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Wang J, Wang S, Xiao B, Li J, Feng Y, Li Y. Maternal distress, parenting stress, maladaptive parenting and children's problematic media use in China: evidence from 2022 spring in Shanghai. BMC Public Health 2024; 24:1857. [PMID: 38992640 PMCID: PMC11238508 DOI: 10.1186/s12889-024-19382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/05/2024] [Indexed: 07/13/2024] Open
Abstract
The COVID-19 lockdown has forced young children to spend more time on media and significantly impacted their mothers' mental health. This study explored how mothers' individual distress influences children's problematic media use during the Shanghai citywide lockdown caused by COVID-19. Data were collected from 1889 Chinese mothers (Mage = 34.69 years, SD = 3.94 years) with preschoolers aged 3-6 years (Mage = 4.38 years, SD = 1.06 years; 49.0% boys) via an online survey. The statistical analyses relied on SPSS Statistics version 26.0 and macro-program PROCESS 3.3. to investigate the associations and mediation analysis among all the study variables. The results indicated a positive association between maternal distress and children's problematic media use, mediated by parenting stress and maladaptive parenting. Specifically, the serial mediation analysis revealed that high levels of maternal distress exacerbate parenting stress, which in turn leads to maladaptive parenting practices. These maladaptive practices subsequently increase problematic media use in preschool children. The findings highlighted that parents need to enhance their ability to manage risk and promote mental health during periods of significant stress and routine disruption to reduce children's problematic media use.
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Affiliation(s)
- Jingyao Wang
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Shumin Wang
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | | | - Juan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Yuemin Feng
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China.
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2
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Kelly MM, Copel L, Herbers JE, Knight AC, McKay MA, McKeever A, Pariseault C. Family experiences reported by healthcare worker parents during the COVID-19 pandemic. J Pediatr Nurs 2024; 77:53-62. [PMID: 38479063 DOI: 10.1016/j.pedn.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE Parents, who were working as essential frontline healthcare workers experienced unique stressors during the COVID-19 pandemic including disruption of regular routines, long lapses away from family, extreme work stress and subsequent difficulty in compartmentalizing work-related concerns when at home. The purpose of this study was to assess COVID-19 exposure and impact of frontline healthcare workers who are parents. DESIGN & METHODS This study quantitatively assessed the COVID-19 exposure and impact and qualitatively explored perceptions of parents of children 9 to 17 years of age, who were also frontline healthcare workers. RESULTS Participants (N = 79) using the COVID-19 Exposure and Family Impact Survey (CEFIS) reported exposure mean scores of 10.03 (SD = 2.63); and impact scores mean scores of 3.18 (SD = 0.46). Thematic analysis identified four themes, each with 2 subthemes: 1) family stressors increased (e.g., concerns about health and safety, losses of lifestyle patterns); 2) changes in children's health and well-being (e.g., isolation from family and friends, mental health problems); 3) virtual school difficulties (e.g., parent and student challenges, home school option); 4) skill building opportunities (e.g., enhanced emotional connections, increased family activities). CONCLUSION The CHAMPS Family Health Study suggests that families of essential workers are especially vulnerable to the effect of COVID-19, as are those families of essential workers who include child/ren with special health care needs. PRACTICE IMPLICATIONS Preparation for future emergencies requires strategies to mitigate consequences and promote well-being. These results highlight the need for supportive approaches to decrease the negative consequences of stress and to augment skills for family connection and cooperation.
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Affiliation(s)
- Michelle M Kelly
- Villanova University, M. Louise Fitzpatrick College of Nursing, United States of America.
| | - Linda Copel
- Villanova University, M. Louise Fitzpatrick College of Nursing, United States of America
| | - Janette E Herbers
- Villanova University, Department of Psychological & Brain Sciences, United States of America
| | - Abigail C Knight
- Villanova University, Department of Psychological & Brain Sciences, United States of America
| | - Michelle A McKay
- Villanova University, M. Louise Fitzpatrick College of Nursing, United States of America
| | - Amy McKeever
- Villanova University, M. Louise Fitzpatrick College of Nursing, United States of America
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3
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Sutherland-Foggio MS, Stanek CJ, Buff K, Nahata L, Foster-Akard T, Gerhardt CA, Skeens MA. The experiences of families of children with cancer during the COVID-19 pandemic: A qualitative exploration. Palliat Support Care 2024; 22:281-288. [PMID: 37559193 DOI: 10.1017/s1478951523001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVES The COVID-19 pandemic posed new challenges to physical and psychological well-being. Families with pediatric cancer patients were particularly vulnerable due to changes like children staying at home, hospital policy shifts, and caring for an immunocompromised child. Limited research exists on COVID-19's effects on these families. This study aimed to assess the pandemic's impact and identify psychosocial support gaps. METHODS Participants (N = 256) were parents of children with cancer recruited via Facebook in partnership with Momcology®, a community-based organization for pediatric cancer, between February and May 2021. Qualitative analyses used open-ended responses about the pandemic's impact on the family. RESULTS Analysis revealed 6 themes, with positive and negative sentiments: family changes (n = 169; 61% negative), social isolation (n = 154; 100% negative), emotional impact (n = 143; 89% negative), school changes (n = 126; 80% negative), health-care changes (n = 111; 96% negative), and physical health (n = 49; 73% negative). Family changes overarched all themes and included financial strains, at-home schooling, and family bonding. Parents highlighted social isolation and the emotional impact of pandemic-related changes. School changes forced parents to balance remote-work and childcare. Health-care changes limited resources and visitation. Parents reported their children were less active and slept less but had fewer illnesses. SIGNIFICANCE OF RESULTS Many common pandemic challenges were exacerbated by the stress of caring for a child with cancer. Parents struggled most with loss of social support and feelings of isolation. Careful consideration should be given to providing resources for parents of children with cancer and their families.
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Affiliation(s)
- Malcolm S Sutherland-Foggio
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Charis J Stanek
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Leena Nahata
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Cynthia A Gerhardt
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Micah A Skeens
- The Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
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Stiles-Shields C, Reyes KM, Lennan N, Zhang J, Archer J, Julion WA, Shalowitz MU. Community Teens' COVID-19 Experience: Implications for Engagement Moving Forward. J Clin Psychol Med Settings 2024; 31:143-152. [PMID: 37803094 PMCID: PMC11174976 DOI: 10.1007/s10880-023-09975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/08/2023]
Abstract
Data collected from pediatric primary care settings during the pandemic suggest an increase in internalizing symptoms and disparities in care based upon minoritized identity status(es). To inform care moving forward, the current study characterized the pandemic and related technology usage experiences of teenaged pediatric patients from communities with high hardship indexes. As part of a larger mixed-methods study, 17 teens (Mean age = 15.99 ± .99) and 10 caregivers independently voiced experiences related to the pandemic during remote focus group and interview sessions. Thematic analyses were used to assess qualitative data; descriptive analyses were used to characterize qualitative data. Despite no direct queries about the pandemic, 41% of teens and 40% of caregivers described their lived experiences during the pandemic. Two subthemes emerged within the primary theme of COVID-19: (1) Wellness/Mental Health and (2) Smartphone Use and Utility. Although distress and negative effects were voiced, questionnaire data indicated normative psychosocial functioning for both teen self-report and caregiver proxy report. Informed by the voiced experiences of teens and their caregivers from communities with high hardship indexes, methods for better assessing and managing internalizing symptoms in teen patients are presented. A multi-modal and multi-informant approach that leverages technology to garner information about teens' experiences and deliver care may help improve the well-being of teens in communities systemically burdened with disparities.
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Affiliation(s)
- Colleen Stiles-Shields
- Institute for Juvenile Research, Department of Psychiatry, The University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA.
| | - Karen M Reyes
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
| | - Nia Lennan
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Joseph Archer
- School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Wrenetha A Julion
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, USA
| | - Madeleine U Shalowitz
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
- Department of Pediatrics, Rush University Medical Center, Chicago, USA
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Skeens MA, Ralph JE, Olsavsky AL, Buff K, Shah N, Akard TF, Gerhardt CA. The Impact of the COVID-19 Pandemic on the Quality of Life of Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024; 41:85-95. [PMID: 38008953 DOI: 10.1177/27527530231194592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Background/objectives: Little is known about the COVID-19 pandemic and its impact on the quality of life (QoL) of children with cancer who may be more vulnerable to the pandemic's effects. We examined associations between COVID-19 exposure and impact on parent-proxy reported QoL in children with cancer, and potential moderation based on the child's cancer status (i.e., time since diagnosis, on/off treatment). Design/method: Parents of children with cancer were recruited February-April 2021 via Facebook and Momcology. Parents completed the COVID-19 Exposure and Family Impact Scale and a child QoL measure. Controlling for parent age, income, child age, and child sex, we examined the indirect effect of COVID-19 impact on the association between COVID-19 exposure and parent-proxy reported child QoL, as well as the moderating role of cancer status. Results: Parents (N = 401) reported lower child QoL scores (M = 59.74) than prepandemic reports of children with cancer, t(735) = -6.98, p < .001. Mediation analyses revealed a significant indirect effect, 95% CI [-0.47, -0.13]: Higher COVID-19 exposure was associated with higher COVID-19 impact (a = 0.47, p < .001), which was related to lower QoL (b = -0.56, p < .001). The association between impact and QoL was stronger as time since diagnosis increased (95%CI [-0.08, -0.001]), yet treatment status did not moderate this path. Conclusions: Parents who report greater COVID-19 impact may also report lower QoL in their children with cancer, especially further from diagnosis. Nurses and clinicians should be aware of the pandemic's negative impact and screen for COVID-19 related distress. Additionally, results highlight the importance of long-term, family-centered care, regardless of whether children receive treatment or survivorship care.
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Affiliation(s)
- Micah A Skeens
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jessica E Ralph
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anna L Olsavsky
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Nilay Shah
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- The Ohio State University College of Medicine, Columbus, Ohio, USA
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Romagnoli BR, Phan TLT, Lewis AM, Alderfer MA, Kazak AE, Arasteh K, Enlow PT. The Psychosocial Impact of the COVID-19 Pandemic on Families of Youth of Color: A Prospective Cohort Study. J Pediatr Psychol 2024; 49:98-106. [PMID: 37930074 PMCID: PMC10874214 DOI: 10.1093/jpepsy/jsad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE Prospectively examine racial and ethnic disparities in exposure to COVID-19-related stressors and their impact on families. METHODS A racially, ethnically, and socioeconomically diverse cohort of caregivers of youth (n = 1,581) representative of the population served by a pediatric healthcare system completed the COVID-19 Exposure and Family Impact Scales in Oct/Nov 2020 and March/April 2021. Linear mixed-effects models were used to examine exposure to COVID-19-related events (Exposure), impact of the pandemic on family functioning and well-being (Impact), and child and parent distress (Distress) across time and as a function of race and ethnicity, adjusting for other sociodemographic variables. RESULTS Exposure and Distress increased over time for all participants. After adjusting for sociodemographic factors, caregivers of Black and Hispanic youth reported greater Exposure than caregivers of White youth and caregivers of Black youth had a greater increase in Exposure over time than caregivers of White youth. Caregivers of White youth reported greater Impact than caregivers of Black and Other race youth. CONCLUSIONS Exposure to and impact of the COVID-19 pandemic on family psychosocial functioning varied by race and ethnicity. Although exposure to COVID-19-related events was greater among Hispanic and non-Hispanic Black families, those of marginalized races reported less family impact than non-Hispanic White families, suggesting resiliency to the pandemic. Research should examine such responses to public health crises in communities of color, with a focus on understanding protective factors. These findings suggest the importance of culturally tailored interventions and policies that support universal psychosocial screenings during times of public health crises.
