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Joshi D, Aschner A, Atkinson L, Halili-Sychangco D, Duku E, Puffer ES, Rieder A, Tonmyr L, Gonzalez A. Predictors of harsh parenting practices and inter-partner conflict during the COVID-19 pandemic in Ontario, Canada: a cross-sectional analysis from the Ontario Parent Survey. BMJ Open 2023; 13:e066840. [PMID: 37640470 PMCID: PMC10462979 DOI: 10.1136/bmjopen-2022-066840] [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: 07/21/2022] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Guided by the bioecological model, the purpose of this study was to examine the associations of (1) individual level factors (sociodemographic, health behaviour and mental health), (2) family (micro) level COVID-19 experiences (difficulty with household management, managing child mood and behaviour, and pandemic-related positive experiences) and (3) community (macro) level factors (residential instability, ethnic concentration, material deprivation and dependency, an indicator of age and labour force) with harsh parenting practices and inter-partner conflict during the early lockdown of the COVID-19 pandemic in Ontario, Canada. DESIGN A cross-sectional analysis of data from the Ontario Parent Survey. SETTING A convenience sample of 7451 caregivers living in Ontario, Canada, at the time of baseline data collection (May-June 2020). PARTICIPANTS Caregivers aged 18 years and older with children 17 years or younger. OUTCOME MEASURES Parenting practices over the past 2 months was assessed using a published modification of the Parenting Scale. The frequency of inter-partner conflict over the past month was assessed using the Marital Conflict scale. RESULTS Individual (sociodemographic factors, alcohol use, and higher depressive and anxiety symptoms) and family (difficulties with managing the household and child mood and behaviour) level factors were positively associated with inter-partner conflict and harsh parenting practices. Having fewer positive experiences (eg, performing activities with children), and economic adversity at the family level were positively associated with inter-partner conflict but inversely associated with harsh parenting. At the community level, residential instability was negatively associated with harsh parenting practices. CONCLUSIONS Individual and family level factors were associated with harsh parenting and inter-partner conflict. The associations of fewer positive experiences and economic hardship with harsh parenting practices may be more complex than initially thought. Efforts that raise awareness and address caregiver mental health concerns are needed as part of the pandemic response to promote positive inter-partner and parent-child interactions.
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Affiliation(s)
- Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Amir Aschner
- Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | - Eric Duku
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Eve S Puffer
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Amber Rieder
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lil Tonmyr
- Family Violence Surveillance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Neumann A, Ulrich SM, Sinß F, Chakraverty D, Hänelt M, Lux U, Ghezih S, Löchner J, Renner I. How are families in Germany doing in 2022? Study protocol of a nationally representative, cross-sectional study of parents with children aged 0-3 years. PLoS One 2023; 18:e0285723. [PMID: 37172028 PMCID: PMC10180634 DOI: 10.1371/journal.pone.0285723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/16/2023] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND In order for Early Childhood Intervention (ECI) to be effective, data-based information on families' resources, burden and current use of support services for families with young children, as well as on children's health and development is needed. The study Kinder in Deutschland [Children in Germany]-KiD 0-3 2022 aims at providing these data to help us understand families' situation and needs in Germany now, including families' experience of the COVID-19 pandemic. METHOD The study will recruit up to 300 pediatricians who will invite parents of children aged up to 48 months to participate in the study during a well-child visit. Parents (goal N = 8,000) will complete an online-questionnaire with their own web-enabled device. Pediatricians will complete a short questionnaire about each participating family. The questionnaires cover family psychosocial burden and resources, child health and development, use of family support services, as well as the families' experiences of the COVID-19 pandemic. Data will be analyzed to assess patterns of families´ psychosocial burdens and resources, use of support services for families with young children, and children´s health and development. Concordance between parent and pediatrician report will be assessed and comparisons with the predecessor study of 2015 will be drawn. DISSEMINATION Findings will be disseminated through scientific conferences, open access peer-reviewed journals, and dissemination channels of the National Centre for Early Prevention. DISCUSSION The present study will provide parent and pediatrician reports on how families with young children are doing in Germany. These data will be used to inform Germany's early childhood intervention (ECI) program ("Frühe Hilfen") on current needs of families with young children.
