Minority and low-SES families' experiences during the early phases of the COVID-19 pandemic crisis: A qualitative study

OBJECTIVES

To explore minority and low-SES families' general experiences with the stay-at-home mandate initiated by the COVID-19 pandemic crisis.

METHODS

Semi-structured qualitative interviews (n = 31) were conducted in May 2020 - six to nine weeks after the stay-at-home mandate was initiated in Chicago Heights, Illinois. Participants were randomly selected from the parent Chicago Heights Early Childhood Center (CHECC) study (N = 2,185). Thematic content analysis of transcribed semi-structured interviews were employed.

RESULTS

During the early phases of the COVID-19 pandemic crisis, ethnic minority and low-SES families were generally comfortable in their homes, but both children and their parents experienced poor wellbeing, such as elevated stress. Families reportedly avoided social resources, despite low-SES. Upon reflection, parents expressed that the pandemic had changed them and, in some ways, the changes were positive.

CONCLUSION

Readily available crisis-oriented resources, for both children and parents, are needed to help families maintain or rebuild their sense of control over their lives during the early phases of a collective crisis (e.g., pandemic). Although early observations help to contextual families' initial experiences, examining long-term trends can inform meaningful policies and practices that both support how low-SES families buffer against COVID-19-related negative impacts and mitigate ethnic and SES inequities and disparities.

The Effect of Literacy-Adapted Psychosocial Treatments on Biomedical and Biopsychosocial Pain Conceptualization

This is a secondary data analysis of a subgroup of participants who received the Learning About My Pain (LAMP) intervention (clinicaltrials.gov identifier NCT01967342). We examined the effects of LAMP on pre-to-post changes in biomedical and biopsychosocial pain conceptualization and whether those changes in pain conceptualization were associated with physical and psychological functioning. Participants were randomized into three conditions: Cognitive Behavioral Therapy (CBT), Pain Psychoeducation (EDU), or Usual Medical Care (UC). Results based on 225 participants who completed the Pain Concepts Questionnaire (PCQ) showed a pre-to-post reduction in biomedical pain conceptualization (BM), an increase in biopsychosocial pain conceptualization (BPS), and an increase in BPS/BM ratio for CBT and EDU but not UC. There were no differences between CBT and EDU in post-treatment PCQ scores. Compared to those with lower BM pain beliefs scores at post-treatment, participants endorsing higher BM pain beliefs scores reported greater pain intensity and greater pain interference. Furthermore, higher BM pain beliefs scores at post-treatment and lower BPS/BM ratio were associated with higher levels of pain catastrophizing. Overall, results of this study suggest the need for targeting specific pain beliefs that influence pain-related outcomes. PERSPECTIVE: This article presents the potential benefits of providing literacy-adapted psychosocial treatments to expand pain conceptualization beyond a biomedical-only understanding and toward a biopsychosocial conceptualization of the experience of pain. Furthermore, the association of changes in pain conceptualization and pain-related functioning argues for its potential clinical relevance.

Comparing in person and internet methods to recruit low-SES populations for tobacco control policy research

Tobacco use and the associated consequences are much more prevalent among low-SES populations in the U.S. However, tobacco-based research often does not include these harder-to-reach populations. This paper compares the effectiveness and drawbacks of three methods of recruiting low-SES adult smokers in the Northeast. From a 5-year, [funding blinded] grant about impacts of graphic warning labels on tobacco products, three separate means of recruiting low-SES adult smokers emerged: 1) in person in the field with a mobile lab vehicle, 2) in person in the field with tablet computers, and 3) online via Amazon Mechanical Turk (MTurk). We compared each of these methods in terms of the resulting participant demographics and the "pros" and "cons" of each approach including quality control, logistics, cost, and engagement. Field-based methods (with a mobile lab or in person with a tablet) yielded a greater proportion of disadvantaged participants who could be biochemically verified as current smokers-45% of the field-based sample had an annual income of <$10,000 compared to 16% of the MTurk sample; 40-45% of the field-based sample did not complete high school compared to 2.6% of the MTurk sample. MTurk-based recruitment was substantially less expensive to operate (1/14th the cost of field-based methods) was faster, and involved less logistical coordination, though was unable to provide immediate biochemical verification of current smoking status. Both MTurk and field-based methods provide access to low-SES participants-the difference is the proportion and the degree of disadvantage. For research and interventions where either inclusion considerations or external validity with low-SES populations is critical, especially the most disadvantaged, our research supports the use of field-based methods. It also highlights the importance of adequate funding and time to enable the recruitment and participation of these harder-to-reach populations.