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Affiliation(s)
| | - Thao-Ly T Phan
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, USA
| | - Amanda M Lewis
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, USA
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, USA
| | - Kamyar Arasteh
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
| | - Paul T Enlow
- Division of Behavioral Health, Nemours Children’s Health, USA
- Center for Healthcare Delivery Science, Nemours Children’s Health, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, USA
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Nigam P, Gramszlo C, Srivastava S, Sood E. Experiences of fetal care, social support, and emotional functioning during the COVID-19 pandemic in women carrying a fetus with CHD. Cardiol Young 2023:1-7. [PMID: 38057139 PMCID: PMC11156789 DOI: 10.1017/s104795112300358x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To explore how the COVID-19 pandemic affected fetal care, social support, and emotional functioning for women carrying a fetus with CHD. METHOD This was a single-centre qualitative study of 31 women who received a prenatal diagnosis of CHD during the pandemic. Patients completed semi-structured interviews about their experiences with fetal care, social support, and perceptions of risk to themselves and their fetus. Consistent themes regarding the impact of the pandemic were identified using an inductive thematic approach. Demographic data were collected via self-report and chart review. RESULTS Women generally reported consistent access to fetal care throughout the pandemic, with frequent use of telemedicine in addition to in-person care, but negative impacts resulting from restrictions on family support at appointments. Limited access to social support overall and a loss of pregnancy traditions were described. Many women reported feeling isolated and experiencing worries and fears about COVID-19 but also noted feeling supported by their healthcare team. Partner/family support during appointments and connection to peer-to-peer support were identified as recommendations to mitigate negative impacts. CONCLUSION Women carrying a fetus with CHD during the COVID-19 pandemic experienced unique stressors that may affect mental health. However, many also experienced unexpected supports that may mitigate effects of pandemic-related stressors. Results can inform efforts to promote positive family outcomes during and following the COVID-19 pandemic.
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Affiliation(s)
- Priya Nigam
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
| | - Colette Gramszlo
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
| | - Shubhika Srivastava
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Erica Sood
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
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Keenan HT, Wade SL, Miron D, Presson AP, Clark AE, Ewing-Cobbs L. Reducing Stress after Trauma (ReSeT): study protocol for a randomized, controlled trial of an online psychoeducational program and video therapy sessions for children hospitalized after trauma. Trials 2023; 24:766. [PMID: 38017574 PMCID: PMC10683223 DOI: 10.1186/s13063-023-07806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Post-traumatic stress symptoms develop in a quarter to half of injured children affecting their longer-term psychologic and physical health. Evidence-based care exists for post-traumatic stress; however, it is not readily available in some communities. We have developed an eHealth program consisting of online, interactive educational modules and telehealth therapist support based in trauma-focused cognitive behavioral therapy, the Reducing Stress after Trauma (ReSeT) program. We hypothesize that children with post-traumatic stress who participate in ReSeT will have fewer symptoms compared to the usual care control group. METHODS This is a randomized controlled trial to test the effectiveness of the ReSeT intervention in reducing symptoms of post-traumatic stress compared to a usual care control group. One hundred and six children ages 8-17 years, who were admitted to hospital following an injury, with post-traumatic stress symptoms at 4 weeks post-injury, will be recruited and randomized from the four participating trauma centers. The outcomes compared across groups will be post-traumatic stress symptoms at 10 weeks (primary outcome) controlling for baseline symptoms and at 6 months post-randomization (secondary outcome). DISCUSSION ReSeT is an evidence-based program designed to reduce post-traumatic stress symptoms among injured children using an eHealth platform. Currently, the American College of Surgeons standards suggest that trauma programs identify and treat patients at high risk for mental health needs in the trauma system. If effectiveness is demonstrated, ReSeT could help increase access to evidence-based care for children with post-traumatic stress within the trauma system. TRIAL REGISTRATION ClinicalTrials.gov NCT04838977. 8 April 2021.
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Affiliation(s)
- Heather T Keenan
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
| | - Shari L Wade
- Cincinnati Children's Hospital Medical Center Division of Pediatric Rehabilitation, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Devi Miron
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave. #8055, New Orleans, LA, 70112, USA
| | - Angela P Presson
- Department of Internal Medicine, University of Utah School of Medicine, 30 N Mario Capecchi Dr. , Salt Lake City, UT, 84112, USA
| | - Amy E Clark
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Linda Ewing-Cobbs
- Children's Learning Institute, McGovern Medical School at UTHealth, 7000 Fannin, Suite 2401, Houston, TX, 77030, USA
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Hails KA, Wellen BC, Simoni M, Gaultney WM, Petts RA, Hostutler CA, Riley AR. Parents' Preferences for Primary Care-Based Behavioral Services and the COVID-19 Pandemic: A Mixed Method Study. J Pediatr Psychol 2023; 48:879-892. [PMID: 37369014 PMCID: PMC11025383 DOI: 10.1093/jpepsy/jsad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This study examined how family factors impacted parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. We hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents' interest in IBH modalities. METHODS Parents of children ages 1.5-5 years (N = 301) from five primary care clinics completed a survey with measures assessing familial contextual factors (income, race and ethnicity, and parents' childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents' preferences for behavioral support in primary care. A subsample of parents (n = 23) completed qualitative interviews to provide deeper insights into quantitative relationships. RESULTS Higher COVID-19 impact was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Overall, lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews identified how pandemic stressors led to increases in parents' desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered. CONCLUSIONS Findings have important implications for the provision of behavioral supports for families in primary care, underlying the need to increase parents' access to IBH services by proactively providing evidence-based resources and continuing to offer telehealth support.
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Affiliation(s)
| | - Brianna C Wellen
- Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, USA
| | - Marisa Simoni
- Pediatric Mental Health Institute, Children's Hospital Colorado, USA
| | - Wendy M Gaultney
- Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, USA
| | - Rachel A Petts
- School of Psychology and Counseling, Fairleigh Dickinson University, USA
| | - Cody A Hostutler
- Department of Pediatric Psychology and Neuropsychology, Nationwide Children’s Hospital, USA
| | - Andrew R Riley
- Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, USA
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Tremolada M, Taverna L, Vietina F, Incardona RM, Pierobon M, Bonichini S, Biffi A, Bisogno G. Adolescents and young adults with oncohematological disease: use of social networks, impact of SARS-COV-2, and psychosocial well-being. Front Psychiatry 2023; 14:1239131. [PMID: 38025461 PMCID: PMC10646548 DOI: 10.3389/fpsyt.2023.1239131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Adolescents and young adults (AYA) with oncohematological diseases could have important psychosocial difficulties that could be worsened by the effects of the COVID19 pandemic. At this developmental stage, it is also important to assess the use of social networks (SNs). This study aims to investigate the type of social network use and the consequences of the COVID19 period. These patients are compared with matched healthy peers. Methods After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SNs, on communication preferences, on social anxiety and on Covid19 impact through the online platform of LimeSurvey. Most of the adolescents belonged to the 18-20 age group (42.5%), were female (62%) and mainly off therapy (72%). Results Adolescents spent more than 2 h/day on Instagram and 1 h and half on Whatsapp, while Tik Tok use was on average 1 h/day, especially used by younger patients (r = -0.33, p = 0.023). Males used Twitch (t45 = -2.06, p = 0.05) and Youtube (t45 = -2.18, p = 0.03) for longer than females. AYA in therapy used more Tik Tok (U = 137.50; p = 0.03), Ask/Tellonym (U = 172.50; p = 0.05) and Twitch (U = 144; p = 0.017) than those off therapy. Healthy AYA showed lower levels of exposure (Z = -4.17; p = 0.00001) and impact (Z = -5.12; p = 0.00001) to Covid19, while the level of social anxiety is comparable and is in the normal range in both groups. Discussion Some clinical considerations and suggestions could be given based on these empirical results to health professionals in the care of AYA cancer patients.
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Affiliation(s)
- Marta Tremolada
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Livia Taverna
- Faculty of Education, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Francesco Vietina
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Roberta Maria Incardona
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Marta Pierobon
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Sabrina Bonichini
- Department of Developmental Psychology and Socialization, School of Psychology, University of Padua, Padua, Italy
| | - Alessandra Biffi
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
| | - Gianni Bisogno
- Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Woman’s and Child’s Health, University of Padua, Padua, Italy
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Kaugars AS, Zemlak J, Oswald DL. Impact of the COVID-19 Pandemic on U.S. Women's Mental Health. J Womens Health (Larchmt) 2023; 32:1166-1173. [PMID: 37788396 DOI: 10.1089/jwh.2023.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background: Women are more likely than men to be diagnosed with depression and anxiety with rates increasing since the COVID-19 pandemic. This study sought to understand how women's intersecting identities, personal strengths, and COVID-19-related stressors were associated with their anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms early in the pandemic. Methods: During May-June 2020, American women (N = 398) recruited via MTurk completed an online questionnaire assessing mental health (PTSD, anxiety, and depression), demographic characteristics, personal strengths (coping, hope, social support), and experiences with COVID-19-specific stressors. Results: Women who had a child younger than 18 years of age, lived in rural or urban areas (compared with suburban), and identified as sexual minority reported increased levels of PTSD, depression, and anxiety symptoms. Social support and hope (Agency) were associated with fewer mental health symptoms. Engagement in maladaptive coping and greater perception of COVID-19 threat and perceived stress was associated with more PTSD, depression, and anxiety symptoms. COVID-19-related illness events and difficulty accessing living essentials were associated with increased anxiety symptoms. COVID-19-related disruption to living and income were associated with increased PTSD symptoms. Loneliness was associated with increased anxiety and depression symptoms. Conclusions: Results of this study can inform prevention and intervention efforts to address depression and anxiety among women with intersecting identities during times of stress. Specifically, supporting the development of women's resilience and adaptive coping and intervening to address maladaptive coping strategies, such as drinking, provide paths to supporting women's mental health.
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Affiliation(s)
- Astrīda S Kaugars
- Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA
| | - Jessica Zemlak
- College of Nursing, Marquette University, Milwaukee, Wisconsin, USA
| | - Debra L Oswald
- Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA
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12
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Wagner N, Perkins E, Rodriguez Y, Ordway C, Flum M, Hernandez-Pena L, Perelstein P, Sem K, Paz Y, Plate R, Popoola A, Lynch S, Astone K, Goldstein E, Njoroge WFM, Raine A, Pincus D, Pérez-Edgar K, Waller R. Promoting Empathy and Affiliation in Relationships (PEAR) study: protocol for a longitudinal study investigating the development of early childhood callous-unemotional traits. BMJ Open 2023; 13:e072742. [PMID: 37802613 PMCID: PMC10565261 DOI: 10.1136/bmjopen-2023-072742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Children with callous-unemotional (CU) traits are at high lifetime risk of antisocial behaviour. Low affiliation (ie, social bonding difficulties) and fearlessness (ie, low threat sensitivity) are proposed risk factors for CU traits. Parenting practices (eg, harshness and low warmth) also predict risk for CU traits. However, few studies in early childhood have identified attentional or physiological markers of low affiliation and fearlessness. Moreover, no studies have tested whether parenting practices are underpinned by low affiliation or fearlessness shared by parents, which could further shape parent-child interactions and exacerbate risk for CU traits. Addressing these questions will inform knowledge of how CU traits develop and isolate novel parent and child targets for future specialised treatments for CU traits. METHODS AND ANALYSIS The Promoting Empathy and Affiliation in Relationships (PEAR) study aims to establish risk factors for CU traits in children aged 3-6 years. The PEAR study will recruit 500 parent-child dyads from two metropolitan areas of the USA. Parents and children will complete questionnaires, computer tasks and observational assessments, alongside collection of eye-tracking and physiological data, when children are aged 3-4 (time 1) and 5-6 (time 2) years. The moderating roles of child sex, race and ethnicity, family and neighbourhood disadvantage, and parental psychopathology will also be assessed. Study aims will be addressed using structural equation modelling, which will allow for flexible characterisation of low affiliation, fearlessness and parenting practices as risk factors for CU traits across multiple domains. ETHICS AND DISSEMINATION Ethical approval was granted by Boston University (#6158E) and the University of Pennsylvania (#850638). Results will be disseminated through conferences and open-access publications. All study and task materials will be made freely available on lab websites and through the Open Science Framework (OSF).
