Perceptions, Attitudes, and Knowledge of Cannabis and its Use: A Qualitative Study among Herbal Heart Study Young Adult Cannabis Consumers in South Florida.

Growing cannabis use among young adults in the United States surpasses research and public understanding, raising health concerns despite potential benefits. Limited research focuses on their knowledge, attitudes, risks, and motivations, especially in states with limited legalization. This study explores cannabis knowledge and attitudes among healthy young adult cannabis consumers to understand their risk and benefit perceptions. Data include a subsample of participants in the Herbal Heart Study, a cohort to examine subclinical cardiovascular risk among healthy young adult (18-35 years old) cannabis consumers and non-consumers. A qualitative thematic analysis of the interviews was performed using a deductive approach driven by the theory of the Health Belief Model to generate categories and codes. Dedoose was used to organize transcripts and coding. A total of 22 young adult cannabis consumers (M age = 25.3, SD = 4.4) were interviewed between May 5, 2021- September 23, 2022. Participants were predominantly female (n = 13) and Hispanic (n = 9) or non-Hispanic Black (n = 7). Five themes were identified: perceived health benefits and risks associated with cannabis use, motivation for cannabis use, knowledge of cannabis, and perceived barriers to cannabis use. Participants discussed knowledge, positive/negative attitudes toward cannabis, and perceived risks/benefits based on personal experience and gathered information. Some showed knowledge deficits, and most wanted more health-related cannabis research. Given the current climate of rising cannabis legalization, availability of novel cannabis products, and societal acceptance, further research and evidence-based cannabis literacy for young adults are essential to keep pace with liberalization trends.

Day-of-the-Week and Time-of-the-Day Patterns of Sedentary Behavior in the Hispanic Community Health Study/Study of Latinos.

PURPOSE: Existing sedentary behavior interventions have largely achieved mixed results. Conventionally, interventions have attempted to reduce sedentary behavior using a full-day approach. An alternative strategy may be to target specific periods during the day and/or week. This study examined the day-of-the-week (Monday to Sunday) and time-of-the-day patterns (3-and 6-h periods) of sedentary behavior among U.S. Hispanics/Latinos adults. METHODS: Participants ( n = 12,241) from the Hispanic Community Health Study/Study of Latinos, a multisite community-based prospective cohort study of Hispanic/Latino adults, were studied. Sedentary behavior was assessed for 1 wk using a hip-mounted accelerometer through total sedentary time, sedentary time in bouts ≥60 min, and total number of sedentary breaks. The temporal patterns of sedentary behavior metrics were evaluated using linear mixed effect models accounting for the Hispanic Community Health Study/Study of Latinos complex survey design. RESULTS: There were statistically significant variations in temporal patterns across day-of-the-week and time-of-the-day periods for all three metrics ( P < 0.001). Adults were more sedentary on weekends than on weekdays and most sedentary on Sundays. The time-of-the-day patterns had a U-curve pattern wherein adults were most sedentary late at night, became less sedentary throughout the day, reached peak activeness around noon, then gradually became more sedentary into the evening. These patterns were largely robust across seasonality and most sociodemographic characteristics, including age, employment status, work shift schedule, acculturation, and field center. CONCLUSIONS: Our findings suggest that early mornings, evenings, and weekends were the more sedentary periods in this cohort of Hispanic/Latino adults, characterized by higher volumes of sedentary time, higher volumes of time in prolonged sedentary bouts, and fewer number of sedentary breaks than other time periods, highlighting important windows of opportunity to reduce sedentary behavior.

Adolescent Polysubstance Use and Co-Occurring Weapon Carrying, Bullying Victimization, and Depressive Symptomology: Patterns and Differences in the United States.

Adolescent substance use commonly co-occurs with poor mental health, bullying victimization and risky behaviors that may lead to violence. The purpose was to describe the United States (US) national prevalence of polysubstance use and co-occurring characteristics and associated demographic characteristics among youth. Middle and high school students in the 2019 CDC YRBS survey reported their demographics and current ( ≥ 1 days in the last 30 days) substances used (alcohol, cigarette, e-cigarette, cannabis); polysubstance combinations were generated. Cross-sectional weighted logistic regression estimated odds of polysubstance use and frequent use ( ≥ 6 days in the last 30 days) by weapon carrying, depressive symptoms, bullying victimization, and demographics. Mean age of the sample was 16 years, 51% were boys, 51% were non-Hispanic White. While accounting for 21% of the sample, 22-40% of Multiracial youth reported polysubstance use and frequent use. Odds of frequent polysubstance use (all combinations) were highest for weapon carrying youth.