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Affiliation(s)
- Anna Neumann
- National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
| | - Susanne M Ulrich
- Department of Families and Family Policies, German Youth Institute, National Centre for Early Prevention, Munich, Germany
| | - Frank Sinß
- National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
| | - Digo Chakraverty
- National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
| | - Maria Hänelt
- National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
| | - Ulrike Lux
- Department of Families and Family Policies, German Youth Institute, National Centre for Early Prevention, Munich, Germany
| | - Sarah Ghezih
- Department of Families and Family Policies, German Youth Institute, National Centre for Early Prevention, Munich, Germany
| | - Johanna Löchner
- Department of Families and Family Policies, German Youth Institute, National Centre for Early Prevention, Munich, Germany
| | - Ilona Renner
- National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
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Khunti K, Aroda VR, Aschner P, Chan JCN, Del Prato S, Hambling CE, Harris S, Lamptey R, McKee M, Tandon N, Valabhji J, Seidu S. The impact of the COVID-19 pandemic on diabetes services: planning for a global recovery. Lancet Diabetes Endocrinol 2022; 10:890-900. [PMID: 36356612 PMCID: PMC9640202 DOI: 10.1016/s2213-8587(22)00278-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/01/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
Abstract
The COVID-19 pandemic has disproportionately affected certain groups, such as older people (ie, >65 years), minority ethnic populations, and people with specific chronic conditions including diabetes, cardiovascular disease, kidney disease, and some respiratory diseases. There is now evidence of not only direct but also indirect adverse effects of COVID-19 in people with diabetes. Recurrent lockdowns and public health measures throughout the pandemic have restricted access to routine diabetes care, limiting new diagnoses, and affecting self-management, routine follow-ups, and access to medications, as well as affecting lifestyle behaviours and emotional wellbeing globally. Pre-pandemic studies have shown that short-term delays in delivery of routine care, even by 12 months, are associated with adverse effects on risk factor control and worse microvascular, macrovascular, and mortality outcomes in people with diabetes. Disruptions within the short-to-medium term due to natural disasters also result in worse diabetes outcomes. However, the true magnitude of the indirect effects of the COVID-19 pandemic on long-term outcomes and mortality in people with diabetes is still unclear. Disasters tend to exacerbate existing health disparities; as we recover ambulatory diabetes services in the aftermath of the pandemic, there is an opportunity to prioritise those with the greatest need, and to target resources and interventions aimed at improving outcomes and reducing inequality.
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Affiliation(s)
- Kamlesh Khunti
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK; NIHR Applied Research Collaboration East Midlands, Leicester, UK.
| | | | - Pablo Aschner
- Asociación Colombiana de Diabetes, Bogotá, Colombia; Oficina de Investigaciones, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Stefano Del Prato
- Diabetology Divisions, Pisa University Hospital, University of Pisa, Pisa, Italy
| | | | - Stewart Harris
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Roberta Lamptey
- Department of Family Medicine, Korle Bu Teaching Hospital, Accra, Ghana; Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Jonathan Valabhji
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, UK; NHS England, London, UK; NHS Improvement, London, UK; Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Samuel Seidu
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK; NIHR Applied Research Collaboration East Midlands, Leicester, UK
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Galacho-Jiménez FB, Carruana-Herrera D, Molina J, Ruiz-Sinoga JD. Tempo-Spatial Modelling of the Spread of COVID-19 in Urban Spaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9764. [PMID: 35955122 PMCID: PMC9368233 DOI: 10.3390/ijerph19159764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
The relationship between the social structure of urban spaces and the evolution of the COVID-19 pandemic is becoming increasingly evident. Analyzing the socio-spatial structure in relation to cases may be one of the keys to explaining the ways in which this contagious disease and its variants spread. The aim of this study is to propose a set of variables selected from the social context and the spatial structure and to evaluate the temporal spread of infections and their different degrees of intensity according to social areas. We define a model to represent the relationship between the socio-spatial structure of the urban space and the spatial distribution of pandemic cases. We draw on the theory of social area analysis and apply multivariate analysis techniques to check the results in the urban space of the city of Malaga (Spain). The proposed model should be considered capable of explaining the functioning of the relationships between societal structure, socio-spatial segregation, and the spread of the pandemic. In this paper, the study of the origins and consequences of COVID-19 from different scientific perspectives is considered a necessary approach to understanding this phenomenon. The personal and social consequences of the pandemic have been exceptional and have changed many aspects of social life in urban spaces, where it has also had a greater impact. We propose a geostatistical analysis model that can explain the functioning of the relationships between societal structure, socio-spatial segregation, and the temporal evolution of the pandemic. Rather than an aprioristic theory, this paper is a study by the authors to interpret the disparity in the spread of the pandemic as shown by the infection data.