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Affiliation(s)
- Nicholas Wagner
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Emily Perkins
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cora Ordway
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Michaela Flum
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lucia Hernandez-Pena
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Polina Perelstein
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Kathy Sem
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Yael Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rista Plate
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ayomide Popoola
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah Lynch
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Kristina Astone
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ethan Goldstein
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wanjikũ F M Njoroge
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adriane Raine
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Donna Pincus
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | | | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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13
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Rohde JF, Harrison M, Berman T, Flatley C, Okonak K, Cutuli JJ, Hatchimonji D. Associations of COVID-19 Stressors and Postpartum Depression and Anxiety Symptoms in New Mothers. Matern Child Health J 2023; 27:1846-1854. [PMID: 37428309 DOI: 10.1007/s10995-023-03749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Early reports during the COVID-19 pandemic showed pregnant and postpartum women have increased rates of anxiety and depression. We hypothesized that exposure to more COVID-19-related events (e.g., stay-at-home orders, school closures, work layoffs, family members ill with COVID-19; Event Exposure), greater perceived impact of COVID-19 events on the family (Family Impact), and less social support would be associated with more anxiety and depression symptoms among first-time mothers. METHODS We interviewed 125 first-time mothers of infants under 3 months of age from four pediatric primary care offices (June 2020 - February 2021) to assess COVID-19 experiences, anxiety and depression symptoms, and social support. Hierarchical linear regression evaluated relations between COVID-19 Event Exposure, COVID-19 Family Impact, and social support on maternal anxiety and depression symptoms. RESULTS COVID-19 Event Exposure was not associated with depression or anxiety symptom scores. However, greater COVID-19 Family Impact was related to increased maternal depression and anxiety symptoms when controlling for COVID-19 Event Exposure. Reduced social support predicted higher depression symptom scores, but not anxiety symptom scores, when accounting for other variables. CONCLUSION The number of COVID-19-related events experienced by first-time mothers did not predict anxiety or depression symptoms. However, greater perceived impact of COVID-19 on their family was associated with higher symptoms of anxiety and depression in these mothers. Pediatricians can promote resilience strategies to help new mothers adapt during the COVID-19 pandemic to help decrease anxiety and depression symptoms.
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Affiliation(s)
- Jessica F Rohde
- Division of General Academic Pediatrics, Nemours Children's Health, Wilmington, DE, USA.
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Meghan Harrison
- Division of General Academic Pediatrics, Nemours Children's Health, Wilmington, DE, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Tara Berman
- Nemours Children's Health, Philadelphia, PA, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Claire Flatley
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE, USA
| | - Katherine Okonak
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE, USA
| | - J J Cutuli
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE, USA
| | - Danielle Hatchimonji
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE, USA
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14
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Williams ME, Berl MM, Corn E, Ansusinha E, Arroyave-Wessel M, Zhang A, Cure C, Mulkey SB. Positive and negative effects of the COVID-19 pandemic on families of young children in rural Colombia and implications for child outcome research. Child Care Health Dev 2023; 49:825-833. [PMID: 37012218 PMCID: PMC10524562 DOI: 10.1111/cch.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/09/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted the lives of children and families worldwide. The objective of this study is to examine exposures and impact of the COVID-19 pandemic on preschool-aged children and caregivers in the Atlántico region of Colombia. METHODS The COVID-19 Exposure and Family Impact Scales (CEFIS) questionnaire was administered in Fall 2021 to 63 caregivers of children in Sabanalarga, Colombia enrolled in a neurodevelopment study as healthy controls. The CEFIS assesses pandemic-related exposures/events and impact; higher scores indicate greater exposure and negative impact. Descriptive and correlation analyses among exposure and impact scores were conducted. RESULTS Caregivers reported a mean (standard deviation[SD]) of 11.1 (3.2) among 25 COVID-19-related exposures/events; most common types included stay-at-home orders, school closures, disruptions to living conditions and income loss. Total number of events was correlated with higher caregiver (P < .001) and child distress (P = .002). However, the mean (SD) impact score of 2.0 (0.6) suggests a trend toward more positive impact than negative. Caregivers reported improvements to sleep, exercise and family interactions. Some caregivers (n = 21) qualitatively reported negative effects including unemployment, fear/anxiety and inability to visit family, and positive effects such as unification, family closeness and spending more time with children. CONCLUSIONS This study highlights the importance of comprehensively exploring positive and negative impacts of COVID-19 and families' subsequent resilience and transformation. Using tools like the CEFIS, those seeking to mitigate negative impacts can contextualize data to better understand study outcomes and tailor services, resources and policy to families' unique needs. CEFIS data likely depend on timing, economic/public health resources and cultural values; future work should prioritize understanding the generalizability of CEFIS findings across samples.
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Affiliation(s)
| | - Madison M. Berl
- Children’s National Hospital, Washington, DC, USA
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | | | - Anqing Zhang
- Children’s National Hospital, Washington, DC, USA
| | | | - Sarah B. Mulkey
- Children’s National Hospital, Washington, DC, USA
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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15
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Perry KJ, Mutignani LM, Gissandaner TD, Penner F, Santos R, Sarver DE. Testing an integrated dimensional model of adverse childhood experiences: Associations with COVID-19 outcomes. CHILD ABUSE & NEGLECT 2023; 143:106239. [PMID: 37244078 PMCID: PMC10176107 DOI: 10.1016/j.chiabu.2023.106239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a salient risk factor for a myriad of negative outcomes. Extant theoretical and empirical models traditionally quantify the impact of ACEs using cumulative representations. Recent conceptualizations challenge this framework and theorize that the types of ACEs children are exposed to differentially impacts their future functioning. OBJECTIVE The current study tested an integrated ACEs model using parent-report of child ACEs across four aims: (1) characterize heterogeneity in child ACEs using a latent class analysis (LCA); (2) examine mean level class differences in COVID specific and COVID non-specific environmental factors (i.e., COVID impact, ineffective parenting, effective parenting) and internalizing and externalizing problems during the COVID pandemic; (3) test interactions between COVID impact and ACEs classes in predicting outcomes, and (4) compare a cumulative risk approach to a class membership approach. PARTICIPANTS AND SETTING A nationally representative sample of U.S. parents (N = 796; 51.8 % fathers, M age = 38.87 years, 60.3 % Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021. METHOD Measures of child's ACEs history, COVID impact, effective and ineffective parenting, and children's internalizing and externalizing problems were completed by parents. RESULTS A LCA demonstrated three distinct classes of ACEs reflecting low-risk, trauma-risk, and environmental-risk classes. In general, the trauma-risk class had more negative COVID-19 outcomes than the other classes (small to large effect sizes). CONCLUSIONS The classes differentially related to outcomes, providing support for dimensions of ACEs and emphasizing the distinct types of ACEs.
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Affiliation(s)
- Kristin J Perry
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802, United States of America.
| | - Lauren M Mutignani
- University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Blvd., Rochester, NY 14642, United States of America
| | - Tre D Gissandaner
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, United States of America
| | - Francesca Penner
- Yale Child Study Center, Yale University, 230 S Frontage Rd, New Haven, CT 06519, United States of America
| | - Roberto Santos
- Division of Infectious Diseases, Department of Pediatrics, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States of America
| | - Dustin E Sarver
- Department of Psychiatry and Human Behavior, School of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States of America; Center for the Advancement of Youth, University of Mississippi Medical Center, 4400 Old, Canton Rd, Jackson, MS 39211, United States of America
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16
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Li J, Zhai Y, Xiao B, Xia X, Wang J, Zhao Y, Ye L, Li Y. Maternal COVID-19 Distress and Chinese Preschool Children's Problematic Media Use: A Moderated Serial Mediation Model. Psychol Res Behav Manag 2023; 16:2553-2567. [PMID: 37457390 PMCID: PMC10348373 DOI: 10.2147/prbm.s414456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Maternal distress increased during the COVID-19 pandemic, significantly impacting children's media use. The purpose of this study was to explore the influence mechanism of maternal COVID-19 distress on preschoolers' problematic media us through a moderated mediation model; specifically, we examined the possible mediating roles of parenting stress and negative instrumental use of media in parenting and the moderating role of supportive co-parenting. Methods An online survey was conducted in a sample of 1357 children (Mage = 4.01, SD = 1.06; 47.4% boys) and their parents from six public kindergartens in Shanghai, China. The mothers provided information by completing measures on their levels of distress related to COVID-19, parenting stress levels, digital parenting practices, and perception of supportive co-parenting from their partners. Additionally, both parents rated their children's problematic media use. Results (1) maternal COVID-19 distress was significantly and positively related to children's problematic media use; (2) this relationship was sequentially mediated by parenting stress and parents' negative instrumental use of media in parenting; and (3) supportive co-parenting moderated the serial mediation path by reducing the effect of maternal COVID-19 distress on parenting stress. Conclusion The findings provide some support and guidance for preventing children's problematic media use and enhancing parental adaptation during the COVID-19 pandemic or in potentially adverse situations.
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Affiliation(s)
- Juan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Yuanyuan Zhai
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Bowen Xiao
- Psychology Department, Carleton University, Ottawa, Ontario, Canada
| | - Xiaoying Xia
- School of Early Childhood Education, Shanghai Normal University Tianhua College, Shanghai, People’s Republic of China
| | - Jingyao Wang
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Yanan Zhao
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Li Ye
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
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17
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Mann M, Harary D, Louis S, Wang T, Bonuck K, Isasi CR, Charron MJ, Fuloria M. Association of parent-child interactions with parental psychological distress and resilience during the COVID-19 pandemic. Front Pediatr 2023; 11:1150216. [PMID: 37425276 PMCID: PMC10326543 DOI: 10.3389/fped.2023.1150216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The effects of psychological distress/resilience on parent-child engagement (e.g., family dinners, reading) during the COVID-19 pandemic have not been well studied. Among very young children from underrepresented backgrounds enrolled in the ongoing longitudinal Bronx Mother Baby Health Study of healthy term infants, we (1) examined associations between exposures to COVID-19-related events, demographic factors and parental psychological distress and resilience; and (2) correlated these factors with parent-child engagement activities. Methods Between June 2020-August 2021, parents of 105 Bronx Mother Baby Health Study participants aged birth-25 months completed questionnaires related to exposures to COVID-19-related events, frequency of positive parent-child engagement activities, food and housing insecurity, and parental psychological distress and resilience. Families were also asked open ended questions about the pandemic's impact. Results 29.8% and 47.6% of parents reported food and housing insecurity, respectively. Greater exposures to COVID-19-related events were associated with increased parental psychological distress. Positive parent-child interactions were associated with demographic factors and higher levels of maternal education, but not with exposures to COVID-19-related events. Discussion This study adds to a growing body of literature on the negative impacts of COVID-19 exposures and psychosocial stressors on families during the pandemic, supporting the need for enhanced mental health resources and social supports for families.
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Affiliation(s)
- Mana Mann
- Department of Pediatrics, Flushing Hospital Medical Center, Queens, NY, United States
| | - David Harary
- Department of Pediatrics, Division of Neonatology, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Shirley Louis
- Department of Pediatrics, Division of Neonatology, Children’s Hospital of Michigan, Detroit, MI, United States
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Karen Bonuck
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Maureen J. Charron
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Mamta Fuloria
- Department of Pediatrics, Division of Neonatology, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States
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18
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Levante A, Martis C, Bianco F, Castelli I, Petrocchi S, Lecciso F. Internalizing and externalizing symptoms in children during the COVID-19 pandemic: a systematic mixed studies review. Front Psychol 2023; 14:1182309. [PMID: 37397311 PMCID: PMC10313408 DOI: 10.3389/fpsyg.2023.1182309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Given the vulnerability of children during the COVID-19 pandemic, paying close attention to their wellbeing at the time is warranted. The present protocol-based systematic mixed-studies review examines papers published during 2020-2022, focusing on the impact of the COVID-19 pandemic on children's internalizing/externalizing symptoms and the determinants thereof. Method PROSPERO: CRD42022385284. Five databases were searched and the PRISMA diagram was applied. The inclusion criteria were: papers published in English in peer-reviewed journals; papers published between January 2020 and October 2022 involving children aged 5-13 years; qualitative, quantitative, and mixed studies. The standardized Mixed Method Appraisal Tool protocol was used to appraise the quality of the studies. Results Thirty-four studies involving 40,976 participants in total were analyzed. Their principal characteristics were tabulated. The results showed that children's internalizing/externalizing symptoms increased during the pandemic, largely as a result of disengagement from play activities and excessive use of the internet. Girls showed more internalizing symptoms and boys more externalizing symptoms. Distress was the strongest parental factor mediating children's internalizing/externalizing symptoms. The quality of the studies was appraised as low (n = 12), medium (n = 12), and high (n = 10). Conclusion Gender-based interventions should be designed for children and parents. The studies reviewed were cross-sectional, so long-term patterns and outcomes could not be predicted. Future researchers might consider a longitudinal approach to determine the long-term effects of the pandemic on children's internalizing and externalizing symptoms. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385284, identifier: CRD42022385284.
