Challenges with social distancing during the COVID-19 pandemic among Hispanics in New York City: a qualitative study

Psychosocial and socioeconomic changes among low-income people with HIV during the COVID-19 pandemic in Miami-Dade County, Florida: racial/ethnic and gender differences

BACKGROUND

COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV.

OBJECTIVE

The objective of this study was to examine psychosocial and socioeconomic stressors related to the COVID-19 pandemic among a diverse sample of people with HIV in South Florida and to determine if the types of stressors varied across gender and racial/ethnic groups.

METHODS

We analyzed data from a cross-sectional survey with Miami-Dade County, Ryan White Program recipients. Outcomes included mental health, socioeconomic, drug/alcohol, and care responsibility/social support changes. Weighted descriptive analyses provided an overview of stressors by gender and racial/ethnic group and logistic regressions estimated associations between demographics and stressors.

RESULTS

Among 291 participants, 39% were Non-Hispanic Black, 18% were Haitian, and 43% were Hispanic. Adjusting for age, sex, language, and foreign-born status, Hispanics were more likely to report several worsened mental health (i.e. increased loneliness, anxiety) and socioeconomic stressors (i.e. decreased income). Spanish speakers were more likely to report not getting the social support they needed. Women were more likely to report spending more time caring for children.

CONCLUSIONS

Findings highlight ways in which cultural and gender expectations impacted experiences across people with HIV and suggest strategies to inform interventions and resources during lingering and future public health emergencies. Results suggest that public health emergencies have different impacts on different communities. Without acknowledging and responding to differences, we risk losing strides towards progress in health equity.

Temporal and Racial/Ethnic Patterns of Social Engagement among Older Adults: Evidence from American Time Use Survey 2019 to 2022

This study examines temporal and racial/ethnic patterns in social engagement among older adults from 2019 to 2022, using data from the American Time Use Survey (ATUS) for adults aged 60 and older (n = 13,605). Social engagement was operationalized as time spent on five activities in in-home and out-of-home settings. Descriptive analysis was used to characterize temporal trends of social engagement, and zero-inflated negative binomial regression was utilized to estimate year-specific racial/ethnic differences. Results indicate an initial decline in out-of-home social engagement, followed by a gradual recovery. Racial differences in social engagement became salient during the pandemic period. The evolving racial and ethnic patterns in social engagement underscore the challenges that Black and Hispanic older adults faced during the public health crisis. Understanding activity patterns specific to racial/ethnic groups has implications for targeted interventions, informing strategies to support Black, Hispanic, and other minoritized older adults in public health emergencies.

Social distancing stress, anxiety/depression, COVID-19 diagnosis, gender identity, and immigration status

BACKGROUND

Strict social distancing public health measures to decrease COVID-19 spread increased social distancing stress. However, differences in social distancing stress by anxiety/depression symptoms are understudied, especially based on COVID-19 diagnosis status, gender identity, and immigration status. We examined whether the association between social distancing stress and anxiety/depression symptoms was moderated by COVID-19 diagnosis status, gender identity, and immigration status. We further examined the associations of social distancing stress with anxiety/depression symptoms, gender identity, and immigration status among individuals with and without COVID-19.

METHODS

We utilized data from a national cross-sectional survey among adults aged ≥ 18 years in the United States between May 13, 2021, and January 9, 2022 (n = 5,255). Multivariable logistic regression models were used to examine the associations.

RESULTS

The prevalence of social distancing stress was higher among individuals with COVID-19 (79.23%) than among those without COVID-19 (67.51%). We observed significant associations between social distancing stress and anxiety/depression symptoms, moderated by COVID-19 diagnosis status, immigration status, and gender identity, respectively. Anxiety/depression symptoms were associated with social distancing stress among both individuals with and without COVID-19. Gender identity and immigration status were associated with social distancing stress among only individuals without COVID-19.

