Instructor Guide for COVID-19 Discussion and Activities to accompany: Health Psychology, 2nd Edition

[alanna_smith]

Chapter 1 What is Health Psychology

p. 2: Defining Health: Health is not merely the absence of disease, it is an optimal state of wellness that includes physical, emotional, and social well-being.  How does coronavirus and being socially isolated impact these different domains to influence people’s perception of their health?
p. 4: The Biopsychosocial Model: The coronavirus pandemic is clearly a biopsychosocial phenomenon.  It influences individuals, families, communities, nations, and the world in similar and different ways.  How is this pandemic, and COVID-19, a biopsychosocial phenomenon at each of these levels?
pp. 6 – 11: Health Around the World, Global Approaches, and Global Health Disparities: From the first case in Wuhan, China onward, each country has handled the coronavirus pandemic differently based on their political structure, economy, population, and perspectives.  We tend to have an ethnocentric view of the “right” ways to do things, but what are some of the features of different countries’ approaches that worked well to stem the contagion?  Why did these approaches work?  How much of a country’s success had to do with factors specific to that nation and its people?
p. 13: Health Disparities in the United States: What trends in social disparities can you see in the effects of the coronavirus?  What factors in the U.S. have contributed to these health disparities and what is being done about them?
p. 17: Historical Views of Health: Many people have said that the coronavirus pandemic is “unprecedented.”  But at the same time, comparisons to the Spanish Flu of 1918 are being made.  What can we learn from history regarding pandemics, and how has the 21^st century influenced the spread, medical treatment, and collective global understanding and awareness of this virus?  How will knowledge of history prepare us for the future?

Chapter 2 Gathering Information on Health & Illness
pp. 29 – 31: At the forefront of the coronavirus pandemic are the daily reports of incidence, prevalence, and mortality rates within regions, states, and nations.  Epidemiological research is at the heart of everything we know about the spread and global impact of this virus.  Take any recent news report of the COVID-19 predictions, death rates, projections for “flattening the curve,” and apply what you know about epidemiological research to help you understand how these results and conclusions are drawn.
pp. 32-40 This chapter presents research methods, including clinical trials, the role of placebos, and the ethics of science, all of which are relevant when considering the factors influencing who was tested for COVID-19, how treatment decisions were made, the progress for testing for antibodies, and the development of a vaccine.  Additionally, there have been pharmaceutical agents and home remedies suggested that scientists have pointed out have no scientific or medical evidence to indicate that they work, and data that suggests they may actually be harmful.  How do you absorb this information in light of what you know about scientific research methods?
p. 47: Around the World: The Health Threat of the Century: At the time this edition was published we did not know about coronavirus and COVID-19.  How would you change the focus of this “Around the World” feature now?

Chapter 3 Health Beliefs and Behaviors
pp. 52 – 53: Health Behaviors: Washing hands, wearing masks, staying six feet apart, not touching our faces—these are all health behaviors, some of which will be new to most of us.  Many people find it is especially difficult to change a behavior like touching the face.  How can we change this behavior?  What steps are necessary to create a new health habit?  Using the information from the textbook on health behavior and behavioral change, can you design a method for breaking the face-touching habit or increasing adherence to the 6-foot rule?
p. 70: There are many ways our country, our towns, the businesses, schools, and organizations in our areas have used social engineering to help us follow restrictions designed to curb the spread of COVID-19.  Think and share with others the things that you’ve noticed with regard to social engineering. 
p. 70: When counties and cities started opening again and people talked about the “new normal” after the COVID-19 outbreak, how do you think people’s behaviors changed?  Are there some health behaviors adopted during the pandemic that may not change?  Are there any ways in which you think the pandemic has changed your behavior permanently?

Chapter 4 Health-Enhancing Behaviors
p. 88: Patterns of Eating: The pandemic caused many shifts in our eating behaviors.  What factors (from stress eating, personality, to the patterns of eating mentioned in the textbook) may influence the way people eat while they are coping with the lifestyle changes brought about by social isolation, quarantine, and the restrictions associated with the COVID-19 pandemic?
p. 92: The Benefits of Exercise: Many people were prevented from going to the gym or getting their regular exercise during the pandemic.  Maybe this has happened to you as well.  How challenging has it been to find new ways to get physical exercise?  What do these lifestyle changes tell us about our perception of the barriers to exercise?  How has this influenced your mental and physical well-being?
p. 96: Sleep: There have been many news reports about the impact of the coronavirus pandemic on peoples’ sleep patterns.  From the textbook we know the importance of sleep for health and well-being.  How has this pandemic influenced your sleep?  What are the individual factors that seem to be affecting you?
p. 102: Other Health-Enhancing Behaviors: Many people engage in preventative medicine and visit their doctors regularly for cancer screenings, routine blood work, and regular annual examinations.  With the lockdown and closure of medical offices and on non-essential medical visits, people’s preventive health behaviors have been impacted.  What do you think the long-term effects of this pandemic will be on people’s preventive health behavior in the future?  Will some people be more conscientious about keeping track of health or will they become more lax about getting regular medical check-ups?  How will this pandemic impact the medical profession?

