COVID-19 pandemic-related changes in wellness behavior among older Americans.

BACKGROUND: COVID-19 has taken its toll on citizens in all 50 states of the United States. The United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 549,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021. The U.S. federal government primarily left the response to the virus to individual states, and each implemented varying measures designed to protect health of citizens and the state's economic well-being. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting access and consumption of food, and lower quality-of-life. Therefore, our primary goal was to quantify the impact of COVID-19 on health and well-being by measuring changes in physical activity, mental health-quality of life, food security and nutrition in adults ages 40 and older. We believed shifts in health behaviors would be more prevalent in minorities, less educated, lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations. METHODS: We conducted an online survey with 9969 adults 40 years and older between 9 August and 15 September 2020 in urban areas across the four U.S. census regions. The survey included questions about demographic variables, pre-existing health conditions, physical activity, access to food, quality-of-life, and nutritional food status and asked participants to respond with information from pre-pandemic and pandemic conditions. We used paired-sample t-tests to detect changes in variables after the start of the pandemic and Cohen's d to determine effect sizes. RESULTS: Our main findings showed a decrease in physical activity since the onset of COVID-19 for minorities and non-minorities. Food security also slightly increased for minorities during the pandemic, but we found no other changes in food security, quality-of-life indicators, or nutritional status of those who responded to this survey. CONCLUSIONS: It is concerning that physical activity declined. Such activity helps maintain physical and mental health, and it is also an important time to socialize for many older adults. In many ways, our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey, so the health and well-being of older adults should continue to be monitored in order to mitigate potential negative impacts.

Perceptions, Opinions, Beliefs, and Attitudes About Physical Activity and Exercise in Urban-Community-Residing Older Adults.

Background: This research study illustrates the perceptions, opinions, beliefs, and attitudes of older adults residing in an urban community as major factors to understanding barriers and motivators in older African Americans, Hispanics, and Asians adults within Washington, DC. Methods: Eight focus group sessions conducted with 58 older adults to determine their understanding of physical activity and exercise, as well as of barriers to, motivators for, and benefits of physical activity and exercise. Results: The results showed that dance was the preferred physical activity and exercise, fixed or limited income were the main barriers, and prolonged life, more energy, and a stronger body were the main benefits. Conclusion: The results will assist in recommendations to policy makers on programs for older adults that will increase physical activity and exercise for local citizens. These interventions are more likely to increase older adults' ability to remain in their communities and improve their overall health and well-being.

Improving health services for residents through community-based participatory research: a public housing leadership perspective.

BACKGROUND: In response to feedback from a health forum, resident leaders of public housing in Washington, DC, were inspired to create a health survey for and by the residents. OBJECTIVE: The survey was designed to document residents' concerns about health, health care, and environmental threats. It also explored tobacco use and support for smoke-free housing. METHODS: A newly created Health Planning Committee of the Citywide Advisory Board, including residents, academics, and representatives of health and housing organizations, facilitated the creation of a health needs assessment. Questionnaires were initially mailed, then hand-delivered to every public housing household. More than 1,000 completed questionnaires have now been returned. LESSONS LEARNED: This project highlights a model that places resident leaders in charge of health issues, including leading advocacy efforts for policies to reduce health disparities in public housing. It identifies research challenges and ways to overcome them and empowers the community for continued research.

Weight perception and weight control practice in a multiethnic sample of US adolescents.

OBJECTIVES: Obesity is disproportionately prevalent among many racial/ethnic minority groups. The main objectives of this study are (1) to examine the extent of body weight misperception for a representative sample of US adolescents; (2) to explore the gender and racial/ethnic differences associated with an adolescents' weight goals and weight loss attempts and; (3) to examine the influence of an array of sociodemographic factors (eg socioeconomic status) on body weight misperception in adolescents. METHODS: A sample of 2,195 adolescents (aged 10 to 18 years) enrolled in the National Health and Nutrition Examination Survey (2005-2006) was examined. Adolescents' weight and height were measured by lab exams. Perception of weight status, weight goals, and weight loss attempts were obtained by questionnaire. Participants' self-perceptions of their current weight status were compared to classification of their body mass index (BMI) in order to determine concordance. We used multinomial logistic regression models to assess the predictive effects of various sociodemographic factors on weight misperception. RESULTS: Twenty-five percent of girls and 33.2% of boys misperceived their weight status by medical standards. Significant sex and racial/ethnic differences existed in weight perception, attempts to lose weight, and weight goals. Multivariate analysis revealed that age, gender, marital status of parent/guardian were independently associated with the misperception of weight status, controlling for body mass index. CONCLUSIONS: Differences in weight perception, weight goals, and weight loss attempts among ethnic and racial groups call for targeted obesity control efforts.

Bioethical issues in biostatistical consulting: development of a survey.

To develop a survey, the Bioethical Issues in Biostatistical Consulting Questionnaire, for investigating bioethical issues in analysis, a comprehensive literature review was conducted to specify areas of bioethics. Through a focus group study and the evaluation by 10 biostatisticians, the questionnaire was constructed. Validation must involve a panel of experts. Now, test-retest reliability and factor analysis should be conducted on a group of eligible subjects.