CONCLUSIONS

Our findings revealed that the association between social distancing stress and anxiety/depression varied by COVID-19 diagnosis status, gender identity, and immigration status. The findings underscore the need for more targeted psychological distress strategies to reduce social distancing stress and anxiety/depression among diverse US populations, while considering the impacts of COVID-19 diagnosis status, gender identity, and immigration status.

MivacunaLA (MyshotLA): A Community-Partnered Mobile Phone Intervention to Improve COVID-19 Vaccination Behaviors among Low-Income, Spanish-Speaking, and Immigrant Latino Parents or Caregivers

We developed and tested MivacunaLA/MyshotLA, a community-informed mobile phone intervention, to increase COVID-19 vaccination among Latino parents/caretakers of minors in under-resourced areas of Los Angeles by addressing misinformation and building trust. We recruited Latino parents/caregivers with at least one unvaccinated child in East and South Los Angeles in the summer of 2021 and evaluated MivacunaLA as a randomized controlled trial with a wait-list control group. A difference-in-difference analysis showed Latino parents/caregivers that participated in MivacunaLA (n = 246), in comparison to the control group, were 15 percentage points more likely (p = 0.04) to report vaccination of minors aged 12-17 years, and 12 percentage points more likely (p = 0.03) to report a positive intention to vaccinate minors aged 2-11 years (when COVID-19 vaccines became available). Mobile phone-delivered digital interventions using videos and culturally tailored educational material to promote COVID-19 vaccine confidence can be an effective way to combat misinformation and deliver timely information to marginalized communities. Community-based participatory research approaches are crucial to advance health equity among minority communities, especially immigrant Spanish-speaking underserved communities.

PARQUES: Dreaming a Future for Our Latinx Children, Youth, and Families

A growing body of evidence suggests that the COVID-19 pandemic has disproportionally affected Latinx children, youth, and families in the United States by increasing the prevalence and incidence of mental health problems. While it is important to document the repercussions of the pandemic, it is also necessary to articulate what a future of wellbeing and positive mental health will look like for Latinx children, youth, and families. To address this need, we propose PARQUES, a framework to dream about the future of Latinx children, youth, and families in the United States. We imagine PARQUES as communal spaces for connection, joy, play, rest, and healing that result from activism and collective action. We use the Spanish word for parks as an acronym "PARQUES," which stands for políticas (policies), alegría (joy), reparación (healing and reparations), querencia (love and belonging), unión (unity), empleo (employment), and seguridad (safety). These components work together to create an ecosystem to foster the physical and mental wellness and wholeness of Latinx children, youth, and families.

Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis

AIMS

To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases.

METHODS

A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023.

RESULTS

We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators.

CONCLUSIONS

This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.

Using Digital Technology to Build COVID-19 Vaccine Confidence: A Qualitative Study among Latinx Parents of Children Aged 5-11 in Under-Resourced Communities across Los Angeles County

Background: Latinx school-aged children are more than twice as likely to be infected with and die from COVID-19 as non-Latinx White children in Los Angeles. Although COVID-19 vaccination has the potential to mitigate health disparities exacerbated by the pandemic, vaccination uptake among Latinx children remains limited. MiVacunaLA (MVLA) is a mobile-phone-delivered digital intervention that improved vaccination rates in 12- to 17-year-old Latinx children and parental intention to vaccinate 2- to 11-year-old children. Since piloting MVLA, the COVID-19 vaccine became available to children aged 5-11. We sought to understand parental experiences with the MVLA intervention and their attitudes and beliefs about vaccinating their young children to improve vaccination confidence in the Latinx community. Methods: We conducted six virtual focus groups with 47 parents/caregivers of children aged 5-11 who participated in the MVLA intervention. We used standard qualitative content analysis methods and rigid and accelerated data reduction to identify and analyze major themes discussed in the sessions. Results: Each salient theme from our focus groups was mapped to one of the 5Cs constructs. The themes included the parents' need for more contemplation about vaccinating their children than about vaccinating themselves; the parents' need for trusted sources of vaccine information; the parents' motivations to vaccinate their children against COVID-19; parental concern about short- and long-term effects of the vaccine in children; digital technology and videos as useful engagement tools; and age and health stratification as an approach to parental vaccination decision-making. Conclusions: The results of this study clarify the key factors that influence the decision of Latinx parents and caregivers to vaccinate their children against COVID-19. Our findings can inform efforts to increase COVID-19 vaccination rates among children in underserved Latinx communities, especially regarding the use of digital technologies for promoting vaccine confidence.

