Showing papers by "Renee M. Johnson published in 2020"

Mental Distress in the United States at the Beginning of the COVID-19 Pandemic.

Abstract: Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults.Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10-16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire.Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress.Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms.

Importance of Driving and Potential Impact of Driving Cessation for Rural and Urban Older Adults.

Abstract: PURPOSE Analyses compared older drivers from urban, suburban, and rural areas on perceived importance of continuing to drive and potential impact that driving cessation would have on what they want and need to do. METHODS The AAA LongROAD Study is a prospective study of driving behaviors, patterns, and outcomes of older adults. A cohort of 2,990 women and men 65-79 years of age was recruited during 2015-2017 from health systems or primary care practices near 5 study sites in different parts of the United States. Participants were classified as living in urban, surburban, or rural areas and were asked to rate the importance of driving and potential impact of driving cessation. Logistic regression models adjusted for sociodemographic and driving-related characteristics. FINDINGS The percentages of older drivers rating driving as "completely important" were 76.9%, 79.0%, and 83.8% for urban, suburban, and rural drivers, respectively (P = .009). The rural drivers were also most likely to indicate driving cessation would have a high impact on what they want or need to do (P < .001). After adjustment for sociodemographic and driving-related characteristics, there was a 2-fold difference for rural versus urban older drivers in odds that driving cessation would have a high impact on what they need to do (OR = 2.03; 95% CI: 1.60-2.58). CONCLUSIONS Older drivers from rural areas were more likely to rate driving as highly important and the prospect of driving cessation as very impactful. Strategies to enhance both the ability to drive safely and the accessibility of alternative sources of transportation may be especially important for older rural adults.

Healthcare system distrust and the breast cancer continuum of care.

Abstract: To identify and synthesize the literature on healthcare system distrust across the breast cancer continuum of care. We searched CINAHL, Cochrane, EMBASE, PubMed, PsycINFO, and Web of Science from January 1, 1990 to December 31, 2018 for all peer-reviewed publications addressing the role of healthcare system trust, distrust or mistrust in the breast cancer continuum of care. We identified a total of 20 studies, seven qualitative studies and thirteen quantitative studies. Two studies assessed genetic testing, eleven assessed screening and seven assessed treatment and follow-up. Twelve studies evaluated mistrust, five evaluated distrust, and three evaluated trust. Study populations included African American, American Indian, Latina, Hispanic, and Asian American participants. Healthcare system distrust is prevalent across many different racial and ethnic groups and operates across the entire breast cancer continuum of care. It is an important yet understudied barrier to cancer. We hope that the knowledge garnered by this study will enable researchers to form effective and targeted interventions to reduce healthcare system distrust mediated disparities in breast cancer outcomes.

National survey of home injuries during the time of COVID-19: who is at risk?

Abstract: Prior to the COVID-19 pandemic, 44% of all reported injuries in U.S. households occurred in the home. Spending more time at home due to the pandemic may increase the number of home injuries. A nationally representative sample of 2011 U.S. adults were surveyed online between June 17 – June 29, 2020. Propensity score weighting and T-tests were used. Twenty-eight percent (28%) of households reported a home injury or ingestion during the pandemic; 13% reported experiencing both. Injuries were most often due to falls (32%). Medication ingestions were reported by 6%; household product ingestions were reported by 4%. Relative to households that experienced no injuries or ingestions, those that reported either or both were more likely to: be in urban areas, have household incomes > $100,000, and have children living in them. Among households reporting more time spent at home, those with children were significantly more likely than those without to report an injury or ingestion. Results help target prevention messages while U.S. families are continuing to work and learn remotely. During this pandemic and future stay-at-home orders, there is a need for public health efforts to prevent home injuries and ingestions.

We must do better science: addressing racism to improve health and safety for all people.

Abstract: The brutal killings of George Floyd, Ahmaud Arbery, Breonna Taylor and others sparked widespread protests for racial and economic justice in the USA and around the globe. A fundamental principle espoused by the Black Lives Matter movement and other groups involved in direct action is that our most enduring social problems are rooted in structural factors and must therefore be addressed with structural solutions. (In this context, ‘structural’ refers to elements of social systems that provide a foundation for how societies operate, such as policies, norms, religion and other belief systems and economies.) This principle is as relevant to injury and violence as it is to other health and social problems; disparities in injury outcomes are closely connected to social inequities.1 At this critical point in history, we are called to confront the influence of structural factors on injury and violence directly. Giles and colleagues2 recently recommended that we incorporate equity as the fourth ‘e’ in injury prevention. Building on their recommendation, we argue that it is critical to highlight structural racism as a determinant of injury and violence. Structural racism is at hand …

Perceived Social Support Differences between Male and Female Older Adults who have Reduced Driving: AAA LongROAD Study

Abstract: Many older adults have reduced their driving behaviors (e.g., restrict driving to daytime, short trips, or familiar locations) because of health issues, such as chronic illness, medication-related side effects, poor vision, and declines in physical and cognitive abilities. Reducing driving is often the first step in the process of stopping driving (i.e., driving cessation), and it can lead to declines in life satisfaction. Older adults who stop driving experience higher levels of depression, are less likely to participate in social activities, and are less able to manage their chronic health problems. Interventions that improve social support through strengthening networks and building support have been found to increase older adults’ overall life satisfaction. The research in this brief examines perceived social support among older drivers who have recently reduced their driving. Findings suggest that older men and women, who have reduced driving, report similar levels of instrumental and emotional support, however, men report lower levels of informational support than women do.