Cited by 728COVID-19 and Mental HealthCOVID-19 Prevention and ImpactCommunication and COVID-19 Impact

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

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Park, Crystal L., Russell, Beth S., Fendrich, Michael, Finkelstein-Fox, Lucy, Hutchison, Morica, Becker, Jessica·2020·Journal of General Internal Medicine

DOI 10.1007/s11606-020-05898-9PMC PMC7259430

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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.

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Wong, L. Y., Francis, S., Genschel, U., Arthur, A. E., Xu, F.-R., Weidauer, L., Monroe-Lord, L., Ventura-Marra, M., Sahyoun, N., & Kendall, C. (2022) · Journal of public health · doi:10.1007/s10389-022-01742-y · Cited by 3
“This can be attributed to fear of the COVID-19 outbreak, vulnerability to being infected, social distancing requirements, exposure, or close contact with someone who has been infected, and changes to social and personal daily care routines (Park et al. 2020).”
Background
A daily examination of perceived stress and coping strategies used among college students during COVID-19
Charvis, J. S., Schulz, C. T., Drohan, M. M., Rafiee, P., Stamates, A. L., & Yang, M. (2023) · Journal of American College Health · doi:10.1080/07448481.2023.2168126 · Cited by 3
“8,12,17 Further, previous studies have implemented cross-sectional designs which have limited insight into change over time.”
Effects of COVID-19 shelter-in-place confinement on diabetes prevention health behaviors among US adults with prediabetes: A cross-sectional survey
Thomas, T., Lindsey, R., Yassin, M., Rodríguez, L. A., Heisler, M., & Schmittdiel, J. A. (2023) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2023.102139 · Cited by 3
COVID-19 Pandemi Sürecinde Annelerin Çocuklarıyla İlişkisi ve Ev Kazalarına Yönelik Tedbir Düzeyleri
ÜSTÜNDAĞ, A. (2023) · İstanbul Gelişim Üniversitesi Sosyal Bilimler Dergisi · doi:10.17336/igusbd.935132 · Cited by 3
Demographic, structural, and psychological predictors of risk-increasing and mask wearing behaviors among US adults between December 2020–March 2021
Thorpe, A., Zhong, L., Scherer, L. D., Drews, F. A., Shoemaker, H. E., & Fagerlin, A. (2023) · Patient Education and Counseling · doi:10.1016/j.pec.2023.107792 · Cited by 3
The effect of pandemic-related stress on the decision-making process for individual outdoor leisure activities
Kim, J. S., Lee, T. J., & Kim, M. J. (2023) · Journal of Leisure Research · doi:10.1080/00222216.2023.2193195 · Cited by 3
“The protracted nature of COVID-19 has raised secondary mental health issues such as stress and depression (Amsalem et al., 2021; Park et al., 2020; Zureigat & Fattah, 2021).”
Background
Health, wellbeing, and social interaction: An international and demographic analysis of perceived life changes and the positives and negatives of the Covid-19 lockdown
Murray, J., Dhami, M. K., McClatchey, K., Weiss‐Cohen, L., & Ayton, P. (2023) · Europe’s Journal of Psychology · doi:10.5964/ejop.7751 · Cited by 3
“, 2020), again with poorer outcomes seen in younger people, which echoes the wider research highlighting that young people experienced higher stress, anxiety and/or negative affect than older people during lockdown (Aymerich-Franch, 2020; Park et al., 2020; Vijayaraghavan & Singhal, 2020).”
Influential
“You would think she would hug me”: Micropractices of Care Between First-Generation College Students and Their Parents During Covid-19
Flores, A., & Mason, K. A. (2023) · Culture Medicine and Psychiatry · doi:10.1007/s11013-023-09833-5 · Cited by 4
Individual Stress, Contextual Stress, and Network Attributes on Cyberbullying Perpetration Among Young Adults During the COVID-19 Lockdown
Ma, Z., Liu, T., & Xia, Y. (2023) · Deviant Behavior · doi:10.1080/01639625.2023.2271117 · Cited by 4
“…to grasp the intrinsic features of psychological responses toward the infection (Achterberg et al. 2021; Hong et al. 2020; Liu et al. 2021); it further served as a psychological trigger for potential long-term coping behaviors (Orgilés et al. 2021; Park et al. 2020; Shechter et al. 2020).”