Chapter 5 Health-Compromising Behaviors
p. 111: Why Take Risks?: The concept of risky behaviors has changed dramatically with the coronavirus pandemic.  As we know from this chapter, there are many factors that influence the perception of risk.  Looking at the theory of triadic influence, how can you explain the patterns in risk behaviors that you observed around you during this pandemic?
p. 124: Eating Disorders: How did the perception of threat, the stress of the pandemic, and the perception of food availability or scarcity impact peoples’ consumption of food during the pandemic?  How might this have exacerbated eating disorders?
p. 131: Substance Use and Abuse: How did the perception of threat, the stress of the pandemic, and social isolation, quarantine, and other restrictions influence peoples’ substance use during the pandemic?  How might this have exacerbated substance abuse disorders?

Chapter 6 Understanding Stress
pp. 153 – 171: Everyone reacts differently to stress.  However, the biopsychosocial stress process is common to most people.  From a biopsychosocial approach, how has the stress of COVID-19 influenced your life in each of these domains?  From the transactional approach, have you viewed the pandemic as a loss, threat, or challenge?  Were there acute episodes of stress within the chronically stressful time period of the pandemic?  How did you experience each of those events?  If you think about the developmental influence of the coronavirus, how might the stress of the pandemic be experienced differently by children, teens, and young-, middle-aged-, and older adults?  Are there particular things associated with the pandemic and the virus that are stressful at different stages of life?
pp. 181 – 182: In this chapter we examine the link between stress and physical and mental health.  We delve into PTSD as well.  Can you think about how your health has been negatively affected by the stress of COVID-19?  Do you know any essential workers or people who were on the front lines in treating this virus?  Did they experience PTSD?  How has reading and watching the daily death tolls of this virus and the tragic stories of this pandemic influenced your mental and physical health?
p. 182: Increased exposure to traumatic information from news and social media can have a triggering effect on those who have previously experienced trauma and PTSD.  How might the constant media attention create stress in all of us and exacerbate or trigger episodes of PTSD in those who have had previous trauma?  Think of someone who has experienced domestic violence being forced to quarantine at home in an unsafe environment, for example.  What signs could you look for if you were concerned about a loved one’s well-being?  Where would you recommend that they go to get help?  How does telemedicine and e-therapy provide assistance?

Chapter 7 Coping with Stress
p. 188: Coping Across the Lifespan: We have thought about how age might differentially influence how stress is perceived and experienced.  But how does age influence coping?  We know how important resources are to coping, but how did the coronavirus pandemic influence people’s resources and how did that, in turn, affect their coping?
p. 191: Choosing the Best Fit: The matching hypothesis suggests that to cope well we need to tailor our coping strategies to the stressor.  In the many new and highly stressful experiences associated with coronavirus, how do you tailor your coping?  How do you identify those stressors that are problems that can be solved and those events that are not solvable but must be emotionally managed?  Can you think of examples of each of these?  What is the role of personal control in coping with COVID-19 and the coronavirus pandemic?  We know that things that are unexpected, unpredictable, and create change in our lives are the most stressful.  How has this virus impacted your life in these ways?  How do you cope?p. 208: In The News: When No News Is Good News: In this feature we look at how major traumatic events such as terrorism, natural disasters, and war impact peoples’ lives.  We look at resilience and how to go beyond coping to growth.  Specifically, this feature examines how we can control our exposure to the media to promote coping and resilience in the face of trauma.  There are many ways we can apply what we learn here to our own lives during COVID-19 and find ways to cope better, develop resilience, and even find opportunities for growth.  Can you apply these principles to your life and your experiences?

Chapter 8 Symptom and Pain
p. 212: Recognizing symptoms: Many people were very confused about the conflicting information regarding the symptoms associated with COVID-19, as the symptoms overlap with many strains of the flu, the common cold, or other respiratory infections.  Many people initially thought they might have had the virus, but when they sought medical treatment they were not tested.  Given that people are notoriously poor at recognizing, labeling, and seeking treatment for symptoms in general, how will the pandemic influence peoples’ perceptions of their internal physiological experiences and when they should seek treatment for them?  Think about the illness perception model.  Has the coronavirus pandemic changed what we interpret as concerning symptoms worthy of seeking medical care?
p. 217: Delay in Seeking Treatment: Many factors influence when people seek treatment for disease.  In the unprecedented times of the coronavirus it became difficult to go to one’s primary care doctor, and many people feared going to the emergency center or urgent care because of the number of cases being treated in hospitals.  How do you interpret peoples’ delay behavior in terms of the anxieties and fears that this pandemic created for seeking medical care?