Perceived barriers to the implementation of social distancing in the COVID-19 pandemic in Iran during 2020-2021: A cross-sectional study

Background and Aims

This research has been on the effective role of social distancing in preventing the spread of COVID-19 and the obstacles to its implementation. The results of this research can highlight the major barriers to distancing and suggest appropriate solutions to remove them.

Methods

We conducted this cross-sectional study during 2020-2021 among 277 faculty members, students of medical universities and ordinary people of Khuzestan province in southwestern Iran. We included them in this study by sampling at convenience. The data collection tool was a researcher-constructed questionnaire that we distributed among the statistical sample through social networks (WhatsApp and Telegram).

Results

Mean ± SD = economic barriers 4.49 (0.65), cultural barriers 4.48 (0.70), social barriers 4.40 (0.61), political barriers 4.28 (0.64), educational barriers in universities and schools 4.27 (0.53) and Educational barriers at societal level 3.82 (1.08) were the self-reported obstacles (perceived) to social distancing during the Covid-19 pandemic. Comparison of occupational groups with faculty members showed that only scores of academic barriers have a significant difference between occupational groups (p < 0.001).

Conclusion

The role of economic barriers, cultural barriers and social barriers in social distancing was very prominent. One of our remarkable results was that there is adequate training for people on the proper implementation of the principles of social distance in the prevention of the Covid-19 pandemic. The responsibility of all members of society to observe social distancing as a moral and even legal duty can be the first step to protect the health of citizens against COVID-19. We can, therefore, use some planned interventions. This must be within the framework of economic, cultural, social and political structures of society.

A Framework for Inspiring COVID-19 Vaccine Confidence in African American and Latino Communities

The COVID-19 pandemic has disproportionately impacted racial and ethnic minority communities, particularly African American and Latino communities. The impacts of social determinants of health, structural racism, misinformation, and mistrust have contributed to a decreased COVID-19 vaccine uptake. Effective methods of addressing and combatting these barriers are essential. Accurate and targeted messaging delivered by trusted voices from community-based organizations, government health systems and organizations, and healthcare and academic systems is imperative. Outreach and communication should be culturally sensitive, provided in the preferred language of the community, flexible, and tailored for in-person and virtual outlets. This communication must also increase trust, combat misinformation, and inspire COVID-19 vaccine confidence. In this manuscript, we outline a framework for inspiring COVID-19 vaccine confidence in African American and Latino communities. These methods of targeted outreach should be considered and implemented for urgent and nonurgent community public health efforts beyond the COVID-19 pandemic (e.g., monkeypox) and as a framework to inspire vaccine confidence in those living in racial and ethnic minority communities globally.

Perspectives of Latinx Individuals Who Were Unvaccinated And Hospitalized for COVID-19: A Qualitative Study

Importance

Latinx individuals in the United States have lower COVID-19 vaccination rates and higher rates of COVID-19 infections, hospitalizations, and deaths than non-Latinx White individuals. Little is known about the perspectives of Latinx adults who had not received the COVID-19 vaccination and were hospitalized for COVID-19.

Objective

To describe the perspectives of Latinx individuals who were unvaccinated and subsequently hospitalized for COVID-19.

Design, Setting, and Participants

This qualitative study was conducted using semistructured phone interviews with 25 Latinx adults who were unvaccinated and survived a COVID-19 hospitalization in a public safety net hospital in Colorado from February to November 2021. Interviews were audio recorded, and transcripts were analyzed using thematic analysis.