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Affiliation(s)
| | | | - Julián Molina
- Department of Applied Economics (Mathematics), University of Malaga, 29071 Malaga, Spain
| | - José Damián Ruiz-Sinoga
- Physical Geography and Territory Group, Department of Geography, University of Malaga, 29071 Malaga, Spain
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Barboza M, Marttila A, Burström B, Kulane A. Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden. BMC Public Health 2022; 22:1091. [PMID: 35650586 PMCID: PMC9158140 DOI: 10.1186/s12889-022-13492-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme models to new locations. An extended early childhood home visiting intervention has been developed on-site in a socioeconomically disadvantaged area of Sweden since 2013 with the aim of reducing persisting health inequities in the population. This study aimed at investigating the core programme components and how the intervention was perceived to contribute towards health equity from early childhood. METHODS Qualitative framework method was applied in a document analysis and subsequent semi-structured interviews with 15 key actors involved in the programme. RESULTS The intervention was found to be constituted of five core components centred around the situation-based, parental strengthening work method delivered by a qualified team of child health care nurse and social worker. The programme theory foresaw positive effects on child and parental health, responsive parenting practices, families' use of welfare services according to need and increased integration and participation in society. The principles of Proportionate Universalism were recognised in the programme theory and the intervention was perceived as an important contribution to creating conditions for improved health equity for the families. Still, barriers to health equity were identified on the structural level which limit the potential impact of the programme. CONCLUSIONS The core components of the Extended home visiting programme in Rinkeby correspond well to those of similar evidence-based home visiting interventions. Combining focus on early childhood development and responsive parenting with promoting access to the universal welfare services and integration into society are considered important steppingstones towards health equity. However, a favourable macro-political environment is required in the endeavour to balance the structural determinants' influence on health inequities. Improved availability and accessibility to welfare services that respond to the needs of the families regarding housing, education and employment are priorities. TRIAL REGISTRATION The study was retrospectively registered on 11/08/2016 in the ISRCTN registry ( ISRCTN11832097 ).
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Affiliation(s)
- Madelene Barboza
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden.
| | - Anneli Marttila
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden.,Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176, Gävle, Sweden
| | - Bo Burström
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden.,Region Stockholm, Centre for Epidemiology and Community Medicine, Box 45436, 104 31, Stockholm, Sweden
| | - Asli Kulane
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, 17177, Stockholm, Sweden
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Nöstlinger C, Van Landeghem E, Vanhamel J, Rotsaert A, Manirankunda L, Ddungu C, Reyniers T, Katsuva D, Vercruyssen J, Dielen S, Meudec M. COVID-19 as a social disease: qualitative analysis of COVID-19 prevention needs, impact of control measures and community responses among racialized/ethnic minorities in Antwerp, Belgium. Int J Equity Health 2022; 21:67. [PMID: 35578292 PMCID: PMC9108705 DOI: 10.1186/s12939-022-01672-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/27/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In high income countries, racialized/ethnic minorities are disproportionally affected by COVID-19. Despite the established importance of community involvement in epidemic preparedness, we lack in-depth understanding of these communities' experiences with and responses to COVID-19. We explored information and prevention needs, coping mechanisms with COVID-19 control measures and their impact on lived experiences among selected racialized/ethnic minority communities. METHODS This qualitative rapid assessment conducted in Antwerp/Belgium used an interpretative and participatory approach. We included migrant communities with geographic origins ranging from Sub-Saharan Africa, North-Africa to the Middle East, Orthodox Jewish communities and professional community workers. Data were collected between May 2020-May 2021 through key informant-, in-depth interviews and group discussions (N = 71). Transcripts were analyzed inductively, adopting a reflexive thematic approach. A community advisory board provided feedback throughout the research process. RESULTS Participants indicated the need for tailored information in terms of language and timing. At the start of the epidemic, they perceived official public health messages as insufficient to reach all community members. Information