Physical Activity and Local Blue/Green Space Access During the COVID-19 Pandemic.

PURPOSE: To examine whether local blue and green space access was associated with weekly physical activity frequency during the COVID-19 pandemic. DESIGN: Cross-sectional. SETTING: Population-based, nationally representative sample of U.S. adults (May and June 2021). SAMPLE: Adults, ages 18-94 (N = 1,771). MEASURES: Self-reported data included the presence of blue spaces (e.g., lakes, outdoor swimming pools, riverside trails) and green spaces (e.g., parks, forests, or natural trails) in their neighborhoods, and days of physical activity per week (e.g., running, swimming, bicycling, lifting weights, playing sports, or doing yoga). ANALYSIS: Multiple Poisson regression assessed relationships between blue and green spaces and physical activity, with coefficients transformed into incidence risk ratios (IRR). RESULTS: Among participants, 67.2% reported living near a blue space and 86.1% reported living near a green space. Racial/ethnic and socioeconomic disparities in access to blue and green spaces were observed, with less access among non-Hispanic Black participants and those with lower income and educational attainment. Living near blue (IRR = 1.23, 95% CI = 1.10, 1.39) or green space (IRR = 1.25, 95% CI = 1.02, 1.54) was significantly associated with more frequent weekly physical activity. CONCLUSION: Proximity to blue or green spaces is associated with more frequent physical activity during the COVID-19 pandemic. Health promotion efforts should include equitable strategies to improve accessibility to blue and green spaces.

Food Insecurity and COVID-19 Vaccination Status and Vaccination Hesitancy in the United States.

During the COVID-19 pandemic, vaccination hesitancy emerged as a factor that impacted vaccine uptake. In addition, during this period, there was a substantial increase in food insecurity in the United States (US). However, there is a lack of research on the potential connection between food insecurity and COVID-19 vaccine intentions. This study assesses whether experiencing food insecurity during the COVID-19 pandemic is associated with COVID-19 vaccination uptake and vaccination hesitancy. Data were from the 2021 Crime, Health, and Politics Survey, a national probability sample of community-dwelling adults 18 years and older living in the US (N = 1741) conducted from May 10, 2021, to June 1, 2021. Results from multinomial logistic regression analyses found that mild food insecurity and moderate-to-severe food insecurity were associated with an increased relative risk of not planning to get the COVID-19 vaccination compared with having been vaccinated or planning to get vaccinated. Moderate-to-severe food insecurity was associated with an increased risk of being unsure about getting the COVID-19 vaccine. The results suggest that efforts to expand vaccination and health literacy outreach to food-insecure populations are essential steps to promote greater health equity.

Socially assistive robotics and older family caregivers of young adults with Intellectual and Developmental Disabilities (IDD): A pilot study exploring respite, acceptance, and usefulness.

INTRODUCTION: The need for caregiver respite is well-documented for the care of persons with IDD. Social Assistive Robotics (SAR) offer promise in addressing the need for caregiver respite through 'complementary caregiving' activities that promote engagement and learning opportunities for a care recipient (CR) with IDD. This study explored the acceptability and usefulness of a SAR caregiver respite program responsive to feedback from both young adults with IDD and their older family caregivers (age 55+). METHOD: Young adults with IDD and caregiver dyads (N = 11) were recruited. A mixed methods research design was deployed in three phases: Phase I with four focus groups to inform the program design; Phase II for program demonstration and evaluation with pre- and post-surveys; and Phase III with post-program interviews for feedback and suggestions. RESULTS: Both young adults with IDD and their caregivers scored favorably the social presence of, social engagement, and satisfaction with robot Pepper. Though there was no significant improvement of caregiving burden/stress as well as well-being of the young adults with IDD based on surveys, results from interviews suggested that the SAR may offer physical/emotional respite to caregivers by providing companionship/friendship as well as promoting independence, safety/monitoring, and interactive engagement with children. DISCUSSION: SAR has potential in providing respite for older family caregivers. Future studies need a longer program design and larger sample size to develop a promising intervention and test its feasibility and efficacy.

Addressing the Syndemics of HIV, Mental Health, and COVID-19 Using the Health and Human Rights Framework among Youth Living with HIV, in Uganda: an Interpretive Phenomenological Study.

Stigma and discrimination negatively impact the prevention, treatment, and care of HIV. The COVID-19 pandemic increased this complexity and created a cluster of synergistic health contexts, wherein the physiological aspects of HIV and the social and environmental conditions increased the vulnerability in health outcomes for youth living with HIV (YPLHIV) in Kampala, Uganda. We used interpretive phenomenological analysis (IPA) and the syndemics framework to understand the lived experiences of YPLHIV. From December 2020 to May 2021, six qualitative focus groups were held with 31 youth living with HIV to understand the lived experiences of YPLHIV. The guided questions used were audio-recorded, transcribed verbatim, and coded for thematic analysis. Findings highlight the complexity of intersecting stigma of HIV and COVID-19 that have worsened antiretroviral treatment adherence and mental health issues due to lack of access to critical needs such as fears of food insecurity, health-related worries, the fear of perishing due to COVID-19, and human rights concerns related to gender and sexual identity. The study recommends addressing human rights-related concerns in addition to health-related concerns to comprehensively mitigate the syndemics of HIV and COVID-19 for YPLHIV in Uganda.