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Affiliation(s)
- Annalisa Levante
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Chiara Martis
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Federica Bianco
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Ilaria Castelli
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Serena Petrocchi
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Flavia Lecciso
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
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19
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Zubair AS, Scharer K, Lembeck P, Ionita C, Roy B. The Impact of COVID-19 on Families With Pediatric Muscular Dystrophy Patients. Cureus 2023; 15:e41138. [PMID: 37519528 PMCID: PMC10386847 DOI: 10.7759/cureus.41138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic resulted in unprecedented changes in daily activities and healthcare services. In the United States, stay-at-home orders and social distancing measures were put, and school closures impacted many students. The psychological impact of the COVID-19 pandemic has been shown to have wide-ranging and long-term effects. With school closures and limitations in in-person visits and provider care, we hypothesized that the patients with pediatric muscular dystrophies and neuromuscular conditions were more vulnerable to the restriction posed by this pandemic. This survey-based study examined the psychosocial impact of this pandemic on pediatric patients with neuromuscular disorders and caregiver burden through chart review and self-reports via survey administration using a validated tool (COVID-19 Exposure and Family Impact Scales {CEFIS}). The majority of families reported that they had a stay-at-home order (91.7%), schools/childcare centers were closed (87.5%), their children's education was disrupted (83.3%), and they were unable to visit or care for a family member (58.3%). Parents/caregivers felt that the COVID-19 pandemic made parenting a little bit worse (mean = 2.6 ± 0.96) and made it more difficult to care for the elderly or those with disabilities in the family (mean = 2.6 ± 0.95) and for their child with a neuromuscular disability (mean = 2.6 ± 0.91). Our data highlights the significant impact of the COVID-19 pandemic on the lives of families and caregivers of pediatric patients with muscular dystrophies.
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Affiliation(s)
| | | | - Paige Lembeck
- Psychiatry, Children's Hospital of Philadelphia, Philadelphia, USA
| | | | - Bhaskar Roy
- Neurology, Yale School of Medicine, New Haven, USA
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Palmer Molina A, Ponting C, Hernandez Y, Traube DE, Pham D, Garcia I, Mennen FE. Pandemic-Related Stress and Resilience Among Latinx Mothers with a History of Depression: Differences by Immigration Status. JOURNAL OF HUMAN RIGHTS AND SOCIAL WORK 2023; 8:1-14. [PMID: 37360667 PMCID: PMC10172054 DOI: 10.1007/s41134-023-00249-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 06/28/2023]
Abstract
This study explores the impact of the COVID-19 pandemic on low-income, Latinx mothers in Southern California with a history of depression, including undocumented mothers and members of mixed status families. Drawing participants from a parent study that provided a maternal depression intervention to Head Start mothers (n = 119), this mixed method study integrates qualitative and quantitative data in a convergent design. Thirty-four mothers completed semi-structured qualitative interviews and standardized questionnaires in the fall of 2020. Mothers shared overwhelming economic difficulties, with the majority reporting that their family income decreased and half reporting that they were unable to pay for housing. Stressors were compounded for undocumented mothers and members of mixed-status families who were excluded from major relief programs. Stress affected maternal mental health, and mothers with precarious status reported differences in functioning. Mothers also identified positive ways that they coped with adversity. Results show that Latinx mothers with a history of depression, particularly mothers with precarious immigration status, continue to suffer considerable economic, social, and emotional impacts of the COVID-19 pandemic. Social workers can support the human rights of this population by advocating for financial relief, food assistance, and the expansion of medical-legal partnerships and physical and mental health services.
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Affiliation(s)
| | - Carolyn Ponting
- Department of Psychology, University of California Los Angeles, Los Angeles, CA USA
| | - Yuliana Hernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Dorian E. Traube
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Duyen Pham
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Iliana Garcia
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
| | - Ferol E. Mennen
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA
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Perry KJ, Penner F, Contreras HT, Santos RP, Sarver DE. A U.S. National Study of Family Resilience During the COVID-19 Pandemic. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:1627-1642. [PMID: 37304391 PMCID: PMC10134703 DOI: 10.1007/s10826-023-02581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/09/2023] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has significantly disrupted the lives of children and their caregivers. Recent research has examined the impact of the pandemic on child and caregiver functioning but there is a paucity of work examining the impact of the pandemic on the broader family system. The current study examined family resilience during the COVID-19 pandemic across three aims: Aim 1 tested whether meaning, control, and emotion systems form a unitary family adaption factor, Aim 2 evaluated a concurrent model of family resilience, and Aim 3 examined whether parent gender and vaccination status moderated paths in the final model. A nationally representative sample of U.S. parents (N = 796; 51.8% fathers, M age = 38.87 years, 60.3% Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021, including measures of COVID-19 family risk and protective factors, pre-existing family health vulnerabilities, race, COVID-19 stressors, and family adaptation. Confirmatory Factor Analysis demonstrated that the meaning (i.e., family making meaning of COVID-19), control (i.e., stability in routines), and emotional (i.e., family support) facets of family adaptation are unique but related. A path model revealed that there were concurrent effects from COVID-19 exposure, pre-existing vulnerabilities, and racial diversity status to the family protective, vulnerability, and adaptation variables. Additionally, parent COVID-19 vaccination status altered the association between pre-existing family health vulnerabilities and the family protective factor. Overall, results underscore the importance of examining pre-existing and concurrent risk and protective factors for family resilience during a stressful, global, and far-reaching event.
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Affiliation(s)
- Kristin J. Perry
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA 16802 USA
| | - Francesca Penner
- Child Study Center, School of Medicine, Yale University, 230 S Frontage Rd, New Haven, CT 06519 USA
| | | | - Roberto P. Santos
- University of Mississippi Medical Center, 2500 N. State St, Jackson, MS 39216 USA
- Department of Population Health Sciences, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500N. State St, Jackson, MS 39216 USA
| | - Dustin E. Sarver
- Department of Psychiatry and Human Behavior, School of Medicine, University of Mississippi, Medical Center, 2500N. State St, Jackson, MS 39216 USA
- Center for the Advancement of Youth, University of Mississippi Medical Center, 4400 Old Canton Rd, Jackson, MS 39211 USA
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22
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Raffa BJ, Heerman WJ, Lampkin J, Perrin EM, Flower KB, Delamater AM, Yin HS, Rothman RL, Sanders L, Schilling S. Parental Perspectives on the Impact of the COVID-19 Pandemic on Infant, Child, and Adolescent Development. J Dev Behav Pediatr 2023; 44:e204-e211. [PMID: 36716765 DOI: 10.1097/dbp.0000000000001166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 11/17/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The purpose of this study is to understand how families from diverse sociodemographic backgrounds perceived the impact of the pandemic on the development of their children. METHODS We used a multimethod approach guided by Bronfenbrenner's Ecological Systems Theory, which identifies 5 developmental systems (micro, meso, exo, macro, and chrono). Semistructured interviews were conducted in English or Spanish with parents living in 5 geographic regions of the United States between July and September 2021. Participants also completed the COVID-19 Exposure and Family Impact Survey. RESULTS Forty-eight families participated, half of whose preferred language was Spanish, with a total of 99 children ages newborn to 19 years. Most qualitative themes pertained to developmental effects of the microsystem and macrosystem. Although many families described negative effects of the pandemic on development, others described positive or no perceived effects. Some families reported inadequate government support in response to the pandemic as causes of stress and potential negative influences on child development. As context for their infant's development, families reported a variety of economic hardships on the COVID-19 Exposure and Family Impact Survey, such as having to move out of their homes and experiencing decreased income. CONCLUSION In addition to negative impacts, many parents perceived positive pandemic-attributed effects on their child's development, mainly from increased time for parent-child interaction. Families described economic hardships that were exacerbated by the pandemic and that potentially affect child development and insufficient government responses to these hardships. These findings hold important lessons for leaders who wish to design innovative solutions that address inequities in maternal, family, and child health.
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Affiliation(s)
- Brittany J Raffa
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - William J Heerman
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Jacarra Lampkin
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Eliana M Perrin
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins Schools of Medicine and Nursing, Baltimore, MD
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alan M Delamater
- Division of General Pediatrics, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
| | - H Shonna Yin
- Division of General Pediatrics, Departments of Pediatrics and Population Health, New York University School of Medicine, New York City, NY ; and
| | - Russell L Rothman
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Lee Sanders
- Division of General Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | - Samantha Schilling
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
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23
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Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults. J Affect Disord 2023; 326:249-261. [PMID: 36586617 PMCID: PMC9794522 DOI: 10.1016/j.jad.2022.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the internal validity of the co-primary outcome, a composite psychopathology "P-score". METHODS The COH-FIT survey has been translated into 30 languages (two blind forward-translations, consensus, one independent English back-translation, final harmonization). To measure mental health, 1-4 items ("COH-FIT items") were extracted from validated questionnaires (e.g. Patient Health Questionnaire 9). COH-FIT items measured anxiety, depressive, post-traumatic, obsessive-compulsive, bipolar and psychotic symptoms, as well as stress, sleep and concentration. COH-FIT Items which correlated r ≥ 0.5 with validated companion questionnaires, were initially retained. A P-score factor structure was then identified from these items using exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) on data split into training and validation sets. Consistency of results across languages, gender and age was assessed. RESULTS From >150,000 adult responses by May 6th, 2022, a subset of 22,456 completed both COH-FIT items and validated questionnaires. Concurrent validity was consistently demonstrated across different languages for COH-FIT items. CFA confirmed EFA results of five first-order factors (anxiety, depression, post-traumatic, psychotic, psychophysiologic symptoms) and revealed a single second-order factor P-score, with high internal reliability (ω = 0.95). Factor structure was consistent across age and sex. CONCLUSIONS COH-FIT is a valid instrument to globally measure mental health during infection times. The P-score is a valid measure of multidimensional mental health.
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24
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Dugger R, Reesor-Oyer L, Beets MW, Wilson DK, Weaver RG. Parental decision-making on summer program enrollment: A mixed methods Covid-19 impact study. EVALUATION AND PROGRAM PLANNING 2023; 97:102200. [PMID: 36527887 PMCID: PMC9721268 DOI: 10.1016/j.evalprogplan.2022.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 05/03/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The closure of childcare organizations (e.g. schools, childcare centers, afterschool programs, summer camps) during the Covid-19 pandemic impacted the health and wellbeing of families. Despite their reopening, parents may be reluctant to enroll their children in summer programming. Knowledge of the beliefs that underlie parental concerns will inform best practices for organizations that serve children. METHODS Parents (n = 17) participated in qualitative interviews (October 2020) to discuss Covid-19 risk perceptions and summer program enrollment intentions. Based on interview responses to perceived Covid-19 risk, two groups emerged for analysis- "Elevated Risk (ER)" and "Conditional Risk (CR)". Themes were identified utilizing independent coding and constant-comparison analysis. Follow-up interviews (n = 12) in the Spring of 2021 evaluated the impact of vaccine availability on parent risk perceptions. Additionally, parents (n = 17) completed the Covid-19 Impact survey to assess perceived exposure (Range: 0-25) and household impact (Range: 2-60) of the pandemic. Scores were summed and averaged for the sample and by risk classification group. RESULTS Parents overwhelmingly supported the operation of summer programming during the pandemic due to perceived child benefits. Parent willingness to enroll their children in summer programming evolved with time and was contingent upon the successful implementation of safety precautions (e.g. outdoor activities, increased handwashing/sanitizing of surfaces). Interestingly, parents indicated low exposure (ER: Avg. 6.3 ± 3.1 Range [2-12], CR: Avg. 7.5 ± 3.6 Range [1-14]) and moderate family impact (ER: Avg. 27.1 ± 6.9 Range [20-36], CR: Avg. 33.7 ± 11.4 Range [9-48]) on the impact survey. CONCLUSION Childcare organizations should mandate and evaluate the implementation of desired Covid-19 safety precautions for their patrons.
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Affiliation(s)
- Roddrick Dugger
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Layton Reesor-Oyer
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Michael W Beets
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Dawn K Wilson
- University of South Carolina, Department of Psychology, College of Art and Sciences, USA
| | - Robert Glenn Weaver
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA.
