The Impact of Covid-19 on Community Perinatal Doula Support Services for Black Women.

OBJECTIVES: To better understand the experiences of Black pregnant women during COVID-19, we examined Black pregnant clients' and doulas' experiences with perinatal support services amid COVID-19's social distancing protocols. METHODS: We used qualitative description, employing a social constructionist framework to interview 12 perinatal support doulas and 29 Black women who were pregnant or gave birth during the pandemic about their experiences during the pandemic, when social distancing was required. RESULTS: Three key themes were identified: (1) Clients experienced increased social isolation; (2) Doulas' exclusion from medical visits limited women's access to support and advocacy; (3) Doula support as a sisterhood helped clients mitigate effects of COVID isolation. CONCLUSIONS FOR PRACTICE: Doulas should be considered essential support persons for Black pregnant women and should not be excluded from the birthing team. Support through technology is acceptable for some clients but less desirable for others and restricted doula's ability to build rapport and be hands on with their clients.

Community Members as Reviewers of Medical Journal Manuscripts: a Randomized Controlled Trial.

BACKGROUND: Community members may provide useful perspectives on manuscripts submitted to medical journals. OBJECTIVE: To determine the impact of community members reviewing medical journal manuscripts. DESIGN: Randomized controlled trial involving 578 original research manuscripts submitted to two medical journals from June 2018 to November 2021. PARTICIPANTS: Twenty-eight community members who were trained, supervised, and compensated. INTERVENTIONS: A total of 289 randomly selected control manuscripts were reviewed by scientific reviewers only. And 289 randomly selected intervention manuscripts were reviewed by scientific reviewers and one community member. Journal editorial teams used all reviews to make decisions about acceptance, revision, or rejection of manuscripts. MAIN MEASURES: Usefulness of reviews to editors, content of community reviews, and changes made to published articles in response to community reviewer comments. KEY RESULTS: Editor ratings of community and scientific reviews averaged 3.1 and 3.3, respectively (difference 0.2, 95% confidence interval [CI] 0.1 to 0.3), on a 5-point scale where a higher score indicates a more useful review. Qualitative analysis of the content of community reviews identified two taxonomies of themes: study attributes and viewpoints. Study attributes are the sections, topics, and components of manuscripts commented on by reviewers. Viewpoints are reviewer perceptions and perspectives on the research described in manuscripts and consisted of four major themes: (1) diversity of study participants, (2) relevance to patients and communities, (3) cultural considerations and social context, and (4) implementation of research by patients and communities. A total of 186 community reviewer comments were integrated into 64 published intervention group articles. Viewpoint themes were present more often in 66 published intervention articles compared to 54 published control articles (2.8 vs. 1.7 themes/article, difference 1.1, 95% CI 0.4 to 1.8). CONCLUSIONS: With training, supervision, and compensation, community members are able to review manuscripts submitted to medical journals. Their comments are useful to editors, address topics relevant to patients and communities, and are reflected in published articles. TRIAL REGISTRATION: ClinicalTrials.gov NCT03432143.

"I felt like it would've been perfect, if they hadn't been rushing": Black women's childbirth experiences with medical providers when accompanied by perinatal support professionals.

AIMS: This study examined the nature and characteristics of Black women's interactions with medical providers during childbirth when accompanied by a perinatal support professional (PSP; similar to a doula). DESIGN: The design was qualitative, and a phenomenological approach was employed to examine the meaning of women's experiences. METHODS: We conducted in-depth interviews with 25 Black women enrolled in a perinatal support program in Cleveland, Ohio, in late 2017 and early 2018, exploring their interactions with medical providers, the meaning of their experiences, and the roles their PSPs played. RESULTS: Clients broadly categorized experiences as positive or negative. When medical providers respected them, their birth plans and/or collaborated with PSPs, women reported more positive experiences. They associated negative experiences with providers having their own timelines and agendas, and women perceiving their needs were unheard and/or disrespected. CONCLUSION: The findings emphasize the need for medical providers to be patient-centred, set aside assumptions, treat their patients as experts, value women's knowledge and voice, and treat patients and their supports as part of the team. IMPACT: Findings support the importance of having a knowledgeable but non-medical support person present during birth. We discuss implications for how empowerment may be a tool to achieving better birth outcomes.

"They should've talked to us more": lay health advisors' experiences with community-engaged hypertension research.

BACKGROUND: Lay health advisors (LHAs) are increasingly being used to increase patient and public involvement in research, disseminate health information, and work toward preventing health disparities within communities at risk. This research explored LHAs' experiences with training and recruiting for a hypertension research project which ended due to minimal enrollment. METHODS: The methodological design was qualitative description. One face-to-face semi-structured focus group was held with eight African American LHAs in Cleveland, Ohio, in the fall of 2019. The focus group was digitally recorded and transcribed by a professional transcriptionist and thematically analyzed. RESULTS: Trainees reflected on how much they learned from the training and described feeling passionate and excited about their community work for the project. We identified three key themes from the data: (1) Systemic and Institutional Factors Affected LHAs' Experiences (subthemes: Unnecessarily Burdensome Requirements and Exploitation of Community Members for Research Gain; (2) Feeling Used Yet Unseen: Exclusion from Decision-Making Processes; (3) Worrying that Project Termination Damaged their Reputation; and (4) Disengaging from Research. We share lessons learned, including the need for LHAs' expertise to be integrated into research studies, and for projects to establish clear communication and expectations regarding research rigor and requirements. CONCLUSION: Our results have implications for future studies attempting to build equitable and strong academic-community relationships to yield rigorous and useful research to reduce health disparities.

