Financial Insecurity Research Articles

Potential unexpected effects of meat reduction in diet: Could educational attainment influence meat substitution strategies?

Regulation of meat consumption appears to be a relevant public policy to limit diet-related greenhouse gas emissions. However, the real impact of such a policy (e.g., tax) on human health and nutrition remains uncertain, especially for underprivileged individuals. Based on representative data from France, we estimate potential trend differences in the association between meat consumption and nutritional outcomes, such as body mass index (BMI) and unhealthy food intake, according to individual educational attainment. We reveal that among adults with low education levels, reduced meat consumption was significantly associated with a higher BMI, a higher risk of being overweight, and greater intake of ultra-processed foods, sweet drinks, and sugar. By contrast, reduced meat consumption was associated with healthier nutritional status for the most educated individuals. These results are robust to several measurements of socioeconomic status (SES) such as household income, occupation, and financial insecurity perception. In summary, high-SES individuals may be more prone to replace meat with healthy alternatives, whereas low-SES individuals may tend to replace meat with energy-dense foods and beverages, including ultra-processed foods. In terms of the contribution to science and society, this study is the first to show that SES changes the relationship between meat consumption and nutritional outcomes. Our findings call for future research on this topic to provide actionable recommendations to implement a fair and healthy food transition.

Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model.

A doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience. A web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period. As hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor. Theoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.

The mediating effect of institutional trust in the relationship between precarity and conspiracy beliefs: A conceptual replication of Adam-Troian etal. (2023).

The paper reports the results of registered conceptual replications of the indirect effect of institutional trust in the relationship between precarity and the endorsement of conspiracy beliefs (CB). The original study of Adam-Troian etal. (2023; British Journal of Social Psychology, 62(S1), 136-159) indicated that subjective appraisals of economic hardship are associated with lower trust in governments and institutions, which in turn is associated with stronger endorsement of CB. Our Studies 1 to 3 report a series of replications using Slovak panel data. Study 4 reports a replication of the mediation model using data from the European Social Survey Round 10 collected in 17 countries. To provide a quantitative synthesis of these and previous results, we conducted mini meta-analysis (N = 50,340). Although the strength of the observed relationships differed across the studies to some degree, the original patterns of relations remained robust, supporting the original model. The study corroborates the view that to curb the spread of CB, it is necessary to address structural issues, such as growing financial insecurity, socioeconomic inequalities, and the deficit of institutional trust. Finally, we discuss the role of cultural and political settings in conditioning the mechanisms through which precarity enhances the endorsement of CB.

Economic precarity and changing levels of anxiety and stress among Canadians with disabilities and chronic health conditions throughout the COVID-19 pandemic.

Early in the COVID-19 pandemic, multiple event stressors converged to exacerbate a growing mental health crisis in Canada with differing effects across status groups. However, less is known about changing mental health situations throughout the pandemic, especially among individuals more likely to experience chronic stress because of their disability and health status. Using data from two waves of a targeted online survey of people with disabilities and chronic health conditions in Canada (N=563 individuals, June 2020 and July 2021), we find that approximately 25% of respondents experienced additional increases in stress and anxiety levels in 2021. These increases were partly explained by worsening perceived financial insecurity and, in the case of stress, additional negative financial effects tied to the pandemic. This paper understands mental health disparities as a function of social status and social group membership. By linking stress process models and a minority stress framework with a social model of disability, we allude to how structural and contextual barriers make functional limitations disabling and in turn, life stressors.

Social Risk Factors and Racial and Ethnic Disparities in Health Care Resource Utilization Among Medicare Advantage Beneficiaries With Psychiatric Disorders.