Local professionals' perceptions of health assets in a low-SES Dutch neighbourhood: a qualitative study

Background

Asset-based approaches have become popular in public health. As yet it is not known to what extent health and welfare professionals are able to identify and mobilise individual and community health assets. Therefore, the aim of this study was to understand professional’s perceptions of health and health assets.

Methods

In a low-SES neighbourhood, 21 health and welfare professionals were interviewed about their definition of health and their perceptions of the residents’ health status, assets available in the neighbourhood’s environment, and the way residents use these assets. A Nominal Group Technique (NGT) session was conducted for member check. Verbatim transcripts of the semi-structured interviews were coded and analysed using Atlas.ti.

Results

The professionals used a broad health concept, emphasizing the social dimension of health as most important. They discussed the poor health of residents, mentioning multiple health problems and unmet health needs. They provided many examples of behaviour that they considered unhealthy, in particular unhealthy diet and lack of exercise. Professionals considered the green physical environment, as well as health and social services, including their own services, as important health enhancing factors, whereas social and economic factors were considered as major barriers for good health. Poor housing and litter in public space were considered as barriers as well. According to the professionals, residents underutilized neighbourhood health assets. They emphasised the impact of poverty on the residents and their health. Moreover, they felt that residents were lacking individual capabilities to lead a healthy life. Although committed to the wellbeing of the residents, some professionals seemed almost discouraged by the (perceived) situation. They looked for practical solutions by developing group-based approaches and supporting residents’ self-organisation.

Conclusions

Our study shows, firstly, that professionals in the priority district Slotermeer rated the health of the residents as poor and their health behaviour as inadequate. They considered poverty and lack of education as important causes of this situation. Secondly, the professionals tended to talk about barriers in the neighbourhood rather than about neighbourhood health assets. As such, it seems challenging to implement asset-based approaches. However, the professionals, based on their own experiences, did perceive the development of collective approaches as a promising direction for future community health development.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4555-6) contains supplementary material, which is available to authorized users.

The Educational and Employment Aspirations of Adolescents from Areas of High Deprivation in London

Adolescents from areas of high deprivation are often assumed to have low aspirations for the future. However, recent research has suggested otherwise and there have been calls for more substantial investigation into the relationship between poverty and aspiration. This article reports levels and variation in aspiration from 1214 adolescents (49.5 % male; 50.5 % female) living in areas of high deprivation across 20 London boroughs. A strength of this study is our large and diverse population of low socio-economic status (SES) adolescents, comprising of white British (22 %), black African (21 %), black Caribbean (9 %), Indian/Pakistani/Bangladeshi/Other Asian (24 %), mixed ethnicity (9 %), and 15 % defining themselves as Other. Our measures indicated a high group level of reported aspiration with notable variations. Females reported higher educational (but not occupational) aspirations than males; white British students reported lower educational and occupational aspirations than other ethnic groups; and black African children reported the highest educational aspirations. Perceived parental support for education had the largest positive association with aspirations. In contrast to previous findings from studies carried out in the United States, aspirations were found to be negatively associated with perceptions of school and school peer environment. These measures explored feelings of safety, happiness and belonging within the school environment and school peer group. We discuss possible explanations for this unexpected finding within our population of adolescents from UK state schools and how it might affect future policy interventions. This study makes an important contribution to the literature on adolescent aspirations because of the unique nature of the data sample and the multiple domains of functioning and aspiration measured.