Objective: The purpose of this study was to assess self-reported data from a sample of U.S. doctors of chiropractic during the COVID-19 pandemic about levels of psychological stress and beliefs of the association between chiropractic spinal manipulation and the immune system.

Methods: Chiropractors in the United States were invited via social media and e-mail to complete a survey about chiropractic and COVID-19. The survey collected demographic information, office protocols, changes made during the COVID-19 pandemic, chiropractic profession opinions, information related to stress, and personal beliefs from April 19 to May 3 of 2020. Data were analyzed using descriptive statistics.

Results: Of approximately 77000 U.S.-licensed chiropractors,750 responded. Of this sample, 51.2% reported moderate and 30.4% reported severe levels of psychological stress. The primary stressors were financial and business concerns. There was a mixed response regarding beliefs if there was evidence to support a connection between spinal manipulation and the immune system. A majority (76.1%) responded that there should be no advertising for immune-boosting effects of spinal manipulation during the pandemic. A minority (18.3%) reported adding use of telehealth to deliver their services.

Conclusion: A majority of chiropractors included in this survey reported that the COVID-19 pandemic caused them psychological stress. More than half of the respondents reported moderate stress, with the second highest number of respondents reporting severe stress. Subgroup differences were noted in stress levels and causes, as well as pandemic-related practice changes. A dichotomy was noted between beliefs and recommended actions about effects on the immune system, which may represent that providers are aware of current evidence and considering association recommendations.

Author keywords: Chiropractic; COVID-19; Professional Practice; Stress, Psychological

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