Racial and ethnic disparities in chronic disease risk in adolescence after prenatal polydrug exposure: Examination of the Hispanic paradox.

Racial disparities exist in fetal development which in turn can influence growth and development of chronic disease later in life. The purpose of this study was to explore potential racial and ethnic differences in chronic disease risk factors throughout the pediatric years given prenatal exposure to substance use. Data from the Maternal Lifestyle Study cohort was used for this analysis. Urine toxicology confirmed maternal substance use (y/n) and offspring height, weight, and systolic blood pressure (SBP) data at 16 years was analyzed. Linear mixed effects modeling with an interaction term for adolescent race/ethnicity and maternal drug use assessed growth trajectories (body mass index (BMI) percentile) and cardiovascular disease risk factors (elevated SBP). Of the sample (n = 1,388 mother/infant dyads), 23% (n = 319) of mothers used three substances during pregnancy and 14% (n = 200) used four or five. Controlling for BMI, Hispanic adolescents prenatally exposed to any singular substance had 13 mmHg higher SBP at age 16 than their unexposed counterparts (95% Confidence Interval [CI]: 12.24, 14.01). Prenatal exposure to >1 substance significantly lowered SBP in Hispanic adolescents only. Results here showed that Hispanic adolescents exposed to singular substance are at higher risk of elevated SBP in adolescence, but SBP decreased when exposed to >1 substance. The Hispanic paradox may play a role; future studies should continue to explore this. Additionally, barriers to prenatal care for Hispanic women should be addressed in order to prevent substance use during pregnancy which can reduce chronic disease risk in offspring adolescence.

Assessing the current and desired levels of training and applied experiences in chronic disease prevention of students during medical school.

INTRODUCTION: Chronic diseases account for approximately 70% of deaths in the U.S. annually. Though physicians are uniquely positioned to provide behavior change counseling for chronic disease prevention, they often lack the necessary training and self-efficacy. This study examined medical student interest in receiving chronic disease prevention training as a formal part of their education as part of an effort to enhance their ability to provide guidance to patients in the future. METHODS: A 23-question, online survey was sent to all undergraduate medical students enrolled in a large medical education program. The survey assessed medical student interest in receiving training related to chronic disease prevention. Survey topics included student awareness of primary prevention programs, perceived importance of receiving training and applied experience in chronic disease prevention, and preferences for how and when to receive this training. RESULTS: Of 793 eligible medical students, 432 completed the survey (54.5%). Overall, 92.4% of students reported receiving formal training in physical activity, public health, nutrition, obesity, smoking cessation, and chronic diseases was of "very high" or "high" importance. Despite this level of importance, students most frequently reported receiving no or 1-5 h of formal training in a number of topics, including physical activity (35.4% and 47.0%, respectively) and nutrition (16.9% and 56.3%, respectively). The level of importance given to public health training was significantly greater across degree type (p = 0.0001) and future specialty (p = 0.03) for MD/MPH students and those interested in primary care, respectively. CONCLUSIONS: While medical students perceive chronic disease prevention as an important topic, most reported receiving little to no formal training. To address the growing prevalence of chronic disease across our society, programs schools should place greater emphasis on integrating training in physical activity, nutrition, and obesity-related content into the medical education curriculum.

Patient acceptance of HIV rapid testing in the dental care setting.

