Evaluation of Confidence Using Motivational Interviewing Skills Before and After In-Person Training Workshop

Motivational interviewing (MI) is a skill used to help individuals make positive behavior changes and may be beneficial for those who work with undergraduate students. A new training, comprised of online content followed by an in-person workshop, was created and offered to staff members working directly with students at Iowa State University. The aim of this study was to evaluate confidence for using MI-related components pre and post an in-person workshop. To do so, participants completed a survey regarding their confidence in using MI-related skills before and after the workshop. From the survey results, a paired t-test was conducted to examine differences, and effect size was calculated to examine the magnitude of this difference. A significant difference was found pre to post with a small-to-moderate effect size, suggesting the in-person workshop was an important component for building self-efficacy to implement principles of MI in future conversations with students

Peer Health Coach Training Practicum: Evidence from a Flipped Classroom

Health coaching is a popular and effective method to assist individuals in gaining motivation to engage in healthy lifestyle behavior changes. The utility has led to an increased demand for trained individuals within the health care field. A new flipped classroom practicum course was developed to offer undergraduate students the opportunity to learn a foundational skill called motivational interviewing (MI) commonly used in health coaching. The 16-week, 2-credit course (led by three trained, graduate student health coaches) consists of online video lectures, in-class activities, experiential training, and supervised practicum experiences in health coaching. The aim of this study is to evaluate the process, impact, and outcomes of this new health coaching practicum. Measures consisted of surveys to assess participant satisfaction and course impact using 6-point Likert scales and were analyzed descriptively (mean ± SD), along with obtaining recorded MI conversations to evaluate fidelity of the training. These preliminary results support the utility of a flipped classroom practicum course designed to teach undergraduate students the skills of MI; however, extended practice with the use of MI may be needed for students to meet all proficiency levels

Associations between employment changes and mental health: US data from during the COVID-19 pandemic

Objectives: To examine associations of changing employment conditions, specifically switching to working from home (WFH) or job loss, with mental health, using data collected during the COVID-19 pandemic. Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental health (PMH) assessed using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followe

High sitting time is a behavioral risk factor for blunted improvement in depression across 8 weeks of the COVID-19 pandemic in April–May 2020

The COVID-19 pandemic has elicited increased sedentary behaviors, decreased moderate-to-vigorous physical activity (MVPA), and worsened mental health, yet the longitudinal impact of these changes and their inter-relations remains unknown. Our purpose was to examine associations between changes in self-reported activity behaviors and mental health over an 8-week period following the COVID-19 outbreak. Participants from all 50 states and the District of Colombia were recruited through convenience and snowball sampling at baseline April 3–10, 2020. Prospective data from 2,327 US adults with ≥2 responses (63.8% female; 74.3% response rate) were collected weekly via online survey for eight consecutive weeks (April 3–June 3, 2020). Primary exposures were self-reported time spent sitting, viewing screens and in MVPA, with primary outcomes being depressive symptoms, anxiety symptoms, and positive mental health (PMH). A significant sitting-by-time interaction (p < 0.05) showed slightly higher marginal effects for depressive symptoms for the 90th-percentile of sitting time than the 10th-percentile at baseline (5.8 [95% confidence interval = 5.5–6.2] vs. 5.7 [5.4–6.1]), with the difference magnifying over time (week 8: 3.5 [3.2–3.9] vs. 2.7 [2.4–2.9]). No other interactions over time were significant. Screen time was negatively associated with PMH and positively associated with depressive and anxiety symptoms (p < 0.05). Sitting time was negatively associated with PMH (p < 0.05). Rapid changes in sitting patterns (e.g., due to a pandemic) may have lasting effects on depressive symptoms. Strategies targeting those most affected (i.e., young adults, females) and/or focused on reducing sitting time may be critical for preventing long-term mental health effects resulting from COVID-19 or other large-scale behavior changes in the general population

Associations between change in outside time pre- and post-COVID-19 public health restrictions and mental health: brief research report

