Ohio pharmacy personnel's burnout and wellbeing: The impact of the COVID-19 pandemic.

BACKGROUND: While burnout is a well-known phenomenon among physicians and nurses, burnout among pharmacists and pharmacy personnel is understudied and less recognized. OBJECTIVES: The primary objectives of this study were to describe and compare Ohio pharmacy personnel's self-reports of burnout and wellbeing prior to and during the COVID-19 pandemic. METHODS: A one-time online survey was completed by over 13,000 health care professionals in Ohio in July and August 2021. This brief report describes a subanalysis of the 1452 participating pharmacy professionals licensed by the State of Ohio Board of Pharmacy. RESULTS: Most survey respondents identified as White (90.84%) and female (70.04%), including pharmacists (59.16%) and pharmacy technicians (38.15%). Findings demonstrated a 360.55% increase in feeling emotionally drained "every day" during the pandemic. Participants felt emotionally drained more frequently; cared less about what happened to patients; felt less accomplished; felt down, depressed, or hopeless more frequently; had more thoughts of suicide; and were more concerned about their substance use during the pandemic than prior to it. CONCLUSION: Pharmacy personnel are experiencing some dimensions of burnout and poor wellbeing more frequently. These issues were present prior to the COVID-19 pandemic and now require even swifter attention as outcomes have worsened. Increased awareness of burnout among pharmacy personnel is required. Additionally, policy and organizational interventions are recommended to improve pharmacy personnel wellbeing.

Structural vulnerabilities and breastfeeding among female sex workers in Mumbai.

Breastfeeding has numerous health, environmental, and economic benefits, and the promotion and support of breastfeeding has been at the centre of efforts from many global organizations such as WHO and UNICEF to promote maternal and child health. Interventions developed from such policies tend to be inaccessible to those who are economically marginalized, however, and thus may further inequities. Understanding the lived experiences of women occupying this segment of society, such as sex workers, illuminates the social and structural determinants of breastfeeding and how they constitute structural vulnerability that renders breastfeeding difficult. This qualitative study explores breastfeeding practices and decisions among sex workers in Mumbai and the factors shaping their experiences. We look at proximal factors-those that women directly indicate as influencing their breastfeeding decision-making or behaviour, and distal factors-macrolevel forces identified by the women, as indication of their structural vulnerability, particularly in relationship to the decision to initiate and sustain breastfeeding. We conclude with discussing the need to promote appropriate infant feeding practices through culturally responsive interventions and mechanisms, taking both proximal and distal factors into account, to work towards equity in health outcomes.

The role of parenting stress in mediating the relationship between neighborhood social cohesion and depression and anxiety among mothers of young children in fragile families.

This study was designed to examine the roles of neighborhood social cohesion and parenting stress in influencing maternal mental health outcomes among primarily low-income, unmarried, urban mothers. Structural equation modeling was conducted using cross-sectional Fragile Families and Child Wellbeing Study data (N = 3,876), to test the hypotheses that neighborhood social cohesion would be associated with depression and anxiety among mothers with children aged 3 years and that this relationship would be mediated by parenting stress. The mediation model demonstrated good fit, χ2 (796) = 3169.07, p < .001; comparative fit index = 0.96; root mean square error of approximation = 0.028 [90% confidence interval [0.027, 0.029]. Parenting stress partially mediated the effect of social cohesion on maternal depression (indirect effect: -0.04, p < 0.001) and anxiety (indirect effect: -0.05, p < 0.001); higher reported neighborhood social cohesion was associated with lower parenting stress, which was associated with a decreased likelihood of maternal anxiety and depression. Efforts to bolster neighborhood social cohesion may improve maternal mental health outcomes by reducing parenting stress.

Recovery Support and Capacity Assessment Using the Calculating an Adequate System Tool: Two Case Studies.

