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Understanding Covid-19 Message Fatigue And Reactance In A Post-Crisis Context, Lillian Hamilton Mantel

Dissertations and Theses

The COVID-19 pandemic prompted widespread public health messaging encouraging behaviors such as vaccination, mask-wearing, and staying home when sick. However, persistent exposure to these messages has sometimes produced unintended effects, including message fatigue and psychological reactance. Drawing on psychological reactance theory (PRT) and the integrative model of behavioral prediction (IMBP), this study examines the relationships between message fatigue, psychological reactance, and behavioral intentions toward three COVID-19 preventive behaviors: vaccination, masking, and staying home when sick. A survey of 348 U.S. adults assessed participants' levels of message fatigue, psychological reactance, attitudes, perceived norms, self-efficacy, response efficacy, collective efficacy, and behavioral intentions. …

The Covid-19 Pandemic And College Students' Experiences: A Phenomenological Study, Mervin L. Davis

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore and comprehend the lived experiences of college students at North Carolinian colleges and universities during the interruption and transitions of studies amid the COVID-19 pandemic. This research used qualitative inquiry design and employed Schlossberg’s transition theory to guide the study. Schlossberg’s transition theory correlates with this research and phenomenological exploration because it underscores the varying abilities and incapacities of students to persist through their studies during challenging circumstances. The setting for this research was North Carolinian higher education institutions within Mecklenburg County which boast 17 colleges and universities within a 50-mile …

The Lingering Effects Of The Covid-19 Pandemic On Nurses, Linda H. Yoder, Jacqueline M. Gordon, Noah Zanville

International Nursing Research Congress (INRC)

Background: Posttraumatic growth (PTG) is the experience of positive psychological change after struggling with major life crises, often resulting in a re-evaluation of priorities, greater appreciation for life, and spiritual/existential growth. The purpose of this national study was to measure PTG levels among nurses caring for patients during the ongoing COVID-19 pandemic.

Design: The survey study consisted of 2,077 U.S. based Academy of Medical-Surgical Nurses (AMSN) members and nurses from 23 hospitals in HCA Healthcare. The Posttraumatic Growth Inventory-Expanded (PTGI-X) and a demographic data collection sheet were used to collect data. Descriptive statistics and reliability testing were performed, as well …

Predictors For Different Levels Of Covid-19 Vaccination Among Immigrant And Non-Immigrant Adults, Cheryl Zlotnick, Orit Cohen Castel

International Nursing Research Congress (INRC)

Overview: This study contributes to the literature by examining a comprehensive operationalization of vaccination status among working-age (21-49 years), immigrant and non-immigrant adults.

Background: The commonly used outcome, obtained any vaccination versus not, tends to overestimate COVID-19 vaccination utilization, distorting the associations found with covariates/predictors. More recent studies have used a three-variable COVID-19 status outcome of any, partial or complete vaccinations. However, they lacked a theoretical framework and focused on older and non-immigrant populations. This study examined working-age immigrants and non-immigrants, used the three-variable operationalization of COVID-19 vaccination, and was guided by Andersen’s Behavioral Model with its three factors …

Nurses’ Lived Experiences During The Covid-19 Pandemic: A Descriptive Phenomenological Study, Kala Mayer, Jo Anne Bennett, Elizabeth Reifsnider, Jeanie Skibiski, Soojung Jo

International Nursing Research Congress (INRC)

The COVID-19 pandemic presented unprecedented challenges for nurses, including confronting end-of-life decisions, witnessing patient suffering, and burnout. Nevertheless, many nurses demonstrated resilience and personal growth despite adversities. Notable gaps in the literature include limited exploration of the long-term impacts of the pandemic on nurses, variations in experiences based on geographic, gender, and cultural factors, as well as the role of leadership and organizational response. Likewise, how nurses adapted to innovations such as new technologies and the impact of their pandemic experiences on patient outcomes and care quality remain underexplored. This study employed a phenomenological descriptive approach to capture nurses’ lived …

Exploring Cultural Dimensions Of Nurses' Experiences During Covid-19 In The Us And Hungary, Kala Mayer, Judit Staller, Jo Anne Bennett, Zoltán Balogh, Jeanie Skibiski, Anna Jeney, Soojung Jo, Elizabeth Reifsnider

International Nursing Research Congress (INRC)