The intersection of social risk and race and ethnicity on mental health care utilization is understudied. This study examined disparities in health care treatment, adjusting for clinical need, among 25,780 Medicare Advantage beneficiaries with a diagnosis of a psychiatric disorder. We assessed contributions to disparities from racial and ethnic differences in the composition and returns of social risk variables. Black and Hispanic beneficiaries had lower rates of mental health outpatient visits than Whites. Assessing composition, Black and Hispanic beneficiaries experienced greater financial, food, and housing insecurity than White beneficiaries, factors associated with greater mental health treatment. Assessing returns, food insecurity was associated with an exacerbation of Hispanic-White disparities. Health care systems need to address the financial, food and housing insecurity of racial and ethnic minority groups with psychiatric disorder. Accounting for racial and ethnic differences in social risk adjustment-based payment reforms has significant implications for provider reimbursement and outcomes.

Barriers and delays in access to abortion care: a cross-sectional study of people traveling to obtain care in England and the Netherlands from European countries where abortion is legal on broad grounds

IntroductionThis study characterized the extent to which (1) financial barriers and (2) abortion care-seeking within a person’s country of residence were associated with delays in abortion access among those travelling to England and the Netherlands for abortion care from European countries where abortion is legal on broad grounds in the first trimester but where access past the first trimester is limited to specific circumstances.MethodologyWe drew on cross-sectional survey data collected at five abortion clinics in England and the Netherlands from 2017 to 2019 (n = 164). We assessed the relationship between difficulty paying for the abortion/travel, acute financial insecurity, and in-country care seeking on delays to abortion using multivariable discrete-time hazards models.ResultsParticipants who reported facing both difficulty paying for the abortion procedure and/or travel and difficulty covering basic living costs in the last month reported longer delays in accessing care than those who had no financial difficulty (adjusted hazard odds ratio: 0.39 95% CI 0.21–0.74). This group delayed paying other expenses (39%) or sold something of value (13%) to fund their abortion, resulting in ~ 60% of those with financial difficulty reporting it took them over a week to raise the funds needed for their abortion. Having contacted or visited an abortion provider in the country of residence was associated with delays in presenting abroad for an abortion.DiscussionThese findings point to inequities in access to timely abortion care based on socioeconomic status. Legal time limits on abortion may intersect with individuals’ interactions with the health care system to delay care.

Expatriate managers' personal financial insecurity indirectly thwarts team innovation: The role of state learning goal orientation

AbstractThis paper studies the downstream effect of expatriate managers' personal financial insecurity on team innovation. Building on resource allocation theory, we propose a moderated serial mediation model. Using four‐wave, multi‐source survey data from 99 R&D expatriate teams within large technology companies in emerging markets, we find that expatriate managers' personal financial insecurity is negatively related to team innovation first through a lower level of state learning goal orientation in the last month, and subsequently through a lower level of intellectual stimulation behavior. The negative effect of expatriate managers' personal financial insecurity on state learning goal orientation is weakened when professional identification is higher (vs. lower). Theoretical and practical implications are discussed.

Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal.

Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal. A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS). Thirteen caregivers of COVID-19 positive patients were purposively selected from April to June, 2022. Face-to-face interviews were conducted at a caregiver residential facility using the interview schedule developed by the department for the purpose of data collection after obtaining ethical clearance from the Institutional review committee of BPKIHS. Data were audio recorded and manually analyzed. Among the 13 caregivers, six were male and seven were female. The findings were categorized into five domains: challenges encountered, changes in physical and mental health, changes in roles and responsibilities, positive experiences, and strategies to ease caregiving tasks. Major challenges included financial burdens, communication problems, stigmatization, Insecurity, substandard accommodation, and visitor restrictions. Caregivers reported negative emotions, unmet physical health needs, and shifts in family and occupational roles. Despite these challenges, caregivers attempted to cope positively and acknowledged the efforts of healthcare personnel and other family members. Suggestions for improving caregiving included providing essential medical and basic services within the hospital, enhancing accommodation facilities, establishing proper communication channels, and allowing visitations. Caregivers of COVID-19 patients face significant challenges during the caregiving process. Enhancing hospital services, promoting effective communication, fostering positive attitudes, and ensuring a safe environment can facilitate caregiving tasks.

