A multidisciplinary journal on gaming and gamification for health education/promotion, teaching and social change.

Healthcare workers are highly regarded for their compassion, dedication, and composure. However, COVID-19 created unprecedented demands that rendered healthcare workers vulnerable to increased burnout, anxiety, and depression. This cross-sectional study assessed the psychosocial impact of COVID-19 on U.S. healthcare frontliners using a 38-item online survey administered by Reaction Data between September and December 2020. The survey included five validated scales to assess self-reported burnout (Maslach Summative Burnout Scale), anxiety (GAD-7), depression (PHQ-2), resilience (Brief Resilience Coping Scale), and self-efficacy (New Self-Efficacy Scale-8). We used regression to assess the relationships between demographic variables and the psychosocial scales index scores and found that COVID-19 amplified preexisting burnout (54.8%), anxiety (138.5%), and depression (166.7%), and reduced resilience (5.70%) and self-efficacy (6.5%) among 557 respondents (52.6% male, 47.5% female). High patient volume, extended work hours, staff shortages, and lack of personal protective equipment (PPE) and resources fueled burnout, anxiety, and depression. Respondents were anxious about the indefinite duration of the pandemic/uncertain return to normal (54.8%), were anxious of infecting family (48.3%), and felt conflicted about protecting themselves versus fulfilling their duty to patients (44.3%). Respondents derived strength from their capacity to perform well in tough times (74.15%), emotional support from family/friends (67.2%), and time off work (62.8%). Strategies to promote emotional well-being and job satisfaction can focus on multilevel resilience, safety, and social connectedness.

One in five homeless people in the United States has a substance use and/or a mental health disorder. Substance use disorders substantially impact the ability to obtain and retain appropriate housing. Professionals who provide substance use treatment are typically required to provide housing assistance by prioritizing clients according to their risk for becoming or remaining homeless; however, existing methods for prioritizing clients can be time-consuming and staff- and training-intensive. This study analyzed the potential use of variables from locally collected and readily available treatment admission records to prioritize clients needing housing assistance. This study analyzed county-level substance use treatment admission and discharge records of 1862 treatment episodes for 1642 clients in publicly funded treatment programs in Utah County, Utah. For at least one admission or discharge, 185 clients lived on the streets or in a homeless shelter. Approximately 55% of treatment episodes that ended in homelessness at discharge did not originally begin with clients being homeless, suggesting a gap in prioritizing individuals for housing assistance. Logistic regression showed statistically significant associations between eventually becoming homeless at the time of discharge and being originally homeless on admission; older age (45 years or older); methamphetamine as primary drug used; and a diagnosis of axis I/II psychiatric disorder besides substance use disorder. These findings suggest that local and routinely collected substance use treatment records may be predictive of homelessness and potentially useful in prioritizing clients for housing assistance.

Childhood stunting is a pressing health issue in Tanzania and results from chronic infections and inadequate nutrition. Educating caregivers on the nutritional determinants, their consequences, and appropriate solutions may improve nutrition-related practices among caregivers in Tanzania. The purpose of this study was to identify factors associated with Tanzanian caregivers' knowledge of childhood nutrition practices. Data for this study came from a cross-sectional survey of 4,095 caregivers of children under 24 months living in the Geita, Kagera, Kigoma, Mwanza, and Shinyanga regions of Tanzania. Complete responses relating to demographic and socioeconomic factors, media exposure, and early childhood nutrition knowledge were analyzed using multiple linear regression modeling techniques. Caregivers' knowledge concerning proper early childhood nutrition practices was found to be significantly related to using a mobile banking account (p<.0001), owning a working radio with batteries (p<.0001), having watched television recently (p<.0001), residing in a southern lake region (p<.0001), affiliating with a Christian faith (p=0.0027), having more children under the age of 5 (p=0.0005), having received advice on maternal nutrition before pregnancy (p<.0001) and having received advice from a community health worker (p=0.0184). Living in a rural environment (p<.0001) and speaking a non-mainstream language (p<0.05) were significantly associated with decreased knowledge. The influences of media and technology, socio-demographic factors and traditional health education may be important in the development of accurate childhood nutrition knowledge among caregivers. These factors may be targeted for future community health worker efforts with vulnerable populations in Tanzania to prevent stunting.