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Introduction: Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a costeffective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants. Methods: At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis. Results: Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections. Conclusion: Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH. [ABSTRACT FROM AUTHOR]

Since 2017, 518 journalists have been attacked while covering protests (U.S. Press Freedom Tracker, 2021) which is one of the most dangerous places to be as a journalist in the United States (Sterne & Peters, 2017). Despite the volatile climate around journalists as they cover increasingly dangerous protests (Luqiu, 2020), there is minimal understanding as to the effect of these events on them (Talabi, et al., 2021). Furthermore, there is a gap in the hostility literature examining harassment that journalists face in the field. Through a survey of U.S. journalists, this study finds that covering protests causes journalists mental and emotional health concerns, which influences how they view their journalistic roles. Furthermore, the effects of positive and negative encounters at protests affected journalists personally, depending on who the perpetrator was (protestor or law enforcement)—influencing everything from PTSD and anxiety to intentions to leave journalism. The paper ultimately underscores the need for news organizations to make sure journalists not only are safe, but also feel safe, when reporting in the field. [ABSTRACT FROM AUTHOR]

Introduction: This study explores the association between self-perceived personal and community changes due to COVID-19 and health among vulnerable primary care patients experiencing multiple chronic conditions. Methods: Between September 2017 and February 2021, we obtained data from 2,426 primary care patients managing multiple chronic conditions from across the United States. We assessed the relationship between self-perceived personal and community changes due to COVID-19 and change in health measured by the PROMIS-29 mental and physical health summary scores, GAD-7 (anxiety), andPHQ-9 (depression), and DASI (functional capacity) adjusting for relevant demographic, neighborhood characteristics, and county covariates. Results: After adjustment, self-perceived personal and community changes due to COVID-19 were associated with significantly worse mental health summary scores (ß = -0.55; 95% Confidence Interval (CI) = -0.72, -0.37), anxiety (ß = 0.28; 95% CI = 0.16, 0.39), depression (ß = 0.35; 95% CI = 0.22, 0.47), and physical health summary scores (ß = -0.44; 95% CI = 0.88, 0.00). There was no association with functional capacity (ß = - 0.05; 95% CI = -0.16, 0.05). Discussion: Among adults managing multiple chronic conditions, self-perceived personal and community changes due to COVID-19 were associated with health. This vulnerable population may be particularly susceptible to the negative effects of COVID-19. As we do not know the long-term health effects of COVID, this paper establishes a baseline of epidemiological data on COVID-19 burden and health among primary care patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate the association of COVID-19 confirmed cases and deaths with mental health, unemployment and financial markets-related search terms for the USA, the UK, India and worldwide using Google Trends. Design/methodology/approach: The authors use Spearman's rank correlation coefficients to assess the relationship between relative search volumes (RSVs) and mental health, unemployment and financial markets-related search terms, with the total confirmed COVID-19 cases as well as deaths in the USA, UK, India and worldwide. The sample period starts from the day 100 cases were reported for the first time, which is 7 March 2020, 13 March 2020, 23 March 2020 and 28 January 2020 for the US, the UK, India and worldwide, respectively, and ends on 25 June 2020. Findings: The results indicate a significant increase in anxiety, depression and stress leading to sleeping disorders or insomnia, further deteriorating mental health. The RSVs of employment are negatively significant, implying that people are hesitant to search for new jobs due to being susceptible to exposure, imposed lockdown and social distancing measures and changing employment patterns. The RSVs for financial terms exhibit the varying associations of COVID-19 cases and deaths with the stock market, loans, rent, etc. Research limitations/implications: This study has implications for the policymakers, health experts and the government. The state governments must provide proper medical facilities and holistic care to the affected population. It may be noted that the findings of this study only lead us to conclude about the relationship between COVID-19 cases and deaths and Google Trends searches, and do not as such indicate the effect on actual behaviour. Originality/value: To the best of the authors' knowledge, this is the first attempt to investigate the relationship between the number of COVID-19 cases and deaths in the USA, UK and India and at the global level and RSVs for mental health-related, job-related and financial keywords. [ABSTRACT FROM AUTHOR]

Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP's that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. [ABSTRACT FROM AUTHOR]

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs. [ABSTRACT FROM AUTHOR]

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations. [ABSTRACT FROM AUTHOR]