Public pedagogues of change: advocacy networks, civil society organisations, and self-help authors in Mexico

ABSTRACT This article explores informal adult education for change in Mexico through the conceptual lens of social movement learning and public pedagogy. It adopts a multiple case design featuring two advocacy networks, two civil society organisations, and two self-help authors. It analyses how they position themselves as change agents addressing issues of food sovereignty, violence against women, social justice, environmental justice, financial insecurity, and emotional health. The article deconstructs how such agents diagnose problems and prescribe solutions that share a common logic: the unlearning of hegemonic knowledges and the learning of alternatives. It presents a continuum of pedagogical strategies, ranging from the most public (spectacular protests and social media work) to most private (targeted lobbying and workshopping). It contributes, methodologically and analytically, to literature at the intersection of social movement learning and public pedagogy. Methodologically, in a field dominated by stand-alone case studies from North America, it offers a comparative study of three domains of informal adult education in Mexico. Analytically, it unpacks public pedagogical messaging common to these domains and explain the strategies, interests and political implications that differentiate them. We encourage educators to assess the range of public pedagogical work that may be mobilised in the pursuit of change.

College focused rapid rehousing: Deploying an existing community model to address homelessness on campus

Research indicates that financial and housing insecurity challenges are widespread on most college campuses throughout the U.S. However, there is wide variability in how campuses address these challenges. This study reports on a three-year implementation of the College-Focused Rapid Rehousing pilot; an initiative in California by which universities commissioned community providers to assist students in need via a modified Rapid Rehousing (RRH) intervention. RRH is a widely implemented intervention that combines move-in assistance, short-term rental subsidies, and ongoing case management, to help individuals quickly transition into stable housing. The mixed-methods evaluation included analyses of online surveys (n = 141), administrative records (n = 368), and focus groups conducted with staff across eight campuses (n = 35). Survey findings indicate that CFRR programs assisted a diverse group of students with similar histories of housing insecurity. Quantitative analyses also show that most participants experienced the intervention as designed, though with some inconsistencies in how quickly some were assisted. Qualitative findings highlight contextual factors that affected the consistency of the intervention, including tight rental markets and philosophical disagreements among administrators about the intervention’s scope. Despite study limitations, findings provide insights into the applicability of the RRH model on campus settings and directions for future research.

The Impact of Counseling Groups on STEM Graduate Student Well-Being: A Qualitative Investigation

ABSTRACT STEM graduate students have high rates of stress, burn-out, and depression fueled by the competitive nature of these programs, financial and job insecurities, and the isolation that often comes alongside graduate school. The purpose of this study is to explore the impact of a brief counseling support group provided to STEM graduate students across two university campuses. Using a phenomenological framework, analysis of focus group and individual interviews revealed the unique challenges of STEM graduate school education, the therapeutic benefits of counseling groups, and the potential difficulties of providing mental health support to this population.

Health care-related transportation insecurity is associated with adverse health outcomes among adults with chronic liver disease.

Health care-related transportation insecurity (delayed or forgone medical care due to transportation barriers) is being increasingly recognized as a social risk factor affecting health outcomes. We estimated the national burden and adverse outcomes of health care-related transportation insecurity among US adults with chronic liver disease (CLD). Using the U.S. National Health Interview Survey from 2014 to 2018, we identified adults with self-reported CLD. We used complex weighted survey analysis to obtain national estimates of health care-related transportation insecurity. We examined the associations between health care-related transportation insecurity and health care-related financial insecurity, food insecurity, self-reported health status, work productivity, health care use, and mortality. Of the 3643 (representing 5.2 million) US adults with CLD, 267 [representing 307,628 (6%; 95% CI: 5%-7%)] reported health care-related transportation insecurity. Adults with CLD experiencing health care-related transportation insecurity had 3.5 times higher odds of cost-related medication nonadherence [aOR, 3.5; (2.4-5.0)], 3.5 times higher odds of food insecurity [aOR, 3.5; (2.4-5.3)], 2.5 times higher odds of worsening self-reported health status over the past year [aOR, 2.5; (1.7-3.7)], 3.1 times higher odds of being unable to work due to poor health over the past year [aOR, 3.1; (2.0-4.9)], and 1.7 times higher odds of being in a higher-risk category group for number of hospitalizations annually [aOR, 1.7; (1.2-2.5)]. Health care-related transportation insecurity was independently associated with mortality after controlling for age, income, insurance status, comorbidity burden, financial insecurity, and food insecurity [aHR, 1.7; (1.4-2.0)]. Health care-related transportation insecurity is a critical social risk factor that is associated with health care-related financial insecurity, food insecurity, poorer self-reported health status and work productivity, and increased health care use and mortality among US adults with CLD. Efforts to screen for and reduce health care-related transportation insecurity are warranted.