Dental settings are untapped venues to identify patients with undiagnosed HIV who may otherwise lack testing opportunities. Perceived lack of patient acceptance has been a significant barrier limiting dentists' willingness to offer HIV testing. This study implemented rapid HIV testing in dental settings located in an HIV prevalent region to evaluate patient acceptance. Two South Florida community health centers implemented routine oral rapid HIV testing as part of clinical practice, followed by exit interviews with patients immediately after to determine patient acceptance. The binary primary outcome was patient's acceptance of the rapid HIV test. Multivariable logistic regression assessed associations between patient characteristics and acceptance. Overall acceptance by dental patients (N = 600) was 84.5%. Patients who were more likely to participate in other medical screenings in dental settings were more than twice as likely to accept the test compared to those who were neutral/less likely (OR: 2.373; 95% CI: 1.406-4.004). Study findings highlight the high patient acceptance of HIV testing in dental settings. Widespread implementation of such testing will require an expanded societal view of the traditional role of the dentist that will embrace the potentially valuable role of dentistry in preventive health screenings and population health.

"Ganja Mamas": Online discussions about cannabis use in pregnancy.

BACKGROUND: Nearly 5 % of pregnant women in the United States use cannabis. However, expecting mothers often do not seek counsel from their healthcare providers about prenatal cannabis use due to stigma and legal ramifications. Instead, cannabis-using pregnant women turn to each other to learn. Online message boards have become a safe place for parents to seek answers anonymously in real-time. The objective of this study was to examine the information-seeking/giving behaviors of cannabis-using pregnant women on an online community forum. METHODS: We extracted 151 original messages and 1260 corresponding comments posted over a 7-day period from Whattoexpect.com's "Ganja Mamas" forum. We iteratively developed a codebook with 16 categories to reflect information-seeking behavior. N = 131 unique forum members posted questions for comment. RESULTS: Approximately half, 46.56 %, reported their geographic location (24 states), and 40.46 % reported gestational age. The top topics for which members sought out information were testing, state-specific questions, postpartum, child protective services (CPS), hospital-specific questions, birth announcements, methods of cannabis use, quitting, breastfeeding/pumping, pregnancy symptoms, mental health, general health and pregnancy, and quantity of cannabis use. The second phase of analysis was based on members' responses. Clustered codes indicated how the respondents were using the forum: (1) interviewing and geographic location, (2) knowledge, experience, and reassurance, (3) congratulations and relief, and (4) concealing cannabis use and symptoms. CONCLUSIONS: Our results demonstrate that mothers on an online cannabis forum are seeking information about location-specific experiences pertaining mostly to testing and child protective services. Additionally, mothers are responding by geographic-specific interviewing, and are expressing relief and reassurance in response to members' experiences.

Food Insecurity Disparities and Mental Health Impacts Among Cancer Survivors During the COVID-19 Pandemic.

Introduction: Food insecurity can negatively impact adherence and receipt of high-quality cancer care. The purpose of the study was to (1) compare the prevalence of COVID-19-associated food insecurity by cancer history and (2) examine determinants associated with COVID-19-related food insecurity among cancer survivors. Methods: We used nationally representative data from the 2020 COVID-19 Household Impact Survey (n=10,760). Our primary exposure was participants' self-report of a cancer diagnosis (n=854, 7.1%). Primary outcomes of food insecurity were categorized by the following questions: "We worried our food would run out before we got money to buy more" or "The food that we bought just didn't last, and we didn't have money to get more"; respondents were categorized as food insecure if they chose often true or sometimes true. Multivariable Poisson regression was used to identify demographic determinants of food insecurity among cancer survivors. Results: Thirty-two percent of cancer survivors were food insecure. Cancer survivors 30-44 years of age and those ≥60 years of age were more likely to report being food insecure compared to respondents without a history of cancer, respectively (30-44 years, 59.9% vs. 41.2% p=0.01, ≥60 years 27.2% vs. 20.2%, p=0.01). Cancer survivors without a high school diploma were more likely to report food insecurity compared to adults with no history of cancer (87.0% vs. 64.1%, p=0.001). In multivariable models, uninsured cancer survivors (adjusted prevalence ratio [aPR] aPR: 2.39, 95% CI: 1.46-3.92) and those on Medicaid (aPR: 2.10, 95% CI: 1.40-3.17) were also more likely to report being food insecure. Conclusion: Food insecurity during the COVID-19 pandemic is vast, but disparities persist. Among cancer survivors, differences in food insecurity were observed by age and socio economic status. Cancer survivors experiencing food insecurity more frequently reported mental health symptoms of depression, loneliness, and hopelessness compared to those who were food secure.

