-five studies were included. Compared to pre-pandemic outbreak, there was an overall increase in mental health symptoms observed during March-April 2020 (SMC = .102 95% CI: .026 to .192) that significantly declined over time and became non-significant (May-July SMC = .067 95% CI: -.022 to .157. Compared to measures of anxiety (SMC = 0.13, p = 0.02) and general mental health (SMC = -.03, p = 0.65), increases in depression and mood disorder symptoms tended to be larger and remained significantly elevated in May-July 0.20, 95% CI: .099 to .302. In primary analyses increases were most pronounced among samples with physical health conditions and there was no evidence of any change in symptoms among samples with a pre-existing mental health condition.
There was a high degree of unexplained heterogeneity observed (I2s > 90%), indicating that change in mental health was highly variable across samples.
There was a small increase in mental health symptoms soon after the outbreak of the COVID-19 pandemic that decreased and was comparable to pre-pandemic levels by mid-2020 among most population sub-groups and symptom types.
Abstract There is interest in the hypothesis that social norms are a determinant of healthy and unhealthy dietary practices. The objective of our work was to assess the weight of evidence that ...experimentally manipulated information about eating norms influences food intake and choice. This systematic review of experimental studies examined whether providing information about other peoples' eating habits influences food intake or choices. To inform the review, three electronic databases (PsycINFO, MEDLINE, and the Social Sciences Citation Index) were searched during July 2012. A narrative approach was used to synthesize studies that examined the influence of norms on food choice and meta-analyses were used to synthesize the effect that informational eating norms have on quantity of food consumed. Fifteen experimental studies were reviewed. There was evidence that both high intake norms ( Z =3.84; P =0.0001; standardized mean difference 0.41, 95% confidence interval 0.20 to 0.63) and low intake norms ( Z =2.78; P =0.005; standard mean difference –0.35, 95% confidence interval –0.59 to –0.10) exerted moderate influence on amounts of food eaten. There was consistent evidence that norms influenced food choices; norm information indicating that others make low-energy or high-energy food choices significantly increased the likelihood that participants made similar choices. Information about eating norms influences choice and quantity of food eaten, which could be used to promote healthy changes to dietary behavior.
Eating, physical activity and other weight-related lifestyle behaviors may have been impacted by the COVID-19 crisis and people with obesity may be disproportionately affected. We examined ...weight-related behaviors and weight management barriers among UK adults during the COVID-19 social lockdown. During April–May of the 2020 COVID-19 social lockdown, UK adults (N = 2002) completed an online survey including measures relating to physical activity, diet quality, overeating and how mental/physical health had been affected by lockdown. Participants also reported on perceived changes in weight-related behaviors and whether they had experienced barriers to weight management, compared to before the lockdown. A large number of participants reported negative changes in eating and physical activity behavior (e.g. 56% reported snacking more frequently) and experiencing barriers to weight management (e.g. problems with motivation and control around food) compared to before lockdown. These trends were particularly pronounced among participants with higher BMI. During lockdown, higher BMI was associated with lower levels of physical activity and diet quality, and a greater reported frequency of overeating. Reporting a decline in mental health because of the COVID-19 crisis was not associated with higher BMI, but was predictive of greater overeating and lower physical activity in lockdown. The COVID-19 crisis may have had a disproportionately large and negative influence on weight-related behaviors among adults with higher BMI.
In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some ...forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity.
In this Opinion article, we review compelling evidence that weight stigma is harmful to health, over and above objective body mass index. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of obesity through multiple obesogenic pathways. Weight stigma is particularly prevalent and detrimental in healthcare settings, with documented high levels of 'anti-fat' bias in healthcare providers, patients with obesity receiving poorer care and having worse outcomes, and medical students with obesity reporting high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize, rather than towards the targets of weight stigma. Medical training must address weight bias, training healthcare professionals about how it is perpetuated and on its potentially harmful effects on their patients.
Weight stigma is likely to drive weight gain and poor health and thus should be eradicated. This effort can begin by training compassionate and knowledgeable healthcare providers who will deliver better care and ultimately lessen the negative effects of weight stigma.