Tackling financial insecurity for autoimmune rheumatic diseases in developing countries in sub-Saharan Africa is of utmost importance.

Tackling financial insecurity for autoimmune rheumatic diseases in developing countries in sub-Saharan Africa is of utmost importance.

Reflections on the trends of suicide in Sri Lanka, 1997-2022: The need for continued vigilance.

Despite reductions in suicide rates in Sri Lanka during the past decades, largely by introduction of national bans on highly hazardous pesticides, the country continues to record a higher than global average rate of suicide. With the changing availability of methods of suicide over time, we aimed to examine the age-standardized suicide rates in Sri Lanka by sex, age, and method between 1997 to 2022 using national police suicide data to identify trends. The rate of suicide in Sri Lanka in 2022 was 27/100,000 and 5/100,000, in males and females respectively, with an overall suicide rate of 15/100,000 population. When considering the previous decades, the overall rate of suicide has declined from 1997 until about 2015, in both sexes, driven by a drop in the numbers of suicides due to pesticide ingestion. In females the overall rates of suicide plateaued around 2015, but in males there has been an upward trend in overall suicide that started in 2016, mostly due to an increase in rates of hanging. Since 2016 rates of suicide by hanging have increased among older males, and young females (17-25 years). Whilst the current suicide rate in Sri Lanka is substantially lower than it was during the 1990s, the upward trend in hanging seen in the last few years, particularly among older men and young women, is of concern. Ongoing monitoring of suicide rates should be a priority during the next few years, to detect and respond to changes as soon as possible. There is an urgent need to address current risk factors for suicide in Sri Lanka, such as significant financial insecurity, unemployment, depression, alcohol misuse, and domestic violence, and to minimize media glamourization of hanging by suicide.

Clinician Awareness of Patient-Reported Health-Related Social Needs: There's Room for Improvement.

People experiencing health-related social needs (HRSNs), such as transportation insecurity, are less likely to undergo preventive health screenings. They are more likely to have worse health outcomes overall, including a higher rate of late-stage cancer diagnoses. If primary care clinicians are aware of HRSNs, they can tailor preventive care, including cancer screening approaches. Accordingly, recent guidelines recommend that clinicians "adjust" care based on HRSNs. This study assessed the level of clinician awareness of patient-reported HRSNs and congruence between clinician perception and patient-reported HRSNs. We surveyed patients aged 50 to 85 years and their clinicians in 3 primary care clinics that routinely screen patients for HRSNs. Patients and clinicians reported the presence/absence of 6 HRSNs, including food, transportation, housing and financial insecurity for medications/healthcare, financial insecurity for utilities, and social isolation. Kappa statistics assessed the concordance of reported HRSNs between patients and clinicians. Across 237 paired patient-clinician surveys, mean patient age was 65 years, and 62% and 13% of patients were female and Latinx/Hispanic, respectively. Concordance between clinician- and patient-reported HRSNs varied by HRSN, with the lowest agreement for food insecurity (kappa = .08; 95% CI: 0.00, 0.17; P = .01) and highest agreement for transportation insecurity (kappa = .39; 95% CI: 0.18, 0.59; P < .001). The other HRSNs assessed were housing insecurity (kappa = .30; 95% CI: 0.05, 0.55; P < .001), social isolation (kappa = .24; 95% CI: 0.03, 0.45; P < .001), financial insecurity for utilities (kappa = .21; 95% CI: -0.02, 0.45; P < .001), and financial insecurity for healthcare/medications (kappa = .12; 95% CI: -0.02, 0.27; P < .001). In particular, discrepancies were noted in food insecurity prevalence: patient-reported food insecurity was 29% whereas clinician-reported food insecurity was only 3%. Clinician awareness of patients' social needs was only modest to fair, and varied by specific HRSN. In order to adjust care for HRSNs, clinics need processes for increased sharing of patient-reported HRSNs screening information with the entire clinical team. Future research should explore options for sharing HRSN data across teams and evaluate whether better HRSN data-sharing impacts outcomes.