Both the Hungarian and U.S. public health and care systems were inadequately prepared to manage the COVID-19 pandemic, contributing to significant distress among nurses. The role of geographical, gender, and cultural factors, along with leadership and organizational response during the pandemic between countries, remains underexplored in the literature. Nurses around the world are now more likely than before the pandemic to leave direct patient care roles. Cultural influences and healthcare system structure play crucial roles in shaping nurses' decisions to stay in or leave the profession. To address this research gap, we are using the lens of Hofstede’s Cultural Dimensions …

The Effect Of A Kn95 Mask On High-Intensity Interval Training Performance, Physiological Response, And Perception, David Kenny, Payton Stanziani, Holly Chambers, Madison Vinovrski, Isabel Allocco, Jack Fisher, Morgan Raley, Kyle S. Beyer

International Journal of Exercise Science

International Journal of Exercise Science 18(3): 984-994, 2025. The purpose of this study was to assess the effect of a KN95 mask on the performance, physiological response, and perception of high-intensity interval training (HIIT). Twenty college-aged participants (Male: 10, Female: 10) completed a two-visit, crossover, counterbalanced study. The HIIT workout included four 1-minute “all-out” intervals at 3.5% of body mass with 4-minute rest intervals, performed with or without a KN95 mask. Following HIIT, participants remained on the cycle ergometer for a 15-minute recovery period. For each interval, peak power and average power were recorded. Throughout the HIIT workout and recovery, …

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Covid-19 Adolescent Technology Use And Physical Activities: Cluster Analysis For Mental Health, Chunling Niu, Rui Jin, Ashley Love, Sohelia Sadeghi, Loren Cossette, Marissa Molina

Journal of Youth Development

This study examined how COVID-19 disrupted adolescent education, social interactions, and mental health by conducting exploratory cluster analysis to identify distinct profiles of technology use and physical activities, then comparing resulting clusters on demographics, social support, and mental health dimensions. Using the first wave of the longitudinal Oxford Achieving Resilience during COVID-19 (ARC) study of 1,196 United Kingdom adolescents aged 13-18, three clustering algorithms (k-means, k-medoids, and agglomerative hierarchical) identified optimal groupings validated both statistically and empirically. Three distinct clusters emerged: Cluster 1 (n = 380) characterized by low media use and moderate activity; Cluster 2 (n = 153) showing …

Restricted Social Engagement Is Associated With Depressive Symptoms In Older Chinese Adults: A Nationwide Cross-Sectional Study, Zheng Guo, Yulu Zheng, Yahong Zhu, Huacheng Wang, Jian Geng, Hengrui Liu, Piyong Ma, Lois Balmer, Xingang Li

Research outputs 2022 to 2026

Background and Aims: Social isolation has been linked to depressive symptoms in older adults. Previous studies have shown that greater engagement in social activities is associated with better mental health. However, it remains unclear whether restricted social engagement is related to poorer mental health outcomes. This study examined the association between reduced social activities/networking and the presence of depressive symptoms among community-dwelling older Chinese adults. Methods: During the COVID-19 pandemic, people chose to minimize going out to reduce the risk of infection, creating a natural setting that mimicked a passive intervention of restricted social engagement for community-based individuals. Data were …

Accordance And Conflict Between Religious And Scientific Precautions Against Covid-19 In 27 Societies, T. Samore, D.M.T. Fessler, A.M. Sparks, C. Holbrook, L. Aarøe, C.G. Baeza, M.T. Barbato, P. Barclay, R. Berniūnas, J. Contreras-Garduño, B. Costa-Neves, M.P. Grazioso, P. Elmas, P. Fedor, Li, Norman P., R. Fernández-Morales, L. Garcia-Marques, P. Giraldo-Perez, P. Gul, F. Habacht

Research Collection School of Social Sciences

Meaning-making systems underlie perceptions of the efficacy of threat-mitigating behaviors. Religion and science both offer threat mitigation, yet these meaning-making systems are often considered incompatible. Do such epistemological conflicts swamp the desire to employ diverse precautions against threats? Or do individuals—particularly individuals who are highly reactive to threats—hedge their bets by using multiple threat-mitigating practices despite their potential epistemological incompatibility? Complicating this question, perceptions of conflict between religion and science likely vary across cultures; likewise, pragmatic features of precautions prescribed by some religions make them incompatible with some scientifically-based precautions. The COVID-19 pandemic elicited diverse precautions thus providing an opportunity …

Engaging Students And Stakeholders In Times Of Crisis: Hbcus Bridging Social Capital On Facebook While Navigating Physical Distancing, Pamela Peters

