Background Although social and structural inequalities associated with COVID-19 have been documented since the start of the pandemic, few studies have explored the association between pandemic-specific risk factors and the mental health of minority populations. Aims We investigated the association of exposure to the virus, COVID-19-related discrimination and stigma with mental health during the COVID-19 pandemic, in a culturally diverse sample of adults in Quebec (Canada). Method A total of 3273 residents of the province of Quebec (49% aged 18–39 years, 57% women, 51% belonging to a minority ethno-cultural group) completed an online survey. We used linear and ordinal logistic regression to identify the relationship between COVID-19 experiences and mental health, and the moderating role of ethno-cultural identity. Results Mental health varied significantly based on socioeconomic status and ethno-cultural group, with those with lower incomes and Arab participants reporting higher psychological distress. Exposure to the virus, COVID-19-related discrimination, and stigma were associated with poorer mental health. Associations with mental health varied across ethno-cultural groups, with exposed and discriminated Black participants reporting higher mental distress. Conclusions Findings indicate sociocultural inequalities in mental health related to COVID-19 in the Canadian context. COVID-19-related risk factors, including exposure, discrimination and stigma, jeopardise mental health. This burden is most noteworthy for the Black community. There is an urgent need for public health authorities and health professionals to advocate against the discrimination of racialised minorities, and ensure that mental health services are accessible and culturally sensitive during and in the aftermath of the pandemic.

Purpose: The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines. Design: This is a cross-sectional study. Setting: Participants responded to an on-line survey in June 2020. Subjects: The study included 3,183 residents within Quebec, Canada aged 18 and over. Measures: Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention. Analysis: We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis. Results: TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB. Conclusions: COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes ( p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes ( p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. Public Policy Relevance StatementTo date, there has been limited research into how coronavirus disease (COVID)-related

Objectives: This article describes an intervention that took place in Québec, Canada, to mitigate COVID-19 vaccine tension in schools, exacerbated by the 12-17 years old vaccination campaign. Building on this initiative, it proposes guiding principles for prevention and intervention in conflict around COVID-19 vaccination in and around schools. Intervention: Three complementary tools were developed by a community program, CoVivre, in collaboration with an interdisciplinary team, to help practitioners and parents understand vaccine tensions and their impact on youth, and to suggest simple ways to prevent and intervene in vaccine related conflicts. Recommendations: A thorough research evaluation could not be performed due to the rapid crisis response; however, the tools received positive feedback by practitioners, institutions, and decision makers. Recommendations were structured around the following principles: (a) fostering transparent and nuanced health communications; (b) avoiding confrontation and refusing to escalate while strongly condemning criminal acts; (c) encouraging open dialogue; and (d) preserving relationships. Implications: Mental health consequences of public health interventions should be considered at inception to avoid collateral damages. Removing children from the heart of societal conflict and maintaining the family-school relationship is crucial to child development. It is imperative to engage interdisciplinary teams to protect youth from societal polarization, and provide an opportunity for growth and resilience. This initiative suggests that more research is needed on the impacts of encouraging an open dialogue around vaccination, and adopting an empathetic approach amongst youth towards others who may not share the same opinion.

Objectives Vaccine hesitancy is a multifaceted decision process that encompasses various factors for which an individual may choose to get vaccinated or not. We aimed to identify the relationship between COVID-19 conspiracy theories, general attitudes towards vaccines, current COVID-19 vaccine factors, and COVID-19 vaccine hesitancy. Methods The present research is a multi-province cross-sectional study design. Survey data were collected in May and June 2021 ( n =4905) in the Canadian provinces of Alberta, Ontario, and Quebec. Multivariate ordinal regression models were used to assess the association between vaccine hesitant profiles and COVID-19 conspiracy theories, general attitudes towards vaccines, and specific factors pertaining to COVID-19 vaccines. Results Participants were aged 18 to 40 years and 59% were women. Individuals with low income, with low educational attainment, and/or who are unemployed were more likely to be vaccine hesitant. COVID-19 conspiracy theory beliefs and general attitudes towards vaccines are significantly associated with greater hesitancy for the COVID-19 vaccine. Vaccine factors including pro-vaccine actions and opinions of friends and family and trust in scientists and government as well as the country in which a vaccine is manufactured are associated with less vaccine hesitancy. Conclusion Conspiracy theories are distinct from criticism and concerns regarding the vaccine. Nevertheless, poverty, low level of education, and distrust towards the government are associated with higher odds of being vaccine hesitant. Results suggest it is imperative to deliver transparent and nuanced health communications to address legitimate distrust towards political and scientific actors and address the societal gap regarding general attitudes towards vaccines as opposed to focusing solely on COVID-19. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00693-x.