Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Anderson, Kelly K.

2nd Supervisor

Gilliland, Jason A.

Co-Supervisor

Abstract

COVID-19 posed novel challenges by limiting in-person interactions and shifting interactions online. Effects of online and offline social connectedness on adolescent mental health and well-being, and the moderating role of the social determinants of health (SDoH) were explored. Canadian adolescents (n=1,586; Mage=15.3, range 13 to 18 years; surveyed summer 2022) reported their social connectedness, psychological distress, and mental well-being. An ordinal logistic regression was performed to examine the association between social connectedness (online and offline) and dual-factor mental health. Responses to two open-ended survey questions were analyzed. Social disconnection was associated with higher odds of being in a poorer mental state, with a stronger association for offline than online social connectedness. The SDoH may moderate this relationship. Participants described negative and positive pandemic-related changes to relationships, mental health and well-being. Although online and offline social connectedness both contribute to adolescent mental health and well-being, offline social connectedness appears more impactful.

Summary for Lay Audience

COVID-19 posed novel challenges to mental health and well-being by limiting opportunities for in-person interactions and shifting them to the online setting. These challenges differentially burdened adolescents according to the Social Determinants of Health (SDoH). The SDoH are socioeconomic and structural factors which influence one’s state of health and well-being. The understanding of mental health and well-being in this thesis was informed by the dual-factor model, which considers both mental illness and mental well-being to understand an individual’s complete state of mental health. Social connectedness encompasses feelings of belongingness, closeness, and interpersonal connection with friends, family, peers, and society. Social connectedness may be derived both from online (i.e., social media) and in-person sources. Existing studies have not compared the impact of online and offline social connectedness on adolescent mental health and well-being at the late stages of the pandemic. This thesis aimed to: (1) compare the effects of online and offline social connectedness on the mental health and well-being of adolescents during the late stages of the COVID-19 pandemic; (2) explore the way this relationship may differ in various groups according to the SDoH; and (3) describe adolescents’ experience of pandemic-related changes to their relationships, mental health and well-being. Canadian adolescents surveyed during the late stages of the pandemic (June - July 2022) were asked about their levels of online and offline social connectedness, mental health, and mental well-being. They also responded to open-ended questions about pandemic-related changes to relationships, mental health and well-being.

Feeling socially disconnected was associated with higher odds of being in a poorer dual-factor mental health state. Offline social connectedness had a stronger effect than online social connectedness. This relationship may differ according to the SDoH. Negative pandemic-related changes included feeling socially disconnected, mental health challenges, and missing out on experiences. Positive changes included staying connected, decompressing or self-improving during lockdowns. For some, the negative impacts of the pandemic reversed during the later stages, while others reported lasting effects. These findings suggest that although online and offline social connectedness were both important contributors to adolescent mental health and well-being, offline social connectedness was more impactful.

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