Cannabis Use and Heart Transplantation: Disparities and Opportunities to Improve Outcomes.

Heart transplantation (HT) remains the optimal therapy for many patients with advanced heart failure. Use of substances of potential abuse has historically been a contraindication to HT. Decriminalization of cannabis, increasing cannabis use, clinician biases, and lack of consensus for evaluating patients with heart failure who use cannabis all have the potential to exacerbate racial and ethnic and regional disparities in HT listing and organ allocation. Here' we review pertinent pre-HT and post-HT considerations related to cannabis use' and relative attitudes between opiates and cannabis are offered for context. We conclude with identifying unmet research needs pertaining to the use of cannabis in HT that can inform a standardized evaluation process.

Mental Health Symptoms during the COVID-19 Pandemic among Cancer Survivors Who Endorse Cannabis: Results from the COVID-19 Cannabis Health Study.

Our objective was to examine the prevalence of mental health symptoms and the behavioral impact of the COVID-19 pandemic on cancer survivors who endorse cannabis. Participants included 158 adults (≥18 years) who self-reported medicinal cannabis use and responded to our internet-based questionnaire (21 March 2020−24 March 2021). Data included 79 cancer survivors and 79 age-matched adults without a history of cancer. Descriptive statistics were used to compare demographics, the prevalence of generalized anxiety (GAD-7), depression (CES-D-10), and changes in behavior during the COVID-19 pandemic by cancer survivorship status. Overall, 60.8% and 48.1% of cancer survivors self-reported the use of cannabis to manage their anxiety and depression, respectively. Probable clinical depression (CES-D-10 score ≥ 10) and anxiety (GAD-7 score ≥ 10) were identified in 50.7% and 38.9% of cancer survivors, respectively. Cancer survivors were more likely to report that their anxiety symptoms made it very or extremely difficult to work, take care of home, or get along with others than their counterparts. Cancer survivors with anxiety and/or depression were more likely to fear giving COVID-19 to someone else (47.5% vs. 23.1%, p = 0.023) and to fear being diagnosed with COVID-19 (77.5% vs. 38.5%, p < 0.001) compared to cancer survivors without anxiety and depression symptoms. Further research is recommended to evaluate the use of cannabis as palliative care to improve mental health among cancer survivors.

Serum Metabolomics of Incident Diabetes and Glycemic Changes in a Population With High Diabetes Burden: The Hispanic Community Health Study/Study of Latinos.

Metabolomic signatures of incident diabetes remain largely unclear for the U.S. Hispanic/Latino population, a group with high diabetes burden. We evaluated the associations of 624 known serum metabolites (measured by a global, untargeted approach) with incident diabetes in a subsample (n = 2,010) of the Hispanic Community Health Study/Study of Latinos without diabetes and cardiovascular disease at baseline (2008-2011). Based on the significant metabolites associated with incident diabetes, metabolite modules were detected using topological network analysis, and their associations with incident diabetes and longitudinal changes in cardiometabolic traits were further examined. There were 224 incident cases of diabetes after an average 6 years of follow-up. After adjustment for sociodemographic, behavioral, and clinical factors, 134 metabolites were associated with incident diabetes (false discovery rate-adjusted P < 0.05). We identified 10 metabolite modules, including modules comprising previously reported diabetes-related metabolites (e.g., sphingolipids, phospholipids, branched-chain and aromatic amino acids, glycine), and 2 reflecting potentially novel metabolite groups (e.g., threonate, N-methylproline, oxalate, and tartarate in a plant food metabolite module and androstenediol sulfates in an androgenic steroid metabolite module). The plant food metabolite module and its components were associated with higher diet quality (especially higher intakes of healthy plant-based foods), lower risk of diabetes, and favorable longitudinal changes in HOMA for insulin resistance. The androgenic steroid module and its component metabolites decreased with increasing age and were associated with a higher risk of diabetes and greater increases in 2-h glucose over time. We replicated the associations of both modules with incident diabetes in a U.S. cohort of non-Hispanic Black and White adults (n = 1,754). Among U.S. Hispanic/Latino adults, we identified metabolites across various biological pathways, including those reflecting androgenic steroids and plant-derived foods, associated with incident diabetes and changes in glycemic traits, highlighting the importance of hormones and dietary intake in the pathogenesis of diabetes.