Chapter 9 Cardiovascular Disease and Diabetes

pp. 243 – 266: There are some research findings on COVID-19 that suggest that obesity and pre-existing conditions, as well as age, made the virus more dangerous and life-threatening for some people.  What are the physiological factors associated with cardiovascular disease and diabetes that might have elevated risk for COVID-19 for people who have these conditions?

Chapter 10 Psychoneuroimmunology and Related Disorders
pp. 267 – 296: People with immune disorders or compromised immune systems were at higher risk for COVID-19.  There are many accounts in the news about people who were in the midst of cancer treatment who were impacted by the virus.  It must have been extremely stressful for them.  How might these people have managed their risks and how might the changes in treatments impacted their mental and physical health during this pandemic?

Chapter 11 Chronic and Terminal Illness
pp. 301 – 303: Emotional Responses to Stress: The number of people who have died from COVID-19 worldwide is astounding.  Treatment in hospitals and other treatment facilities (such as nursing homes) required that people with the virus were kept quarantined and isolated, their only contact being with the medical staff overseeing their care.  Many people faced the end of their lives alone.  How do you think that exacerbated the emotional processes associated with death and dying?
pp. 315 – 319: End of Life: In the early stages of the coronavirus as the alarming number of cases in countries like China, Italy and in New York City began rising, there was concern about the number of available ventilators and hospital beds to care for all those who were projected to become ill with COVID-19.  Several articles appeared in reputable news outlets about the ethical, moral, and practical challenges for hospital physicians in determining who should get life-saving equipment.  These challenges presented difficult end-of-life decisions and changed the way medical care was thought about during this crisis.  If you saw these news reports, what were your thoughts?  How did these discussions change the way you think about health care and end-of-life care?
pp. 320 – 322: Coping with Loss: The pandemic has also impacted the way that we cope with loss, the way that we mark death, and the way that we grieve.  For example, in the time of quarantine and social distancing it became impossible to have funerals and bury the dead the way we might in other times.  Many families whose loved ones died from COVID-19 had to deal with the fact that they could not be with or say their goodbyes to their loved one, because they were being kept in isolation in hospitals/nursing homes and because COVID-19 deaths often happen very quickly with little time to prepare the family.  Families also could not hold ceremonies, funerals, memorial services, or worship the dead person in the desired way since gatherings of two or more people were against restrictions in many states.  ?  What additional emotional impact might this have on the grief process and how does it affect survivors?

Chapter 12 Health Care Services, Systems, and Alternatives
p. 327: There have been so many changes to the health care system and the way health care is performed due to the coronavirus pandemic, from telemedicine, to a cancellation of “elective” surgeries, to a shortage of supplies to protect health care providers and treat patients.  How will this pandemic change the health care profession?  How will it impact health care delivery?  How will hospitals change to be better prepared for the future?  What does this mean for our health care system nationally and globally?
p. 328: Health Care Services: Nursing homes and other long-term care facilities were hit hard by COVID-19.  Some of the largest death rates are associated with these institutions.  What caused these high rates of contagion and high death rates?  How will these institutions need to change to be better prepared for the future?  What is the public perception of these health care institutions now?  How must that be repaired for the people to feel comfortable and safe placing a loved one in one of these facilities?
p. 328: Health Care Services: The President of Bard College, Dr. Leon Botstein, gave a webinar for the parents of students of the college about how the coronavirus pandemic will affect students, faculty, staff, parents, and the future of education.  In it, he predicted that this pandemic will impact the importance of higher education in general, that more students will consider seeking education in the health care and medical fields, and that there will be an increased interest in biomedicine, medical and nursing training, and hospital and health care administration.  Do you agree?

Chapter 13 Achieving Emotional Health and Well-being
p. 357: Health & Well-Being: The individual wellness wheel shows the important pieces that go together to promote mental and physical health and well-being.  This pandemic has certainly presented challenges in many of these domains.  Through self-reflection can you think of the ways in which your emotional, intellectual, physical, social, environmental, financial, and spiritual life has been affected by the pandemic?  What did you need to do to preserve your well-being?  Are there things that you began doing during the pandemic that helped you to cope and stay well that you will carry into your future? 
pp. 364 – 365: Resilience: What does the term “resilient” mean to you and how can we be more resilient in the face of a pandemic such as coronavirus?

Chapter 14 The Future of Health Psychology
Health psychology is at the foundation of everything that we learn about coronavirus and COVID-19.  It helps us to understand the data and information shared by the media, to understand the science and medical advances being made, to evaluate the global, federal, and local policies that have impacted our lives, and it helps us to think about how we, as individuals, fare through a crisis of such unpredictable and unprecedented magnitude.  What do you think the future of the field will look like?  What will the next edition of this textbook need to present?  Can you think about all the ways that what you have learned has been changed by what you now know about COVID-19 and the coronavirus pandemic?  When will this become history?  And what will the world look like when we are there?