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25
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Canter KS, Vega G, Perez Ramirez A, Munoz Osorio A, Thomas C, Lewis AM, Arasteh K, Kazak A. Acceptability and Feasibility of eSCCIP: Results From a Pilot Study of the Electronic Surviving Cancer Competently Intervention Program. J Pediatr Psychol 2023; 48:216-227. [PMID: 36303445 PMCID: PMC10027060 DOI: 10.1093/jpepsy/jsac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cancer Competently Intervention Program (eSCCIP) is a psychosocial eHealth intervention for caregivers, developed using an iterative, user-centered process. METHOD eSCCIP was tested in a single-arm pilot trial at Nemours Children's Hospital, Delaware (NCT05333601). The primary outcomes were intervention acceptability and feasibility, assessed via enrollment and retention targets, and item-level acceptability ratings. Enrollment and retention targets of 45% were set based on previous work, and an item-level acceptability threshold of 80% was set. A secondary exploratory analysis was conducted examining acute distress, anxiety, symptoms of post-traumatic stress, and family functioning. RESULTS 44 caregivers enrolled in the study and 31 completed. The intervention was rated favorably by completers, with over 80% of the sample selecting "mostly true" or "very true" for all items of the eSCCIP Evaluation Questionnaire, which was used to assess acceptability and feasibility. Enrollment and retention rates were 54% and 70%, respectively. Exploratory psychosocial outcomes showed statistically significant decreases from pre-intervention to post-intervention for overall symptoms of post-traumatic stress disorder (PTSD), cluster D symptoms of PTSD (negative mood and cognitions), and anxiety. Small-moderate effect sizes were observed for all psychosocial outcomes of interest. CONCLUSIONS eSCCIP is an acceptable and feasible intervention for caregivers. Results are promising regarding reductions in symptoms of post-traumatic stress and anxiety.
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Affiliation(s)
- Kimberly S Canter
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gabriela Vega
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Alejandra Perez Ramirez
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Angel Munoz Osorio
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Courtney Thomas
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Amanda M Lewis
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Kamyar Arasteh
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Anne Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA
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26
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Jamison JM, Egger D, Vazquez CE, McBride MJ, Pauling SN, Hess KE, Calzada EJ, Bearman SK. Mental Health Trajectories of Latinx Female Caregivers and Young Children During COVID-19: A Longitudinal Analysis. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:571-585. [PMID: 36788947 PMCID: PMC9911948 DOI: 10.1007/s10826-023-02545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Studies of the impact of COVID-19 on mental health symptoms suggest that there may be a unique impact of COVID-19 on minoritized individuals, young children (children five and younger), and their caregivers. Longitudinal studies with representative samples including minoritized populations are needed to accurately reflect the experience of families during COVID-19. The current study used a longitudinal design to assess trajectories of mental health among Latinx female caregivers and their young children over time, beginning prior to the onset of the COVID-19 pandemic and over the course of 12 months. In fall of 2019, Latinx female caregivers (N = 213; 93.0% biological mother) of young children (M age = 5.38, SD = 0.34) reported on their own and their child's (52.6% female) mental health symptoms, as well as parenting stress, at three time points through Fall of 2020. Growth curve models showed that self-report of caregiver global mental health worsened over time, though caregiver depression and parenting stress did not change significantly, nor did caregiver-report of their children's mental health. Results suggest that while female caregiver well-being was adversely affected by COVID-19, caregivers showed resilience in the face of this pandemic, which in turn may have buffered the impact of the pandemic on Latinx child mental health. Methodological and contextual implications of these results are considered.
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Affiliation(s)
- Jesslyn M. Jamison
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Dominique Egger
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Christian E. Vazquez
- School of Social Work, The University of Texas at Arlington, 211S Cooper St, Arlington, TX 76019 USA
| | - Megan J. McBride
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Sydney N. Pauling
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Katherine E. Hess
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
| | - Esther J. Calzada
- The Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712 USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Stop D5800, Austin, TX 78712-0383 USA
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27
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Schweinhart A, Aramburú C, Bauer R, Simons-Rudolph A, Atwood K, Luseno WK. Changes in Mental Health, Emotional Distress, and Substance Use Affecting Women Experiencing Violence and Their Service Providers during COVID-19 in a U.S. Southern State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2896. [PMID: 36833591 PMCID: PMC9957159 DOI: 10.3390/ijerph20042896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Research conducted during the COVID-19 pandemic has revealed many unintended consequences of mandated safety precautions, including increased perpetration of intimate partner violence (IPV), increases in substance use, and worsening mental health conditions. We conducted a repeated, cross-sectional survey of survivors of IPV, a longitudinal survey of service providers working in an IPV shelter, and interviews with both. We conducted surveys at the beginning of the pandemic and nearly half a year later to assess mental health and, for clients, substance use. Results showed that two small samples of survivors living in the shelter in 2020 and 2021 experienced both mental health decline and increased use of substances. Qualitative data from in-depth interviews suggest that COVID-19-related restrictions mirrored survivors' experiences of power and control in violent relationships. Further, IPV service providers-essential workers during COVID-19-experienced stress associated with reports of burnout and mental fatigue. This study suggests that community-based organizations can help mitigate the impacts of COVID-19 on survivors of IPV but should avoid adding additional work for staff as service providers experienced mental and emotional stress.
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Affiliation(s)
- April Schweinhart
- Pacific Institute for Research and Evaluation, 4061 Powder Mill Road, Suite 350, Beltsville, MD 20705, USA
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28
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Mavragani A, Sanchez T, Yang H, Zhao F, Qin Y, Wu J, Yan H, Xu Y, Zhang L. Caregiver Perceptions of Children's and Adolescents' Psychosocial Functioning During the Stringent COVID-19 Lockdown Restrictions in Shanghai: Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e43689. [PMID: 36749625 PMCID: PMC9907570 DOI: 10.2196/43689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic represents a global health crisis. The Shanghai municipal government in China implemented strict and comprehensive pandemic control strategies in the first half of 2022 to eliminate a wave of COVID-19 infection. The pandemic and the resulting government responses have led to abrupt changes to families' daily lives, including the mental health of children and adolescents. OBJECTIVE The aim of this paper is to examine the impact of COVID-19 exposure and the stringent lockdown measures on the daily life and mental health of children and adolescents and to provide suggestions on maintaining their mental health when similar public health emergencies occur in the future. METHODS In this cross-sectional study, an anonymous survey was distributed online in May 1-15, 2022, in Shanghai. Individuals were eligible to participate if they were currently the caregiver of a child or adolescent (aged 4-17 years). Outcomes were psychosocial functioning of children and adolescents, as reported by parents, using the Pediatric Symptom Checklist-17. COVID-19 exposure and life changes were also reported. Multivariate logistic regression was used to analyze risk factors for poor psychosocial functioning. RESULTS In total, 2493 valid questionnaires were analyzed. The rate of positive scores on the global Pediatric Symptom Checklist-17 scale was 16.5% (n=411). Internalizing, attention, and externalizing problem subscale positivity rates were 17.3% (n=431), 10.9% (n=272), and 8.9% (n=221), respectively. Caregivers reported that 64.2% (n=1601) and 20.7% (n=516) of the children's interactions with friends or peers and parents deteriorated, respectively. Compared with male caregivers, female caregivers were less likely to report psychosocial problems in children and adolescents (adjusted odds ratio [aOR] 0.68; 95% CI 0.53-0.88). Older children and those with lower COVID-19 Exposure and Family Impact Scales scores were less likely to have psychological problems (aOR 1.15; 95% CI 1.10-1.21). Compared with children with screen times <1 hour per day for recreation, those using screens for >3 hours had higher odds of psychological distress (aOR 2.09; 95% CI 1.47-1.97). Children who spent 1-2 hours exercising and had better interactions with friends or peers and parents showed a trend toward lower odds of psychological problems. Children and adolescents with worse sleep compared with preclosure were more likely to have psychological problems. CONCLUSIONS The prevalence of psychosocial problems among children and adolescents is relatively high. Being young, having more COVID-19 exposure, and having more screen times (>3 h/day), less exercise time (<30 min), worse sleep, and deteriorated interactions with friends or peers and parents were risk factors for poor psychosocial functioning. It is necessary for governments, communities, schools, and families to take appropriate countermeasures to reduce the negative impact of the stringent control measures on caregivers' parenting and psychosocial functioning of children and adolescents.
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Affiliation(s)
| | | | - Hongyang Yang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Fangjie Zhao
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Yuchen Qin
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Jiali Wu
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Hongli Yan
- School of Nursing, Second Military Medical University, Shanghai, China
| | - Yan Xu
- College of Health Service, Second Military Medical University, Shanghai, China
| | - Lulu Zhang
- College of Health Service, Second Military Medical University, Shanghai, China
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29
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Williford DN, McTate EA, Hood AM, Reader SK, Hildenbrand AK, Smith-Whitley K, Creary SE, Thompson AA, Hackworth R, Raphael JL, Crosby LE. Psychologists as leaders in equitable science: Applications of antiracism and community participatory strategies in a pediatric behavioral medicine clinical trial. AMERICAN PSYCHOLOGIST 2023; 78:107-118. [PMID: 37011163 PMCID: PMC10474572 DOI: 10.1037/amp0001086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Psychologists have an ethical responsibility to advance health equity and can play a significant role in improving health care experiences for families racialized as Black, including those with sickle cell disease (SCD), a group of genetic blood disorders primarily affecting communities of color. Parents of children with SCD report experiences of stigma and discrimination due to racism in the health care system. The current commentary describes the application of antiracism and participatory strategies to the research design, implementation, and dissemination of a behavioral medicine clinical trial (Engage-HU; NCT03442114) of shared decision-making (SDM) for pediatric patients with SCD, including (a) the development of a research question to promote justice for racialized groups; (b) a focus on "redressing imbalances" through SDM and a multidisciplinary, inclusive research team led by a Black psychologist; (c) community participatory approaches through the integration of stakeholder feedback across the study; and (d) centering context by attending to structural realities in response to the COVID-19 and racism pandemics. With attention to the fact that most primary caregivers of children with SCD are Black women, an intersectionality lens was applied. Implications and considerations for psychologists working to advance health equity in medical settings are also discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Desireé N. Williford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Emily A. McTate
- Department of Psychiatry and Psychology, Department of Pediatrics, Mayo Clinic, Rochester, MN USA
| | - Anna M. Hood
- Division of Psychology and Mental Health, University of Manchester, Manchester, England GBR
| | - Steven K. Reader
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE USA
| | - Aimee K. Hildenbrand
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE USA
| | - Kim Smith-Whitley
- Division of Hematology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Susan E. Creary
- Division of Hematology & Oncology, Nationwide Children’s Hospital, Columbus, OH USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH USA
| | - Alexis A. Thompson
- Division of Hematology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Rogelle Hackworth
- Cincinnati Children’s Hospital Medical Center Partner, Cincinnati, OH USA
| | - Jean L. Raphael
- Department of Pediatrics, Section of Hematology-Oncology and Section of Academic General Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Lori E. Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
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30
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Rodríguez-Rabassa M, Torres-Marrero E, López P, Muniz-Rodriguez K, Borges-Rodríguez M, Appleton AA, Avilés-Santa L, Alvarado-Domenech LI. Stressors and Impact of the COVID-19 Pandemic on Vulnerable Hispanic Caregivers and Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1838. [PMID: 36767218 PMCID: PMC9914744 DOI: 10.3390/ijerph20031838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 06/18/2023]
Abstract
Psychological sequelae are important elements of the burden of disease among caregivers. Recognition of the impact of adversity and stress biomarkers is important to prevent mental health problems that affect rearing practices and child well-being. This cross-sectional study explored social determinants of health (SDoH)-mediated stressors during COVID-19 and risks for mental health problems among caregivers of children with prenatal Zika virus exposure. Twenty-five Hispanic caregivers completed surveys assessing SDoH vulnerabilities, COVID-exposures and impact, post-traumatic stress disorder (PTSD) symptomatology, and provided a hair sample for cortisol concentration (HCC). Most caregivers had low education, household income < $15,000/year, and were unemployed. Stressors included disrupted child education and specialized services, and food insecurity. While most reported PTSD symptomatology, multivariate linear regression models adjusted for the caregiver's age, education, and the child's sex, revealed that caregivers with high symptomatology had significantly lower HCC than those with low symptomatology and those with food insecurity had significantly higher HCC than participants without food insecurity. The impact of COVID-19 on daily life was characterized on average between worse and better, suggesting variability in susceptibility and coping mechanisms, with the most resilient identifying community support and spirituality resources. SDoH-mediators provide opportunities to prevent adverse mental health outcomes for caregivers and their children.
