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Americans’ COVID-19 Stress, Coping, and Adherence to CDC Guidelines
Open accessAbstract
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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“Research conducted during the initial lockdown period found that American adults commonly dealt with stress through distraction, active coping, and seeking emotional support [31]”
From Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic (2023) · cites this paper as [31]
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Qussiny, L., Wiley, C. R., Martin, L. T., & Pressman, S. D. (2024) · Cogent Psychology · doi:10.1080/23311908.2024.2333657 · Cited by 1
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Niankara, I., Zoungrana, T. D., & Traoret, R. I. (2024) · Global Digital Health Knowledge Exchange & Empowerment Conference (gDigiHealth.KEE) · doi:10.1109/gdigihealth.kee62309.2024.10761690 · Cited by 1
“…its origin, transmission routes, and clinical outcomes, coupled with the absence of vaccines or targeted therapies, governments and health authorities resorted to non-pharmaceutical interventions (NPIs) as immediate measures to mitigate transmission and prevent healthcare system overload [4],[5].”
SturtzSreetharan, C., Kuehn, K., Jolly, D., Puckett, J. A., Hope, D. A., Mocarski, R. A., Jagielski, A., Gutierrez, J., Dunn, T., Juster, R., et al. (2025) · International Journal of Transgender Health · doi:10.1080/26895269.2025.2538738 · Cited by 1
The predictors of fatigue among Iranian nurses during the COVID-19 pandemic
Mohsenzadeh, N., Khameslou, M. A., & Aghamohammadi, M. (2025) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2025.100917 · Cited by 1
Knapp, S. J., Gottlieb, M. C., & Handelsman, M. M. (2021) · Practice Innovations · doi:10.1037/pri0000144 · Cited by 1
Fallah, B., Nasiriani, K., Mehrabbeik, A., Nazmiah, H., Pour, E. S., Ghanizadeh, F., Hajimaghsoudi, M., & Baghian, N. (2021) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.112635 · Cited by 1
“(7) showed that the most common strategies for stress management included distraction, active coping, and seeking emotional social support (7).”
BackgroundMethodInfluentialStressors and Coping Strategies of Medical Staff in the COVID-19 Pandemic in Wuhan
Liu, L., Shi, Y., Fei, X., Wang, Z., Wang, Z., Li, L., Ding, L., & Yan, Q. (2021) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2021.015699 · Cited by 1
“Financial concerns, for example, worrying about loss of current job or lack of resources, were found one of the most stressful factors in the first national US survey [24].”
BackgroundÖzkul, S., Uysal, B., Morgül, E., & Eren, S. (2021) · TALIM JOURNAL OF EDUCATION IN MUSLIM SOCIETIES AND COMMUNITIES · doi:10.37344/talim.2021.18 · Cited by 1
Melnyk, B. M., Tan, A., Hsieh, A. P., Amaya, M., Regan, E. P., & Stanley, L. M. (2021) · Building Healthy Academic Communities Journal · doi:10.18061/bhac.v5i2.8474 · Cited by 1
“81 younger populations also have been reported in several other studies (Chirikov et al., 2020; Gallè et al., 2020; Park et al., 2020; Zheng et al., 2020).”
ResultNaeimijoo, P., Yousefi, A., Masjedi‐Arani, A., Heidari, M., Karimi, R., & Lighvan, M. A. (2022) · Medical Science · doi:10.54905/disssi/v26i119/ms25e1941 · Cited by 1
“As being kind, helpful, good-natured, sympathetic, and cooperative are the main characteristic of an agreeable individual (Abdelrahman, 2020; Park et al., 2020).”
