A descriptive literature review of early research on COVID-19 and close relationships

A Randomized Clinical Trial of Online Social Intelligence Training With Custodial Grandmothers

BACKGROUND AND OBJECTIVES

In this study, we investigated the efficacy of a self-administered, online Social Intelligence Training (SIT) program aimed at enhancing psychological and relational well-being among a nationwide U.S. sample of custodial grandmothers.

RESEARCH DESIGN AND METHODS

A two-arm randomized clinical trial (RCT) was conducted, where 349 grandmothers raising grandchildren aged 11-18 years were assigned to either SIT or an attention control condition (ACC). Participants self-completed online surveys at baseline and immediately postintervention, in addition to follow-ups at 3-, 6-, and 9-month postintervention. First-order latent difference score models were used to compare SIT to ACC, across all times of measurement, along key indicators of psychological and relational well-being on an intent-to-treat basis.

RESULTS

Although SIT was largely superior to ACC at yielding positive results, it appears that it attenuated longitudinal declines that occurred among ACC participants. SIT also exerted stronger effects on relational than psychological outcomes, with perceived relations with grandchildren being the most positively affected.

DISCUSSION AND IMPLICATIONS

Given that the historical time of this RCT unpredictably corresponded with the coronavirus disease 2019 pandemic, we suspect that SIT helped offset declines in psychological and relational well-being that are widely documented to have resulted from the pandemic. Our overall positive findings support future use of the inexpensive and easily delivered SIT program under normal environmental conditions, with the vulnerable and geographically disperse population of custodial grandmothers.

CLINICAL TRIALS REGISTRATION NUMBER

NCT03239977.

Referrals to Community and State Agencies to Address Social Determinants of Health for Improving Mental Health, Functioning, and Quality of Care Outcomes for Diverse Adults

Objectives. To examine whether referral for social determinants of health (SDH) needs decreases psychological distress and posttraumatic stress disorder (PTSD) symptoms and improves level of functioning and quality of care among diverse adults. Methods. Data are from control participants (n = 503 adults) in a randomized controlled trial testing a mental health intervention in North Carolina and Massachusetts. We fitted multilevel mixed-effects models to repeated assessments (baseline, 3, 6, and 12 months) collected between September 2019 and January 2023. Results. After referral to services for trouble paying utility bills, participants reported lower PTSD symptoms. Participants reported better quality of care when receiving referrals to mental health care. After adjusting for income and employment status, we found that participants who were referred more often also had lower PTSD symptoms and better levels of functioning. Conclusions. Referrals for certain SDH needs might decrease PTSD symptoms and improve self-reported quality of care and functioning. However, referrals alone, without ensuring receipt of services, might be insufficient to affect other mental health outcomes. Research is needed on training and providing care managers time for offering interpersonal support, securing services, and understanding agencies' contexts for addressing high SDH needs. (Am J Public Health. 2024;114(S3):S278-S288. https://doi.org/10.2105/AJPH.2023.307442).

Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data

BACKGROUND

The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces.

METHODS

The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes.

RESULTS

Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03).

DISCUSSION

Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.

Resilience Communication Mitigates the Negative Relational Effects of Topic Avoidance: Evidence from Parental Caregiving and COVID-19 Pandemic Contexts

Communicating about hardships with close others can be challenging, leading to avoidance of hardship-related topics. Although typically considered relationally damaging, topic avoidance could serve as a beneficial or neutral strategy when paired with relationally affirming communication. The current research investigates if the resilience communication processes outlined in the communication theory of resilience mitigate the negative relational effects of topic avoidance. Hypotheses are tested in two different contexts: sibling communication during parental caregiving (N=207) and spousal communication in the first months of the COVID-19 pandemic (N=598). The processes of crafting normalcy, communication networks, and productive action were beneficial across contexts. When participants reported higher engagement in these processes, topic avoidance was not significantly related to relationship satisfaction. At lower engagement levels, topic avoidance was negatively related to relationship satisfaction. Nuance between contexts existed. For example, humor moderated the effect of sibling caregiving topic avoidance but not spousal COVID-19 topic avoidance.

Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries

Objective

To determine individual- and country-level factors associated with self-reported changes in solo and partnered sexual behaviors in an international sample of adults during COVID-19.