Background
The public health impact of COVID-19 variants of concern on the effectiveness of contact tracing in Vermont, United States
Castonguay, F. M., Borah, B. F., Jeon, S., Rainisch, G., Kelso, P. T., Adhikari, B. B., Daltry, D., Fischer, L. S., Greening, B., Kahn, E. B., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-68634-x · Cited by 3
ECONOMIC INSECURITY AND STRESS AS DETERMINANTS OF COVID-19 PREVENTIVE BEHAVIOUR IN DENPASAR
Wirawan, G. B. S., Taroreh, T. A. P., Arthaningsih, D. A. A. D., Loka, M. A. D. P., Mahardika, N. M. A., & Januraga, P. P. (2021) · Jurnal Administrasi Kesehatan Indonesia · doi:10.20473/jaki.v9i2.2021.124-134 · Cited by 3
“Another previous study points out mental health problems due to the COVID-19 pandemic and social distancing (Park et al., 2020).”
Background
Monthly Trends in the Life Events Reported in the Prior Year and First Year of the COVID-19 Pandemic in New Zealand
Howard, C., Overall, N. C., & Sibley, C. G. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.829643 · Cited by 3
Prospective assessment of anxiety among pediatric oncology patients and their caregivers during the COVID-19 pandemic a cohort study
Ornstein, M. Y., Friedlander, E., Katz, S., & Elhasid, R. (2022) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2022.2086092 · Cited by 3
Στρατηγικές αντιμετώπισης αντίξοων καταστάσεων, αντιλαμβανόμενο αίσθημα απειλής και πηγές κοινωνικής υποστήριξης σε ενηλίκους κατά την περίοδο της πανδημίας COVID-19
Antoniou, A., Greenglass, E. R., Dimopoulos, M. A., Χρούσος, Γ., Παπαγεωργίου, Χ., & Τούντας, Γ. (2022) · Psychology the Journal of the Hellenic Psychological Society · doi:10.12681/psy_hps.28912 · Cited by 4
Older Adults and Positive Mental Health during the Second and Sixth COVID-19 Waves in Spain
Moret‐Tatay, C., Lozano, A. C., Pérez-Bermejo, M., & Moreno, F. (2022) · Healthcare · doi:10.3390/healthcare10112159 · Cited by 3
“ccording to a piece of research, women tended to be more vulnerable in terms of stressor exposure at a younger age and having to adopt to a caregiver status during the pandemic [15].”
Background
Perceived Stress and Psychological Well-Being in Adult Individuals during COVID-19: The Mediating Role of Coping Strategies
Şahan, B., & KARADEMİR, Ç. (2022) · Türk Psikolojik Danışma ve Rehberlik Dergisi · doi:10.17066/tpdrd.12250133 · Cited by 3
COVID-19 Lockdown as an Atypical Stressful Situation and Ways of Coping with It
Lelek‐Kratiuk, M., & Szczygieł, M. (2021) · Polish Psychological Bulletin · doi:10.24425/ppb.2021.137256 · Cited by 3
“Other common coping strategies used by Americans during the outbreak of COVID-19 were: seeking a distraction, active coping, and seeking emotional social support (Park et al., 2020).”
