Skip to main content
Top
Published in: Journal of General Internal Medicine 8/2020

01-08-2020 | COVID-19 | Original Research

Americans’ COVID-19 Stress, Coping, and Adherence to CDC Guidelines

Authors: Crystal L. Park, Ph.D., Beth S. Russell, Ph.D., Michael Fendrich, Ph.D., Lucy Finkelstein-Fox, MS, Morica Hutchison, MFT, Jessica Becker, MSW

Published in: Journal of General Internal Medicine | Issue 8/2020

Login to get access

Abstract

Importance

Documenting Americans’ stress responses to an unprecedented pandemic and their degree of adherence to CDC guidelines is essential for mental health interventions and policy-making.

Objective

To provide the first snapshot of immediate impact of COVID-19 on Americans’ stress, coping, and guideline adherence.

Design

Data were collected from an online workers’ platform for survey research (Amazon’s Mechanical Turk) from April 7 to 9, 2020. The current data represents the baseline of a longitudinal study. Best practices for ensuring high-quality data were employed.

Participants

Individuals who are 18 years of age or older, living in the USA, and English-speaking were eligible for the study. Of 1086 unique responses, 1015 completed responses are included.

Setting

Population-based.

Main Outcomes

Exposure to and stressfulness of COVID-19 stressors, coping strategies, and adherence to CDC guidelines.

Results

The sample was 53.9% women (n = 547), with an average age of 38.9 years (SD = 13.50, range = 18–88), most of whom were White (n = 836, 82.4%), non-Hispanic (n = 929, 91.5%), and straight/heterosexual (n = 895, 88.2%); 40% were currently married (n = 407), and 21.6% (n = 219) were caregivers. About half (50.5%) endorsed having at least “mostly” enough money to meet their needs. Respondents’ locations across the USA ranged from 18.5% in the Northeast to 37.8% in the South. The most commonly experienced stressors were reading/hearing about the severity and contagiousness of COVID-19, uncertainty about length of quarantine and social distancing requirements, and changes to social and daily personal care routines. Financial concerns were rated most stressful. Younger age, female gender, and caregiver status increased risk for stressor exposure and greater degree of stressfulness. The most frequently reported strategies to manage stress were distraction, active coping, and seeking emotional social support. CDC guideline adherence was generally high, but several key social distancing and hygiene behaviors showed suboptimal adherence, particularly for men and younger adults.