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Affiliation(s)
- Mary Rodríguez-Rabassa
- Clinical Psychology Program, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA
- RCMI Center for Research Resources, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA
- Department of Pediatrics, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA
| | - Estefanía Torres-Marrero
- Clinical Psychology Program, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA
| | - Pablo López
- RCMI Center for Research Resources, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA
| | | | | | - Allison A. Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, 1 University Place, Rensselaer, NY 12144, USA
| | - Larissa Avilés-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd. Suite 800, Bethesda, MD 20892, USA
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Skeens MA, Hill K, Olsavsky A, Ralph JE, Udaipuria S, Akard TF, Gerhardt CA. Family functioning buffers the consequences of the COVID-19 pandemic for children's quality of life and loneliness. Front Psychol 2023; 13:1079848. [PMID: 36710839 PMCID: PMC9880325 DOI: 10.3389/fpsyg.2022.1079848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
COVID-19 resulted in mass quarantine measures early in the pandemic. This disruption of daily life widened inequities and made children one of the most vulnerable populations during the crisis. This national, cross-sectional "COVID-Kids" study collected data from almost 500 parent-child dyads using standardized measures to better understand the effects of COVID exposure and impact on children's quality of life and loneliness. Data were collected via social media from May to July 2020. According to parent proxy and child self-report, United States children experienced worse quality of life (p < 0.0001; d = 0.45 and 0.53) and greater child-reported loneliness (p < 0.0001) when compared to normative, healthy samples (i.e., children who do not have a chronic medical condition). Older children (r = 0.16, p = 0.001) and female children (r = 0.11, p = 0.02) reported greater loneliness. Higher child-reported family functioning scores were associated with better quality of life (r = 0.36, p < 0.0001) and less loneliness (r = -0.49, p < 0.0001). Moderated mediation analyses indicated the indirect effect of parent COVID impact on the association between COVID exposure and child quality of life was weaker in the context of better family functioning. Results of this study raise concern for the short-and long-term sequelae of the pandemic on the physical and mental health of children. Healthcare providers and researchers must find new and innovative ways to protect the well-being of children. Strengthening family functioning may buffer the effects of the pandemic and improve overall quality of life in our "COVID Kids."
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Affiliation(s)
- Micah A. Skeens
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States,Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, United States,*Correspondence: Micah A. Skeens, ✉
| | - Kylie Hill
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Anna Olsavsky
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Jessica E. Ralph
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Shivika Udaipuria
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Terrah Foster Akard
- Vanderbilt School of Nursing, Vanderbilt University, Nashville, TN, United States
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States,Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, United States
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Valenzuela JM, Dimentstein K, Yee S, Pan B, Snyder MC, Wolf RM. Psychosocial Impact of the COVID-19 Pandemic in Racially/Ethnically Diverse Youth With Diabetes. J Pediatr Psychol 2023; 48:17-28. [PMID: 36137256 PMCID: PMC9673468 DOI: 10.1093/jpepsy/jsac070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE This study examined caregiver perceived impact of the Coronavirus Disease 2019 (COVID-19) pandemic on a diverse sample of U.S. youth with diabetes and their families. METHODS Caregivers of youth with diabetes completed an electronic survey in English or Spanish at two sites. Participants provided demographic and disease characteristics and completed the COVID-19 Exposure and Family Impact Scales (CEFIS). Glycemic health was assessed via Hemoglobin A1c (HbA1c) from medical chart review. Analysis of variance and analyses of covariance were utilized to examine racial/ethnic differences in glycemic health and in COVID-19 Exposure, Impact, and Distress scales. Hierarchical linear regression was conducted to predict HbA1c. Thematic analysis was conducted on open-ended responses regarding the effects of COVID-19 on youth and families' overall and diabetes-related well-being. RESULTS Caregivers (n = 114) of youth with diabetes (M = 12.6 ± 3.5 years) completed study measures. Mean HbA1c for Non-Hispanic White youth was lowest and significantly different from Hispanic and Non-Hispanic Black youth. Exposure to COVID-19 stressors differed by race/ethnicity (p < .05) with Hispanic caregivers reporting greatest exposure. CEFIS scales did not predict HbA1c after controlling for demographic/disease variables. Caregivers described child/family changes during COVID (e.g., more time together, health-related hypervigilance), as well as differences in diabetes management during COVID-19. CONCLUSIONS Findings indicate differences in COVID-19 exposure but did not demonstrate other racial/ethnic disparities in COVID-19 impact or distress. Household income was the most important predictor of glycemic health. Addressing structural inequalities experienced by youth with diabetes and their families is critical. Recommendations to support families with diabetes are made.
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Affiliation(s)
- Jessica M Valenzuela
- College of Psychology, Department of Clinical & School Psychology, Nova
Southeastern University, USA
- Salah Foundation Children’s Hospital, Broward Health Medical
Center, USA
| | - Karen Dimentstein
- College of Psychology, Department of Clinical & School Psychology, Nova
Southeastern University, USA
| | - Shanique Yee
- College of Psychology, Department of Clinical & School Psychology, Nova
Southeastern University, USA
| | - Bernard Pan
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA
| | - Meg C Snyder
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA
- Department of Behavioral Psychology, Kennedy Krieger
Institute, USA
| | - Risa M Wolf
- Division of Pediatric Endocrinology, Johns Hopkins School of
Medicine, USA
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Wu J, Yang H, Qin Y, Wu J, Yan H, Xu Y, Sun X, Zhang L, Liu X. Change of daily life and depression among adults under stringent lockdown restrictions during COVID-19 pandemic in Shanghai, China. Asian J Psychiatr 2023; 79:103327. [PMID: 36410280 PMCID: PMC9651937 DOI: 10.1016/j.ajp.2022.103327] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/17/2022] [Accepted: 11/10/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Jing Wu
- School of Nursing, Naval Medical University, Shanghai, China.
| | - Hongyang Yang
- President's Office, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Yuchen Qin
- College of Health Service, Naval Medical University, Shanghai, China.
| | - Jiali Wu
- College of Health Service, Naval Medical University, Shanghai, China.
| | - Hongli Yan
- School of Nursing, Naval Medical University, Shanghai, China.
| | - Yan Xu
- College of Health Service, Naval Medical University, Shanghai, China.
| | - Xiaoyu Sun
- College of Health Service, Naval Medical University, Shanghai, China.
| | - Lulu Zhang
- College of Health Service, Naval Medical University, Shanghai, China.
| | - Xu Liu
- College of Health Service, Naval Medical University, Shanghai, China.
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Chen S, Kracht CL, Beyl RA, Staiano AE. Temporal Changes in Energy-Balance Behaviors and Home Factors in Adolescents with Normal Weight and Those with Overweight or Obesity. INTERNATIONAL JOURNAL OF PHYSICAL ACTIVITY AND HEALTH 2023; 2:5. [PMID: 37675056 PMCID: PMC10481771 DOI: 10.18122/ijpah.020205.boisestate] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; n = 82 ), ≤ six months before (T1; n = 68 ), and ≤ three months after the COVID-19 pandemic outbreak (T2; n = 82 ), to capture energy-balance behaviors (i.e., physical activity [PA], screen time, sleep) and home factors (i.e., food environment, food worry, parent support for PA). At T0 and T1 (before pandemic), participants visited our laboratory for anthropometric measurements. At T2, parent proxies also completed a survey to report the COVID-19 pandemic exposure and impact. The participating families experienced moderate levels of pandemic exposure and impact, although exposure was higher in the OWOB group F 1,78 = 5.50 , p < . 05 . Repeated-measure multivariate analyses of covariance (RM-MACOVAs) did not show significant time by weight status interaction effects (p > 0.05 ; adjusted for race and sex). However, the models detected significant time (T0 vs. T2) by race (White vs. non-White) interaction effect λ 7,66 = 0.81 , p < 0.05 , with greater increase in food worry F 1,72 = 4.36 , p < . 05 but less increase in screen time F 1,72 = 4.54 , p < . 05 among the non-White group. Graphical visualization depicted some favorable change patterns in adolescents with normal weight (vs. those with OWOB) for certain behaviors and home factors (e.g., number of days per week ≥ 60 mins PA, food worry). These findings suggest that the COVID-19 pandemic exerted greater adverse effects on adolescents with OWOB and specifically on screen time and food worry among non-White adolescents.
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Payne LA, Seidman LC, Ren B, Greenfield SF. COVID-Related Distress Is Associated with Increased Menstrual Pain and Symptoms in Adult Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:774. [PMID: 36613098 PMCID: PMC9819102 DOI: 10.3390/ijerph20010774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic resulted in heightened stress for many individuals, with women reporting more stress than men. Although a large body of evidence has demonstrated that stress, in general, can impact the menstrual cycle, it is not yet clear if COVID-specific stress would impact women's menstrual health. The current study explored the relationship between COVID-related stress and distress and menstrual variables (menstrual pain, number and severity of menstrual symptoms, and menstrual pain interference) in a sample of reproductive-age adult women. Seven-hundred fifteen women completed the initial survey and were re-contacted to complete the same survey three months later. Of those recontacted, 223 completed the follow-up survey. Results indicated that COVID-related stress and distress was associated with higher levels of menstrual pain, more frequent and more severe menstrual symptoms, and greater menstrual pain interference, even after accounting for age, hormonal use, bodily pain, and pain catastrophizing. Our findings suggest that women experience unique vulnerabilities that directly impact their health and functioning, and both research and clinical care should address these symptoms through careful assessment and treatment of menstrual pain and symptoms, particularly during and after periods of high stress and distress.
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Affiliation(s)
- Laura A. Payne
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Boyu Ren
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Shelly F. Greenfield
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
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Piccolo LR, Oliveira JBA, Hirata G, Canfield CF, Roby E, Mendelsohn AL. Pre-pandemic support for shared reading buffers adverse parenting impacts: an RCT in Brazil. Pediatr Res 2022:10.1038/s41390-022-02419-8. [PMID: 36522551 PMCID: PMC9753875 DOI: 10.1038/s41390-022-02419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/05/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND To examine whether (1) a parent-child reading program (Universidade do Bebê [UBB]), conducted in Brazil pre-pandemic can support parenting and parent-child reading 6 months into the pandemic, (2) cognitive stimulation at pandemic onset mediates effects of UBB on these outcomes, and (3) UBB pre-pandemic buffers associations between COVID-19-related distress and parenting/parent-child reading 6 months into the pandemic. METHODS 400 women, either pregnant or with children 0-24 months, were randomized to UBB (n = 200) or control groups. UBB consisted of monthly parent workshops focusing on parent-child reading and a book-lending library. Assessments pre-pandemic (June-2019) and at pandemic onset (April-2020) included cognitive stimulation. Assessments 6 months into the pandemic (October-2020) included COVID-19 exposure/impact/distress, as well as parenting and parent-child reading. RESULTS 133 families (n = 69 UBB) contributed data 6 months into the pandemic. Participation in UBB pre-pandemic was associated with parent-child reading but not parenting 6 months into the pandemic. Indirect effects of UBB through cognitive stimulation at pandemic onset were observed for both outcomes. Increased COVID-19-related distress was significantly associated with reduced parenting/parent-child reading 6 months into the pandemic in the control group only. CONCLUSION Promotion of cognitive stimulation pre-pandemic may have reduced risk for effects of the pandemic on parenting/parent-child reading. CLINICAL TRIAL REGISTRATION The trial has been registered with the Brazilian Clinical Trials Registry RBR-29RZDH on 05/28/2018. IMPACT This is the first study showing sustained impacts of a reading aloud intervention beginning in pregnancy and early infancy implemented pre-pandemic. Findings suggest that participation in a reading-aloud intervention buffered associations between COVID-19 distress and parenting/parent-child reading 6 months into the pandemic. Novel empirical evidence suggests that promotion of cognitive stimulation prior to the pandemic may buffer its impacts on parenting and parent-child book reading following onset in low- and middle-income countries. Findings provide important new support for implementation of parent-child reading aloud programs and likely have implications for early childhood development beyond the COVID-19 pandemic for disasters generally.
