The mental health consequences of COVID-19 on a sample of health professions students: a mixed methods study.

Objective: To assess and examine how the COVID-19 pandemic may have impacted the mental health of a sample of health professions students (HPS) using an explanatory sequential mixed-methods design. Participants: Participants included 41 HPS enrolled in a co-curricular interprofessional education (IPE) program. Measurements: Measures included the CES-D scale, PSS scale, and the GAD scale. Qualitative description was used to explore the experiences of these HPS. Results: The HPS explained that fear of acquiring COVID-19, transmitting the virus to loved ones, and dying as a result of the disease negatively influenced their mental health. The HPS revealed that there were some beneficial outcomes resulting from the pandemic, including the strengthening of family bonds and the cultivation of resiliency. Conclusions: The pandemic has had a negative impact on the mental health of these HPS. It is essential that these students receive support for their mental health in order to provide optimal care to the population they serve.

Teaching Person-Centered Care and Interprofessional Collaboration through a Virtual Mental Health World Café: A Mixed Methods IPE Pilot Project.

The purpose of this convergent mixed methods interprofessional education (IPE) pilot project was to help health profession students gain valuable insight about the experiences of people living with mental illness, to help them have a better understanding of person-centered care and have greater knowledge about the importance of interprofessional collaboration. A developmental workgroup which consisted of mental health consumers, four interdisciplinary students, and our team developed and implemented a virtual Mental Health World Café IPE event. Twelve other students attended the World Café event. A paired sample t-test was used to examine group differences between pre- and post-test scores for the Interprofessional Socialization and Valuing Scale and the Texas AHEC Survey measures among the four student leaders and the 12 student participants of the virtual Mental Health World Cafe. We conducted individual interviews with the four student leaders and collected reflective journals from the 12 students who attended the World Café event. We examined to what extent the statistically significant quantitative results supported the qualitative results separately for the student leaders and for the student participants of the virtual World Café. We also examined how both the quantitative and qualitative findings aligned with the key components of the Patient-Centered Care in Interprofessional Collaborative Practice Model. While the project allowed the students to reflect upon how they may apply the principles of person-centered care and interprofessional collaboration, the impact of the consumers on the student's experiences was profound and resulted in widespread engagement of the students who attended the event.

Supporting community health workers during the COVID-19 pandemic: A mixed methods pilot study.

OBJECTIVE: To examine how the COVID-19 Project ECHO program may have influenced the mental health of community health workers (CHWs) from South Texas. The program was designed around case-based learning and mentorship to provide support to CHWs and help them gain expertise to provide services to their communities. DESIGN: An explanatory sequential mixed methods pilot study. SAMPLE: Fifteen CHWs who were enrolled in the program participated in this study. MEASUREMENTS: The Center for Epidemiological Studies-Depression (CES-D) and the Perceived Stress Scale (PSS) were used to measure the differences pre- and post-intervention. Qualitative description was used to explore the experiences of the participating CHWs. RESULTS: The PSS post-test mean (12.53) showed a statistically significant decrease from the pretest mean (17.01) (t (14 = 2.456, p = .028). The CHWs explained that the death of loved ones, feelings of isolation, and work-related concerns influenced their mental health. CHWs expressed that the program provided them with emotional support and resources for their clients. CONCLUSIONS: The impact of the COVID-19 pandemic on disadvantaged and medically underserved areas will be long-lasting; therefore, the need is greater than ever for CHWs to receive mental health support and be able to connect communities with vital resources.

Stigmatization of Pregnant Individuals with Opioid Use Disorder.

Objective: The purpose of this study was to critically analyze the role of stigma in the care of pregnant and parenting individuals with opioid use disorder (OUD) through the theoretical lens of the Reproductive Justice (RJ) framework. Background: Overdose related maternal mortality, often involving opioids, is a national growing public health concern. OUD is a highly stigmatized condition that may negatively influence the well-being of pregnant/parenting individual's reproductive and human rights. Study Design: Secondary qualitative data analysis. Methods: A secondary data analysis was conducted using individual interviews (N = 23) from a larger study aimed at examining contextual factors surrounding pregnant/parenting individual's experiences with opioid use return to use and/or overdose. The RJ framework was used as a framework to examine the influence of OUD-related stigma and a person's right to bodily autonomy, their right to parent, and their right to parent the children they have in safe and sustainable environments. Results: The RJ framework supported the examination of factors that perpetuate stigma in this population. Individuals described stigmatizing experiences in the health care setting. Verbal and nonverbal interactions with health care providers and fear of child welfare involvement were counterproductive to recovery and potentially triggered OUD recurrence and/or overdose. Conclusions: Due to existing stigma, pregnant and parenting individuals with OUD often avoided health care and recovery support services; therefore, there should be the removal of barriers that prevent this population from accessing life-saving services. Future efforts should focus on health policy-related research to support structural changes within institutions.