Community health workers (CHWs) are usually community members trained broadly to help the community address health issues. Community members (including patients and the public) who have experiences with specific diseases can be important resources in health research, contributing critical on-the-ground feedback and information about and to their communities, especially those with high rates of health disparities. In this study, CHWs with personal experience as patients with hypertension were trained to become lay health advisors (LHAs) specifically to assist with a hypertension research study in Cleveland, Ohio. This study explored LHAs' experiences with their training for the research study and the study itself, which ended early because the project did not get enough participants. Eight African American LHAs participated in a focus group in the fall of 2019, sharing their experiences. The focus groups were recorded on a digital device and a professional transcriptionist transcribed them. We found that the LHA trainees learned a lot from the training. They were passionate and excited about working with the community work for the project, but also felt used by the project leadership, and not included in important decisions. When the project ended, they also felt their reputations were damaged. Finally, the experience with the project led to LHAs wanting to not participate in research anymore. We conclude that projects should include strong and clear lines of communication, better integrate LHAs into research studies as partners and honor their expertise.

Community members' experiences training as medical journal reviewers.

PURPOSE: Although medical research dissemination is intended to benefit members of society, few members of society actually participate in the process of publishing findings. This study shares findings from community members' (including patients and the public) experiences being trained as medical journal reviewers. METHODS: We analyzed findings from two focus group interviews of community reviewers (N = 29) to identify themes in their experiences with the training program. RESULTS: Community members trained as journal reviewers appreciated learning the context under which manuscript development and review occur from authors and funders, the value of the community member perspectives to science, and strengthened their critical thinking skills. A range of training tools and strategies included glossaries of research terms, creating review guides, practicing reviews, being trained by a supportive team, and working with and learning collaboratively. CONCLUSIONS: Training as a journal reviewer has a positive impact on participating community members. Programs training community members as journal reviewers should incorporate guest speakers well-versed in community engaged research, group activities, a variety of training tools and materials, and highly supportive training teams.

The findings of medical research are supposed to benefit society, but few members of society that are not specialists actually help publish findings. In this study we hoped to learn about the experiences of community members who were trained to be medical journal reviewers. We interviewed 29 of the 34 community members who were trained to learn what they liked and did not like about the training. We learned that community members appreciated learning about how journal articles get published. Learning from journal article authors was helpful, as well as from people who work for organizations that finance the research. They also learned about how patient and community perspectives are important in science. They also said they learned to strengthen their critical thinking skills. They mentioned training tools and strategies that would have helped them. These included lists of research terms and their definitions, review guides, practicing reviews ahead of time, having supportive trainers, and working with and learning from each other. We conclude that training as a journal reviewer has had a positive impact on the community members. We suggest that programs who want to train community members as journal reviewers should incorporate guest speakers who understand community engaged research. They should also make sure they incorporate group activities, a variety of training tools and materials, and be very supportive.

Experiences of Black women during pregnancy: The meaning of perinatal support.

This study describes findings of a phenomenological study of Black women's experiences with a community-based perinatal support organization based in Cleveland, Ohio. Twenty-five women participated in interviews after their babies were born about how the organization in general, and perinatal support professionals (PSPs) in particular supported them during their pregnancies and the meaning of that support. The overall meaning of perinatal support was described as easing participants' transitions into motherhood through reducing uncertainty, social isolation, and stress. The three main themes described the meaning of perinatal support and included (a) easing the transition to motherhood through emotional support, expressed via love and help managing relationships; (b) easing the transition to motherhood through instrumental support, expressed via helping with basic needs and obtaining material goods for the baby; and (c) easing the transition to motherhood through informational support, expressed via help navigating systems and information, and gaining knowledge and skills around mothering and self-care. Implications for practice, policy, and research are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Paid sick leave and psychological distress: An analysis of U.S. workers.

Paid sick leave is increasingly identified as a social justice issue having important implications for health and wellness; however, little is known about its relationship to mental health. Data from the 2015 cross section of the National Health Interview Survey (NHIS; 2015) were used to examine the relationship between paid sick leave and psychological distress during the last 30 days among N = 17,897 working United States adults. The 6-item Kessler Psychological Distress Scale (K6), a valid and reliable instrument for assessing psychological distress in population based samples, was used to measure the outcome variable of interest. The K6 score was computed from 6 questions and was regressed on paid sick leave status, after controlling for variables known to be related to psychological distress. Results indicated that workers who lack paid sick leave benefits report a statistically significant higher level of psychological distress, and are 1.45 times more likely to report their distress symptoms interfere a lot with their life or activities compared with workers with paid sick leave. This research adds to a body of work analyzing institutional structures and social determinants of health. Findings support the potential value of paid sick leave as an intervention to promote behavioral health. (PsycINFO Database Record

Effects of gender and level of parental involvement among parents in drug treatment.

Most studies of parents in drug treatment have focused exclusively on mothers, and few studies have examined the effects of parents' level of involvement with their children on the parents' drug use and psychological functioning, either before or after treatment. This study examined mothers and fathers (n = 331) who were parents of children under the age of 18; participants were sampled from 19 drug treatment programs across four types of treatment modalities in Los Angeles County. A majority of each group (57% of 214 mothers and 51% of 117 fathers) were classified as being highly involved with their children. At the baseline assessment, higher parental involvement was related to lower levels of addiction severity, psychological severity, and symptoms of psychological distress, and to higher levels of self-esteem and perception of parenting skills. In general, fathers had higher levels of alcohol and drug-use severity than did mothers, but fathers who were more involved with their children showed lower levels of addiction severity than fathers who were less involved. Parental involvement at baseline was unrelated to drug use at the 12-month follow-up, although parents who were less involved with their children reported experiencing more stressors. Given the association of parental involvement with lower levels of addiction severity and psychological distress at baseline, treatment protocols should build upon the positive relationships of parents with their children, and seek to improve those of less-involved parents.