Journal of Research Initiatives

COVID-19 placed a strain on colleges that tend to rely on tuition, especially small HBCUs, which traditionally serve a high percentage of underrepresented students. Being away from campus, many stakeholders were experiencing higher levels of stress and anxiety. Social media offers an outlet for schools and stakeholders to stay connected during a crisis. Using social capital, this study examined how small HBCUs bridged social capital on Facebook during the year before and the first two years of the pandemic. A comparative analysis of Facebook posts of 30 HBCUs with a student population of under 2000 was conducted to determine post …

The After Effects Of The Covid-19 Pandemic On The Mental Health Of International V/S Domestic Students - A Qualitative Study, Keerat Sidhu Bhatti

Doctoral Dissertations

The COVID-19 pandemic significantly impacted the mental health of both international and domestic graduate students, exacerbating social isolation, financial strain, and psychological distress. This qualitative study examines the long-term effects of the pandemic on these student populations, exploring shared and divergent experiences, coping strategies, and evolving priorities. While both groups faced heightened anxiety and academic disruptions, international students encountered additional stressors, including cultural displacement, visa uncertainties, and limited support networks. Domestic students, in contrast, struggled with routine disruptions but had greater access to familial and social support. Across both groups, the pandemic prompted a reassessment of personal and professional priorities, …

Exploring The Effects Of The Covid-19 Pandemic On The Biblical Organizational Culture Of A K-12 School In Kansas, Michael Jacob Wiebe

Doctoral Dissertations and Projects

The purpose of this qualitative research design was to understand the lived experiences of K-12 Christian school teachers regarding the perceived impact of the COVID-19 pandemic on the biblical organizational culture of a school in Wichita, Kansas. A qualitative interview methodology was utilized for teachers to answer questions pertaining to their own experiences in changes within the school, the school’s environment, and the school’s level of involvement in a biblical culture during and post the COVID-19 pandemic. The data were analyzed to understand the effects and the changes the COVID-19 pandemic has had on K-12 Christian school biblical organizational culture, …

The Impact Of Emergency Remote Learning During The Covid-19 Pandemic On Student Learning Outcomes, Kelley Bazemore

Creating Healthy Work Environments (CHWE)

Background: Prelicensure nursing programs have traditionally taught students in person. In March 2020, as the novel coronavirus spread, many programs changed to emergency remote learning.

Methods: This exploratory, retrospective study examined the impact of emergency remote learning on three learning outcomes (completing the program within the published time, scoring >74.7% on the ATI Comprehensive Predictor Assessment, and passing the NCLEX-RN on the first attempt). The study received IRB approval and was exempt from review. This study had two aims: to determine the relationship between the time students spent in emergency remote learning and three outcomes, and to examine the relationship …

The Covid-19 Pandemic As An Environmental Jolt And Its Impact On Firms And Essential Workers, Kimberly Kay Hyett Nehls

Electronic Theses and Dissertations

Environmental jolts are sudden, large-scale disruptions that challenge organizational and societal stability and demand new ways of understanding adaptation across individuals and firms. This two-paper dissertation explores the human and organizational dimensions of such jolts through the empirical context of the COVID-19 pandemic. Paper 1 examines how global tourism firms navigated the crisis, introducing the constructs of global stakeholder interconnectedness and stakeholder prioritization fluidity to refine stakeholder theory. The findings show how international exposure shaped communication strategies under duress. Paper 2 turns to the lived experiences of low-wage essential workers, extending sensemaking theory through the concept of constrained sensemaking, highlighting …

Ai-Driven Biomedical Perspectives On Mental Fatigue In The Post-Covid-19 Era: Trends, Research Gaps, And Future Directions, Saba Parveen, Md Belal Bin Heyat, Umair Tariq, Faijan Akhtar, Hafiz Muhammad Zeeshan, Seth Christopher Yaw Appiah, Shang-Ming Zhou, Huang Lei

School of Nursing and Midwifery

Mental fatigue is a complex condition arising from various neurological processes and influenced by external factors such as stress and cognitive demands. This comprehensive review elucidates the primary neurological mechanisms underlying mental fatigue, particularly emphasizing how it was elevated or otherwise affected during the COVID-19 pandemic. We explore the intricate relationship between prolonged cognitive tasks, chronic stress, and the development of mental fatigue, emphasizing the impacts that mental fatigue has on mental health across diverse populations. Utilizing advanced artificial intelligence techniques, including machine learning and deep learning, this study identifies and quantifies the patterns of mental fatigue. The innovative approach …

Investigating Relationships Between Education Professionals' Trauma Histories And Causal Attributions For Students' Disruptive Behaviors, Christina D. Rodefeld