Relationship between risky behaviors and non-prescription opioid use among Asian American youth.

Asian Americans (AA) are a highly understudied population and are often considered the "model minority" for health. However, there is a dearth of research on risky behaviors associated with opioid use in AA teens. Data among AA youth aged 12 to 16 was collected from the 2017 Youth Risk Behavior Surveillance System. Multivariate logistic regression models were run to determine associations between opioid use and risky behaviors, controlling for age and sex. Findings showed that opioid use is significantly associated with weapon carrying, risky sexual behavior, and body image. These conclusions inform public health practice on substance abuse treatment in AA teens.

Association of Accelerometer-Measured Physical Activity and Cardiovascular Health in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

INTRODUCTION: Evidence regarding the associations between accelerometer-measured moderate-vigorous physical activity (MVPA) and cardiovascular health (CVH) indicators among Hispanic/Latino adults are unavailable. METHODS: Examined cross-sectional data from 12,008 Hispanic/Latino adults aged 18-74 years participating in the Hispanic Community Health Study/Study of Latinos. Accelerometer-measured MVPA was assessed categorically and dichotomously per 2008 PA guidelines. Adverse and ideal CVH indicators were determined by standard cut-points for blood glucose, total cholesterol, blood pressure, body mass index (BMI), and smoking. A composite of low CV risk, defined as achieving all ideal CVH indicators, was included. Adjusted Poisson regression models and complex survey design methods were used for all analyses. RESULTS: Compared to high MVPA, lower MVPA categories were associated with higher prevalence of all adverse CVH indicators, except hypertension, and with lower prevalence of low CV risk and ideal blood glucose, blood pressure, and BMI. Similarly, non-adherence to PA guidelines was associated with a higher prevalence of diabetes (16%), hypercholesterolemia (9%), obesity (28%), and smoking (9%); and lower prevalence of low CV risk (24%), ideal blood glucose (6%), ideal blood pressure (6%), and ideal BMI (22%). CONCLUSION: Overall, high accelerometer-measured MVPA and meeting PA guidelines were associated with favorable CVH in Hispanic/Latino adults.

Physical and Mental Health Impacts of the COVID-19 Pandemic among US Adults with Chronic Respiratory Conditions.

Adults living with chronic respiratory diseases are at higher risk of death due to COVID-19. Our objective was to evaluate the physical and mental health symptoms among US adults living with chronic respiratory conditions. We used data of 10,760 US adults from the nationally representative COVID-19 Impact Survey. Chronic respiratory conditions were self-reported and included asthma (14.7%), chronic obstructive pulmonary disease or COPD (4.7%), and bronchitis/emphysema (11.6%). We used multivariable Poisson regression to evaluate physical health symptoms. We estimated associations of mental health symptoms using multinomial logistic regression. In multivariable models, adults with asthma were more likely to report physical symptoms including runny or stuffy nose, chest congestion, fever, and chills. In addition, adults with COPD were more likely to report several physical symptoms including fever (adjusted prevalence ratio [aPR]: 1.37, 95% confidence interval [CI]: 1.09-1.72), chills (aPR: 2.10, 95% CI: 1.67-2.64), runny or stuffy nose (aPR: 1.78, 95% CI: 1.39-2.27), chest congestion (aPR: 2.14, 95% CI: 1.74-2.61), sneezing (aPR: 1.59, 95% CI: 1.23-2.05), and muscle or body aches (aPR: 1.38, 95% CI: 1.06-1.81). Adults with chronic respiratory conditions are more likely to report physical and mental health symptoms during the COVID-19 pandemic compared to others. Providers should prioritize discussing mental health symptom management as the pandemic continues to be a public health concern in the US.

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study.

