The impact of COVID-19 on the lives of Canadians with and without non-communicable chronic diseases: results from the iCARE Study.

BACKGROUND: The COVID-19 pandemic and its prevention policies have taken a toll on Canadians, and certain subgroups may have been disproportionately affected, including those with non-communicable diseases (NCDs; e.g., heart and lung disease) due to their risk of COVID-19 complications and women due to excess domestic workload associated with traditional caregiver roles during the pandemic. AIMS/OBJECTIVES: We investigated the impacts of COVID-19 on mental health, lifestyle habits, and access to healthcare among Canadians with NCDs compared to those without, and the extent to which women with NCDs were disproportionately affected. METHODS: As part of the iCARE study ( www.icarestudy.com ), data from eight cross-sectional Canadian representative samples (total n = 24,028) was collected via online surveys between June 4, 2020 to February 2, 2022 and analyzed using general linear models. RESULTS: A total of 45.6% (n = 10,570) of survey respondents indicated having at least one physician-diagnosed NCD, the most common of which were hypertension (24.3%), chronic lung disease (13.3%) and diabetes (12.0%). In fully adjusted models, those with NCDs were 1.18-1.24 times more likely to report feeling lonely, irritable/frustrated, and angry 'to a great extent' compared to those without (p's < 0.001). Similarly, those with NCDs were 1.22-1.24 times more likely to report worse eating and drinking habits and cancelling medical appointments/avoiding the emergency department compared to those without (p's < 0.001). Moreover, although there were no sex differences in access to medical care, women with NCDs were more likely to report feeling anxious and depressed, and report drinking less alcohol, compared to men with NCDs (p's < 0.01). CONCLUSION: Results suggest that people with NCDs in general and women in general have been disproportionately more impacted by the pandemic, and that women with NCDs have suffered greater psychological distress (i.e., feeling anxious, depressed) compared to men, and men with NCDs reported having increased their alcohol consumption more since the start of COVID-19 compared to women. Findings point to potential intervention targets among people with NCDs (e.g., prioritizing access to medical care during a pandemic, increasing social support for this population and mental health support).

Canadian healthcare workers' mental health and health behaviours during the COVID-19 pandemic: results from nine representative samples between April 2020 and February 2022.

OBJECTIVE: In the context of COVID-19, Canadian healthcare workers (HCWs) worked long hours, both to respond to the pandemic and to compensate for colleagues who were not able to work due to infection and burnout. This may have had detrimental effects on HCWs' mental health, as well as engagement in health-promoting behaviours. This study aimed to identify changes in mental health outcomes and health behaviours experienced by Canadian HCWs throughout the COVID-19 pandemic. METHODS: Nine representative samples (Ntotal = 1615 HCWs) completed the iCARE survey using an online polling firm between April 2020 (Time 1) and February 2022 (Time 9). Participants were asked about the psychological effects of COVID-19 (e.g., feeling anxious) and about changes in their health behaviours (e.g., alcohol use, physical activity). RESULTS: A majority of the HCWs identified as female (65%), were younger than 44 years old (66%), and had a university degree (55%). Female HCWs were more likely than male HCWs to report feeling anxious (OR = 2.68 [1.75, 4.12]), depressed (OR = 1.63 [1.02, 2.59]), and irritable (OR = 1.61 [1.08, 2.40]) throughout the first two years of the pandemic. Female HCWs were more likely than their male counterparts to report eating more unhealthy diets (OR = 1.54 [1.02, 2.31]). Significant differences were also revealed by age, education level, income, parental status, health status, and over time. CONCLUSION: Results demonstrate that the impacts of COVID-19 on HCWs' mental health and health behaviours were significant, and varied by sociodemographic characteristics (e.g., sex, age, income).

RéSUMé: OBJECTIF: Dans le contexte de la COVID-19, les travailleurs de la santé canadiens ont travaillé de longues heures, à la fois pour répondre à la pandémie et pour compenser pour les collègues qui n'étaient pas en mesure de travailler en raison d'infection et d'épuisement professionnel. Cela a pu générer un important impact sur leur santé mentale, ainsi que sur leurs engagements dans des comportements favorables à la santé. MéTHODES: Neuf échantillons représentatifs (Ntotal = 1 615 travailleurs de la santé) ont répondu à l'enquête iCARE par l'intermédiaire d'une compagnie de sondage en ligne entre avril 2020 (temps 1) et février 2022 (temps 9). Les participants ont été interrogés sur les effets psychologiques de la COVID-19 (p.ex., le sentiment d'anxiété) et sur les changements dans leurs comportements de santé (p.ex., la consommation d'alcool, l'activité physique). RéSULTATS: La majorité des travailleurs de santé répondants sont des femmes (65 %), ont moins de 44 ans (66 %) et ont un diplôme universitaire (55 %). Les femmes travailleuses de la santé étaient plus susceptibles de se sentir anxieuses (OR = 2,68 [1,75, 4,12]), déprimées (OR = 1,63 [1,02, 2,59) et irritables (OR = 1,61 [1,08, 2,40]) que les hommes au cours des deux premières années de la pandémie. Les femmes travailleuses de la santé étaient plus susceptibles d'avoir une alimentation plus malsaine (OR = 1,54 [1,02, 2,31]) que leurs homologues masculins. Des différences significatives ont également été révélées selon l'âge, le niveau d'éducation, le revenu, le statut parental, l'état de santé et à travers le temps. CONCLUSION: Les résultats démontrent que les impacts de COVID-19 sur la santé mentale et les comportements de santé des travailleurs de santé sont significatifs, mais varient selon les caractéristiques sociodémographiques (p.ex., le sexe, l'âge, le revenu).

Prevalence and Motivators of Getting a COVID-19 Booster Vaccine in Canada: Results from the iCARE Study.

Studies have shown that the protection afforded by COVID-19 vaccines against hospitalization and death decreases slowly over time due to the emergence of new variants and waning immunity. Accordingly, booster doses remain critical to minimizing the health impacts of the pandemic. This study examined the prevalence rate, sociodemographic determinants, and motivators of getting a COVID-19 booster vaccine within the Canadian population. We recruited a representative sample of 3001 Canadians aged 18+ years as part of the iCARE study using an online polling form between 20 January and 2 February 2022. Participants self-reported their booster status and were dichotomized into two groups: those who did vs. did not receive at least one booster dose. A total of 67% of participants received a booster dose. Chi-square analyses revealed that older age (p < 0.001) and having a chronic disease diagnosis (p < 0.001) were associated with being more likely to get a booster. Boosted individuals reported motivators tied to efficacy and altruism, whereas non-boosted individuals reported motivators tied to efficacy and safety. Results suggest that messaging will require careful tailoring to address the identified behavioral motivators among non-boosted individuals who emphasize safety and efficacy of additional vaccine doses.