"If You Don't Have the Heart to Help, You Cannot Do This Job": The Multidimensional Wellbeing of Community Health Workers Serving Refugees During the COVID-19 Pandemic.

Community health workers are members of two groups whose short- and long-term health has been uniquely shaped by the COVID-19 pandemic: health workers and the oft-marginalized populations that they serve. Yet, their wellbeing, particularly of those serving resettled refugees, before and during the pandemic has been largely overlooked. Drawing from a holistic conceptualization of wellness, this study examined the effects of the COVID-19 pandemic on a group of cultural health navigators (CHNs), who serve resettled refugees. We conducted semi-structured individual interviews with CHNs at a southwestern U.S. hospital system between July and August 2020, a critical time in the pandemic. Our analysis produced four themes that encapsulate the effects of the pandemic on CHN wellbeing: (1) "You fear for your life": Chronic risk of COVID-19 exposure takes a toll on physical, emotional, and environmental wellbeing; (2) "It is stressful because it is completely new": Uncertainty diminishes occupational, financial, and emotional wellbeing; (3) "If you don't have the heart to help, you cannot do this job": CHNs remain committed while facing challenges to their occupational wellbeing on multiple fronts; and (4) "Now, you cannot release your stress": Loss of and shifts in outlets integral to social and spiritual wellbeing. The findings deepen empirical understanding of how the pandemic affected the holistic wellbeing of CHNs, as they continued to serve their communities in a time of crisis. We discuss the implications for addressing the multidimensionality of community health worker wellbeing in research, policy, and practice.

Individual interviews versus focus groups for evaluations of international development programs: Systematic testing of method performance to elicit sensitive information in a justice study in Haiti.

Focus group discussions (FGDs) and individual interviews (IIs) with community members are common methods used in evaluations of all kinds of projects, including those in international development. As resources are often limited, evaluators must carefully choose methods that yield the best information for their particular program. A concern with FGDs and IIs is how well they elicit information on potentially sensitive topics; very little is known about differences in disclosure by methodology in the domain of justice. Using FGDs (n = 16) and IIs (n = 46) from a USAID project in Haiti, we systematically coded responses based on a shared elicitation guide around access to and engagement with the formal and informal justice systems and performed thematic and statistical comparisons across the two methods. We introduce the continuous thought as the novel standard unit for statistical comparison. Participants in IIs were statistically more likely to provide themes relevant to genderbased violence. Importantly, sensitive themes extracted in IIs (e.g., related to sexual violence, economic dimensions, and restorative justice) did not emerge in FGDs. Given these results and other limitations to the FGD, prioritizing interviews over focus group modalities may be appropriate to guide targeted, effective programming on justice or other socially sensitive topics.

First-generation inequality and college integration.

Institutional integration has long been an important focus in literatures on inequality, education and mobility. Building on this work and drawing from multi-wave survey and records data from a large public university, the analyses we offer in this article provide unique and systematic comparative tests of first- versus continuing-generation inequalities in integration, disaggregated by academic versus social types, and with attention to other potentially influential status attributes. Our findings reveal: (1) clear overall inequalities in campus integration for first-generation students that cut across gender and race/ethnic lines; (2) a higher likelihood of employment among first-generation students-employment that tends to detract from integration opportunities; and (3) especially pronounced inequalities when it comes to forms of academic and social integration that entail bureaucratic- and resource-related barriers. We discuss the implications for understanding inequality and the first-generation experience in higher education and for more general sociological conceptions of institutional integration and mobility.

Nonmedical use of over-the-counter medications is significantly associated with nonmedical use of prescription drugs among university students.

OBJECTIVE: To examine the association between nonmedical use of over-the-counter medications (NMUOTC) and nonmedical use of prescription drugs (NMUPD). PARTICIPANTS: University students surveyed on NMUOTC and NMUPD between August and December 2011 (N = 939). METHODS: Cross-sectional data analysis of online survey. RESULTS: The majority of respondents were women, undergraduate, Caucasian, and not affiliated with Greek life. NMUPD and NMUOTC were reported by 21.4% and 11.2% of students, respectively. NMUOTC was significantly associated with NMUPD in unadjusted analyses and after adjustment for gender, age, race/ethnicity, and Greek membership (odds ratio: 3.37, 95% confidence interval: 2.17, 5.23). Secondary analyses showed a relationship between over-the-counter (OTC) cough medication misuse and NMUPD, OTC stimulant misuse and prescription stimulant misuse, and OTC sleep aid misuse with prescription depressant misuse. CONCLUSIONS: Results suggest the importance of both measuring the prevalence of OTC misuse and incorporating its misuse into assessments of polydrug use in the university population.

Sexual Orientation and College Students' Reasons for Nonmedical Use of Prescription Drugs.

BACKGROUND: Nonmedical use of prescription pain medications, sedatives, and stimulants is a well-documented problem among college students. Research has indicated that students who identify as lesbian, gay, or bisexual are at elevated risk. However, little is known about students' reasons for use. OBJECTIVES: (1) To replicate findings that sexual minority students report higher nonmedical use than heterosexual students, moving from a campus-specific to a multicampus sample and (2) to test for an association between sexual orientation and reasons for use. METHODS: The 2015 College Prescription Drug Study surveyed 3389 students from nine 4-year public and private colleges and universities across the United States using an anonymous online survey. Measures assessed demographic information, prevalence of nonmedical use, frequency of use, where the drugs were obtained, reasons for use, and consequences of use. Stepwise logistic regression models were used to determine if sexual orientation predicted use. Chi-square tests of independence were also used to analyze prevalence of use by demographics as well as to assess differences in reasons for use by sexual orientation. RESULTS: Sexual minority students were significantly more likely than heterosexual students to nonmedically use any prescription drug, pain medications, and sedatives. Sexual minority students were also more likely to select that they used pain medications to relieve anxiety, enhance social interactions, and to feel better. Conclusions/Importance: Although sexual minority students are more likely to report nonmedical use, students overall use prescription medications for similar reasons, with the exception of painkillers. Implications and areas for future research are discussed.

Motherhood and the Wages of Women in Professional Occupations.

It is well established that mothers are paid less than childless women and that fathers tend to earn higher wages relative to childless men, but we do not know whether these findings apply to workers in all occupations. Using IPUMS and ACS data from 1980 and 2010, we examine the family wage gap for highly educated professionals, the most advantaged sector of the occupational distribution. Results indicate that the size of the negative wage differential for motherhood has declined over time in all professions. Moreover, in the traditionally male-dominated professions of STEM, medicine, and law, women with children experience a positive wage differential, whereas their counterparts in female-dominated professions continue to experience a negative one. The positive differential for fatherhood has remained stable over time. These findings underscore the growing heterogeneity of women's experiences in combining work and family and raise important questions for further research.

The black gender gap in educational attainment: historical trends and racial comparisons.

It is often asserted that the gender gap in educational attainment is larger for blacks than whites, but historical trends comparing the black and white gender gap have received surprisingly little attention. Analysis of historical data from the U.S. census IPUMS samples shows that the gender gap in college completion has evolved differently for whites and blacks. Historically, the female advantage in educational attainment among blacks is linked to more favorable labor market opportunities and stronger incentives for employment for educated black women. Blacks, particularly black males, still lag far behind whites in their rates of college completion, but the striking educational gains of white women have caused the racial patterns of gender differences in college completion rates to grow more similar over time. While some have linked the disadvantaged position of black males to their high risk of incarceration, our estimates suggest that incarceration has a relatively small impact on the black gender gap and the racial gap in college completion rates for males in the United States.