The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic

Abstract

Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed.

Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others.

Results: . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive.

Limitations: . Cross-sectional survey, preponderance of non-representative participants.

Conclusions: . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.

Keywords: COH-FIT; COVID-19; adolescents; adults; anxiety; children; depression; functioning; international; mental health; physical health; post-traumatic; psychiatry; representative; resilience; survey; well-being.

Fig. 1

Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) logo.

Fig. 2

COH-FIT survey participation flow chart Legend. ASRM, Altman Self-Rating Mania Scale (Altman et al., 1997); BOCS, Brief Obsessive Compulsive Scale (Bejerot et al., 2014); BRS, Brief Resilience Scale(Smith et al., 2008); CGAS, Children's Global Assessment Scale(Shaffer et al., 1983); GAD-7, Generalized Anxiety Disorder 7-item scale(Spitzer et al., 2006); OCD, Obsessive Compulsive Disorder; PCL-5, PTSD Checklist for DSM-5(Blevins et al., 2015); PHQ-9, Patient Health Questionnaire 9-item scale(Kroenke et al., 2001); PQ-LES-Q, Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire(Endicott et al., 2006); PQ-16, Prodromal Questionnaire-16(Ising et al., 2012); PTSD, Post-Traumatic Stress Disorder; SBQ-R, Suicidal Behaviors Questionnaire-Revised(Osman et al., 2001).

Fig. 3

COH-FIT variables universe Legend. P-score is a psychopathology composite score indicating an “overall” symptom measure. It includes anxiety, depressive, obsessive-compulsive, post-traumatic, delusional and hallucinatory experiences, as well stress, sleep, concentration.