The novel coronavirus disease 2019 (COVID-19) and associated pandemic has resulted in systemic changes to much of life, affecting both physical and mental health. Time spent outside is associated with positive mental health; however, opportunities to be outside were likely affected by the COVID-19 public health restrictions that encouraged people not to leave their homes unless it was required. This study investigated the impact of acute COVID-19 public health restrictions on outside time in April 2020, and quantified the association between outside time and both stress and positive mental health, using secondary analyses of cross-sectional data from the COVID and Well-being Study. Participants (n = 3,291) reported demographics, health behaviors, amount of time they spent outside pre/post COVID-19 public health restrictions (categorized as increased, maintained, or decreased), current stress (Perceived Stress Scale-4), and positive mental health (Short Warwick-Edinburgh Mental Well-being Scale). Outside time was lower following COVID-19 restrictions (p < 0.001; Cohen’s d = −0.19). Participants who increased or maintained outside time following COVID-19 restrictions reported lower stress (p < 0.001, 5.93 [5.74–6.12], Hedges’ g = −0.18; p < 0.001, mean = 5.85 [5.67–6.02], Hedges’ g = −0.21; respectively) and higher positive mental health (p < 0.001, 24.49 [24.20–24.77], Hedges’ g = 0.21; p < 0.001, 24.78 [24.52–25.03], Hedges’ g = 0.28) compared to those who decreased outside time. These findings indicate that there are likely to be negative stress and mental health implications if strategies are not implemented to encourage and maintain safe time outside during large-scale workplace and societal changes (e.g., during a pandemic)

Bidirectional associations between depressive and anxiety symptoms and loneliness during the COVID-19 pandemic: dynamic panel models with fixed effects

Background: Understanding the direction and magnitude of mental health-loneliness associations across time is important to understand how best to prevent and treat mental health and loneliness. This study used weekly data collected over 8 weeks throughout the COVID-19 pandemic to expand previous findings and using dynamic panel models with fixed effects which account for all time-invariant confounding and reverse causation. Methods: Prospective data on a convenience and snowball sample from all 50 US states and the District of Colombia (n = 2,361 with ≥2 responses, 63.8% female; 76% retention rate) were collected weekly via online survey at nine consecutive timepoints (April 3–June 3, 2020). Anxiety and depressive symptoms and loneliness were assessed at each timepoint and participants reported the COVID-19 containment strategies they were following. Dynamic panel models with fixed effects examined bidirectional associations between anxiety and depressive symptoms and loneliness, and associations of COVID-19 containment strategies with these outcomes. Results: Depressive symptoms were associated with small increases in both anxiety symptoms (β = 0.065, 95% CI = 0.022–0.109; p = 0.004) and loneliness (β = 0.019, 0.008–0.030; p = 0.001) at the subsequent timepoint. Anxiety symptoms were associated with a small subsequent increase in loneliness (β = 0.014, 0.003–0.025; p = 0.015) but not depressive symptoms (β = 0.025, −0.020–0.070; p = 0.281). Loneliness was strongly associated with subsequent increases in both depressive (β = 0.309, 0.159–0.459; p < 0.001) and anxiety (β = 0.301, 0.165–0.436; p < 0.001) symptoms. Compared to social distancing, adhering to stay-at-home orders or quarantining were not associated with anxiety and depressive symptoms or loneliness (both p ≥ 0.095). Conclusions: High loneliness may be a key risk factor for the development of future anxiety or depressive symptoms, underscoring the need to combat or prevent loneliness both throughout and beyond the COVID-19 pandemic. COVID-19 containment strategies were not associated with mental health, indicating that other factors may explain previous reports of mental health deterioration throughout the pandemic

Joint prevalence of physical activity and sitting time during COVID-19 among US adults in April 2020

The COVID-19 pandemic significantly altered much of US life with shifts to working-from-home and social distancing changing day-to-day behavior. We aimed to determine the self-reported prevalence of meeting US physical activity guidelines, stratified by sitting time during the early lockdown phase of COVID-19 in US adults. We conducted two cross-sectional internet-based studies April 3rd-May 4th, 2020 in convenience samples of US adults. Participants self-reported daily sitting time and weekly moderate-to-vigorous physical activity (MVPA) via questions from the International Physical Activity Questionnaire. A total of 5036 US adults (65.3% women, 30.2% with chronic conditions) provided complete physical activity and sitting time data (80.3% of total). Overall, 42.6% of participants reported sitting for > 8 h/day (95% CI: 41.2%–44.0%) and 72.5% (71.2%–73.7%) reported being either sufficiently (150–300 MVPA minutes) or highly active (>300 min). The greatest proportion of people self-reported being highly active and sitting for > 8 h/day (24.0%; 22.8%-25.2%), followed by being highly active and sitting for 6–8 h/day (20.9%; 19.8%–22.1%). Sitting and activity appeared similar between sexes, while there was evidence of some age differences. For example, more young adults (ages 18–34) appeared to self-report being inactive and more appeared to sit for > 8 h/day compared to older adults. High sitting time was reported by US adults (>40% sitting > 8 h/day) during April 2020. However, high levels of physical activity (>70% meeting guidelines) were also reported. Since physical activity cannot eliminate the negative health effects of sitting, maintaining activity and limiting sitting during periods of large workplace and societal shifts is encouraged