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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. Significance: Despite Cuyahoga County, Ohio being home to world-class medical institutions, a Black, non-Hispanic infant born there is more than twice as likely as a White non-Hispanic infant to die before his or her first birthday (Cuyahoga County Board of Health, 2021). It is thus urgent to identify effective interventions to address such disparate infant mortality rates. Our research discusses one such intervention dedicated to employing Black perinatal support doulas to serve Black women in Cleveland. The research discusses how program clients and staff experienced adjustments to its service model during restrictions that were imposed throughout the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Although the foreclosure crisis is considered over, some areas of the U.S. continue to suffer from high foreclosure rates. This research presents findings from in-depth interviews conducted with 18 service providers who worked with families to prevent their foreclosures in Cleveland, Ohio. The research focused on better understanding the landscape of the Cleveland foreclosure experience. Service providers provided insight into families' experiences with the foreclosure process. The three main themes developed from the interviews included: (1) clients lacked knowledge about the mortgage process; (2) lenders exploited clients' lack of knowledge, setting them up to fail with predatory mortgages and targeting specific groups; and (3) mortgage servicers were inflexible, inconsistent, incompetent, and lacked regard for clients, except for local servicers. The findings provide implications for housing research, policy, and practice. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. Public Policy Relevance Statement: Black infant and maternal mortality rates, which research finds are related to the stress of racism, are at crisis levels. All women should have free access to community-based perinatal support, a cost-effective intervention that could work to reduce health disparities in part by reducing women's stress. [ABSTRACT FROM AUTHOR]

The purpose of this study was to conduct an exploratory qualitative study of the impact of foreclosure on health. Twenty-nine interviews were conducted with people who had children under the age of 18 years at the time of the foreclosure. Interviews explored perspectives on the foreclosure experience, including factors that led to the foreclosure, the meaning(s) the foreclosure has had for them, and the health care impact. Thematic analyses identified themes underlying families' descriptions of their experiences. Participant families described the stress of losing a home and how that had contributed to a number of psychological and physiological ailments. Psychological effects included high levels of perceived stress, anxiety, grief, and a sense of shame and failure, while physiological effects were often described as either stress-induced or existing issues worsened by stress. These findings are discussed with regard to their implications for improving services and policies offered to families. [ABSTRACT FROM AUTHOR]

This study explores the extent to which teen participants in a youth development program had a greater empowerment self-connectedness, intrapersonal, and interpersonal skills after participating in the program. Findings from 2 years of a youth development program in East Cleveland, Ohio, are reported. A collaborative health navigator model was used to increase connectedness, empowerment, improve health care access, and ultimately prevent health disparities. Pre-test and post-test surveys covering two 10-month periods for two cohorts of teens collected standardized data on teens' (N = 31) senses of empowerment and connectedness. Focus groups were conducted with both health navigators and teen ambassadors about their experiences with the program and its impact. The quantitative findings were mixed, but qualitative findings suggested that the program helped the teens develop a sense of personal empowerment through increased intrapersonal and interpersonal skills. While long-term research including control groups is needed, the findings suggest that targeted teen programming can be a useful tool in the battle against health disparities. [ABSTRACT FROM AUTHOR]

While quantitative studies have described foreclosure's correlates, and qualitative work has shed light on homeowners' experiences in general, research has not focused specifically on how families with children younger than 18 years experience foreclosure. This study was an exploratory qualitative examination of families' experiences with home foreclosure, focusing especially on the meaning(s) the foreclosure had for them. In-depth interviews were conducted with 29 adult homeowners living with children younger than 18 years during their foreclosures. The analysis revealed key themes of foreclosure threatening personal and social identity, family relationships and routines, and emotional attachment and experiences of loss. Adults tended to blame themselves for the foreclosures as opposed to seeing structural forces as responsible for their predicaments. The findings help illuminate some of the potential mechanisms underlying the negative impact of foreclosure. Understanding families' experiences is critical to formulating services and policies to help affected families regain stability. [ABSTRACT FROM AUTHOR]