Background
Perceived Stress and Coping Styles among the General Population in Saudi Arabia during COVID-19 Pandemic
Alghamdi, W., Alzahrani, S. H., Shaaban, S. S., & Alhujaili, N. A. (2022) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2022.017685 · Cited by 3
Estrés percibido en universitarios durante la cuarentena por la COVID-19 en Santander, Colombia
Oliveros, N. A. G., Arguello, D. F. G., Jerez, A. J. Ú., Méndez, S. N. V., & Ramírez, N. V. L. (2022) · Revista de Psicología Universidad de Antioquia · doi:10.17533/udea.rp.e344735 · Cited by 3
Factors related to adherence to public COVID-19 prevention behaviors, United States, April–July 2021
Agaku, I. T., Nkosi, L., Agaku, Q. D., Gwar, J., & Tsafa, T. (2022) · Population Medicine · doi:10.18332/popmed/154850 · Cited by 3
Patterns of Stress and Wellbeing Among Families Enrolled in Early Head Start/Head Start During COVID-19
Fisk, E., & Russell, B. S. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03523-1 · Cited by 3
Self-citation
Stress and coping strategies in the general population of Greece and Cyprus in response to the COVID-19 pandemic: A cross-sectional study
Kleanthous, E., Evangelou, E., Georgiadou, A., Galanis, P., Andreadaki, E., Tzavara, C., Καϊτελίδου, Δ., & Kallergis, G. (2022) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2022.100306 · Cited by 3
“6 Several studies revealed the importance of the public’s compliance with the precautions for COVID-19 (Wang et al., 2020; Park et al., 2020).”
The Effects of Organizational Climate on Adherence to Guidelines for COVID-19 Prevention and Organizational Identification: A Three-Wave StudyPreprint
Hubert, P., Hadi, S. A., Mojzisch, A., & Häusser, J. A. (2021) · doi:10.31234/osf.io/sj94b · Cited by 3
Child Externalizing and Internalizing Behavior and Parental Well-Being During the COVID-19 PandemicPreprint
Portnoy, J., Bedoya, A., & Wong, K. K. (2021) · doi:10.14324/111.444/000093.v1 · Cited by 3
A systematic review on sex- and gender-sensitive research in public mental health during the first wave of the COVID-19 crisisPreprint
Tibubos, A. N., Otten, D., Ernst, M., & Beutel, M. E. (2021) · doi:10.31234/osf.io/cbsj6 · Cited by 3
The Effect of Food Insecurity and Stress on Delay Discounting across Families: A COVID-19 Natural ExperimentPreprint
Crandall, A. K., Madhudi, N., Osborne, B., Carter, A., Williams, A. K., & Temple, J. L. (2022) · Research Square · doi:10.21203/rs.3.rs-1630961/v1 · Cited by 4
The Individual- and Organization-Related Stressors in Pandemic Scale for Healthcare Workers (IOSPS-HW): Development and Psychometric Properties of a New Instrument to Assess Individual and Organizational Stress Factors in Periods of Pandemics
Primi, C., Giuli, M., Baroni, E., Zurkirch, V. P., Galanti, M., Belloni, L., Gori, C., & Donati, M. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054082 · Cited by 2
“Recently, new measures have been developed to assess different stressors related to the pandemic, such as the Pandemic Stress Questionnaire (PSQ) [26]; the COVID-19 Stressors Scale [27]; the COVID-19 Stress Scale (CSS) [28]; the COVID-19 Stressors Score [29]; and the Pandemic Stressor Scale (PSS) [30] (Table 1).”
Background
Investigating Racial Differences among Men in COVID-19 Diagnosis, and Related Psychosocial and Behavioral Factors: Data from the Michigan Men’s Health Event
Hawkins, J., Gilcher, K., Schwenzer, C., & Lutz, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063284 · Cited by 2
“Thus far, studies on the impact of COVID19 have demonstrated that women report higher rates of stress and worse well-being compared to men [25,26].”