Conclusions and Relevance

Americans have high COVID-19 stress exposure and some demographic subgroups appear particularly vulnerable to stress effects. Subgroups less likely to adhere to CDC guidelines may benefit from targeted information campaigns. these findings may guide mental health interventions and inform policy-making regarding implications of specific public health measures.
Literature
2.
go back to reference Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395:912–20.CrossRef Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395:912–20.CrossRef
3.
go back to reference Qiu J, Shen B, Zhao M, Wang Z, Xie B, & Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry 2020;33:e100213.CrossRef Qiu J, Shen B, Zhao M, Wang Z, Xie B, & Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry 2020;33:e100213.CrossRef
4.
go back to reference Zhang Y, Ma ZF. Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study. Int J of Env Rsch and Pub Hlth. 2020 Jan;17(7):2381.CrossRef Zhang Y, Ma ZF. Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study. Int J of Env Rsch and Pub Hlth. 2020 Jan;17(7):2381.CrossRef
5.
go back to reference Wang C. Pan R, Wan X. et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in china. In J o f Env Res Pub Health 2020;17:1729.CrossRef Wang C. Pan R, Wan X. et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in china. In J o f Env Res Pub Health 2020;17:1729.CrossRef
8.
go back to reference Baumeister RF, & Leary MR. The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psych Bull 1995;117:497–529.CrossRef Baumeister RF, & Leary MR. The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psych Bull 1995;117:497–529.CrossRef
9.
go back to reference Aldwin, CM (2007). Stress, coping, and development. New York, NY: Guilford. Aldwin, CM (2007). Stress, coping, and development. New York, NY: Guilford.
10.
go back to reference Finkelstein-Fox L, Park CL. Control-coping goodness-of-fit and chronic illness: a systematic review of the literature. Health Psych Rev. 2019 Apr 3;13(2):137–62.CrossRef Finkelstein-Fox L, Park CL. Control-coping goodness-of-fit and chronic illness: a systematic review of the literature. Health Psych Rev. 2019 Apr 3;13(2):137–62.CrossRef
11.
go back to reference Stoycheff E. Please participate in Part 2: Maximizing response rates in longitudinal MTurk designs. Meth Innov 2016;9:1–5.CrossRef Stoycheff E. Please participate in Part 2: Maximizing response rates in longitudinal MTurk designs. Meth Innov 2016;9:1–5.CrossRef
12.
go back to reference Bartneck C, Deunset A, Moltchanova E, & Zawieska K. Comparing the similarity of responses received from studies in Amazon’s Mechanical Turk to studies conducted online and with direct recruitment. PLoS ONE 2015;10:1–23.CrossRef Bartneck C, Deunset A, Moltchanova E, & Zawieska K. Comparing the similarity of responses received from studies in Amazon’s Mechanical Turk to studies conducted online and with direct recruitment. PLoS ONE 2015;10:1–23.CrossRef
13.
go back to reference Huff C, & Tingley D. “Who are these people?” Evaluating the demographic characteristics and political preferences of MTurk survey respondents. Res & Politics 2015;2:1–12. Huff C, & Tingley D. “Who are these people?” Evaluating the demographic characteristics and political preferences of MTurk survey respondents. Res & Politics 2015;2:1–12.
14.
go back to reference Sheehan KB, & Pittman M. Amazon’s mechanical Turk for academics: The HIT handbook for social science research. Irvine, CA: Melvin & Leigh, 2016. Sheehan KB, & Pittman M. Amazon’s mechanical Turk for academics: The HIT handbook for social science research. Irvine, CA: Melvin & Leigh, 2016.
15.
go back to reference Berinsky AJ, Huber GA, & Lenz GS. Evaluating online labor markets for experimental research: Amazon.com’s Mechanical Turk. Pol Analysis 2012;20:351–68.CrossRef Berinsky AJ, Huber GA, & Lenz GS. Evaluating online labor markets for experimental research: Amazon.com’s Mechanical Turk. Pol Analysis 2012;20:351–68.CrossRef
16.
go back to reference Kees J, Berry C, Burton S, & Sheehan K. An analysis of data quality: Professional panels, student subject pools, and Amazon’s mechanical Turk. J of Advertising 2017;46:141–55.CrossRef Kees J, Berry C, Burton S, & Sheehan K. An analysis of data quality: Professional panels, student subject pools, and Amazon’s mechanical Turk. J of Advertising 2017;46:141–55.CrossRef
17.
go back to reference Mortensen K, Hughes TL. Comparing Amazon’s Mechanical Turk platform to conventional data collection methods in the health and medical research literature. J of Gen Int Med. 2018 Apr 1;33(4):533–8.CrossRef Mortensen K, Hughes TL. Comparing Amazon’s Mechanical Turk platform to conventional data collection methods in the health and medical research literature. J of Gen Int Med. 2018 Apr 1;33(4):533–8.CrossRef
19.
go back to reference Main A, Zhou Q, Ma Y, Luecken LJ, & Liu X. Relations of SARS-related stressors and coping to Chinese college students’ psychological adjustment during the 2003 Beijing SARS epidemic. J of Couns Psych 2011;58:410–23.CrossRef Main A, Zhou Q, Ma Y, Luecken LJ, & Liu X. Relations of SARS-related stressors and coping to Chinese college students’ psychological adjustment during the 2003 Beijing SARS epidemic. J of Couns Psych 2011;58:410–23.CrossRef
20.
go back to reference Carver CS. You want to measure coping but your protocol’s too long: Consider the Brief COPE. Int J of Beh Med 1997;4:92–100.CrossRef Carver CS. You want to measure coping but your protocol’s too long: Consider the Brief COPE. Int J of Beh Med 1997;4:92–100.CrossRef
21.
go back to reference DeSimone JA, Harms PD, & DeSimone AJ. Best practice recommendations for data screening. J of Org Beh 2015;36:171–81.CrossRef DeSimone JA, Harms PD, & DeSimone AJ. Best practice recommendations for data screening. J of Org Beh 2015;36:171–81.CrossRef
22.
go back to reference Sheehan KB. Crowdsourcing research: Data collection with Amazon’s Mechanical Turk. Comm Monographs 2018;85:140–56.CrossRef Sheehan KB. Crowdsourcing research: Data collection with Amazon’s Mechanical Turk. Comm Monographs 2018;85:140–56.CrossRef
23.
go back to reference Butler LD, Blasey CM, Garlan RW, et al. Posttraumatic growth following the terrorist attacks of September 11, 2001: Cognitive, coping, and trauma symptom predictors in an internet convenience sample. Traumatology. 2005 Dec;11(4):247–67.CrossRef Butler LD, Blasey CM, Garlan RW, et al. Posttraumatic growth following the terrorist attacks of September 11, 2001: Cognitive, coping, and trauma symptom predictors in an internet convenience sample. Traumatology. 2005 Dec;11(4):247–67.CrossRef
24.
go back to reference Janson J, Rohleder N. Distraction coping predicts better cortisol recovery after acute psychosocial stress. Biol Psych. 2017 Sep 1;128:117–24.CrossRef Janson J, Rohleder N. Distraction coping predicts better cortisol recovery after acute psychosocial stress. Biol Psych. 2017 Sep 1;128:117–24.CrossRef
25.
go back to reference Powell-Wiley TM, Miller PE, Agyemang P, Agurs-Collins T & Reedy J. Perceived and objective diet quality in US adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). Pub Health Nutr 2014;17:2641–49.CrossRef Powell-Wiley TM, Miller PE, Agyemang P, Agurs-Collins T & Reedy J. Perceived and objective diet quality in US adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). Pub Health Nutr 2014;17:2641–49.CrossRef
Metadata
Title
Americans’ COVID-19 Stress, Coping, and Adherence to CDC Guidelines
Authors
Crystal L. Park, Ph.D.
Beth S. Russell, Ph.D.
Michael Fendrich, Ph.D.
Lucy Finkelstein-Fox, MS
Morica Hutchison, MFT
Jessica Becker, MSW
Publication date
01-08-2020
Publisher
Springer International Publishing
Keyword
COVID-19
Published in
Journal of General Internal Medicine / Issue 8/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-05898-9

Other articles of this Issue 8/2020

Journal of General Internal Medicine 8/2020 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.