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Affiliation(s)
- Luciane R. Piccolo
- grid.137628.90000 0004 1936 8753Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, NYU Grossman School of Medicine, 462 First Ave—Bellevue Hospital, New York, NY 10016 USA
| | - João B. A. Oliveira
- Instituto Alfa e Beto, 538 Lineu Anterino Mariano st, Uberlândia, MG 38402-346 Brazil
| | - Guilherme Hirata
- IDados, 470 Visconde de Pirajá st., Rio de Janeiro, RJ 22410-002 Brazil
| | - Caitlin F. Canfield
- grid.137628.90000 0004 1936 8753Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, NYU Grossman School of Medicine, 462 First Ave—Bellevue Hospital, New York, NY 10016 USA
| | - Erin Roby
- grid.137628.90000 0004 1936 8753Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, NYU Grossman School of Medicine, 462 First Ave—Bellevue Hospital, New York, NY 10016 USA
| | - Alan L. Mendelsohn
- grid.137628.90000 0004 1936 8753Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, NYU Grossman School of Medicine, 462 First Ave—Bellevue Hospital, New York, NY 10016 USA
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South K, Bakken S, Koleck T, Barcelona V, Elhadad N, Dreisbach C. Women's Experiences of Symptoms of Suspected or Confirmed COVID-19 Illness During the Pandemic. Nurs Womens Health 2022; 26:450-461. [PMID: 36265561 PMCID: PMC9575040 DOI: 10.1016/j.nwh.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/19/2022] [Accepted: 09/22/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To explore experiences of symptoms of suspected or confirmed COVID-19 illness among women using the CovidWatcher mobile citizen science app. DESIGN Convergent parallel mixed-methods design. PARTICIPANTS Twenty-eight self-identified women consented for follow-up after using CovidWatcher. Participants' ages ranged from 18 to 83 years old. METHODS We collected data via semistructured, virtual interviews and surveys: the COVID-19 Exposure and Family Impact Survey and Patient-Reported Outcomes Measurement Information System measures. We used directed content analysis to develop codes, categories, themes, and subthemes from the qualitative data and summarized survey data with descriptive statistics. RESULTS We derived five themes related to symptom experiences: (a) Physical Symptoms, (b) Mental Health Symptoms, (c) Symptom Intensity, (d) Symptom Burden, and (e) Symptom Trajectories. Subthemes reflected more nuanced experiences of suspected or confirmed COVID-19 disease. For those without COVID-19, anxiety and mental health symptoms were still present. Of those who attested to one of the PROMIS-measured symptoms, all but one had at least mild severity in one of their reported symptoms. CONCLUSION This study demonstrates the cross-cutting impact of the COVID-19 pandemic on individuals who identify as women. Future research and clinical practice guidelines should focus on alleviating physical and mental health symptoms related to the ongoing pandemic, regardless of COVID-19 diagnosis. Furthermore, clinicians should consider how patients can use symptom reconciliation apps and tracking systems.
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Wan Tham S, Murray CB, Law EF, Slack KE, Palermo TM. The impact of the COVID-19 pandemic on pain and psychological functioning in young adults with chronic pain. Pain 2022; 163:e1095-e1101. [PMID: 35413028 PMCID: PMC9470785 DOI: 10.1097/j.pain.0000000000002618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Data are equivocal on the consequences of COVID-19 pandemic on pain and well-being for individuals with chronic pain. Furthermore, little is known regarding its impact on the health of young adults with chronic pain. We conducted a longitudinal study to compare pain, psychological functioning, and substance use before and during the pandemic of 196 young adults with chronic pain. Participants aged 18 to 24 years (M = 21.1 years; 79.6% females) reported on pain, anxiety, depression, and substance use before (October 2018-August 2019) and during the pandemic (October 2020-November 2020), in addition to the assessment of COVID-19 exposure and its impact. Before the pandemic, young adults experienced mild-to-moderate pain intensity (M = 3.75, SD = 2.33) and pain interference (M = 3.44, SD = 2.69). Findings were that pain intensity, pain interference, and depression symptoms remained stable during the pandemic. In contrast, anxiety symptoms increased significantly (M = 8.21, SD = 5.84 vs M = 8.89, SD = 5.95, P = 0.04). Tobacco, alcohol, and cannabis use were unchanged. Mixed linear models revealed that COVID-19 exposure and impact were not associated with changes in pain intensity or interference, with female sex associated with increased pain intensity (β = 0.86, P = 0.02) and pain interference (β = 0.87, P = 0.02). Our findings indicated relative stability of pain symptoms experienced by young adults with chronic pain. However, the increases in anxiety highlight the need to facilitate treatment access for mental health services to mitigate downstream impact.
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Affiliation(s)
- See Wan Tham
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, United States
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, United States
| | - Caitlin B. Murray
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, United States
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, United States
| | - Emily F. Law
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, United States
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, United States
| | - Katherine E. Slack
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, United States
| | - Tonya M. Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, United States
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, United States
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Vazquez CE, Hess KE, McBride MJ, Cubbin C, Bearman SK, Calzada EJ. Impact of COVID social distancing measures on eating and exercise behaviors among a sample of Hispanic parents of young children in the United States. J Public Health Res 2022; 11:22799036221132389. [PMID: 36337260 PMCID: PMC9634197 DOI: 10.1177/22799036221132389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background: In the United States, healthy behaviors, such as eating fruits/vegetables and
exercise, are well below recommended levels, particularly for Hispanics. The
COVID pandemic may have exacerbated existing health behavior disparities.
The current study examines the impact of COVID social distancing measures on
Hispanic parents’ eating and exercise behaviors, and how the impact may
differ by socioeconomic status (SES) and distress levels. Design and methods: This cross-sectional logistic regression study utilized data from a sample of
Hispanic parents in Texas (n = 237). COVID-related
questions were collected in Summer 2020. Dependent variables included
self-reported changes in exercise and eating behaviors due to the pandemic
(i.e. got better or got worse). Primary independent variables included
family-SES, neighborhood-SES, and distress due to COVID. Results: More than half (60%) of parents reported that their eating and exercise
behaviors worsened. Results showed a significant relationship between
distress due to COVID and both dependent variables; changes in eating
(OR = 1.38, 95% CI [1.20, 1.58]) and changes in exercise (OR = 1.28, 95% CI
[1.11, 1.48]). There were no observed differences by SES. Conclusions: Results suggest distress due to COVID was associated with worsening of eating
and exercise behaviors, regardless of SES. The direction of the relationship
between distress and healthy eating and exercise behaviors requires further
attention.
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Affiliation(s)
- Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Katherine E Hess
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Megan J McBride
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Esther J Calzada
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Robbertz AS, Cohen LL, Armistead LP, Reed B. Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases. J Pediatr Psychol 2022; 47:981-990. [PMID: 35730966 PMCID: PMC9384296 DOI: 10.1093/jpepsy/jsac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship. METHODS A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship. RESULTS Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not. CONCLUSIONS PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.
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Affiliation(s)
| | | | | | - Bonney Reed
- Division of Gastroenterology, Hepatology, & Nutrition, Emory University School of Medicine, USA
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Shoychet G, Browne DT, Wade M, Prime H. Assessing positive adaptation during a global crisis: The development and validation of the family positive adaptation during COVID-19 scale. Front Psychol 2022; 13:886504. [PMID: 36118478 PMCID: PMC9476998 DOI: 10.3389/fpsyg.2022.886504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has negatively impacted the psychosocial functioning of children and families. It is important to consider adversity in relation to processes of positive adaptation. To date, there are no empirically validated multi-item scales measuring COVID-related positive adaptation within families. The aim of the current study was to develop and validate a new measure: the Family Positive Adaptation during COVID-19 Scale (Family PACS). The sample included 372 female and 158 male caregivers (73% White-European/North American; median 2019 income = $50,000 to $74,999 USD) of children ages 5–18 years old from the United Kingdom (76%), the United States (19%), Canada (4%), and Australia (1%), who completed measures in May 2020. Participants responded to a 14-item survey indexing a range of perceived coping and adaptation behaviors at the beginning of the pandemic. An exploratory factor analysis yielded an optimal one-factor solution comprised of seven items related to family cohesion, flexibility, routines, and meaning-making (loadings from 0.44 to 0.67). Multigroup confirmatory factor analysis demonstrated measurement invariance across female and male caregivers, demonstrating that the factor structure, loadings, and thresholds did not vary by caregiver sex. There was evidence for concurrent validity with significant bivariate correlations between the Family PACS scores and measures of caregiver positive coping, parenting practices, couple satisfaction, and family functioning (correlations from 0.10 to 0.23), but not negatively-valenced constructs. Findings inform our conceptualization of how families have adapted to adverse pandemic-related conditions. Further, we provide preliminary support for the Family PACS as a practical tool for evaluating positive family adaptation during this global crisis, with implications for future widespread crises.
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Affiliation(s)
| | - Dillon T. Browne
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Mark Wade
- Applied Psychology and Human Development, University of Toronto, Toronto, ON, Canada
| | - Heather Prime
- Department of Psychology, York University, Toronto, ON, Canada
- *Correspondence: Heather Prime,
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Penner F, Elzaki Y, Contreras HT, Santos RP, Sarver DE. Behavioral, Affective, and Cognitive Parenting Mechanisms of Child Internalizing and Externalizing Problems during the COVID-19 Pandemic. Res Child Adolesc Psychopathol 2022; 50:1121-1138. [PMID: 35526192 PMCID: PMC9080345 DOI: 10.1007/s10802-022-00920-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/01/2022]
Abstract
The COVID-19 pandemic has led to increased mental health concerns, including depression and anxiety among parents and internalizing and externalizing problems among youth. To better understand the mechanisms and moderators of child mental health during the pandemic, the current study tested two moderated mediation models in which parent depression and anxiety indirectly impacted child internalizing and externalizing problems through negative effects on multiple parenting variables, with these associations moderated by families' exposure to COVID-19-stressors. A national sample representative of U.S. parents (N = 796, 48.2% female, Mage = 38.87 years, 60.3% Non-Hispanic white, 18.1% Hispanic/Latinx, 13.2% Non-Hispanic Black/African-American, 5.7% Asian, 2.8% Other Race) completed a cross-sectional online survey in February-April 2021. Children ranged from 5-16 years old (Mage = 10.35 years, 59.8% Non-Hispanic white, 17.2% Hispanic/Latinx, 13.7% Non-Hispanic Black/African-American, 4.5% Asian, 4.8% Other Race). Parent depression/anxiety was directly and indirectly associated with child internalizing and externalizing problems. For both internalizing and externalizing problems, indirect associations occurred by means of increased parent hostility and inconsistent discipline and decreased routines and parent supportiveness. There were also specific indirect effects through decreased monitoring (internalizing problems) and parenting self-efficacy (externalizing problems). Multiple indirect effects were moderated by number of COVID-19-stressors experienced. Notably, COVID-19-stressors did not have direct effects on child mental health when other variables were considered. Findings highlight the buffering effects of parents for child mental health, the need to address parent depression/anxiety in child interventions, the utility of existing evidence-based parent interventions during the pandemic, and the need to assess families' level of exposure to COVID-19-stressors.
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Affiliation(s)
- Francesca Penner
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, USA.
- Yale Child Study Center, Yale School of Medicine, 230 S Frontage Rd., New Haven, CT, 06520, USA.
| | - Yasmin Elzaki
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, USA
| | - Haglaeeh T Contreras
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, USA
| | - Roberto P Santos
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, USA
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Dustin E Sarver
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, USA
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, USA
- Center for the Advancement of Youth, University of Mississippi Medical Center, Jackson, USA
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43
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Oswald DL, Kaugars AS, Tait M. American Women's Experiences With Intimate Partner Violence during the Start of the COVID-19 Pandemic: Risk Factors and Mental Health Implications. Violence Against Women 2022; 29:1419-1440. [PMID: 35989667 PMCID: PMC9398889 DOI: 10.1177/10778012221117597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In an online survey, women self-reported high prevalence of intimate partner
violence during the early days of the pandemic. Risk factors for experiencing
intimate partner violence (IPV) included having a child under the age of 18,
being a sexual minority, living in a rural community, and stressors related to
healthcare access, income/employment stress, and COVID-19 exposure or illness.
Women who worked during the pandemic and were older were less likely to
experience IPV. Women who reported IPV also reported increased anxiety and
depression. The results are discussed in terms of clinical and policy
implications for supporting women who are victims of IPV.
