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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]

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. Plain English summary: 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. [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]

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. Plain English summary: 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. [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]

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]

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]

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 study uses mixed methods and theory from cognitive anthropology to examine the cultural models of domestic violence among domestic violence agency workers, welfare workers, nurses, and a general population comparison group. Data collection and analysis uses quantitative and qualitative techniques, and the findings are integrated for interpretation. Findings reveal consensus among service providers on how controllable domestic violence factors are and whether they are most characteristic of victims or perpetrators, but diversity with regard to their understandings of the importance of the factors suggesting that occupational category alone is inadequate in predicting service providers' beliefs and subsequent delivery of services. The implications of the findings extend into the areas of domestic violence service delivery, cognitive anthropology, and mixed methods research. [ABSTRACT FROM PUBLISHER]

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]