Long-Term Impact of the COVID-19 Pandemic on Self-Management of Chronic Conditions: The C3 Study

COVID-19 大流行对慢性病自我管理的长期影响：C3 研究

• 批准号: 10342940
• 负责人: Stacy C Bailey
• 金额: $ 68.29万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10342940
• 关键词: Acute; Adherence; Adult; Affect; Age; Alcohols; Anxiety; Award; Biometry; COVID-19; COVID-19 impact; COVID-19 pandemic effects; COVID-19 stress; Caring; Cessation of life; Chicago; Chronic; Chronic Disease; Cohort Studies; Collection; Communities; Data; Data Collection; Diet; Disease; Disease Outbreaks; Disease Outcome; Elderly; Electronic Health Record; Ethnic Origin; Exhibits; Fright; Gender; Grief reaction; Health; Health Professional; Health Status; Health behavior; Health system; Healthcare; Individual; Infection; Infection prevention; Intervention; Interview; Life Style; Long COVID; Mediating; Medical; Mental Depression; Mental Health; Modernization; Monitor; New York City; Outcome; Parents; Participant; Patient Outcomes Assessments; Patients; Personal Satisfaction; Persons; Physical activity; Prevalence; Preventive Health Services; Public Health; Race; Reporting; Research Personnel; Risk Factors; Role; Self Efficacy; Self Management; Site; Sleep; Sleep disturbances; Social Distance; Social isolation; Social support; Socioeconomic Status; Stress; Surveys; Time; Virus; Voice; Weight Gain; authority; cohort; comorbidity; coronavirus disease; experience; follow up assessment; functional status; health care service; health data; health disparity; health literacy; health management; long term consequences of COVID-19; middle age; novel; pandemic disease; physical conditioning; physical inactivity; psychosocial; response; sex; sex disparity; socioeconomics; substance use; telehealth; treatment adherence

ABSTRACT We will extend an active NIA cohort study of diverse, middle age and older adults with ≥1 chronic conditions to assess COVID-19’s long-term and disparate impact on health and healthcare experiences. COVID-19 has become an unprecedented public health threat in modern times, especially for older adults with a chronic illness. As of January 2021, 94% of COVID deaths have been among adults over 55; 92% of those who have died had ≥1 underlying health conditions. Beyond consequences to personal health associated with acquiring COVID-19, the impact of the pandemic may likely extend to non-COVID-19 outcomes as a patient’s ability to self-manage chronic conditions during and after a pandemic may be compromised for several reasons. In March 2020, our team rapidly launched the COVID-19 & Chronic Conditions (C3) study as cases of COVID-19 emerged in the U.S. to assess how adults with ≥1 chronic conditions were responding to the pandemic. Five active studies with uniform data collection on a range of patient-reported outcomes prior to COVID-19 and with electronic health records access were leveraged to establish the C3 cohort; 673 adults in Chicago were interviewed during the 1st week of the outbreak. The cohort was immediately expanded using two of the ‘parent studies’ that also had sites in New York City (n=200; N=873). C3 participants are diverse by socioeconomic status, race, ethnicity, gender, health literacy, and comorbidity. An NIA COVID-19 supplement was awarded in August 2020 to expand the cohort via the parent studies (N=1200) and continue data collection up to 2022; 5 of 7 planned survey waves have been completed (83-94% retention). C3 findings reveal many adults exhibit sustained, high stress due to COVID-19 that impacts lifestyle, treatment adherence, and healthcare use. Disparities by sex, race, ethnicity, and SES also are present. Health professionals and researchers are now voicing concern for possible long-term consequences of COVID-19 on personal health & healthcare. In response, we propose to continue to follow the C3 cohort to capture data 5 years post onset of the U.S. outbreak. All participants will have a ‘Pre-COVID’ baseline and 7+ follow-up assessments to assess trajectories in health care use, patient-reported & chronic disease outcomes. Our primary aims are to: 1) evaluate changes in lifestyle, health behaviors, healthcare use, health status, and chronic disease outcomes from a pre-pandemic baseline through 5 years after onset of COVID-19; 2) determine the extent to which stress, anxiety, and depression contribute to poor health status and chronic disease outcomes through 5 years after the pandemic’s onset. Our secondary aim is to: 3) identify factors that mediate or moderate associations between stress, anxiety, and depression during/after the pandemic with health status and chronic disease outcomes, while our exploratory aim is to: 4) explore whether health disparities by age, sex, race, ethnicity, or socioeconomic status emerge or worsen during/after the pandemic and the contributing role of stress, anxiety, and depression.

摘要 我们将扩展一项在≥1例慢性乙型肝炎患者中进行的不同年龄、中年和老年人的活跃NIA队列研究。 评估COVID-19对健康和医疗保健体验的长期和不同影响。 COVID-19已成为现代前所未有的公共卫生威胁，特别是对老年人 患有慢性病截至2021年1月，94%的COVID死亡病例发生在55岁以上的成年人中;其中92%的人 死亡者有≥1种基础健康状况。除了对个人健康的影响， 感染COVID-19，大流行的影响可能会延伸到非COVID-19的结果，因为患者的 在大流行期间和之后自我管理慢性病的能力可能由于几个原因而受到损害。 2020年3月，我们的团队迅速启动了COVID-19和慢性病（C3）研究， COVID-19在美国出现，以评估患有≥1种慢性疾病的成年人对 流行病5项积极研究，在研究开始前收集了一系列患者报告结局的统一数据。 利用COVID-19和电子健康记录访问来建立C3队列; 芝加哥在疫情爆发的第一周接受了采访。该队列立即扩大使用两个 在纽约市也有研究中心的“母研究”（n=200; N=873）。C3参与者的多样性， 社会经济地位、种族、民族、性别、健康素养和科摩罗。NIA COVID-19补充 于2020年8月被授予通过母研究（N=1200）扩展队列并继续收集数据 到2022年;计划的7次调查中有5次已经完成（保留率为83-94%）。C3研究结果显示， 成年人因COVID-19而表现出持续的高压力，影响生活方式，治疗依从性和医疗保健 使用.性别、种族、民族和社会经济地位也存在差异。卫生专业人员和研究人员现在 对COVID-19可能对个人健康和医疗保健造成的长期影响表示担忧。 作为回应，我们建议继续随访C3队列，以获取美国发病后5年的数据。 爆发所有参与者将有一个“前COVID”基线和7+后续评估，以评估轨迹 在卫生保健使用、患者报告和慢性疾病结果方面。我们的主要目标是：1）评估变化 在生活方式、健康行为、医疗保健使用、健康状况和流行前的慢性疾病结局方面， 基线至COVID-19发病后5年; 2）确定压力、焦虑和 抑郁症在大流行后5年内导致健康状况不佳和慢性病结果 发病我们的第二个目标是：3）确定调解或缓和压力之间联系的因素， 大流行期间/之后的焦虑和抑郁与健康状况和慢性疾病结果的关系，而我们的 探索性的目的是：4）探索年龄，性别，种族，民族或社会经济地位是否存在健康差异 在大流行期间/之后出现或恶化，以及压力、焦虑和抑郁的作用。