Background“We are praying from home”: reflections on the pandemic from resettled Rohingya refugees
Mitschke, D. B., Laney, E., Costello, E., & Faizal, M. (2022) · International Journal of Migration Health and Social Care · doi:10.1108/ijmhsc-03-2021-0026 · Cited by 1
Reay, S. R. (2022) · Advances in Social Work · doi:10.18060/24758 · Cited by 1
Zuhal Beyza, A. T. A. K., & Alkar, Ö. Y. (2022) · Ayna Klinik Psikoloji Dergisi · doi:10.31682/ayna.973914 · Cited by 1
Cardona, E. Y. B., Hansen-Rodríguez, G., & Molina-Fernández, A. (2022) · African journal of rhetoric · doi:10.21134/haaj.v22i1.712 · Cited by 1
Mirzakhani, N., Saei, S., Zarei, M. A., Dibajnia, P., & Oshnari, L. A. (2022) · Middle East Journal of Rehabilitation and Health Studies · doi:10.5812/mejrh-118587 · Cited by 1
Depressive Symptoms and Perception of COVID-19 Risk in Ohio Adults
Bischof, K. M., Chakraborty, P., Miller, W. C., & Turner, A. N. (2022) · Ohio Journal of Public Health · doi:10.18061/ojph.v5i1.8805 · Cited by 1
Parental working memory buffers associations between COVID-19 hardships and child mental health
Kelm, M. R., Diercks, C. M., Dunning, E. D., & Lunkenheimer, E. S. (2023) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2023.101559 · Cited by 1
“These stressors may be salient for families with young children (Park et al., 2020) who require constant care and supervision.”
Finkelstein‐Fox, L., Park, C. L., Eigsti, I., Awao, S., & Mancini, A. D. (2023) · Stress and Health · doi:10.1002/smi.3310 · Cited by 1
Self-citationQuick, C., & Lin, X. (2021) · Journal of Data Science · doi:10.6339/21-jds994b · Cited by 1
Statistical Inferences and Analysis based on the COVID-19 Data from the United StatesPreprint
Rethnakar, N. (2021) · medRxiv · doi:10.1101/2021.11.30.21267096 · Cited by 1
Saalwirth, C., & Leipold, B. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.3988592 · Cited by 1
Spiegel, T., Brons, M. D., & Völker, B. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4017654 · Cited by 1
Child Externalizing and Internalizing Behavior and Parental Well-Being During the COVID-19 PandemicPreprint
Portnoy, J., Bedoya, A., & Wong, K. K. (2022) · doi:10.14324/111.444/000093.v2 · Cited by 1
Mhlongo, T. H., Phalane, E., Voet, K. A., Ndaramu, P., Siyamayambo, C., Mabaso, M., Sewpaul, R., & Phaswana-Mafuya, N. R. (2023) · Preprints.org · doi:10.20944/preprints202310.1267.v1 · Cited by 1
Social ecological resilience, social capital, anomie and the impact of COVID-19.
Gonzaga, K. P. (2023) · ThinkIR: The University of Louisville's Institutional Repository (University of Louisville) · doi:10.18297/etd/4120 · Cited by 1
Emotional state should not be used to differentiate IBD from IBS – Authors' reply
Iacucci, M., Cannatelli, R., Labarile, N., & Ghosh, S. K. (2020) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(20)30199-0
Homeschooling Implementation: Indonesian Parents' Experience During The COVID-19 Pandemic
Daulay, N., Hendriani, W., Nur, H., & Haque, S. A. U. (2021) · AL-ISHLAH Jurnal Pendidikan · doi:10.35445/alishlah.v13i1.390
“Furthermore, Park et al. (2020) revealed that during a pandemic, a person experiences stress due to the spread of the disease and uncertainty over Al- Ishlah: Jurnal Pendidikan, June 2021, 13 (1), Pages 242-252 Homeschooling Implementation: Indonesian Parents' Experience During The COVID-19…”
BackgroundChristianity and COVID: Conservative Authoritarianism
Kimet, B., & Shipley, C. (2021)
A Continuous Adjustment: The Impact of COVID-19 on International Graduate Students
Moraga, C. A. (2021) · Louisiana State University · doi:10.31390/gradschool_dissertations.5658
Vernaglia, T. V. C., Paravidino, V. B., Silva, E. S., Valiati, L., Heritage, P., Priebe, S., & Cruz, M. S. (2021) · Research Society and Development · doi:10.33448/rsd-v10i13.21508
Metadata
- 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.
- Venue
- Journal of General Internal Medicine
- Published
- 2020-05-29
- Volume
- 35
- Issue
- 8
- Pages
- 2296-2303
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- 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
- 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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