Persons living with dementia continue to desire and need air travel. This study gives voice to the current lived experiences of persons with dementia and their caregiving travel companions using U.S. airports. Forty-eight persons living with dementia and 176 travel companions shared information about themselves and their airport experiences through a web-survey. Results identified common challenges and ways in which U.S. airports could be improved to better serve persons living with dementia and their travel companions. Anxiety, understanding signs and announcements, and getting lost or separated were primary travel concerns. Participants detailed themes of frustration with security and locating family restrooms or quiet spaces. Many are unaware of the services available to assist travelers. Among other recommendations, participants suggested staff training on hidden disabilities to improve air travel experiences. Results inform ongoing efforts to develop dementia-friendly airports and support continuing independence and quality of life. This study surveyed the air travel experiences of persons living with dementia and their travel companions to understand how going through the airport can be made more comfortable for them. Primary concerns voiced by the participants were anxiety and frustration at security, trouble finding their way around the airport, and not enough quiet spaces or family bathrooms. Participants shared that better staff training, hidden disability badges, and more wheelchair or electric cart services could help travelers like them and other persons living with disabilities. Airport updates that reduce noise and add more family bathrooms can make airport travel better for persons living with dementia and their travel companions. This paper shows how persons living with dementia and their travel companions' could be more comfortable in public spaces like airports if we use their experiences and opinions to make improvements. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) screening tools for autism are gaining in prevalence, and have benefits such as video content and direct resources linkage. However, it is unclear whether such tools will ameliorate autism inequities or will help only those already advantaged in autism care. To investigate this issue, we conducted semi-structured qualitative interviews with 18 primary care and Early Intervention/Early Childhood Special Education providers in six US states. Providers were given hypothetical scenarios in which a family presents to care with results from one of 9 mHealth autism screening tools. Providers discussed their clinical approach and assessed the tool's fit with their patient/client population. Each transcript was audio-recorded, transcribed, and coded; a phenomenological approach was used to develop key themes. 4 themes and 18 subthemes emerged. These included Clinical and business factors (e.g. scope of practice concerns and clinical efficiency), Validity and trustworthiness (e.g. familiarity, data privacy/security), Family interaction quality (e.g. supporting family advocacy, provision of information, affecting family anxiety, and emotional support), and Accessibility (e.g. English proficiency/language issues, cultural inclusivity, and literacy/educational level). Providers suggested modifications to enhance equity, such as portraying diverse families, reducing the reading level of text, and making tools shorter to better fit clinical context. Families may find information about autism online, and health care and education providers may use online tools to screen for autism. However, we do not know if online autism screening tools are easily used by families and providers. We interviewed primary care and educational providers, asking them to review results from online tools that screen for autism. Providers had concerns about how usable and accessible these tools are for diverse families and suggested changes to make tools easier to use. [ABSTRACT FROM AUTHOR]

Background: Gender-diverse youth experience twice the risk for homelessness as their same-age cisgender peers and report experiencing discrimination in homeless shelters and supported housing. Method: Eighteen participants (9 gender-diverse residents and 9 staff members) were interviewed individually to understand their experience of and needs in these settings. Results: The major findings included: (a) Gender-diverse service recipients felt unsafe and vulnerable in these facilities. Sharing space in which to carry out occupations of vulnerability often triggered anxiety and PTSD. (b) Gender-diverse service recipients felt that staff members did not understand how cumulative trauma adversely affected participation in programmatic activities. (c) Staff members reported that their facilities did not provide formal training needed to understand and address the unique needs of gender-diverse residents. (d) Gender-diverse service recipients commonly sustained trauma throughout their lives that compromised their ability to attain desired daily life skills and adult occupational roles. Such ruptures in their knowledge base likely served to maintain their homelessness despite repeated shelter admissions and housing placements. Conclusion: Occupational therapists could provide essential intervention to a gender-diverse youth population, including assisting with the attainment of skills needed for apartment management, employment seeking, maintenance, and health management. [ABSTRACT FROM AUTHOR]

