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A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis.

ABSTRACT: Background: Sex and gender are important modifiers of mental health and behavior in normal times and during crises. We investigated whether they were addressed by empirical, international research that explored the mental health and health behavior ramifications after the onset of the COVID-19 pandemic. Methods: We systematically searched the databases PsyArXiv, PubMed, PsycInfo, Psyndex, PubPsych, Cochrane Library, and Web of Science for studies assessing mental health outcomes (main outcomes) as well as potential risk and protective health behavior (additional outcomes) up to July 2, 2020. Findings: Most of the 80 publications fulfilling the selection criteria reflected the static difference perspective treating sex and gender as dichotomous variables. The focus was on internalizing disorders (especially anxiety and depression) burdening women in particular, while externalizing disorders were neglected. Sex- and gender-specific evaluation of mental healthcare use has also been lacking. With respect to unfavorable health behavior in terms of adherence to prescribed protective measures, men constitute a risk group. Interpretations: Women remain a vulnerable group burdened by multiple stresses and mental health symptoms. The neglect of sex- and gender-specific evaluation of aggression-related disorders, substance addiction, and mental healthcare use in the early stage represents a potentially dangerous oversight. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192026, PROSPERO 2020 CRD42020192026.

SUBMITTER: Tibubos AN

PROVIDER: S-EPMC8484908 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundIn 2015-2017, the Americas experienced a highly consequential epidemics for pregnancy and childbearing. Mainly transmitted by the mosquito Aedes aegypti, but also through sexual intercourse, the Zika virus poses the risk of congenital Zika syndrome to fetus, which includes microcephaly and other child development complications. When a public health crisis taps directly into reproductive health, typically a feminine realm, responses to the emergency may exacerbate deeply-rooted gender norms. This paper investigates the role of gender in two relational contexts: (a) the government-led response to the pandemic in terms of communication campaigns aimed at preventing Zika infections; and (b) an individual level of response to the emergency, concerning women's negotiation with their sexual partners with regard to the prevention of Zika as well as pregnancies.MethodsWe conducted content analysis of 94 unique pieces from public health communication campaigns produced by governmental agencies with the goal of promoting Zika awareness. Print and online materials were collected from May 2016 to August 2017, and included TV ads, Internet Pop-ups, and pamphlets. We also analyzed transcripts from 16 focus groups conducted with reproductive-aged women (18-40) in Belo Horizonte and Recife, two large cities differently affected by the Zika outbreak. Women answered open-ended questions connected to the epidemic, in areas such as personal knowledge and experiences with the Zika virus, experiences of their friends and acquaintances, their primary information sources, their perceptions of public health efforts toward containing the outbreak, as well as women's contraceptive use.ResultsCampaign pieces handling pregnancy and microcephaly were largely gendered. Pieces targeted women, placing on their shoulders the responsibility for protecting a potential fetus from the disease. Importantly, campaigns neglected addressing male's participation on Zika prevention and contraceptive management, while failing to take into account Brazil's large proportion of unplanned pregnancies. Women were placed in a double bind by being expected to prevent both pregnancy and Zika, in a context where gendered power imbalances often translate in women having little power/means for condom negotiation/avoiding unprotected sexual intercourse.ConclusionGovernment and individual responses to the epidemics reinforced gender roles, situating pregnant women as responsible for averting mosquito bites and microcephaly. Further, prevention campaigns largely excluded men. Since low-socioeconomic status women possessed fewer resources to preclude infection, we also found that beyond the gender divide, this subgroup faced more pronounced Zika prevention challenges as they found it harder to negotiate condom use with their sexual partners and often could not access other types of contraceptives resulting in unplanned pregnancies.

Project description:INTRODUCTION:Health reporting is one of the foundations on which public health interventions and policies as well as prevention measures are developed. However, it faces the challenge of adequately reflecting social and sex/gender-related heterogeneity. The German Federal Ministry of Education and Research-funded joint project, AdvanceGender, aims to develop guidelines for sex/gender-sensitive and intersectional approach to population-based studies and health reporting. In its subproject, AdvanceHealthReport, four focus groups will be conducted to provide essential information on possible ways of participation of civil society stakeholders and on communication of health information for the further development of the guidelines (research period: from January 2019 to March 2020). METHODS AND ANALYSIS:The civil society stakeholders provide valuable information which health topics are relevant in regard to specific populations and how health information should be communicated in a non-stigmatising way. The groups will also discuss how civil society stakeholders should participate in health reporting. The starting point for intersections will be sex/gender. The intersection of sex/gender and migration and sex/gender and sexual orientation is particularly taken into account. The focus groups will be recorded, transcribed, anonymised and then analysed according to the qualitative content analysis. RESULTS:The results will show the pathways as well as benefits and possible limitations of civil society stakeholder involvement in national health reporting and will contribute in developing guidelines for sex/gender-sensitive and intersectional health reporting. ETHICS AND DISSEMINATION:The results of the focus groups will be published in scientific journals and presented at various national and international conferences. Furthermore, the findings will be incorporated into guidelines for research and health reporting. The study was approved by the Ethics Commission of Brandenburg Medical School Theodor Fontane (AZ: E-01-20180529).