Informal and formal systems of care for women experiencing intimate partner violence in Kenya.

Several factors influence a victim's decision on whether or not to seek help after experiencing Intimate Partner Violence (IPV). This study used data from the Demographic and Health Surveys (DHS) for Kenya (2014) of ever married women (n = 5265). Majority of the women did not seek help after experiencing IPV (55.5%). Women justification for IPV decreased the odds of seeking help from informal services by 0.75 times and formal services by 0.58 times. Understanding cultural determinants of help seeking would contribute in the development of effective policies and programs for preventing and responding to IPV in Kenya and across the world.

The "humane in the loop": Inclusive research design and policy approaches to foster capacity building assistive technologies in the COVID-19 era.

The COVID-19 pandemic is emerging as a driver of greater reliance on wireless technologies, including intelligent assistive technologies, such as robots and artificial intelligence. We must integrate the humane "into the loop" of human-AT interactions to realize the full potential of wireless inclusion for people with disabilities and older adults. Embedding ethics into these new technologies is critical and requires a co-design approach, with end users participating throughout. Developing humane AT begins with a participatory, user-centered design embedded in an iterative co-creation process, and guided by an ethos prioritizing beneficence, user autonomy and agency. To gain insight into plausible AT development pathways ("futures"), we use scenario planning as a tool to articulate themes in the research literature. Four plausible scenarios are developed and compared to identify one as a desired "humane" future for AT development. Policy and practice recommendations derived from this scenario, and their implications for the role of AT in the advancement of human potential are explored.

Determinants of broadband access and affordability: An analysis of a community survey on the digital divide.

Broadband access in the home is a necessity, especially since the COVID-19 pandemic. Increasingly, connectivity is of vital importance for school, work, family, and friends. Existing international research on the implementation of broadband has studied its adoption patterns with a focus on the rural/urban digital divide. This paper explores the digital divide in a case study of the seventh largest city, by population, in the United States; San Antonio is a majority-minority city where over half of the people are Hispanic. This paper focuses on the five key affordability factors that drive broadband adoption. Researchers test social exclusion theory, the structural facets of poverty and social marginality to ascertain its potential impact on broadband access. The authors conducted a survey in both English and Spanish to learn more about the affordability factors that influence the broadband digital divide. Through our analysis, we found evidence that four of the factors (geographical disparities, profit-based discrimination, technology deployment cost, and socio-economic factors) played a role in the digital divide in this case study. The results of this study demonstrate that the digital divide is not exclusively a rural/urban digital divide, but can also occur in an intra-city context. This is especially evident in low-income areas within the city because they have substantially lower broadband adoption rates. The results of this study demonstrate the importance of looking closely at issues of social exclusion of marginalized groups and the affordability of broadband access intra-city.

Mental Health and Weather Extremes in a Southeastern U.S. City: Exploring Group Differences by Race.

The connection between mental health and weather extremes is a public health concern, but less studied to date than physical health. This exploratory study examines the mental health impacts of two kinds of weather extremes increasingly linked to climate change-summer heat waves and extreme winter weather-in a low- to middle-income population in the Southeastern U.S. The distribution of mental health impacts, and potential pathways to them, are examined with a focus on race. Data are from a random-sample survey of 426 participants and are analyzed with bivariate statistics and path analysis. Self-reported mental health impacts, in both seasons, were common in our study, with White participants tending to report worse impacts than participants who identified with other racial groups. Physical health had direct effects on mental health across several models, overall and by racial group. For summer heat waves, concern about climate change and social cohesion had direct and indirect effects, respectively, on mental health in White participants only. For extreme winter weather, preparedness had a direct negative effect on mental health in White, but not Black, participants. Results suggest that there may be racial differences in the influence of human and social capital factors on mental health related to weather extremes, warranting further study of this critical topic and with larger racial subgroup samples.

Hegemonic Masculinity Attitudes Toward Female Genital Mutilation/Cutting Among a Sample of College Students in Northern and Southern Sierra Leone.

Introduction: Female genital mutilation or cutting (FGM/C) is a public health problem. Approximately three million women and girls undergo FGM/C every year, worldwide. The purpose of the study was to assess the influence of education on hegemonic masculinity attitudes between male and female students and whether parental education differentiated the groups. Method: A cross-section design was used. Data were collected through a survey response from 338 students in May 2017. The data were analyzed using chi-square and correlational tests. Results: Education did not change the attitudes of students toward FGM/C (χ2 = 3.64, p = .16); however, parental education had an influence on both male and female students' attitudes toward FGM/C. Discussion: The study suggests that education alone may not be sufficient to end FGM/C practice. A comprehensive community-led strategy incorporating culturally congruent health care to involve multiple parties of health professionals, religious leaders, government, and policy makers may be needed to address the problem.

Women's Autonomy and Attitudes toward Condom Use: A Multicountry Analysis.

Autonomy gives women the ability to negotiate safe sex and make decisions on their health. This study explores the gender stratification framework to understand the intertwined nature of HIV and women's autonomy using the nationally representative Demographic Health Survey. It examines women's autonomy and attitudes toward condom use for prevention of HIV/AIDS in four culturally diverse countries. Findings from the logistic regression indicate that labor force participation, individual autonomy, and decision making significantly increased the odds of always using a condom during sex in all countries. Promoting prevention policies highlighting women's autonomy may contribute in reducing the spread of HIV infection.