Background: Chronic pain affects over 100 million Americans, with a disproportionately high number being Veterans. Chronic pain is often difficult to treat and responds variably to medications, with many providing minimal relief or having adverse side effects that preclude use. Cannabidiol (CBD) has emerged as a potential treatment for chronic pain, yet research in this area remains limited, with few studies examining CBD's analgesic potential. Because Veterans have a high need for improved pain care, we designed a clinical trial to investigate CBD's effectiveness in managing chronic pain symptoms among Veterans. We aim to determine whether CBD oral solution compared to placebo study medication is associated with greater improvement in the Patient Global Impression of Change (PGIC). Methods: We designed a randomized, double-blind, placebo-controlled, pragmatic clinical trial with 468 participants. Participants will be randomly assigned in a 1:1 ratio to receive either placebo or a CBD oral solution over a 4-week period. The trial is remote via a smartphone app and by shipping study materials, including study medication, to participants. We will compare the difference in PGIC between the CBD and placebo group after four weeks and impacts on secondary outcomes (e.g., pain severity, pain interference, anxiety, suicide ideation, and sleep disturbance). Discussion: Once complete, this trial will be among the largest to date investigating the efficacy of CBD for chronic pain. Findings from this clinical trial will contribute to a greater knowledge of CBD's analgesic potential and guide further research. Given the relative availability of CBD, our findings will help elucidate the potential of an accessible option for helping to manage chronic pain among Veterans. Trial registration: This protocol is registered at clinicaltrials.gov under study number NCT06213233. [ABSTRACT FROM AUTHOR]

Wildland fire dispatchers play a key role in wildland fire management and response organization; however, to date, wildland fire studies have largely focused on the physical hazards and, to a lesser extent, mental health hazards of wildland firefighting operational personnel, and dispatcher studies have primarily focused on 911 and police dispatchers. Studies of other dispatchers have provided some limited insight into potential strains impacting this workforce, including work-related fatigue, burnout, and traumatic exposure. However, the specific job hazards that are faced by wildland fire dispatchers are poorly understood. In 2023, we conducted a cross-sectional survey of 510 wildland fire dispatchers with questions about their occupational health, general health, and well-being. We used validated screening instruments to measure the rates of anxiety, depression, PTSD, and suicidal thoughts and ideation. Here, we also present the results of mental health and trauma exposure questions that were asked as part of a larger survey. We found that demographic factors were significant indicators of anxiety, depression, and binge/restrictive eating. Our data indicate that rates of anxiety, depression, PTSD, and suicidal thoughts and ideation are significantly higher for both the wildland fire dispatching workforce and other emergency responder populations than those of the general United States population. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine. [ABSTRACT FROM AUTHOR]

Globally, climate change is leading to environmental crises, which activists have been fighting against for decades. Social scientists have rarely considered older adults as environmentalists and their feelings about climate change. Most studies focus on younger people's emotions or concerns about environmental crises. The purpose of this study is to explore the emotional responses and coping strategies related to environmental degradation of older adult environmental activists. We conducted a qualitative research study with 20 participants who were over the age of 60 years, engaged in environmentalism and living in Kansas, USA. We utilized thematic analysis to identify the following themes: a) Emotional Experiences of Environmental Destruction, b) Destruction of Specific Landscapes, and c) Coping Strategies including Environmental Justice Activism. Despite navigating the emotions of loss and grief in response to the destruction of specific places and certain political concerns, often without the language or concepts of environmental grief, these participants have and continue to direct their efforts toward protecting the environment. They have contributed for decades in the hopes of preserving the Earth for future generations and eagerly seek engagement with younger activists to both share grief, and, more importantly, do the work that needs to be done. [ABSTRACT FROM AUTHOR]

Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health. [ABSTRACT FROM AUTHOR]

Introduction: Missed visits have been estimated to cost the U.S. healthcare system $50 billion annually and have been linked to healthcare inefficiency, higher rates of emergency department visits, and worse outcomes. COVID-19 disrupted existing outpatient healthcare utilization patterns. In our study, we sought to examine the frequency of missed outpatient visits over the course of the COVID-19 pandemic and to examine patient-level characteristics associated with non-attendance. Methods: This study utilized data from a longitudinal cohort study (the Chicago COVID-19 Comorbidities (C3) study). C3 participants were enrollees in 1 of 4 active, "parent" studies; they were rapidly enrolled in C3 at the onset of the pandemic. Multiple waves of telephone-based interviews were conducted to collect experiences with the pandemic, as well as socio-demographic and health characteristics, health literacy, patient activation, and depressive and anxiety symptoms. For the current analysis, data from waves 3 to 8 (05/01/20-05/19/22) were analyzed. Participants included 845 English or Spanish-speaking adults with 1 or more chronic conditions. Results: The percentage of participants reporting missed visits due to COVID-19 across study waves ranged from 3.1 to 22.4%. Overall, there was a decline in missed visits over time. No participant sociodemographic or health characteristic was consistently associated with missed visits across the study waves. In bivariate and multivariate analysis, only patient-reported anxiety was significantly associated with missed visits across all study waves. Conclusion: Findings reveal that anxiety was consistently associated with missed visits during the COVID-19 pandemic, but not sociodemographic or health characteristics. Results can inform future public health initiatives to reduce absenteeism by considering patients' emotional state during times of uncertainty. [ABSTRACT FROM AUTHOR]