Main Outcomes and Measures

Themes and subthemes of perspectives on vaccination.

Results

Among 25 adults (14 [56.0%] women, 11 [44.0%] men; mean [SD] age, 51 [15] years) who participated, all participants self-identified as Latino, Latina, or Latinx or Hispanic. There were 11 individuals who relied on emergency Medicaid (hospital coverage for Denver residents who are undocumented), while 10 individuals (40.0%) were essential workers and 13 individuals (52.0%) were unemployed. In interviews, 3 themes (with subthemes) were identified: factors associated with vaccination after hospitalization (subthemes: fear of death, avoiding hospitalization and reinfection, convinced COVID-19 is real, and responded to pressure from others), concerns about the COVID-19 vaccine (subthemes: experimental status and short timeline for production, contents of vaccine unknown or concerning, vaccine considered ineffective, worrisome immediate and long-term adverse effects, mixed and conflicting information, and government aimed to control or mark population through vaccination), and opportunities to improve vaccine uptake (subthemes; sharing personal experiences through social media, testimonials about minimal vaccine adverse effects, connecting with friends and family about the hospitalization experience, making the vaccine more accessible, and connecting with trusted sources of information).

Conclusions and Relevance

This study found that Latinx individuals who were unvaccinated and subsequently hospitalized for COVID-19 were motivated to engage in advocacy to encourage vaccination in their communities. These findings suggest that supporting patient advocacy after hospital discharge and continued efforts to create low-barrier, patient-informed public health strategies may be associated with increased vaccine uptake in Latinx communities.

"The System Doesn't Let Us in"-A Call for Inclusive COVID-19 Vaccine Outreach Rooted in Los Angeles Latinos' Experience of Pandemic Hardships and Inequities

OBJECTIVE

Latino adults in Los Angeles have experienced disproportionate cases, deaths, and socioeconomic impacts from the COVID-19 pandemic. This qualitative study aimed to explore community perspectives on readiness for COVID-19 vaccination and to identify culturally tailored vaccine outreach strategies.

METHODS

We conducted virtual focus groups with Los Angeles County Latino/a residents via Zoom between December 2020 to January 2021, as the first COVID-19 vaccines were receiving Emergency Use Authorization (EUA). Focus groups were facilitated in Spanish and English by bilingual members of the research team. Discussions were analyzed via Atlas.ti software using reflexive thematic analysis.

RESULTS

Three focus groups (n = 15; four to six people each; two Spanish focus groups; one English) were conducted. Thematic findings centered on Latino COVID-19 vaccine equity: (1) Disproportionate infection risk due to essential worker status and socioeconomic burdens, misinformation, and familial or cultural tensions (2) Concerns for inequitable vaccine access due to immigration fears and limited healthcare access, and (3) A need for community-centered COVID-19 vaccine outreach and access.

CONCLUSIONS

Our study on early Latino adult reactions to vaccine roll-out suggests the need for outreach strategies centering on validating community hardships, combating dis-/misinformation through trusted sources, and addressing socio-economic needs impacted by the pandemic.

How South African Families Protected Themselves during the COVID-19 Pandemic: A Qualitative Study

The World Health Organization (WHO) reported a cluster of cases of ‘viral pneumonia’—‘Coronavirus Disease 2019’ (COVID-19)—in Wuhan City, the People’s Republic of China on 31 December 2019. To curb the spread of the virus, various containment measures were introduced. However, no study has explored how families protected themselves during the pandemic. Therefore, this study explored how families protected themselves during the COVID-19 pandemic using a qualitative exploratory design. Thirty-one adult participants, representing families in the Western Cape province of South Africa, were virtually interviewed. The sampling approach was both convenient and snowball. The data were analysed using thematic analysis. The results show that families followed and adapted to the mainstream protection measures as implemented by the South African government but in addition believed that adherence to non-pharmaceutical interventions would protect them from contracting the virus. Therefore, the government and other stakeholders should support families in making it easier to protect themselves during the current and future pandemic(s).