Background
Reviewing the trend of health artificial intelligence technology in COVID-19 pandemic prevention
Tsai, W., & Chang, W. (2021) · Health Technology · doi:10.21037/ht-20-27 · Cited by 2
Which profile of people tends to ignore preventive measures against COVID-19? The role of intelligence and the big five personality traits
Morales-Vives, F., Ferrando, P. J., Vigil‐Colet, A., & Hernández-Dorado, A. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e13277 · Cited by 2
The Effects of the COVID-19 Pandemic on the Anxiety Levels and Sleep among University Students
Çifçi, S., Değer, V. B., & Kaçan, H. S. (2023) · Journal of Turkish Sleep Medicine · doi:10.4274/jtsm.galenos.2022.43534 · Cited by 2
Locked, Stocked, and Charmin: Sources of White Americans’ Responses to the COVID-19 Pandemic
Jonson, C. L., Graham, A., Cullen, F. T., Pickett, J. T., Haner, M., & Sloan, M. M. (2023) · Victims & Offenders · doi:10.1080/15564886.2023.2183917 · Cited by 3
Different facets of COVID-19-related stress in relation to emotional well-being, life satisfaction, and sleep quality
Saalwirth, C., & Leipold, B. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1129066 · Cited by 3
“For example, it is imaginable that people are also stressed by changes in work routines and child care, mistrust or discontent with governmental policies, or social discrimination, as implied by previous research (Park et al., 2020).”
BackgroundResultInfluential
“It’s Gonna Be Okay”—A Qualitative Exploration of the COVID-19 Pandemic’s Effects on African American Participants During a Dietary Intervention Study
Bernhart, J. A., Quattlebaum, M. J., Eustis, S. J., Okpara, N., Wilson, M. J., Sentman, C., & Turner‐McGrievy, G. M. (2023) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2023.07.003 · Cited by 2
Knowledge, attitudes, and practices regarding COVID-19 among university students and employees in Massachusetts, USA: A qualitative study
Ravenhurst, J., Snyder, T., Wallace, K. F., Pennell, S., Goff, S. L., & Lover, A. A. (2023) · Journal of American College Health · doi:10.1080/07448481.2023.2225626 · Cited by 2
Parental Anxiety, Practices, and Parent–Child Relationships among Families with Young Children in China: A Cross-Sectional Study
Yu, W., Guo, Z., Tian, J., Li, P., Wang, P., Chen, H., Zcm, D., Li, M., Ge, Y., & Liu, X. (2023) · Children · doi:10.3390/children10081388 · Cited by 2
“Additionally, consistent with other studies, parenting issues referring to daily caregiving and child development issues [20,32], issues related to parent–child interactions [33–37], and childcare resource access [20,32] were key factors influencing caregivers’ parental anxiety.”
Result
Identification of factors associated with non-adherence to recommended COVID-19 preventive behaviours: a cross-sectional study based on a survey among 1004 French primary care professionals
Bouton, C., Meziere, P., Gaultier, A., Dupouy, J., & Rat, C. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-071215 · Cited by 2
Social networks as a protective factor for worsened self-perceived health status related to self-perceived changes in loneliness and health conditions in adults aged 50+ during the COVID-19 outbreak
Musbat, S., Reuveni, I., & Magnezi, R. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e20529 · Cited by 2
“Therefore, avoiding social contact in favor of limiting the spread of COVID-19 increased anxiety and stress in the population [33].”
Background
Emotion dysregulation and family functioning moderate family caregiving burden during the pandemic
Kim, D., Russell, B. S., Park, C. L., & Fendrich, M. (2023) · Palliative & Supportive Care · doi:10.1017/s1478951523001712 · Cited by 2
Self-citation
Differential effects of COVID-19 stressor types on mental health and moderating roles of coping strategies.