BACKGROUND: There are multiple, reliable, and authoritative federally managed data sources for understanding the incidence and prevalence of substance use disorder (SUD) and its sequela. However, there remains a gap in metrics representing the need and capacity for treatment and related supports within local communities. To address this challenge, Calculating an Adequate System Tool (CAST) was developed in 2016 by an interdisciplinary group of researchers at the Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality to assess the capacity of the SUD care system within a defined geographic area. It allows for risk assessment of local social and community determinants of substance abuse, as well as an assessment of local service needs across the continuum of SUD care. METHODS: This article describes the application of the CAST to 2 counties in Ohio and 1 county in Montana. The purpose of using CAST for each area, results of the application, and experiences in utilizing the tool are described. RESULTS: Application of the CAST demonstrated unique findings within each of the geographic areas. In Ohio, recovery support services were lacking in both counties assessed, while differences in crime rate and alcohol outlet density were attributed to varying rates of drug-related hospitalization. Notable findings in Montana included an oversaturation of coalitions focused on substance use prevention and gaps in the areas of detoxification services, partial day treatment, recovery residences, and peer support specialists. CONCLUSIONS: CAST is a useful tool for guiding decision-making relative to substance use care needs and capacities for local geographic areas. Findings should be interpreted thoughtfully and in the context of data availability. CAST continues to be enhanced and further expanded for assessing capacity of local and statewide substance use care systems.

Postpartum physical health: The role of mothers' adverse childhood experiences and material hardship.

OBJECTIVE: Postpartum physical health is a neglected field of research, yet postpartum physical health problems can significantly interfere with mothers' abilities to meet personal, familial, and work-related responsibilities. This study sought to provide increased understanding of the role that social determinants of health-adverse childhood experiences (ACEs), material hardship, and social support; and discrimination-play in mothers' postpartum physical health. METHOD: An online survey was completed by a racially, ethnically, and socioeconomically diverse sample (n = 306) of United States women (age 18 and older) who delivered a live baby within the previous year. RESULTS: Logistic regression results demonstrated that mothers' ACEs and material hardship were associated with poorer self-rated postpartum physical health. Furthermore, an interaction between ACEs and material hardship was found suggesting that ACEs did not impact physical health as strongly for mothers who reported material hardship when compared to mothers who did not. No associations were found for social support or experiences of discrimination. CONCLUSION: Study results provide further support for macrolevel interventions to prevent ACEs and material hardship and to intercede in existing cases to reduce negative effects on postpartum physical health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations Between Mothers' Adverse Childhood Experiences, Material Hardship, and Breastfeeding Challenges in the United States.

BACKGROUND: Breastfeeding is the biological norm and is associated with numerous superior health outcomes for children and mothers when compared to human milk substitutes. Yet, breastfeeding difficulties and the inability to meet one's breastfeeding goals are common in the United States and maybe more common among mothers who have experienced trauma. RESEARCH QUESTIONS: (1) Are mothers' adverse childhood experiences, and current experiences of discrimination, material hardship, and decreased social support associated with breastfeeding challenges; and (2) are these experiences associated with the number of breastfeeding challenges reported? METHODS: A prospective, non-probability, cross-sectional study design with a diverse sample who had delivered a live baby within the previous year (N = 306) was conducted. RESULTS: Over 70% of participants reported breastfeeding challenges and 45.2% reported material hardship. Among those who attempted breastfeeding (n = 286), 74.1% had at least one adverse childhood experience; 30.3% had four or more. Logistic and negative binomial regression models determined that adverse childhood experiences, experiences of discrimination, material hardship, and decreased social support were not associated with experiencing any breastfeeding challenges. However, adverse childhood experiences were associated with the number of breastfeeding challenges reported. (The adjusted rate ratio was 1.05; 95% CI [1.00, 1.09], p = .034). CONCLUSION: We recommend further research on adverse childhood experiences and potential relationships with discrimination, material hardship, and social support to prevent and intervene in cases of breastfeeding challenges to maximize infant, maternal, and public health.

Mothers' Resilience: Experiences of Intimate Partner Violence Survivors at Work.

Mothers who experience intimate partner violence can be resilient in maintaining employment during periods of abuse. The current qualitative study examines mothers' experiences of abusive workplace disruptions as well as helpful responses from workplaces. Two main research questions are addressed: 1. What ways do abusive partners use issues related to children to disrupt mothers' employment? 2. How do workplaces respond to mothers experiencing IPV? How do mothers show resilience? Mothers (n = 18) receiving services for abuse explained that abusive partners disrupted their work through compromising or withholding childcare, manipulating them through children, and jeopardizing child safety during work hours. However, mothers showed resilience when coworkers extend housing, childcare, and genuine concern for their situations. Implications for researchers, practitioners, and employers of survivors are discussed.