Summary
Background
The COVID‐19 crisis is likely to have had wide‐ranging consequences on lifestyle behaviours and may have affected weight management. The objective of the present study was to ...examine perceptions of how weight‐related lifestyle changed in social lockdown among UK adults compared with before the emergence of the COVID‐19 crisis.
Methods
As part of an online cross‐sectional survey conducted during social lockdown in the United Kingdom, 723 UK adults reported on the extent to which their eating (healthiness of diet, frequency of bingeing on food), physical activity, sleep and alcohol consumption had changed since the emergence of the COVID‐19 crisis and completed measures of current psychological well‐being.
Results
Although both improvements and declines in weight gain protective behaviours were reported, 79% of participants reported a decline in one or more weight gain protective behaviours. Both participants with a diagnosis of psychiatric illness or obesity (body mass index BMI ≥ 30) were most likely to report declines in weight gain protective behaviours and show an overall profile of weight management behaviours worsening. Participants experiencing high levels of stress also reported reductions in more weight gain protective behaviours.
Conclusions
Lifestyle behaviours associated with weight gain are likely to have been affected by the COVID‐19 crisis. Reductions to the perceived frequency by which people engage in behaviours usually associated with successful weight management appear to be common, and people living with obesity and mental health problems may be at increased risk.
Purpose
To determine if children with UPJO demonstrate a clinically significant change in somatic growth following pyeloplasty.
Methods
We retrospectively evaluated the growth chart data of infants ...with SFU grade 3 or 4 congenital hydronephrosis at our institution from 2015 to 2022. Of those, 35 patients underwent pyeloplasty and 66 had no surgical intervention. Patients met criteria if they had SFU 3 or 4 hydronephrosis and MAG3 renal scan. If patients underwent surgery, height and weight percentiles were recorded from the pre-op and 6–16-month follow-up visits. In non-surgery patients, measurements were taken near the median age of surgery in the intervention group and 6–16 months later. Interval changes in group height and weight percentiles are compared for significant changes.
Results
The surgery and non-surgery groups did not differ in terms of gender (71% vs 74% Male), starting age (296 vs 244 days), starting weight (58th vs 52nd percentile), or time between measurements (255 vs 260 days), though the surgery group had significantly less height in the pre-operative period (43rd vs 55th percentile,
p
= 0.050) and were more likely to have delayed drainage on renal scan (83% w/delay vs 35%). The surgery group showed a significant increase in height (18.9 percentiles; 95% CI 11–27) and weight (6.0 percentiles; 95% CI 0.50–12) after intervention.
Conclusions
Patients with congenital hydronephrosis due to UPJO that underwent pyeloplasty showed a significant increase in weight and height at 6–16 months postoperatively compared to those that were managed with close observation. This suggests UPJO might lead to growth delay in infants.
Several studies have assessed the effects of food and nonalcoholic beverage (hereafter collectively referred to as food) advertising on food consumption, but the results of these studies have been ...mixed. This lack of clarity may be impeding policy action.
We examined the evidence for a relation between acute exposure to experimental unhealthy food advertising and food consumption.
The study was a systematic review and meta-analysis of published studies in which advertising exposure (television or Internet) was experimentally manipulated, and food intake was measured. Five electronic databases were searched for relevant publications (SCOPUS, PsycINFO, MEDLINE, Emerald Insight, and JSTOR). An inverse variance meta-analysis was used whereby the standardized mean difference (SMD) in food intake was calculated between unhealthy food advertising and control conditions.
Twenty-two articles were eligible for inclusion. Data were available for 18 articles to be included in the meta-analysis (which provided 20 comparisons). With all available data included, the analysis indicated a small-to-moderate effect size for advertising on food consumption with participants eating more after exposure to food advertising than after control conditions (SMD: 0.37; 95% CI: 0.09; 0.65; I(2) = 98%). Subgroup analyses showed that the experiments with adult participants provided no evidence of an effect of advertising on intake (SMD: 0.00; P = 1.00; 95% CI: -0.08, 0.08; I(2) = 8%), but a significant effect of moderate size was shown for children, whereby food advertising exposure was associated with greater food intake (SMD: 0.56; P = 0.003; 95% CI: 0.18, 0.94; I(2) = 98%).
Evidence to date shows that acute exposure to food advertising increases food intake in children but not in adults. These data support public health policy action that seeks to reduce children's exposure to unhealthy food advertising.
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