Methods

Data were from the International Sexual Health And REproductive Health during COVID-19 study (I-SHARE)-a cross-sectional, multi-country study (N = 26 countries) assessing adult (N = 19,654) sexual/reproductive health before and during the first wave of COVID-19. We examined self-reported changes (three-point scale: decreased, no change, increased) in solo masturbation, hugging/holding hands/cuddling with a partner, sex with a primary partner, sex with a casual partner, sexting with a partner, viewing sexually explicit media and partnered cybersex. Ordinal regression assessed the impact of individual (age, gender- and sexual-identity, romantic partnership status, employment and income stability, household change and content, mental well-being, changes in alcohol use, and changes in marijuana use) and country-level (e.g., Oxford Stringency Index, Human Development Index, and the Palma Ratio) factors on behavior change.

Results

The most common behavior to increase was hugging, kissing, or cuddling with a partner (21.5%), and the most common behavior to decrease was sex with a main partner (36.7%). Household factors like job/income instability and having children over the age of 12 years were significantly associated with decreased affectionate and sexual partnered sexual behaviors; more frequent substance use was linked to significantly increased solo, partnered, and virtual sexual behaviors.

Conclusions

Understanding changes in sexual behaviors-as well as the factors that make changes more or less likely among adults around the world-are important to ensure adequate sexual health support development for future public health emergencies.

Implications of the COVID-19 Pandemic for the Well-Being of Emerging Adult Populations: A Synthesis of Findings From the COVID-19 Eating and Activity Over Time (C-EAT) Study

Research addressing the impact of the COVID-19 pandemic on psychosocial well-being and health behavior is accumulating; however, implications for emerging adult populations are underexplored. This manuscript synthesizes findings from a mixed-methods study of well-being, eating and activity behaviors, and food insecurity among a diverse, longitudinal cohort of emerging adults. The review includes findings from 11 original studies that involved collecting online surveys from 720 emerging adults and in-depth, virtual interviews with 33 respondents who were food insecure. Findings indicated the pandemic had widespread impacts on well-being. Population groups at greatest risk for poor outcomes included women; those who identified as Black, Indigenous, or a Person of Color; persons in households of low socioeconomic status; parents of young children; and persons who previously experienced mental health challenges or weight stigma. Further research will be needed to evaluate efforts to improve the well-being of emerging adults in the aftermath of the pandemic.

Understanding the Impact of COVID-19 on Chronic Lymphocytic Leukemia (CLL) Caregiving and Related Resource Needs

Chronic lymphocytic leukemia (CLL) caregivers play a central role in disease management-a role that has been heightened during the COVID-19 pandemic given the healthcare system's reliance on frontline family caregivers and CLL patients' increased risk of infection and mortality. Using a mixed-method design, we investigated the impact of the pandemic on CLL caregivers (Aim 1) and their perceived resource needs (Aim 2): 575 CLL caregivers responded to an online survey; 12 spousal CLL caregivers were interviewed. Two open-ended survey items were thematically analyzed and compared with interview findings. Aim 1 results showed that two years into the pandemic, CLL caregivers continue to struggle with coping with distress, living in isolation, and losing in-person care opportunities. Caregivers described experiencing increasing caregiving burden, realizing the vaccine may not work or didn't work for their loved one with CLL, feeling cautiously hopeful about EVUSHELD, and dealing with unsupportive/skeptical individuals. Aim 2 results indicate that CLL caregivers needed reliable, ongoing information about COVID-19 risk, information about and access to vaccination, safety/precautionary measures, and monoclonal infusions. Findings illustrate ongoing challenges facing CLL caregivers and provide an agenda to better support the caregivers of this vulnerable population during the COVID-19 pandemic.

Relationship and Sexual Quality in the Wake of COVID-19: Effects of Individual Regulatory Focus and Shared Concerns over the Pandemic

Research has shown mixed findings regarding the effect of the COVID-19 pandemic on relationship and sexual quality and activity. We argue that some of these findings might be understood considering people's predisposition to maintain safety (i.e., prevention focus) or take risks (i.e., promotion focus), and sharing concerns with one's partner about the pandemic. A longitudinal study (N = 153) tested if regulatory focus before the pandemic (November 2019) was associated with relationship quality, sexual quality, and joint sexual activity later on (June 2020) and whether these effects were moderated by shared concerns over the pandemic. Results showed that participants more focused on prevention experienced higher relationship quality later on, but also less sexual quality and less frequent joint sexual activity, when they shared fewer (vs. more) concerns with their partner. In contrast, participants more focused on promotion experienced higher relationship quality later on when they shared more (vs. less) concerns with their partner. These results indicate how individuals' regulatory focus and shared concerns in times of crisis, such as the COVID-19 pandemic, can have downstream consequences on people's relational and sexual dynamics. We offer insights for mental health professionals to improve psychosocial health and well-being when people are faced with critical events.