Perceptions of Community Health Workers during Two Concurrent National Health Crises: Opioid Use Disorder and COVID-19.

The purpose of this study is to describe the perceptions of community health workers (CHWs), post opioid use disorder training, including the impact of the intervening COVID-19 pandemic, on service delivery and communication. Semi-structured interviews with 10 CHWs were conducted. Categories from the interviews focused on the loss of connections with their clients and how the COVID-19 pandemic caused the CHWs to experience significant interruptions in both their professional and personal lives. The COVID-19 pandemic caused dramatic changes in how CHWs operate within the communities they serve and limiting the interpersonal relationships that are vital to their profession.

A Meta-Analysis of Breastfeeding Effects for Infants With Neonatal Abstinence Syndrome.

BACKGROUND: Neonatal abstinence syndrome (NAS) rates have dramatically increased. Breastfeeding is a nonpharmacological intervention that may be beneficial, reducing NAS symptom severity and thus the need for and duration of pharmacological treatment and length of hospital stay. OBJECTIVES: Conduct meta-analysis to determine whether breastfeeding results in better outcomes for NAS infants. Variables included symptom severity, need for and duration of pharmacological treatment, and length of hospital stay. METHODS: PubMed, Scopus, Embase, and Cochrane Library were searched from 2000 to 2020, and comparative studies examining breastfeeding for NAS infants were extracted. Randomized trials and cohort studies were included. Data were extracted and evaluated with Review Manager Version 5.3. A random-effects model was used to pool discontinuous outcomes using risk ratio and 95% confidence intervals. Continuous outcomes were evaluated by mean differences and 95% confidence intervals. RESULTS: Across 11 studies, 6,375 neonates were included in the meta-analysis. Using a random-effects analysis, breastfeeding reduced initiation of pharmacological treatment, reduced duration of pharmacological treatment, and reduced length of stay. No differences were detected for severity of NAS symptoms. Most studies only reported one to two variables of interest. For most studies, these variables were not the primary study outcomes. All studies were found to be of low risk and good quality based on the Cochrane Risk Assessment Tools. Varying breastfeeding definitions limit generalizability. DISCUSSION: Breastfeeding is associated with decreased initiation and duration of pharmacological treatment and length of stay.

Developing and implementing a co-curricular IPE program: AHEC Scholars Program.

As part of a new directive, the Human Resources Services Administration (HRSA) mandated Area Health Education Center (AHEC) Programs across the nation to implement an interprofessional education (IPE) program for health professional students, with the goal of fostering collaborative practice among health profession students and motivating students to work in medically underserved areas post-graduation. The South Texas AHEC Program collaboratively developed and implemented a co-curricular IPE initiative, the AHEC Scholars Program, including didactic and practicum components, focused on the needs of communities in our area. A pre-post quasi-experimental design was used to evaluate the student outcomes related to IPEC Competencies and knowledge and preparation for the practice of core topic areas mandated by HRSA. Student outcomes showed statistically significant improvement in all measures. In order to obtain more detailed accounts of students' practicum experiences, students were asked to complete reflective journals after each practicum. The AHEC Scholars Program provides students with opportunities to work with underserved populations and enables students to explore the benefits of team-based care. This article summarizes the collaborative process of the development and implementation of the AHEC Scholars Program; secondly, it details student outcomes from a 3-month pilot study.

Young Hispanic fathers during COVID-19: Balancing parenthood, finding strength, and maintaining hope.

OBJECTIVES: This study examined how the effects of the COVID-19 crisis has impacted young Hispanic fathers. DESIGN/SAMPLE: Using qualitative description, in-depth interviews were conducted among Hispanic fathers between the ages of 18 and 24 years, from community-based fatherhood program. The interviews of seven young Hispanic fathers were analyzed using qualitative content analysis. RESULTS: The participants' initial and ongoing fears about COVID-19 resulted from not having adequate information about the severity of the disease and how easily one can contract and transmit it to others. They also expressed concerns about the threat of the pandemic on their family's well-being, finances, and employment status. Providing for their families was their main priority, with some continuing to work, despite the risks of becoming infected with COVID-19. Despite their many hardships, fathers found strength in their families and remained hopeful in overcoming the challenges during the pandemic. CONCLUSIONS: The pandemic has presented difficulties and loss for many. Nurses in the community are well positioned to serve young Hispanic fathers to ensure their needs are met. A family-centered approach is ideal for young fathers to provide them equal opportunity to be actively involved in promoting health for themselves and their families during the pandemic.