Theses and Dissertations

Using attribution theory as a theoretical framework, this mixed methods study investigated how education professionals reported and perceived the relationship between their histories of trauma and their attributions for disruptive student behavior. Participants completed four surveys to measure Adverse Childhood Experiences, adulthood trauma, COVID-19-related trauma, and causal attributions for disruptive behavior. Bivariate correlations between each of the trauma history datasets and causal attributions datasets were conducted to investigate these relationships. Two semi-structured interviews with six participants were also conducted and analyzed using deductive and inductive coding processes. Quantitative analyses found a statistically significant relationship between participants’ reported adulthood trauma amounts …

The Influence Of School Closing Mandates On Student Performance During The Covid-19 Pandemic: A Case Study, Cody Ryan Ratliff

Doctoral Dissertations and Projects

The purpose of this embedded single case study was to describe the lack of student needs support during the COVID-19 pandemic for parents of middle school students at a county board of education in West Virginia. (Chiwona et al., 2020; Devereux et al., 2020; Dunn et al., 2020). The theory guiding this study was Abraham Maslow’s (1943) theory on the hierarchy of needs, which demonstrated an impact on student performance. This qualitative single-case study utilized an embedded approach. The central research question this study aimed to answer was to describe how a lack of necessary resources affected students during the …

Christian Schoolteachers’ Shared Experiences Of Learning And Teaching In The Face Of The Covid-19 Pandemic On The East Coast Of The United States, Elizabeth Joy Geddes

Doctoral Dissertations and Projects

This phenomenological study sought to better understand and describe the lived experiences of Christian schoolteachers who provided in-person instruction during COVID-19. Using a qualitative phenomenological design, 12 ACSI Christian schoolteachers from the East Coast of the United States were asked to share their stories of providing in-person instruction during the fall of 2020. While studies have explored the challenges and adaptations of public-school educators during COVID-19, there remains a significant gap in understanding the experiences of Christian schoolteachers who navigated in-person instruction amidst the pandemic. The gap highlights the need for focused research to capture the unique perspectives, challenges, and …

The Impact Of Gender, Training Year, Medical Specialty And The Covid-19 Pandemic On Resident Wellness, Sara Beachy, Jessica Luzier, Chantel Weisenmuller, Kathleen Bors, Mary Ann Maurer, Amna Anees, Tiffany Lasky, Lisa Calderwood

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Data are limited as to which factors most strongly impact medical trainees' well-being, and few studies have assessed trainee's wellness at multiple time points during the COVID-19 pandemic. Additionally, much research has not taken an intersectional approach to understanding the ways in which different facets of a resident's identity impact their wellness. Thus, more person-centred, probability-driven statistical approaches that can produce distinct heterogenous groups of individuals are warranted to understand the way in which different identities are associated with resident wellness scores.

METHODS: A latent profile analysis was conducted using institutional data from resident surveys administered from 2019 to …

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred Kim, Maureen Mcmahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, T Mark Beasley

Faculty, Staff and Students Publications

Objective: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

Methods: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …

Measuring The Impact Of A Delay In Care On Pediatric Otolaryngologic Surgery Completion, Geethanjeli N Mahendran, Ching Siong Tey, Mary Frances Musso, Grace Shebha Anand, Jeffrey Larson, Mitesh Mehta, Lara Reichert, Kara Prickett, Nikhila Pinnapureddy Raol

Faculty, Staff and Students Publications

Objective: To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression.

Methods: We identified patients ≤18 years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients' rate of and patterns of rescheduling surgery. Surveys were also sent to caregivers to better characterize his/her decision regarding moving forward with his/her child's surgery during COVID-19.

Results: A total of 1915 pediatric patients had elective surgeries canceled, of which 992 (51.8%) were rescheduled within 4 months. No …

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Seth Eisen, Alfred Kim, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

METHODS: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …

Factors Of Anxiety Symptoms Due To Large-Scale Social Restriction Policy During The Covid-19 Pandemic In Indonesia, Indri Hapsari Susilowati, Sudibyo Alimoeso, Susiana Nugraha, Bonardo Prayogo Hasiholan, Magda Sabrina Theofany Simanjuntak, Nur Rachmat Satria

Kesmas

The Indonesian Government took some preventive measures to slow the spread of the COVID-19 virus, including social restrictions and encouraging individuals to stay at home and avoid needless gatherings. This study aimed to identify factors related to anxiety symptoms during large-scale social restrictions. This study employed a cross-sectional design using the snowball technique in an online survey. A total of 788 respondents comprised the target population to detect the smallest effect size (Cohen's dz = .2), with the level of power of 0.8 using G*Power 3.1, specifically targeting adults aged over 18 years. Out of 1,194 people who took part …