Project description:Background: The lockdowns associated with the COVID-19 pandemic has been called a crisis in mental health, and adolescents may have been among the most affected. Comparing the first period of societal lockdown in spring 2020 to periods going back to 2014 using a rich cross-sectional dataset based on repeated surveys, we explore the potential changes in self-reported mental well-being across sociodemographic groups among Norway's adolescents. Methods: Norway closed schools and implemented strict restrictions in March 2020; an electronic questionnaire survey was distributed to lower secondary school students in Trøndelag county (N = 2,443) in May 2020. Results were compared with similar surveys conducted annually in the same county dating back to 2014. Logistic regression models were applied to investigate potential changes in depressive symptoms, loneliness, and quality of life and life satisfaction, and to detect possible differences in the impact of lockdown between the genders and socioeconomic groups. Results: The prevalence of boys and girls reporting high quality of life (43-34%; 23-16%) and life satisfaction (91-80%; 82-69%) decreased significantly compared to the pre-pandemic. For girls only, lockdown was associated with higher odds for reporting high depressive symptoms. As expected, the least privileged socioeconomic groups showed the greatest psychological distress. However, our trend analyses provided no evidence that the socioeconomic inequalities in psychological distress (according to prevalence of high depressive symptoms or loneliness) changed substantial in any direction during the first wave of the pandemic [between the pre-pandemic and inter-pandemic periods]. Conclusion: Adolescents are vulnerable, and interventions should provide them with mental health support during crises such as societal lockdown. In particular, the social and health policy, public health, and further research should target these least privileged groups.

Project description:Importance:Previous studies demonstrate sex bias in surgical research. Female participants and investigators are underrepresented in surgical scientific research. Objectives:To describe the distribution of male and female authors in 5 general-interest surgery journals, assess the association of author gender with sex bias, and explore whether investigators benefit from performing sex-inclusion research. Design, Setting, and Participants:For this bibliometric analysis, data were abstracted from 1921 original, peer-reviewed articles published from January 1, 2011, through December 31, 2012, in Annals of Surgery, American Journal of Surgery, JAMA Surgery, The Journal of Surgical Research, and Surgery. Excluded articles pertained to a sex-specific disease or did not report the number of study participants. An additional 119 articles contained gender-ambiguous author names and were omitted. Data were analyzed from April to June 2017. Main Outcomes and Measures:Male and female first and senior authors, number of female and male participants in each study, surgical specialty, and number of citations received per article. Results:Of the 3604 authors of 1802 articles included in this study, 2791 first and senior authors (77.4%) were male and 813 (22.6%) were female. The prevalence of male and female authors was consistent across all 5 journals and among clinical and basic science research. Articles by female authors included a higher median number of female study participants compared with their male counterparts (27.5 vs 16.0; P?=?.01), but sex matched the inclusion of participants less frequently (36% vs 45%; P?=?.001). No sex-based differences occurred between male and female authors in reporting, statistical analysis, and discussion of the data or in the number of citations received. Compared with studies that did not report, analyze, or discuss data by sex, studies that performed sex-specific data reporting yielded a mean of 2.8 more citations (95% CI, 1.2-4.4; P?=?.001); those that performed statistical analysis, a mean of 3.5 more citations (95% CI, 1.8-5.1; P?=?.001); and those that discussed the data, a mean of 2.6 more citations (95% CI, 0.7-4.5; P?=?.001). Articles with a higher percentage of sex matching of participants also received more citations, with an increase of 1 citation per 4.8% (95% CI, 2.0%-7.7%; P?=?.001) increase in percentage of sex matching. Conclusions and Relevance:Sex bias in surgical research is prevalent among male and female authors; however, female authors included proportionally more female participants in their studies compared with male authors. Notably, studies that addressed sex bias were rewarded by the scientific community with increased citations of their published work.

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A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis.

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