Understanding Whole-Person Health and Resilience During the COVID-19 Pandemic and Beyond: A Cross-sectional and Descriptive Correlation Study

Abstract

Background The COVID-19 pandemic has prompted an interest in whole-person health and emotional well-being. Informatics solutions through user-friendly tools such as mobile health apps offer immense value. Prior research developed a consumer-facing app MyStrengths + MyHealth using Simplified Omaha System Terms (SOST) to assess whole-person health. The MyStrengths + MyHealth app assesses strengths, challenges, and needs (SCN) for 42 concepts across four domains (My Living, My Mind and Networks, My Body, My Self-care; eg, Income, Emotions, Pain, and Nutrition, respectively). Given that emotional well-being was a predominant concern during the COVID-19 pandemic, we sought to understand whole-person health for participants with/without Emotions challenges. Objective This study aims to use visualization techniques and data from attendees at a Midwest state fair to examine SCN overall and by groups with/without Emotions challenges, and to explore the resilience of participants. Methods This cross-sectional and descriptive correlational study surveyed adult attendees at a 2021 Midwest state fair. Data were visualized using Excel and analyzed using descriptive and inferential statistics using SPSS. Results The study participants (N=182) were primarily female (n=123, 67.6%), aged ≥45 years (n=112, 61.5%), White (n=154, 84.6%), and non-Hispanic (n=177, 97.3%). Compared to those without Emotions challenges, those with Emotions challenges were aged 18-44 (P<.001) years, more often female (P=.02), and not married (P=.01). Overall, participants had more strengths (mean 28.6, SD 10.5) than challenges (mean 12, SD 7.5) and needs (mean 4.2, SD 7.5). The most frequent needs were in Emotions, Nutrition, Income, Sleeping, and Exercising. Compared to those without Emotions challenges, those with Emotions challenges had fewer strengths (P<.001), more challenges (P<.001), and more needs (P<.001), along with fewer strengths for Emotions (P<.001) and for the cluster of health-related behaviors domain concepts, Sleeping (P=.002), Nutrition (P<.001), and Exercising (P<.001). Resilience was operationalized as correlations among strengths for SOST concepts and visualized for participants with/without an Emotions challenge. Those without Emotions challenges had more positive strengths correlations across multiple concepts/domains. Conclusions This survey study explored a large community-generated data set to understand whole-person health and showed between-group differences in SCN and resilience for participants with/without Emotions challenges. It contributes to the literature regarding an app-aided and data-driven approach to whole-person health and resilience. This research demonstrates the power of health informatics and provides researchers with a data-driven methodology for additional studies to build evidence on whole-person health and resilience.

Using data visualization to characterize whole‐person health of public health nurses

“…The finding that there were inverse relationships between strengths and challenges/needs is consistent with previous MSMH studies, where concepts identified as strengths were less often identified as challenges and less likely to have needs, and vice versa (Agboola et al, 2022; R. R. R. R. Austin, Mathiason, Lu, et al, 2022;Rajamani et al, 2022). This aligns with the literature: healthy individuals with many strengths may not have as many challenges or needs;…”

“…The level of PHN strengths exceeded that of all pre-vious samples reported in MSMH research (Agboola et al, 2022; R. R. R. R. Austin, Mathiason, Lu, et al, 2022;Rajamani et al, 2022). This aligns with literature noting the ability of PHNs to manage stressful situations through resilience factors and coping abilities (Kim et al, 2022;Monsen, Austin, Goparaju, et al, 2021;Nordstrom, 2022;Sierra-García et al, 2022).…”

“…The finding that PHNs had fewest strengths and most challenges and needs in four problem concepts ( Emotions, Sleeping, Nutrition and Exercising ) was previously observed in a study of Minnesota State Fair attendees in 2021 during the COVID‐19 pandemic (Rajamani et al., 2022) and was partially observed in a rural population in Nigeria (Agboola et al., 2022) and in a sample from the Minnesota State Fair in 2017 (R. R. Austin, Mathiason, Lu, et al., 2022; Rajamani et al., 2022). That this pattern persists over time in diverse samples and settings suggests an important relationship between mental health and self‐care that has been previously studied in various forms (Chambers et al., 2007; Colditz et al., 1997; Gu et al., 2019; Heuel et al., 2022; Kagan et al., 2022; Perry et al., 2018; Tai et al., 2014; Tucker et al., 2013; Van Herk et al., 2011).…”

“…Further research is needed to examine the financial motivations of PHNs and ways to support their income needs. Austin, Mathiason, Lu, et al, 2022;Rajamani et al, 2022).…”

“…That this pattern persists over time in diverse samples and settings suggests an important relationship between mental health and self‐care that has been previously studied in various forms (Chambers et al., 2007; Colditz et al., 1997; Gu et al., 2019; Heuel et al., 2022; Kagan et al., 2022; Perry et al., 2018; Tai et al., 2014; Tucker et al., 2013; Van Herk et al., 2011). Sleep, nutrition and physical activity are three health behaviors known to impact mental health, however the interrelationships among them and how they may individually or collectively influence whole‐person health is not fully understood (Firth et al., 2020; Gu et al., 2019; Heuel et al., 2022; Rajamani et al., 2022; Wickham et al., 2020). The use of MSMH in future prospective studies may help to understand interrelationships among these problems.…”