sources included non-mainstream (social) media and media from home countries, hampering a nuanced understanding of virus transmission mechanisms and local and national protection measures. Participants felt the measures' most negative impact on their livelihoods (e.g. loss of income, disruption of social and immigration support). Economic insecurity triggered chronic stress and fears at individual and family level. High degrees of distrust in authorities and anticipated stigma were grounded in previously experienced racial and ethnic discrimination. Community-based initiatives mitigated this impact, ranging from disseminating translated and tailored information, providing individual support, and successfully reaching community members with complex needs (e.g. the elderly, digitally illiterate people, those with small social networks or irregular legal status). CONCLUSION Study participants' narratives showed how coping with and responding to COVID-19 was strongly intertwined with socio-economic and ethnic/racial characteristics. This justifies conceptualizing COVID-19 a social disease. At the same time, communities demonstrated resilience in responding to these structural vulnerabilities. From a health equity perspective, we provide concrete policy recommendations grounded in insights into communities' structural vulnerabilities and resilience.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Stef Dielen
- Department of Public Health, Antwerp, Belgium
| | - Marie Meudec
- Department of Public Health, Antwerp, Belgium
- Outbreak Research Team, Institute of Tropical Medicine, Antwerp, Belgium
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Determinantes sociales y salud mental en las pandemias: nuevos retos. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lima-Serrano M. Social determinants and mental health in pandemics: new challenges. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:141-142. [PMID: 35690429 PMCID: PMC9179045 DOI: 10.1016/j.enfcle.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Marta Lima-Serrano
- Departamento de Enfermería, Universidad de Sevilla, Grupo CTS-969 "Innovación en cuidados y determinantes sociales en salud", Spain.
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Evidence of the Relationship between Social Vulnerability and the Spread of COVID-19 in Urban Spaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095336. [PMID: 35564729 PMCID: PMC9104638 DOI: 10.3390/ijerph19095336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
Modeling the social-spatial structure of urban spaces can facilitate the development of guidelines aimed at curbing the spread of the COVID-19 pandemic while also acting as an instrument that helps decision-making concerning mitigation policies. The modeling process starts with categorization of urban spaces based on the concept of social vulnerability. A model is created based on this concept and the theory of analysis of social areas. Statistical techniques of factor analysis and geostatistics are applied. This generates a map of social differentiation that, when related to data on the evolution of the contagion, generates a multidimensional model of social vulnerability. The application of this model towards people (social structure) and the environment where they live (spatial structure) is specified. Our model assumes the uniqueness of cities, and it is intended to be a broadly applicable model that can be extrapolated to other urban areas if pertinent revisions are made. Our work demonstrates that aspects of the social and urban structures may be validly used to analyze and explain the spatial spread of COVID-19.
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Ljung R, Feychting M, Burström B, Möller J. Differences by region of birth in SARS-CoV-2 vaccine coverage and positive SARS-CoV-2 test among 400 000 healthcare workers and the general population in Sweden. Vaccine 2022; 40:2904-2909. [PMID: 35428499 PMCID: PMC8995201 DOI: 10.1016/j.vaccine.2022.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/21/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
Abstract
Background Globally SARS-CoV-2 vaccine coverage varies among healthcare workers. Methods Based on Swedish registers, data on vaccination status as of 31 October 2021 were analysed for all adults aged 35–64 years, 3 861 565 individuals, in Sweden by healthcare worker occupation group and region of birth. Results For both men and women vaccination coverage decreased in a graded manner by healthcare worker group with physicians having the highest coverage (96%), followed by registered nurses, licensed practical nurses, and nurse aides. Coverage also differed by region of birth for all groups of healthcare workers and non-healthcare workers with those born in Sweden with Sweden born parents having the highest coverage, and those born outside Sweden but within EU the lowest. Conclusion The difference in vaccine coverage by region of birth among healthcare workers, regardless of whether it results from socioeconomic inequalities or sociocultural beliefs, puts them at a great occupational hazard and increased risk of nosocomial transmission.
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