A Qualitative Study of Intimate Partner Violence and Employment Instability.

Maintaining employment while suffering from intimate partner violence (IPV) is extremely difficult given the direct and indirect ways abusers disrupt work. The current qualitative study seeks to strategically fill a gap in knowledge regarding survivors' employment instability and gain insight toward creating more supportive workplaces for survivors. Women (N = 19) receiving services for IPV at a Midwest U.S. agency were interviewed about their experiences of employment instability, workplace disruptions (including via technology), and their perceptions of policies and practices that employers use to support employees experiencing abuse. Specifically, the study asks four research questions to address gaps in literature: (a) What are the employment instability experiences of survivors related to IPV, including attendance, hours, and job loss? (b) What are survivors' experiences of workplace disruptions, including with technology? (c) What formal employer policies and practices related to IPV are survivors familiar with? and (d) What workplace supports do IPV survivors perceive to be helpful or harmful? Findings uniquely contribute to existing literature by revealing employment instability among mothers, highlighting the use of technology to disrupt survivors' work, and determining existing policies and procedures that workplaces use to address IPV. Implications for advocates working with survivors as well as employer and state policymakers are discussed.

Peer-to-Peer Human Milk Sharing: Recipient Mothers' Motivations, Stress, and Postpartum Mental Health.

BACKGROUND: Some mothers who cannot breastfeed-partially or completely-choose to feed their infants human milk donated from a peer. Few studies have examined mothers' experiences with using donor milk; none has examined whether or not mothers' stress and mental health are associated with using donor milk from a peer. METHODS: Researchers conducted semistructured individual interviews with mothers from the United States and Canada (N = 20) to answer the following questions: (a) what are recipient mothers' motivations for participation in peer-to-peer breast milk sharing and (b) what is the relationship between receiving donated milk and mothers' stress and mental health postpartum? Transcripts were coded using an inductive approach and principles of grounded theory were used to analyze data. RESULTS: Data were organized under two themes: (a) motivations for using milk from a peer and (b) milk-sharing and stress-related experiences. Motivations included health benefits, medical need, and preference for human milk over formula. Factors inducing stress were as follows: logistical stressors of securing donor milk and fear of running out of milk. Factors reducing stress were as follows: donor milk provided relief and comfort and its use reduced mothers' self-reported symptoms of postpartum depression and anxiety. CONCLUSIONS: Mothers participated in peer-to-peer breast milk sharing primarily because of health benefits for children. However, participation also had important psychological benefits for some mothers. Additional research and open discourse are needed to support mothers who choose to use milk from a peer and to promote safety of this practice.

A Liberation Health Approach to Examining Challenges and Facilitators of Peer-to-Peer Human Milk Sharing.

BACKGROUND: Human milk sharing between peers is a common and growing practice. Although human milk has been unequivocally established as the ideal food source for infants, much stigma surrounds the practice of human milk sharing. Furthermore, there is little research examining peer-to-peer human milk sharing. Research Aim: We used the liberation health social work model to examine the experiences of mothers who have received donated human milk from a peer. Research questions were as follows: (a) What challenges do recipient mothers experience in peer-to-peer human milk sharing? (b) What supports do recipient mothers identify in peer-to-peer human milk sharing? METHODS: Researchers conducted in-depth interviews with mothers ( N = 20) in the United States and Canada who were recipients of peer-to-peer human milk sharing. Researchers independently reviewed transcripts and completed open, axial, and selective coding. The authors discussed conflicts in theme identification until agreement was reached. RESULTS: Challenges to peer-to-peer human milk sharing were (a) substantial effort required to secure human milk; (b) institutional barriers; (c) milk bank specific barriers; and (d) lack of societal awareness and acceptance of human milk sharing. Facilitators included (a) informed decision making and transparency and (b) support from healthcare professionals. CONCLUSION: Despite risks and barriers, participants continued to pursue peer-to-peer human milk sharing. Informed by a liberation health framework, healthcare professionals-rather than universally discouraging human milk sharing between peers-should facilitate open dialogue with parents about the pros and cons of this practice and about screening recommendations to promote safety and mitigate risk.