In 2013, Cuyahoga County, Ohio, began DNA testing and investigating nearly 5000 previously unsubmitted sexual assault kits (SAKs) from 1993 through 2009. We examined case files from a sample of SAKs that were tested but not previously adjudicated (n = 429). More than 10% (n = 45) involved victims who reported to police that a former or current intimate partner sexually assaulted them. This article integrates the available data on the offenders, the victims, the initial investigation, and the specifics of the assaults to provide a more complete understanding of intimate partner sexual assault (IPSA). More than one-third of the IPSA offenders were serial sex offenders; that is, the offenders sexually assaulted an intimate partner and another person(s). Comparing IPSAs to all other sexual assaults, IPSAs more frequently involved bodily force, less frequently involved a weapon, and IPSA investigations were more frequently closed because (1) the victims stated they lied or the police doubted the victims and (2) the victims declined to prosecute. The most common sequencing of events was a demand for sex by the offender followed by a verbal refusal by the victim and the use of bodily force in the sexual assault. The findings, however, indicate a great deal of variation in the sequencing of events surrounding the sexual assault, with over 25% involving no physical confrontation before or after the sexual assault and no demands for sex. Unsubmitted SAK data provide a unique window into understanding the understudied and underreported issue of IPSA. [ABSTRACT FROM AUTHOR]

Abstract The Housing First approach has shown promise in helping to combat homelessness among chronically homeless single males, but less is known about the approach when it is applied to families and young adults. This study examined data from a pilot Housing First program that served 78 families (n = 63) and single young adults (n = 15) with homeless histories and mental health and/or substance use disorders to explore program functioning and client service use patterns. Using an exploratory sequential mixed methods research design (Creswell & Plano Clark, 2011), qualitative interview data were conducted first, and quantitative administrative data and qualitative progress note data were then analyzed to explore ideas presented in the qualitative interviews. The in-depth qualitative interviews with staff (N = 9) collected information on program functioning and client successes and challenges. Quantitative data were collected on all 78 clients and sources included administrative data about return to homelessness, child welfare involvement, receipt of public assistance, and interactions with case managers. Qualitative exploration of a sample of client progress notes (N = 32) then followed. Integrating the findings, interviews suggested that clients faced many challenges, especially those related to having little to no income, multiple children, and stigmas, but that "success" would be indicated by needing their case managers less over time. We found that 89% remained enrolled in the program, 21% returned to shelter at some point, child welfare involvement decreased, and public assistance receipt increased after program entry. Content analysis of case management notes indicated that case managers worked with clients to develop independent living skills to improve clients' chances for becoming sufficient over the long-term. Highlights • 79% of families and young adults participating in a Housing First pilot avoided re-entering shelter • Program participation was significantly associated with increased SNAP enrollment and decreased child welfare involvement • Case management topical content was significantly more focused on housing for families than young adults • The number of case management contacts and time spent within them decreased over time in the program • Self-sufficiency was hampered by crises but supported by case management focused on independent living skills [ABSTRACT FROM AUTHOR]

This article reports the findings from in-depth qualitative interviews with 18 service providers who worked with families facing foreclosure. The interviews' purpose was to better understand a broad range of families' experiences and inductive coding focused on quotes that reflected the meaning of those experiences. The analysis extracted three main themes related to foreclosure representing threat: (a) foreclosure threatened children's education, (b) foreclosure threatened family memories, and (c) foreclosure threatened clients' sense of self and attaining the American Dream. Providers reported that families fought to keep their homes and hoped to buy again after foreclosure. The findings suggest that social work services could be beneficial in helping families navigate the emotional and financial impact of the foreclosure experience. [ABSTRACT FROM AUTHOR]