CONCERNED AND LONELY AMIDST COVID-19: FINANCIAL STRAIN AND LATER-LIFE PSYCHOLOGICAL WELL-BEING IN NEVADA

Abstract Objectives Nevada has some of the nation’s highest suicide rates among older adults, which are linked to social isolation, loneliness, and mental health. The COVID-19 pandemic is likely to have exacerbated the loneliness and financial insecurity that older Nevadans have already been experiencing to a greater extent since the 2008 financial crisis. Prior research based on national data has documented the relationship between financial strain and mental health in later life. However, the social and psychological mechanisms that underlie such relationships have not been investigated, particularly in light of the devastating economic and health effects of the pandemic on older adults in Nevada. Methods Based on our web-based survey of adults aged 50 years and older (n=313), we examined the roles of loneliness and concerns about the pandemic in explaining the impact of financial strain on depressive symptoms and anxiety. Results We documented a statistically significant effect of financial strain on depressive symptoms (b=2.41, p-value&amp;lt; 0.001) and anxiety (b=1.74, p-value&amp;lt; 0.001). The inclusion of loneliness and concerns about the pandemic in our regression models led to substantial reduction in the impact of financial strain on depressive symptoms, whereas such impact on anxiety became statistically not significant. We also found significantly higher levels of depressive symptoms and anxiety among our respondents who reported greater feeling loneliness and concerns about the pandemic. Discussion Our findings underscore the need for mental health resources and financial support programs for economically disadvantaged older adults to alleviate their feelings of loneliness and improve mental health in Nevada.

ADDRESSING THE CHRONIC PAIN EPIDEMIC AMONG OLDER ADULTS IN UNDERSERVED COMMUNITY HEALTH CENTERS

Abstract Current nonpharmacological treatments are inadequate for addressing chronic pain among older adults from disadvantaged backgrounds. These treatments have been developed for affluent populations and are not implemented in underserved community health centers (CHCs) where most older adults with chronic pain seek care. We conducted 4 focus groups with 23 providers (e.g., primary care doctors, nurse practitioners, medical interpreters and support staff) and 4 focus groups with 15 English- and Spanish-speaking patients at a CHC. Our goals were to: 1) understand barriers and facilitators to sustained implementation of the GetActive+ mind-body activity program delivered by a nurse practitioner; 2) gather perceptions of program skills to facilitate cultural tailoring; and 3) gather information to support a future hybrid type 1 effectiveness implementation trial of GetActive+ versus usual care to improve pain outcomes. Qualitative analyses were conducted using a deductive-inductive approach and the Framework method. Questions were informed by Aaron’s implementation model and the Socioecological model. Results revealed multiple barriers at the individual (e.g., pain misconceptions, perceived bias, stigma, shame, treatment expectations and loneliness, language barriers, food and financial insecurity), health clinic (e.g., provider burnout, understaffed clinic, budget cuts, multiple languages) and environmental levels (e.g., lack of technology, lack of reliable transportation to clinic, billing challenges). Clinic providers felt unprepared to support older adults with chronic pain. Both patients and providers endorsed the need for, and skills of GetActive+. Nuanced differences between patient-provider and English-Spanish patients as well as modifications to the program manual, protocol, and interventionist training will be discussed.

