Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income, postpartum women are limited by poor intervention attendance and high attrition rates. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions Objective: To adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. Methods: This study comprised of three single group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program to Facebook delivery by translating the protocol to a content library to be delivered in a Facebook feed with additional input from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, MA. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first eight weeks, Facebook intervention posts were delivered two times per day with additional posts from coaches. For the following 8 weeks, posts were delivered once per day without additional coaching. Outcome measures were collected at baseline and 16-week follow-up and included changes in weight as well as feasibility outcomes including retention, engagement (defined by likes, comments, and posts), and acceptability. Results: Pilot 1 (n = 27) had a retention rate of 89% and 62% engaged in the group during the 8-week coached phase. Mean weight loss was 2.6 pounds (SD = 8.64) and 75% reported being satisfied with the program. Pilot 2 (n = 24) had a retention rate of 83% and 55.2% engaged in the group during the 8-week coached phase. Mean weight loss was 2.5 pounds (SD = 9.23) and 80% were satisfied with the program. Pilot 3 (n = 16) had a retention rate of 88% and 67% engaged in the group during the 8-week coached phased. Mean weight loss was 7.0 pounds (SD = 11.6) and 64.3% were satisfied with the program. Conclusions: Findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to the low-income, postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.

Religiosity may influence COVID-19 vaccination. However, it remains unclear how religiosity is associated with beliefs toward COVID-19 and vaccination against it, particularly amongst ethnic minorities. This study examined the association between religiosity, vaccination intent, beliefs, and attitudes related to COVID-19 and vaccination among adults in Puerto Rico. Data from an online survey conducted between December 2020–February 2021 among adults (≥18 yr; n = 1895) residing in Puerto Rico were used. Rating of the importance of religiosity was used to capture the level of religiosity (‘less important’, ‘somewhat important’, ‘important’, and ‘very important’). The health belief model (HBM) assessed beliefs and attitudes toward COVID-19 and vaccination against it. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR) and 95% confidence intervals for vaccination intent and individual COVID-19 HBM constructs. Compared to individuals rating religiosity as ‘less important’ to them, those rating it as ‘very important’ were more likely to be unwilling or uncertain to get the COVID-19 vaccine (PR = 1.51, 95% CI = 1.10–2.05). Higher ratings of importance of religiosity, compared to the lowest level, were associated with significantly lower perceived COVID-19 susceptibility, more vaccine barriers, and lower vaccine benefits (all p < 0.05). Individuals who reported religiosity being very important to them were more likely to report that they will get the COVID-19 vaccine only if given adequate information about it (PR = 1.14, 95% CI = 1.02–1.27) and more likely to get the vaccine if more people decide to receive it (all p < 0.05). In conclusion, our results suggest an association between religiosity and COVID-19 vaccination intent and beliefs and attitudes toward vaccination. The study highlights important guidelines for public health campaigns to increase vaccine uptake among religious communities in Puerto Rico.

Residents of Puerto Rico bear a significant burden of mental health disorders, which the COVID-19 pandemic may have exacerbated. However, age-specific data on these disorders during the pandemic in Puerto Rico are scarce. This study evaluated age-related differences in the self-reported diagnosis of depression and anxiety among adults ≥18 years residing in Puerto Rico during the pandemic. An anonymous online survey was administered from December 2020 to February 2021 via Google Forms to measure self-reported sociodemographic and behavioral characteristics and physician-diagnosed mental health disorders. Multivariable logistic regression models were conducted for each self-reported mental health diagnosis after adjusting for sex, education, income, marital status, chronic diseases, and smoking. Out of 1945 adults, 50% were aged 40 years and over. Nearly 24% of responders self-reported an anxiety diagnosis, whereas 15.9% reported depression. Compared to individuals 50 years and over, those 18–29 y, 30–39 y, and 40–49 y had significantly higher odds of an anxiety diagnosis (OR = 1.84, 95% CI = 1.34–2.55; OR = 1.50, 95% CI = 1.09–2.07; and OR = 1.37, 95% CI = 1.01–1.87, respectively). However, no association between age and depression diagnosis was found. Despite anxiety and depression being frequent disorders during the pandemic in this sample, younger adults bear a higher burden of anxiety. Further research is needed to allocate appropriate mental health resources during emergencies according to population subgroups.

Poor sleep quality is associated with negative emotions and may modulate emotional eating (EE). However, this has not been studied among US Latinx adults, a group experiencing sleep disparities.To ...