Introduction/Objective: Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older. Methods: Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated in our outpatient medicine office between July 1, 2020 and June 30, 2021 for acute problems, management of chronic medical problems, or well visits. We divided our patients into a group who suffered from chronic pain disorder, and another group who did not have chronic pain disorder. The association of variables were compared between those groups. Results: Of the 2431 patients, 493 (20.3%) had a chronic pain disorder. A higher frequency of females in the group with chronic pain disorder was found compared to the group without a chronic pain disorder (60.6% vs 55.2%; P =.033). The mean ages between the two groups were similar in the group with a chronic pain disorder compared to the group without (76.35 ± 7.5 year vs 76.81 ± 7.59 year; P =.228). There were significant associations of certain comorbidities in the group with a chronic pain disorder compared to the group without a chronic pain disorder, such as depression (21.9% vs 15.2%; P <.001), anxiety (27.0% vs 17.1%; P <.001), chronic obstructive pulmonary disease (8.7% vs 6.1%; P =.036), obstructive sleep apnea (16.8% vs 11.6%; P =.002), gastroesophageal reflux disease (40.8% vs 29.0%; P <.001), osteoarthritis (49.3% vs 26.1%; P <.001), other rheumatologic diseases (24.9% vs 19.4%; P =.006), and peripheral neuropathy (14.4% vs 5.3%; P <.001). Conclusion: Female sex, depression, anxiety, chronic obstructive pulmonary disease, obstructive sleep apnea, gastroesophageal reflux disease, osteoarthritis, other rheumatologic diseases, and peripheral neuropathy were significantly associated with chronic pain disorder in elderly patients, while BMI was not associated with chronic pain disorder. [ABSTRACT FROM AUTHOR]

COVID-19 increased the prevalence of clinically significant anxiety in the United States. To investigate contributing factors we analyzed anxiety, reported online via monthly Generalized Anxiety Disorders-7 (GAD-7) surveys between April 2020 and May 2022, in association with self-reported worry about the health effects of COVID-19, economic difficulty, personal COVID-19 experience, and subjective social status. 333,292 anxiety surveys from 50,172 participants (82% non-Hispanic white; 73% female; median age 55, IQR 42–66) showed high levels of anxiety, especially early in the pandemic. Anxiety scores showed strong independent associations with worry about the health effects of COVID-19 for oneself or family members (GAD-7 score +3.28 for highest vs. lowest category; 95% confidence interval: 3.24, 3.33; p<0.0001 for trend) and with difficulty paying for basic living expenses (+2.06; 1.97, 2.15, p<0.0001) in multivariable regression models after adjusting for demographic characteristics, COVID-19 case rates and death rates, and personal COVID-19 experience. High levels of COVID-19 health worry and economic stress were each more common among participants reporting lower subjective social status, and median anxiety scores for those experiencing both were in the range considered indicative of moderate to severe clinical anxiety disorders. In summary, health worry and economic difficulty both contributed to high rates of anxiety during the first two years of the COVID-19 pandemic in the US, especially in disadvantaged socioeconomic groups. Programs to address both health concerns and economic insecurity in vulnerable populations could help mitigate pandemic impacts on anxiety and mental health. [ABSTRACT FROM AUTHOR]

The negative impact of misinformation on public discourse and public safety is increasingly a focus of attention. From the COVID-19 pandemic to national elections, exposure to misinformation has been linked to conflicting perceptions of social, economic, and political issues, which has been found to lead to polarization, radicalization, and acts of violence at the individual and group level. While a large body of research has emerged examining the development and spread of misinformation, little has been done to examine the human processes of being exposed to, and influenced by, misinformation material online. This article uses reinforcement sensitivity theory to examine the effect of individual differences in the Behavioral Inhibition System (BIS) on the behavioral and cognitive intentions to engage in violence after exposure to misinformation online. Using an online panel sample (Mechanical Turk), and a behavioral study that involved exposure to, and interaction with, misinformation, this study found that trait BIS score impacted how much individuals engaged with misinformation, as well as their ensuing activism and radicalism toward the narratives that were depicted. This study identified that engagement with misinformation impacted intentions for activism and radicalism, as did trait BIS. However, these effects were present for both misinformation and correct information conditions. These findings highlight the importance of BIS-related processes and raise important questions about the degree to which we need to think about online influence as a general process versus specific processes that directly relate to the effect of misinformation. [ABSTRACT FROM AUTHOR]