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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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“…mengelola stress, strategi yang paling sering dilaporkan untuk mengelola stres adalah gangguan, koping aktif, dan mencari dukungan sosial emosional (Park et Dari tabel diatas, didapatkan 30 anggota PDHS rata-rata berusia 64 tahun dengan usia terendah 44 tahun dan usia tertua 86 tahun serta standar…”
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“On the other hand, several studies (Barari et al., 2020; Cohen et al., 2020; Park et al., 2020) have reported fear and anxiety as driving positive healthy behaviors among older adults, hence enhancing adherence to preventive measures, as observed in this study.”
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“Guideline adherence was generally high but marked by some non-adherence and mistrust in medical institutions [4].”
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“A study conducted by Park et al. (2020) reported that women are more prone to experiencing stress than men.”
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“Presently, few studies have examined the coping strategies utilized by individuals in response to COVID-19 (Park et al., 2020).”
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“Rates of stress during the first few months of the pandemic were particularly high for some populations (Park et al., 2020).”
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“Park and colleagues [60], in a population-based survey of Americans in the early pandemic period, reported that finances were rated the most stressful aspect of the pandemic.”
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Burnout among behavioral healthcare workers during the pandemic
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“Examining Table 2, consistent with prior research (e.g., Park et al., 2020), the items showing the highest elevation related to economic impact (item 9; M = 2.5; s.d. = 1.21), followed by stress related to fears of infection among loved ones (item 2; M = 3.3; s.d. = 1.34) and the stress of…”
InfluentialSelf-citationMonica, Y. E., Aruna, M., Lakshmi, K. S., Dhanasree, K., & Prakash, K. K. (2024) · International Journal of Farm Sciences · doi:10.5958/2250-0499.2024.00043.0
Prenatal incarceration exposure and adverse COVID-19 related experiences during pregnancy
Fahmy, C., Testa, A. M., Jacobs, B., & Jackson, D. B. (2024) · Journal of Crime and Justice · doi:10.1080/0735648x.2024.2403481
“The COVID-19 pandemic was a tremendous and widespread source of stress and instability for households across the United States (Park et al. 2020; Sinsky et al. 2021; Yıldırım and Solmaz 2022).”
InfluentialOyejide, A. O., Besharati, S. N., Alcock, S., Schiöth, H. B., & Brooks, S. J. (2024) · Research Square · doi:10.21203/rs.3.rs-5083107/v1
Lac, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-32046-0_84-1
Threats on SNS Use in Crisis With Conditional Analysis With Risk Mitigation and Fear of Missing Out
Kim, J., Jun, J., Oh, K., Song, R., Park, M., & Kim, H.-J. (2024) · International Journal of Cyber Behavior Psychology and Learning · doi:10.4018/ijcbpl.358621
Stress and Coping Experiences of Turkish University Students During COVID‐19: A Qualitative Study
Aracı‐İyiaydın, A., Çok, F., Yılmaz, H. A., Atay, Ş., & Serttaş, Ş. Y. (2024) · Psychology in the Schools · doi:10.1002/pits.23361
Alexandrova‐Karamanova, A., Mineva, K., Dimitrova, E., & Kotzeva, T. (2025) · Child & Youth Care Forum · doi:10.1007/s10566-024-09850-4
“…been registered for measures such as mobile phone and frequently touched surface disinfection, avoidance of touching the face (Nivette et al., 2021; Park et al., 2020), washing hands after cough/sneezing, use of hand disinfectants (Nivette et al., 2021), and social distancing (Nivette et al.,…”
InfluentialThe impact of age and sexual orientation on work-related changes and stress early in the pandemic
Iacono, G., Loveland, E. K., Fendrich, M., Kim, D., Russell, B. S., Park, C. L., & Hutchison, M. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108213
Self-citationLima, P. O., de Lira, A. N., Tavares, A. R., & de Morais, N. A. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.70010
Dyadic coping strategies of Turkish couples and dyadic adjustment during the COVID-19 pandemic
Bilican, F. I., & Temiz, Z. T. (2025) · Anxiety Stress & Coping · doi:10.1080/10615806.2025.2489372
“Among couples, COVID-19-related stress correlated with a daily decline in positive affect and an increase in negative mood (Brooks et al., 2020; Park et al., 2020; Torales et al., 2020).”
Yazla, E., Karakaşlı, A. A., Aydınoğlu, Ü., & Özalp, E. (2025) · Journal of Surgery and Medicine · doi:10.28982/josam.7648
Parenting during the COVID-19 pandemic: Mental health, coping, and preventative behavior
Russell, B. S., Tambling, R. R., Horton, A. L., Hutchison, M., & Tomkunas, A. J. (2025) · Journal of Family Social Work · doi:10.1080/10522158.2025.2493714
“A total stressor count of the items endorsed, as well as total stress appraisals for the continuous ratings of stressfulness can be calculated (Park et al., 2020).”
InfluentialSelf-citationLi, C., Jordan, A., Ge, Y., & Park, A. (2025) · Journal of Medical Internet Research · doi:10.2196/51638
“This is consistent with studies that have reported that participants experienced moderate to high stress levels during the pandemic period [10,41,42], which can manifest in negative dietary behavior.”
Cheung, W. W. L., Sahakari, S. S., & Götz, F. M. (2025) · Journal of Personality · doi:10.1111/jopy.70002
“Park et al. (2020) found that common stressors related to the pandemic include the uncertainty of social distancing requirements and the exposure to news regarding the severity of COVID.”
Gani, S., & Laher, S. (2025) · Journal of Muslim Mental Health · doi:10.3998/jmmh.3576
Kangmennaang, J., Siiba, A., & Antabe, R. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03134-8
“For example, in the context of the United States (US), a survey conducted by the Center for Translational Neuroscience found that parents of young children experienced signi fi cant stress, resulting from the dif fi culties faced in accessing basic needs for parenting during the pandemic (Center for Translational Neuros…”
InfluentialMahfooz, M. S., Husain, M., Roy, M., Fatima, K., Akhter, M. S., & Khan, M. T. (2025) · International Journal of Basic & Clinical Pharmacology · doi:10.18203/2319-2003.ijbcp20252571
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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