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Affiliation(s)
| | | | - Mary Tait
- Department of Psychology, Marquette University, WI, USA
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Schilling S, Orr CJ, Delamater AM, Flower KB, Heerman WJ, Perrin EM, Rothman RL, Yin HS, Sanders L. COVID-19 vaccine hesitancy among low-income, racially and ethnically diverse US parents. PATIENT EDUCATION AND COUNSELING 2022; 105:2771-2777. [PMID: 35393230 PMCID: PMC8966372 DOI: 10.1016/j.pec.2022.03.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/24/2022] [Accepted: 03/26/2022] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Examine factors impacting U.S. parents' intention to vaccinate their children against COVID-19. METHODS Data were collected February-May 2021 from parents living in six geographically diverse locations. The COVID-19 Exposure and Family Impact Survey assessed perceived susceptibility and severity to adverse outcomes from the pandemic. Semi-structured interviews assessed perceptions about benefits and risks of vaccinating children. RESULTS Fifty parents of 106 children (newborn-17 years) were included; half were Spanish-speaking and half English-speaking. 62% were hesitant about vaccinating their children against COVID-19. Efficacy and safety were the main themes that emerged: some parents perceived them as benefits while others perceived them as risks to vaccination. Parent hesitancy often relied on social media, and was influenced by narrative accounts of vaccination experiences. Many cited the lower risk of negative outcomes from COVID-19 among children, when compared with adults. Some also cited inaccurate and constantly changing information about COVID-19 vaccines. CONCLUSION Main drivers of parent hesitancy regarding child COVID-19 vaccination include perceived safety and efficacy of the vaccines and lower severity of illness in children. PRACTICE IMPLICATIONS Many vaccine-hesitant parents may be open to vaccination in the future and welcome additional discussion and data.
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Affiliation(s)
- Samantha Schilling
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Colin J Orr
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Kori B Flower
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Eliana M Perrin
- Department of Pediatrics, Johns Hopkins Schools of Medicine and Nursing, Baltimore, MD, USA.
| | - Russell L Rothman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - H Shonna Yin
- Departments of Pediatrics and Population Health, New York University School of Medicine, New York, USA.
| | - Lee Sanders
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
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Koop J, Holliday D, Mathews BL, Namaste J, Alt R, Biel CH. Efficacy of a peer-based in-home education program in improving social-emotional outcomes of parents and children. Infant Ment Health J 2022; 43:783-796. [PMID: 35913374 DOI: 10.1002/imhj.22010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/10/2022] [Indexed: 11/06/2022]
Abstract
Significant disparities in education and social-emotional outcomes exist between racial/ethnic groups, particularly impacting children growing up in impoverished environments. Home visitation intervention programs, such as the Home Instruction for Parents of Preschool Youngsters (HIPPY), have been used for decades to improve academic readiness in these vulnerable preschool-aged children. Although the benefits of HIPPY on academic readiness and performance are well-documented, there has been no examination of social-emotional benefits to participating parent-child dyads. This study followed a HIPPY cohort over the course of 1 year to evaluate change in maternal and child social-emotional and behavioral functioning. Program participants demonstrated reduced parental stress and depression and increased parental social connection as well as reduced child externalizing behaviors and improved child adaptive functioning over the course of the program, even in the context of the COVID-19 pandemic and associated lockdown. These data highlight the additional benefits of early home-based academic intervention programs.
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Affiliation(s)
- Jennifer Koop
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Daniel Holliday
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Brittany L Mathews
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Rebecca Alt
- HIPPY Program, COA Milwaukee, Milwaukee, Wisconsin, USA
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Hails KA, Petts RA, Hostutler CA, Simoni M, Greene R, Snider TC, Riley AR. COVID-19 distress, negative parenting, and child behavioral problems: The moderating role of parent adverse childhood experiences. CHILD ABUSE & NEGLECT 2022; 130:105450. [PMID: 34969517 PMCID: PMC8710429 DOI: 10.1016/j.chiabu.2021.105450] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Heightened familial stress and distress during the COVID-19 pandemic may lead to increased negative parenting practices, particularly for parents with substantial adverse childhood experiences (ACES). OBJECTIVE To determine whether families' COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' ACEs. PARTICIPANTS AND SETTING Participants were 267 parents of children ages 1.5-5 years recruited from five primary care sites across the United States. METHODS Participants completed internet questionnaires including measures of demographics, parent ACES, negative parenting, parent mental health, and COVID-19 distress. We used regression analyses to test a moderated mediation model in which the relationship between COVID-19 distress and child emotional/behavioral problems is mediated by negative parenting, and both the direct and indirect effects of COVID-19 distress on child emotional/behavioral problems is moderated by parents' ACEs. RESULTS Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems (indirect effect β = 0.07). Parents' ACEs moderated the associations between COVID-19 distress and both negative parenting and child emotional/behavioral problems, such that each relationship was stronger in the context of higher parental ACEs. The model accounted for 42% of the variance in child emotional/behavioral problems. CONCLUSIONS Findings have implications for managing risk and promoting well-being in young children during periods of significant stress and routine disruption. This study advances understanding of factors influencing negative outcomes in children during the pandemic's acute phase and may have implications for the development of targeted interventions to improve families' adjustment in the future.
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Affiliation(s)
- Katherine A Hails
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America; University of Oregon Prevention Science Institute, 1600 Millrace Dr., Eugene, OR 97403, United States of America.
| | - Rachel A Petts
- Fairleigh Dickinson University, 1000 River Rd., Teaneck, NJ 07666, United States of America.
| | - Cody A Hostutler
- Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH 43205, United States of America.
| | - Marisa Simoni
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
| | - Rachel Greene
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
| | - Tyanna C Snider
- Nationwide Children's Hospital, 700 Children's Dr., Columbus, OH 43205, United States of America.
| | - Andrew R Riley
- Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States of America.
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47
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Lisenbee J, Gil-Rivas V, Webb JB, Dahl AA, Quinlan MM. Birth Doula Care in California During COVID-19: The Impacts of Social Distancing on a High-Touch Helping Profession. QUALITATIVE HEALTH RESEARCH 2022; 32:1477-1486. [PMID: 35739081 PMCID: PMC9234372 DOI: 10.1177/10497323221110807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Birth doulas were deemed "non-essential" personnel during the COVID-19 pandemic and were generally excluded from attending hospital births in person. This study documents the impacts of pandemic-related contextual factors on birth doula care in the San Francisco Bay Area, examines how doulas adapted their services, and explores implications for policy and practice. We employed a contextually bound qualitative case study methodology driven by social action theory and conducted interviews with 15 birth doulas. The pandemic disrupted physical settings, the social environment, communication modalities, contractual arrangements, and organizational level factors. The historical context also amplified awareness of institutionalized racism in birth settings and highlighted birth doulas' advocacy role. Striking deficits exist in birth doulas' integration into US healthcare systems; this made their services uniquely vulnerable to the pandemic circumstances. Birth doulas' value ought to be more formally recognized within health policy, health insurance, and hospital systems as complementary care to that provided by medical providers to improve access to high-quality perinatal care.
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Affiliation(s)
- Jodie Lisenbee
- Interdisciplinary Health Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Virginia Gil-Rivas
- Interdisciplinary Health Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jennifer B. Webb
- Interdisciplinary Health Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Alicia A. Dahl
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Margaret M. Quinlan
- Communication Studies, University of North Carolina at Charlotte, Charlotte, NC, USA
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Beal SJ, Nause K, Greiner MV. Understanding the impact of COVID-19 on stress and Access to Services for Licensed and Kinship Caregivers and Youth in Foster Care. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 39:633-640. [PMID: 35855445 PMCID: PMC9283847 DOI: 10.1007/s10560-022-00833-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 06/15/2023]
Abstract
Children in foster care in the United States face unique challenges related to access to health and education services. With the COVID-19 pandemic, many of those services were temporarily disrupted, adding burden to an already strained system. This observational study describes the experiences of licensed and kinship caregivers (N = 186) during the peak of COVID-19 stay-at-home orders and as restrictions to services were lifted, to understand the overall impact of COVID-19 on this already vulnerable population. Purposive sampling methods were used, where caregivers known to have received placement of children prior to, during, and following COVID-19 stay-at-home orders were identified and recruited to complete a 45-minute phone-administered survey assessing stress, risks for contracting COVID-19, strain resulting from COVID-19, and access to services for children in foster care in their care across five domains: healthcare, mental health, education, child welfare, and family visitation. Differences by caregiver type (licensed, kinship) and timing in the pandemic were examined. Licensed and kinship caregivers reported similar social and economic impacts of COVID-19, including similar rates of distress for themselves and the youth placed with them. Almost half of caregivers experienced challenges accessing mental health services, with access to services more disrupted during COVID-19 stay-at-home orders. Caregiver reports regarding the social and economic impacts of COVID-19 were similar across the study, suggesting that lessened restrictions have not alleviated strain for this population.
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Affiliation(s)
- Sarah J. Beal
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, 45229 Cincinnati, Ohio USA
| | - Katie Nause
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio USA
| | - Mary V. Greiner
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, 45229 Cincinnati, Ohio USA
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Shear D, Harrison LE, O'Brien S, Khazendar Z, Lyons S, Morgan JJ, Chan SK, Feinstein AB, Simons LE. Rapid Transition to Virtual Assessment and Treatment in an Interdisciplinary Randomized Clinical Trial for Youth With Chronic Pain: Adaptations and Implications for Future Trials. Clin J Pain 2022; 38:459-469. [PMID: 35686576 PMCID: PMC9199594 DOI: 10.1097/ajp.0000000000001040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES COVID-19 abruptly halted in-person clinical care and research requiring a shift to virtual assessment and treatment. This unexpected transition of a 2-arm randomized controlled trial (RCT) examining interdisciplinary graded exposure treatment (GET Living) compared with multidisciplinary pain management for youth with chronic pain provided an opportunity to implement the first remotely delivered exposure treatment and remotely delivered biomechanical assessment for pediatric chronic pain. Here we describe these new approaches and provide lessons learned to inform future efforts in digital health care. METHODS A total of 68 youth (M=14.2 y; 80.9% female) were enrolled in the RCT (n=31 in-person, n=5 hybrid, n=32 virtual, n=9 withdrew). Of those withdrawn, n=3 withdrew due to COVID-19 related reasons. Some RCT elements required slight modification (eg, e-consent, actigraphy deployment, recruitment, and screening), while others were significantly altered (eg, session format and lab-based biomechanical assessment). Data from exit interviews were also examined to assess perspectives on the virtual format transition. RESULTS Results showed an increased enrollment rate when virtual care was an option (70.7%) compared with in-person (44.3%). Equivalent rates of completion for daily assessment (in-person, 72.8%; virtual, 73.3) were also observed, and participants described enhanced experience when able to complete exercises and exposures in their home environment during session (vs. a rehabilitation gym) allowing for genuine in vivo exposures (eg, household chores, riding bicycles). DISCUSSION Overall, our data demonstrate acceptability, feasibility, and equivalent patient engagement to virtual treatment. Novel methods implemented in this RCT can inform trial design and measures of clinical endpoints for future digital health interventions.
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Affiliation(s)
- Deborah Shear
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
| | - Lauren E Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
| | - Shannon O'Brien
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
| | - Zeena Khazendar
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
| | - Samuel Lyons
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Sunnyvale, CA
| | - Jeffery J Morgan
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Sunnyvale, CA
| | - Salinda K Chan
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Sunnyvale, CA
| | - Amanda B Feinstein
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
| | - Laura E Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto
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50
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Klosky JV, Gazmararian JA, Casimir O, Blake SC. Effects of Remote Education During the COVID-19 Pandemic on Young Children's Learning and Academic Behavior in Georgia: Perceptions of Parents and School Administrators. THE JOURNAL OF SCHOOL HEALTH 2022; 92:656-664. [PMID: 35411613 PMCID: PMC9115169 DOI: 10.1111/josh.13185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/20/2022] [Accepted: 03/08/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND In Spring 2020, Georgia public schools implemented remote learning to manage the spread of COVID-19. This study explores the effects of remote schooling on the learning of young children in Georgia during the early COVID-19 pandemic from the perspectives of school administrators and essential working parents. METHODS A qualitative exploratory study was conducted with eight school administrators and 26 essential working parents of children in kindergarten through third grades of two rural and two urban schools in Georgia. Data collection included online surveys, virtual interviews and focus groups. Descriptive analyses of the demographics provided context to emerging themes from qualitative data. RESULTS Most school administrators and parents reported declines in student learning and academic behavior related to remote learning. Lack of Wi-Fi, technology, and digital literacy were often cited as barriers to learning. Challenges with remote learning were amplified for students and parents of vulnerable groups. CONCLUSIONS The findings of this study illustrate the need to institute policies, procedures, and supports to maximize schools' ability to safely offer in-person learning during the COVID-19 pandemic. Considerations should be made of the needs of essential working parents, vulnerable populations, and the digital divide.
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Affiliation(s)
- Jill V. Klosky
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322USA
| | - Julie A. Gazmararian
- Department of Epidemiology, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322USA
| | - Olivia Casimir
- Department of Global Health, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322USA
| | - Sarah C. Blake
- Department of Health Policy & Management, Rollins School of Public HealthEmory University1518 Clifton RoadAtlantaGA30322USA
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