Clinical indications for medicinal cannabis use include those with cancer, a subgroup advised to avoid exposure to COVID-19. This study aims to identify changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors since the pandemic by cancer status. Chi-squared tests were used for univariate comparisons of demographic characteristics, cannabis use patterns, COVID-19 symptoms, and coping behaviors by cancer survivor status. Data included 158 responses between 21 March 2020 and 23 March 2021, from medicinal cannabis users, categorized as cancer survivors (n = 79) along with age-matched medicinal cannabis users without a history of cancer (n = 79). Compared to adults without a history of cancer, cancer survivors were more likely to report use of cannabis as a way of managing nausea/vomiting (40.5% versus 20.3%, p = 0.006), headaches or migraines (35.4% versus 19.0%, p = 0.020), seizures (8.9% versus 1.3%, p = 0.029), and sleep problems (70.9% versus 54.4%, p = 0.033), or as an appetite stimulant (39.2% versus 17.7%, p = 0.003). Nearly 23% of cancer survivors reported an advanced cannabis supply of more than 3 months compared to 14.3% of adults without a history of cancer (p = 0.002); though the majority of cancer survivors reported less than a one-month supply. No statistically significant differences were observed by cancer survivor status by cannabis dose, delivery, or sharing of electronic vaping devices, joints, or blunts. Cancer survivors were more likely to report a fear of being diagnosed with COVID-19 compared to adults without a history of cancer (58.2% versus 40.5%, p = 0.026). Given the frequency of mental and physical health symptoms reported among cancer survivors, clinicians should consider conversations about cannabis use with their patients, in particular among cancer survivors.

What Anansi Did for Us: Storytelling's Value in Equitably Exploring Public Health.

There is growing implementation of storytelling as a specific application of narrative in public health. As the field's latest epoch evolves to consider cultural determinants, reimagination of how scientists conceptualize, operationalize, and capture populations' unique elements is necessary, and storytelling provides a genuine and efficacious methodology that can assist with that reimagination. Professionals are creating more spaces that demonstrate how storytelling elucidates, promotes, and supports contextual factors that are not captured by orthodox methodologies. However, more opportunities are needed to exhibit storytelling's impact on capturing the nuances in human experiences, such as those of historically and systemically underrepresented populations. This study synthesizes the past decade of research in public health and related fields that primarily utilized storytelling and reports significant implications. Additionally, this study highlights explorations in public health that primarily use storytelling as a research and practice approach. Each case study includes a description of the background and aims, elaborates on storytelling's utilization, and discusses findings, observations, and future directions. Finally, this study discusses conceptual issues in public health raised by use of storytelling, such as how to best capture impact on human beings and the importance of context. This article's goal is to present current evidence of critical reevaluations to the epistemological, conceptual, and practical paradigms within public health through storytelling. Additionally, this article aims to provide support and empowerment to public health scientists considering creative approaches to better acknowledge and appreciate humanity's inherent subjectivity.

Disparities in Awareness of Hepatitis C Virus Among US Adults: An Analysis of the 2019 Health Information National Trends Survey.

BACKGROUND: The U.S. Preventive Services Task Force updated hepatitis C virus (HCV) screening 2020 guidelines to target adults aged 18 to 79 years: a major shift from the prior focus on high-risk populations ("baby boomers" aged ≥55 years as of 2019). To inform efforts to maximize HCV screening coverage, our objective was to identify demographic groups reporting a lack of HCV awareness, particularly by race/ethnicity and age, and sources of health information. METHODS: We used nationally representative data of adults (≥18 years) included in the 2019 Health Information National Trends Survey (n = 5438). Awareness of HCV was defined using the following question: "Have you ever heard of the hepatitis C virus (also known as Hep C or HCV)?" We estimated frequencies by demographic groups and computed risk differences (RDs) with 95% confidence intervals (CIs) to compare lack of HCV awareness by age (<55 and ≥55 years) and race/ethnicity. RESULTS: Overall, 17% of adults never heard of HCV. Younger adults (<55 years; 21%) were more likely to have never heard of HCV compared with older adults (≥55 years; 12%; χ2P < 0.001). This observation was consistent across most demographic characteristics including, racial/ethnic categories, and residing in the Southern United States. More than one-third of adults with low English fluency had a lack of HCV awareness in both age groups (χ2P = 0.537). Non-Hispanic (NH) Asian (RD, 25%; 95% CI, 6.9%-43.3%) and Hispanic (RD, 10%; 95% CI, 0.01%-19.6%) adults younger than 55 years were significantly more likely to have never heard of HCV compared with their NH White counterparts after adjustment for sex, educational level, household income, English fluency, and having a regular provider. Adults younger than 55 years with a lack of HCV awareness commonly obtained their health information from the Internet across most sociodemographic characteristics. CONCLUSIONS: Hispanic and NH Asian young adults should be targeted for public health messaging regarding HCV screening, potentially through social media campaigns.

Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: an analysis of the nationally representative COVID-19 impact survey.

BACKGROUND: Preventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours. STUDY DESIGN: Cross-sectional. SETTING AND PARTICIPANTS: We used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA. PRIMARY MEASURES: Adults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%). RESULTS: Compared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income

Evaluating Mental Health-Related Symptoms Among Cancer Survivors During the COVID-19 Pandemic: An Analysis of the COVID Impact Survey.

PURPOSE: The COVID-19 pandemic has affected the mental health of adults in the United States because of recommended preventive behaviors such as physical distancing. Our objective was to evaluate mental health symptoms and identify associated determinants among cancer survivors during the COVID-19 pandemic in the United States. METHODS: We used nationally representative data of 10,760 US adults from the COVID-19 Impact Survey. We defined cancer survivors as adults with a self-reported diagnosis of cancer (n = 854, 7.6%). We estimated associations of mental health symptoms among cancer survivors using multinomial logistic regression. We estimated determinants of reporting at least one mental health symptom 3-7 times in the 7 days before survey administration among cancer survivors using multivariable Poisson regression. RESULTS: Cancer survivors were more likely to report feeling nervous, anxious, or on edge (adjusted odds ratio [aOR], 1.42; 95% CI, 1.07 to 1.90); depressed (aOR, 1.57; 95% CI, 1.18 to 2.09); lonely (aOR, 1.42; 95% CI, 1.05 to 1.91); and hopeless (aOR, 1.51; 95% CI, 1.11 to 2.06) 3-7 days per week in the last 7 days when compared with adults without cancer. Among cancer survivors, adults of age 30-44 years (adjusted prevalence ratio [aPR], 1.87; 95% CI, 1.18 to 2.95), females (aPR, 1.55, 95% CI, 1.12 to 2.13), adults without a high school degree (aPR, 1.79; 95% CI, 1.05 to 3.04), and adults with limited social interaction (aPR, 1.40, 95% CI, 1.01 to 1.95) were more likely to report at least one mental health-related symptom in the last 7 days (3-7 days/week). CONCLUSION: Cancer survivors are reporting mental health symptoms during the COVID-19 pandemic, particularly young adults, adults without a high school degree, women, and survivors with limited social support.

Mental Health among LGBTQ Cannabis Users During the COVID-19 Pandemic: Analysis of the COVID-19 Cannabis Health Study.

The purpose of this study is to compare the responses of LGBTQ cannabis consumers and their non-LGBTQ counterparts on anxiety, depression, substance use, and COVID-19 coping and stress during the pandemic. Data from an internet-survey of cannabis users during the COVID-19 pandemic were analyzed (N = 2,319). Approximately 18% of the sample identified as LGBTQ. Bivariate analyses were used to examine the relationship between LGBTQ identity and symptoms of anxiety and depression, substance use, and pandemic-related coping strategies and stressors. Logistic regression models were used to evaluate the association between pandemic stressors and coping strategies with LGBTQ identity, while adjusting for sex, age, and race and ethnicity. Differences in the proportion of medicinal cannabis use among LGBTQ respondents (74.6%) and non-LGBTQ respondents (75.3%) were insignificant. LGBTQ cannabis users were more likely to report COVID-19 related stressors and coping behaviors, including increased alcohol use. After adjustment for covariates, LGBTQ cannabis users were more likely to report symptoms of depression and anxiety than non-LGBTQ cannabis users. These results show that compared to their cisgender heterosexual counterparts, LGBTQ cannabis users are experiencing more problematic mental health outcomes during the COVID-19 pandemic.