Behavioral & Community Health
Permanent URI for this communityhttp://hdl.handle.net/1903/2271
Prior to January 24, 2011, this unit was named the Department of Public & Community Health.
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Item “People Will Continue to Suffer If the Virus Is Around”: A Qualitative Analysis of Sub-Saharan African Children’s Experiences during the COVID-19 Pandemic(MDPI, 2021-05-25) Kallander, Samantha Watters; Gordon, Rebecca; Borzekowski, Dina L.G.Children are particularly impressionable and at risk during a global public health crisis, making it important to examine their unique perspectives. To hear and understand sub-Saharan African children’s experiences with the COVID-19 pandemic, we conducted an exploratory qualitative analysis based on interviews with 51 children, ages 9 to 13, from Nigeria, Tanzania, and Sierra Leone. Applying the organization of Bronfenbrenner’s ecological systems theory, we reveal how COVID-19 affected children’s daily lives and domestic challenges, schooling and neighborhood issues, media use (and its relationship to knowledge and fear of the disease), perceptions of the country and government response, and thoughts of religion and hope. Children’s responses differed greatly, but patterns emerged across sex, age, household size, religion, and country. This study offers guidance and recommendations for meeting the needs of children, especially in times of crisis.Item DEVELOPMENT OF A CORE OUTCOME SET FOR STUDIES INVESTIGATING SAFETY, EFFICACY, AND IMPLEMENTATION OF COVID-19 VACCINES: A COLLABORATION WITH AFRICAN AMERICAN/BLACK COMMUNITIES IN BALTIMORE CITY, MARYLAND(2022) Datar, Reva; Howard, Donna; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Since it was declared a global pandemic in March 2020, Coronavirus Disease 2019 (COVID-19) has claimed over one million lives in the United States. Since COVID-19 vaccine rollout efforts began in Baltimore City, Maryland in December 2020, approximately 63.4% of all residents have been fully vaccinated (i.e., received their first and second doses in a two-dose series or received a single-dose vaccine). Despite efforts to implement equitable vaccine distribution in Baltimore City, prominent disparities in COVID-19 vaccine uptake persist, with poorer, predominantly Black neighborhoods frequently reporting lower levels of vaccine uptake than affluent, predominantly White neighborhoods. Guided by key principles of community-based participatory research, this dissertation explores community experiences with COVID-19 vaccines and develops a core outcome set (COS), inclusive of community-important outcomes, for use in studies evaluating the safety, efficacy, and implementation of COVID-19 vaccines. Methods: In March 2022, semi-structured interviews were held with vaccinated and unvaccinated Black residents of a community in Baltimore City reporting 40% vaccination uptake. Data were analyzed using inductive thematic analysis with subsequent subgroup analyses and thematic network analyses. To assess the extent to which outcomes measured in COVID-19 vaccine studies published between December 2019 and March 2022 aligned with factors of vaccine hesitancy, a systematic literature review (SLR) was conducted. Results from the qualitative analyses and the SLR informed the development of a candidate list of outcomes used in the first round of a Delphi study held in June 2020. After two rounds of Delphi survey distribution, a face-to-face consensus meeting was held with community members and community health workers to prioritize outcomes of interest to all relevant stakeholders and finalize the COS.Results: Thematic analysis yielded four emergent themes relating to COVID-19 vaccine uptake decision making: (I) Safety and efficacy of vaccines, (II) Perceived importance of COVID-19 vaccines in relation to pre-existing community needs, divided into two subthemes, a) Environmental injustice and (b) Personal health concerns, (III) Access to trustworthy, understandable information, and (IV) Physical access to vaccines. Participants acknowledged that physical access to COVID-19 vaccines was not a major barrier to uptake, however finding trustworthy and understandable information about the safety and efficacy of the vaccines were common areas of concern. Of all primary outcomes (N=20) identified in the 56 articles included in the SLR, 85% (n=17) corresponded with factors of vaccine hesitancy. The final COS included 19 outcomes across four “domains:” “Is the vaccine safe?”; “Does the vaccine work in my body?”; “Does the vaccine work in the community?”; and “Outcomes identified during consensus meeting.” Conclusion: The findings from this dissertation suggest that although community-important outcomes related to safety and efficacy of vaccines are often addressed in clinical studies, outcomes measuring institutional trust, economic and health impacts, community acceptance of the vaccines, and trustworthiness of vaccine information are underutilized in studies of vaccine implementation. As these social factors function as barriers to vaccine uptake, particularly among underserved communities, they should be regarded as indicators of equitable access to COVID-19 vaccines. The findings from this dissertation provide a framework with which public health researchers can begin to rethink measures of equity in vaccine rollout efforts.Item Experiences of young parents with foster care backgrounds during the COVID-19 pandemic: Brief report(2021-12) Shpiegel, Svetlana; Aparicio, ElizabethThe COVID-19 pandemic has brought unique challenges to parents of young children due to the closure of schools and childcare centers and increased caregiver burden. These challenges may be especially pronounced for youth with foster care backgrounds, as they often lack family supports and other critical safety nets. This multi-method qualitative study aimed to explore the unique experiences of parenting foster care alumni during the COVID-19 pandemic. Our study included 26 young parents ages 18-26, who participated in in-depth interviews or Photovoice sessions between January and March 2021. A structured thematic analysis approach was used to examine youths` accounts. Findings indicated that young parents with foster care backgrounds faced significant challenges due to COVID-19, and often struggled to access critical resources and supports. Implications for policy and practice are discussed below.Item Brief Report: Perspectives of Foster Care Alumni on COVID-19 Vaccination: Key Findings and a Call to Action(2021-06) Shpiegel, Svetlana; Aparicio, Elizabeth M.The United States recently surpassed 32 million cases and 570 thousand deaths due to COVID-19. Vaccination of the general population is critical to ending the pandemic, and several highly effective vaccines have now received emergency FDA approval. Young adults are a key group to target for vaccination, as they may be asymptomatic carriers of COVID-19 and unknowingly spread the virus to others. However, recent research suggests that young adults have concerns about COVID-19 vaccination, particularly if they belong to racial and ethnic minority groups or other marginalized populations. Young people with foster care backgrounds are predominantly Black, Indigenous, and people of color (BIPOC), and their hesitancy toward COVID-19 vaccination may be exacerbated by public systems mistrust and ineffective messaging channels. To better understand vaccination attitudes among this population, we conducted focus groups and individual interviews with 23 young people ages 18 to 26 who had recently aged out of foster care. All young people in our sample were parents of young children; thus, their attitudes towards COVID-19 vaccination have relevance for their own as well as their children’s likelihood of getting vaccinated. As part of this project, participants described their attitudes towards COVID-19 vaccination and their reasoning for either accepting or declining a vaccine. Interview audio files were transcribed verbatim and rigorously analyzed using a structured approach to thematic analysis.Item Storms and blossoms: Foster care system alumni parenting during the COVID-19 pandemic(2021-05) Martínez-García, Genevieve; Sanchez, Alexander; Shpiegel, Svetlana; Ventola, Marissa; Channell Doig, Amara; Jasczyński, Michelle; Smith, Rhoda; Aparicio, ElizabethOur team conducted this PhotoVoice project from January to March 2021. Parenting foster youth and foster system alumni aged 18-26 met for three sessions to use photography to explore their experiences of the COVID-19 pandemic. This photobook was designed as a keepsake for PhotoVoice group participants to be able to share their photographs, experiences, captions, and stories with one another as well as with researchers, practitioners, and policymakers. Names used in the book are pseudonyms.