The ways in which teenagers understand their social environments can be important for social service providers to understand. A cognitive anthropological approach grounded in cultural consensus theory was used to investigate teenagers and social and health service providers in a pilot study in East Cleveland, Ohio (N = 28). The qualitative method of free listing was used to determine the cultural models of popularity, stress, social support, and causes of violence. Teens were also surveyed to examine their levels of stress, anxiety, and depression. Consensus was tested and not found in the domains. Teens were found to have above-average rates of stress and anxiety. A greater understanding of the sources of stress and causes of violence is described, along with the clinical, policy, and research implications of this study. [ABSTRACT FROM PUBLISHER]

Despite progress in policies and services for domestic violence, service use remains lower than the need suggests. This study, an analysis from a larger project on social service providers, examines welfare workers' shared beliefs about domestic violence. Using a mixed method design utilizing pile sorts (n= 38; 11 child welfare and 29 financial assistance), a survey (n= 57; 24 child welfare and 33 financial assistance), and in-depth interviews (n= 3; two child welfare and one financial assistance)—workers organized their ideas about factors that contribute to domestic violence, rated the factors along key dimensions of meaning (importance, controllability, characteristics of victims or perpetrators, and cause or effect), and shared experiences of their work with domestic violence cases. Financial assistance and child welfare workers organized their beliefs similarly demonstrating consensus on the importance of the factors, and shared beliefs about the factors that were causes and effects of domestic violence. In interviews, child welfare workers emphasized their focus on systems and collaboration. Despite areas of agreement, child welfare and financial assistance workers did not demonstrate consensus on ideas about domestic violence overall. The findings have implications for practice, specifically for improving responses to domestic violence and increasing the use of domestic violence services. [ABSTRACT FROM PUBLISHER]

This article examines the perspectives and experiences of staff who work for a pilot permanent supportive housing program for families. The program follows Housing First principles by providing supportive housing to chronically homeless families with disabling conditions (typically substance abuse and/or mental health issues). Nine service providers participated in in-depth, semistructured interviews in which they described their experiences with the program, including facilitators and barriers to providing high-quality services for this difficult-to-serve population. The findings indicate that stabilizing families is particularly challenging in part because of the complexity of their needs, both material and instrumental, that are dynamic and ongoing. Implications for practice are discussed, as the Housing First model, established as a best practice for single adults, is applied to families. [ABSTRACT FROM AUTHOR]

This study employed a unique theoretical approach and a series of participant-based ethnographic interviewing techniques that are traditionally used in cognitive anthropology to examine and compare social work and anthropology students' cultural models of the causes of domestic violence. The study findings indicate that although social work students and anthropology students share understandings of a general model of domestic violence, social work students agree on distinctive elements of this model that anthropology students do not. These findings are important in better understanding the role social work education plays in developing social workers' understandings of the roots of domestic violence. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

• Quick housing was a major success; treatment clients were housed and stayed housed. • Progress note data indicated that over time, workers' time with clients decreased. • Housing-unstable child welfare-involved families require individualized services. Child welfare-involved homeless families are at greater risk of poor social and economic outcomes compared with homeless families not involved with child welfare, and these negative outcomes reverberate in terms of economic and social costs to society. This study employed a mixed-methods approach to examine process findings from a randomized control trial from the first county-level Pay for Success initiative, Partnering for Family Success. The research compared housing, child welfare and public assistance outcomes for the treatment (N = 90) and control (N = 73) groups, explored how the program delivered its services, the service pattern over time, and perspectives of child welfare and program staff. We found that during and in the year after exiting the program, treatment group clients were less likely to use homeless services and were more likely to access public assistance benefits as compared with the control group clients, and during and after the program, the treatment and control group clients' child maltreatment reports were not statistically significantly different. There were positive indications from quantitative data showing that the intervention patterns align with those of Critical Time Intervention (CTI), with qualitative interview data indicating shifts over time in case management focus from short-term crisis management and housing stability toward working on longer-term independent living skills. The findings contribute to the literature regarding how best to serve homeless, child welfare-involved families, and suggest the necessity for longer-term interventions and greater attention to non-housing-related needs. [ABSTRACT FROM AUTHOR]

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 [ABSTRACT FROM AUTHOR]

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 [ABSTRACT FROM AUTHOR]