Emrich, M., Park, C. L., Russell, B. S., & Fendrich, M. (2024) · International Journal of Stress Management · doi:10.1037/str0000318 · Cited by 2
Self-citation
Financial Distress and Indonesian Family Resilience during the COVID-19 Pandemic: A Case Study of a Muslim Family in Yogyakarta
Amilia, F. (2024) · Global Review of Islamic Economics and Business · doi:10.14421/grieb.2023.111-06 · Cited by 2
“The results of this study support research conducted by Power et al. (2015) and Park et al., (2020) which states that resilient families are more resilient individually and experience less anxiety in dealing with security tensions because resilience tends to be about maintaining a balance between…”
Result
The association of self-perceived changes due to COVID-19 with mental and physical health among adult primary care patients with multiple chronic conditions: A US-based longitudinal study
Bonnell, L. N., Clifton, J., Natkin, L. W., Hitt, J. R., & Littenberg, B. (2024) · Journal of Multimorbidity and Comorbidity · doi:10.1177/26335565231222148 · Cited by 2
Subjective Stress Appraisals Over Time: the Evolving Structure of the COVID-19 Stressor Scale
Hynes, K. C., Russell, B. S., Tambling, R. R., Park, C. L., & Fendrich, M. (2024) · Prevention Science · doi:10.1007/s11121-024-01694-7 · Cited by 2
“One recently developed measure of stress exposure and appraisal to measure overall stress related to the COVID-19 pandemic is the COVID-19 Stressors Scale (Park et al., 2020).”
InfluentialSelf-citation
Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults
Woolverton, G. A., Stevens, C., Hahm, H. C., & Liu, C. H. (2024) · Anxiety Stress & Coping · doi:10.1080/10615806.2024.2383766 · Cited by 2
“…escapism model of PIU, we hypothesize that stressful experiences that were elevated during the pandemic for young adults – low social support, stress and adjustment challenges related to COVID-19, and ﬁ nancial distress – will predict greater PIU (Park et al., 2020; Refaeli & Achdut, 2021).”
Resilience and Hassles Trajectories Among Older Adults During the COVID-19 Pandemic
Kurth, M. L., Segerstrom, S. C., Chandler, K. D., Hooker, K. A., & Aldwin, C. M. (2024) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbae145 · Cited by 2
“I feel like it's just really become second nature, almost like the screen’s not there”: a qualitative case study of the transition to telehealth for home visitation program to support fragile infants due to the COVID-19 pandemic
Thomas, N. A., Williams, E. M. P., Virk, A., Harrison, J., Koskan, A. M., & Berkel, C. (2024) · Discover Medicine · doi:10.1007/s44337-024-00014-w · Cited by 2
“The COVID-19 pandemic incited high levels of global stress, including concerns about hygiene, the severity of the illness, and the contagious nature and spread of COVID-19 [17].”

Authors: Park, C. L., Russell, B. S., Fendrich, M., Finkelstein-Fox, L., Hutchison, M., & Becker, J.
Affiliations: University of Connecticut (US)
Corresponding author: Park, Crystal L.
ORCID: Park, Crystal L.
Russell, Beth S.
Fendrich, Michael
Hutchison, Morica
Becker, Jessica
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2020-05-29
Volume: 35
Issue: 8
Pages: 2296-2303
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-020-05898-9
PMC: PMC7259430
OpenAlex: W3031875368
Cited by: 728
References: 26
Citations by year: 2026: 10 · 2025: 31 · 2024: 74 · 2023: 120 · 2022: 219 · 2021: 224 · 2020: 49
FWCI: 61.25
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Journal of General Internal Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (1R34AA027455)
Topics: Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
Social Sciences › Communication › Communication and COVID-19 Impact
Keywords: COVID-19 pandemic, psychological stress, coping strategies, social distancing, hygiene practices, financial stress, caregiver burden, gender differences, age differences, social support, mental health
MeSH terms: Betacoronavirus, COVID-19, SARS-CoV-2, Adaptation, Psychological, Adult, Centers for Disease Control and Prevention, U.S., Female, Humans, Male, Mental Health, Pneumonia, Viral, Public Health, Surveys and Questionnaires, Stress, Psychological, United States, Guidelines as Topic, Coronavirus Infections, Disease Transmission, Infectious, Guideline Adherence, Pandemics

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

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