The Psychological And Social Experiences Of Hospitalized Patients With Covid-19: A Qualitative Study, Fatma Kantaş Yılmaz, Zeynep Koca, Zuhal Kunduracılar

Makara Human Behavior Studies in Asia

Individuals infected with coronavirus disease 2019 (COVID-19) have experienced torrents of problems associated with the pandemic, impairing their health, mental, social, and economic conditions. This study aimed to determine the psychological reactions and emotions of patients with COVID-19 infection and the social consequences during hospitalization. The current study used a qualitative and phenomenological design at a training and research hospital in Istanbul, Turkey. The study sample included 17 patients (41.6 ± 16.5 years) who had been discharged after COVID-19 treatment. The gathered information was classified into two main domains (social and psychological) and relevant themes and subthemes using a content …

Qualitative Thematic Analysis Of Crisis Communications From The Digital Pulpits Of Megachurches During Covid-19, Ralph Dustin Henderson

Doctoral Dissertations and Projects

The purpose of this qualitative thematic analysis multi-case study was to explore how secular crisis communication theories were adopted and modified by theological themes in U.S. megachurches during the first six weeks of the COVID-19 pandemic related lockdowns. Image Repair Theory (IRT), Discourse Renewal Theory (DRT), and Rhetorical Arena Theory (RAT) were examined alongside Christian themes (Theodicy, Radical Love, Physical Care, and Nontraditional Stakeholder Scope). Thematic analysis of sermon transcripts from 18 megachurches showed that IRT modified: high-attribution tactics were minimal; denial (via IMRA theodicy) defended the Church Universal (CU); evasion justified Church Local (CL)actions; and offensiveness reduction (esp. Transcendence) …

Leading Through Critical Incidents: A Phenomenological Study Of K–12 School Leaders’ Responses To Critical Incidents, Terry-Ann Griffin

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore how K–12 school leaders respond to critical incidents in schools. A critical incident is any actual or alleged event or situation that creates a significant risk of substantial or severe harm to physical or mental health, safety, or well-being. The study focused on three major critical incidents: school shootings/gun violence, the COVID-19 pandemic, and racial unrest. The research was guided by Bandura’s Social Cognitive Theory, which explains human behavior through reciprocal interactions between personal, environmental, and behavioral factors. The central research question was: How do K–12 school leaders respond to …

Iowa Test Scores Before And After Covid-19 In Early Adolescents, Carmel F. W. Ontoy

Doctoral Dissertations and Projects

This paper addresses past research that examined the effects of COVID-19 on academics and presents a study further examining an area of academics before and after COVID-19. Research relating to COVID-19 has varied, studying correlations and effects on factors such as mental health and relationships. Researchers and educators projected various degrees of learning loss, and while some studies have revealed some loss, others have revealed little to no change. Further research is needed to continue developing researchers’ and educators’ understanding of how COVID-19 and the shift to online learning may have been related to learning and academics of young adolescents. …

Impact Of Sars-Cov-2 On Healthcare And Essential Workers: A Longitudinal Study Of Promis-29 Outcomes, Jocelyn Dorney, Imtiaz Ebna Mannan, Caitlin Malicki, Lauren E. Wisk, Joann Elmore, Kelli N. O'Laughlin, Dana Morse, Kristyn Gatling, Michael Gottlieb, Michelle Santangelo, Michelle L'Hommedieu, Nicole L. Gentile, Sharon Saydah, Mandy J. Hill, Ryan Huebinger, Katherine Riley Martin, Ahamed H. Idris, Efrat Kean, Kevin Schaeffer, Robert M. Rodriguez, Robert A. Weinstein, Erica S. Spatz, Inspire Group

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The mandatory service of essential workers during the COVID-19 pandemic was associated with high job stress, increased SARS-CoV-2 exposure, and limited time for recovery following infection. Understanding outcomes for frontline workers can inform planning for future pandemics.

OBJECTIVE: To compare patient-reported outcomes by employment type and SARS-CoV-2 status.

DESIGN: Data from the INSPIRE registry, which enrolled COVID-positive and COVID-negative adults between 12/7/2020-8/29/2022 was analyzed. Patient-reported outcomes were collected quarterly over 18 months.

SETTING: Participants were recruited across eight US sites.

PARTICIPANTS: Employed INSPIRE participants who completed a short (3-month) and long-term (12-18 month) survey.

EXPOSURE: SARS-CoV-2 index status and …