Spreading rapidly across the United States beginning in the spring of 2020, the coronavirus disease 2019 (COVID-19) pandemic radically disrupted Americans' lives. Previous studies of community-wide disasters suggested people are fairly resilient and identified resources and strategies that promote that resilience. Yet, the COVID-19 pandemic is in some ways unique, with high levels of uncertainty, evolving implications and restrictions, and varied and uneven impacts. How resilient were Americans as the pandemic progressed? What psychosocial resources and coping strategies facilitated adjustment as the country moved into a summer of uneven reopenings and reclosures? Data from a national sample of 674 Americans were gathered at the height of early lockdowns and peaking infections in mid-April, 2020, and again, 5 and 10 weeks later. The study aimed to determine levels and sources of distress and to identify the resources and coping efforts that promoted or impeded resilience. Early levels of distress diminished to some extent over subsequent months while levels of wellbeing were comparable with usual norms, suggesting a largely resilient response. COVID-19-related stress exposure also decreased gradually over time. Older age, higher levels of mindfulness and social support, and meaning focused coping predicted better adjustment, reflecting resilience, while avoidance coping was particularly unhelpful. In models predicting change over time, approach-oriented coping (i.e., active coping, meaning-focused coping, and seeking social support) was minimally predictive of subsequent adjustment. Given the unique and ongoing circumstances presented by COVID-19, specific interventions targeting psychosocial resources and coping identified here may help to promote resilience as the pandemic continues to unfold. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Recruitment and retention of low-income African Americans in clinical trials is challenging. This paper reports recruitment and retention strategies that yielded high rates for both in a clinical trial pilot to improve hypertension self-management among low-income African Americans. The study successfully recruited 96.7% (59 of 61 participants) within a seven month period. Retention rates for the 1, 3, and 6-month post-baseline assessment visits were 91.5%, 88.1%, and 83.1%, respectively. Recruitment and retention strategies include two grounded in previous literature: a culturally sensitive and diverse research team and use of incentives. Four additional strategies were developed for this study to meet the needs of the study site and participants, which included: study site collaboration; ongoing communications; responding to the clinical environment; and addressing participants' health literacy levels. A discussion of key recruitment and retention strategies and suggestions for future studies focused on low-income African American participants ensues.

Background: We sought to understand the association between heavy alcohol and frequent drug use and non-adherence to recommended social distancing and personal hygiene guidelines for preventing the spread of COVID-19 early in the US pandemic. Methods: A survey was offered on the crowdsourcing platform, Amazon Mechanical Turk (MTurk) during April 2020 (the early days of strict, social distancing restrictions). The study included 1,521 adults ages 18 years and older who resided in the US and were enrolled as MTurk workers, i.e., workers who are qualified by Amazon to complete a range of human interaction tasks, including surveys through the MTurk worker platform. Main predictors included measures of heavy drinking, marijuana, and polysubstance use. The dependent measures were measures of social distancing and personal hygiene, based on guidelines recommended at the time of the survey by the US Centers for Disease Control to prevent the spread of COVID-19. Results: We found consistent negative associations between heavy drinking and drug use and adherence to social distancing and personal hygiene. Additionally, three control variables, age, gender, and race/ethnicity, were significant correlates of adherence to these measures. Conclusions: The findings here are consistent with previous research exploring links between substance use and other adverse health behaviors. Further, the negative association between heavy drinking (five or more drinks in one sitting) and adherence underscore the public health risks entailed with the unrestricted reopening of public drinking establishments.

Objectives: We sought to understand how pharmacists viewed and used a newly implemented prescription drug monitoring program (PDMP). We also sought to understand pharmacist orientation toward dispensing of controlled substances and the people who obtain them. Methods: We conducted three mini focus groups. The focus group findings were used to inform the design of a structured survey. We emailed a survey to 160 pharmacists who were employed in one statewide community chain store; we obtained 48 survey responses. Results: Focus groups findings suggested that, in relation to the dispensing of scheduled prescription medication, pharmacists were either “healthcare” oriented, “law-enforcement” oriented, or an orientation that combined these two perspectives. Surveys suggested that pharmacists found PDMPs easy to use and that they used them frequently – often to contact physicians directly. Surveys suggested that pharmacists were typically either “healthcare” oriented or “mixed” (combined perspectives). Pharmacist orientation was associated with the frequency with which they counseled patients about medication risk and the frequency with which they used the PDMP as the basis for contacting prescribers. Conclusions: Ongoing tracking of pharmacists' use of PDMPs is important both at the implementation stage and as PDMPs develop over time. The orientation construct developed here is useful in understanding pharmacist behavior and attitudes towards patients potentially at risk for misuse of controlled substance medications. Further research on this construct could shed light on barriers and incentives for pharmacist PDMP participation and use and provide guidance for pharmacist training, ultimately enhancing patient care.