Economic insecurities and patient-reported outcomes in patients with systemic lupus erythematosus in the USA: a cross-sectional analysis of data from the California Lupus Epidemiology Study

Social determinants of health are consistently associated with systemic lupus erythematosus (SLE) outcomes. However, social determinants of health are typically measured with conventional socioeconomic status factors such as income or education. We assessed the association of economic insecurities (ie, food, housing, health care, and financial insecurity) with patient-reported outcomes in a cohort of patients with SLE. In this cross-sectional analysis, data were derived from the California Lupus Epidemiology Study based in the San Francisco Bay Area, CA, USA. Participants were recruited between Feb 25, 2015, and Jan 10, 2018, from rheumatology clinics. Inclusion criteria were Bay Area residency; oral fluency in English, Spanish, Cantonese, or Mandarin; 18 years or older; ability to provide informed consent; and a physician confirmed SLE diagnosis. Food, housing, health care, and financial economic insecurities were assessed by validated screening tools. Patient-reported outcomes were obtained using PROMIS, Quality of Life in Neurological Disorders (known as Neuro-QoL) Cognitive Function short form, Patient Health Questionnaire (PHQ)-8, and General Anxiety Disorder (GAD)-7 instruments. Poverty was defined as household income of 125% or less of the federal poverty limit. Lower education was defined as less than college-graduate education. The association of economic insecurities with patient-reported outcomes was assessed by multivariable linear regression models adjusting for demographics, SLE disease characteristics, and comorbidities. We tested for interactions of insecurities with poverty and education. The final cohort included 252 participants. Mean age was 49·7 (SD 13·4) years, 228 (90%) of 252 were women and 24 (10%) were men. 80 (32%) individuals self-identified as Asian, 26 (10%) as Black, 101 (40%) as White, eight (3%) as mixed race, and 37 (15%) as other race; 59 (23%) self-identified as Hispanic. 135 (54%) individuals had at least one insecurity. Insecurities were highly prevalent, and more common in those with poverty and lower education. Adjusted multivariate analyses revealed that participants with any insecurity had significantly worse scores across all measured patient-reported outcomes. For physical function, no insecurity had an adjusted mean score of 48·9 (95% CI 47·5-50·3) and any insecurity had 45·7 (44·3-47·0; p=0·0017). For pain interference, no insecurity was 52·0 (50·5-53·5) and any insecurity was 54·4 (53·0-55·8; p=0·031). For fatigue, no insecurity was 50·5 (48·8-52·3) and any insecurity was 54·9 (53·3-56·5; p=0·0005). For sleep disturbance, no insecurity was 49·9 (48·3-51·6) and any insecurity was 52·9 (51·4-54·5; p=0·012). For cognitive function, no insecurity was 49·3 (47·7-50·9) and any insecurity was 45·6 (44·1-47·0; p=0·0011). For PHQ-8, no insecurity was 4·4 (3·6-5·1) and any insecurity was 6·1 (5·4-6·8; p=0·0013). For GAD-7, no insecurity was 3·3 (2·6-4·1) and any insecurity was 5·2 (4·5-5·9; p=0·0008). Individuals with more insecurities had worse patient-reported outcomes. There were no statistically significant interactions between insecurities and poverty or education. Having any economic insecurity was associated with worse outcomes for people with SLE regardless of poverty or education. The findings of this study provide insight into the relationship between economic insecurities and SLE outcomes and underscore the need to assess whether interventions that directly address these insecurities can reduce health disparities in SLE. US Centers for Disease Control, Rheumatology Research Foundation, and National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Compassion Fatigue in Chimpanzee (Pan troglodytes) Caregivers: Prevalence, Contributing Factors, and Coping Mechanisms

Compassion fatigue (CF) refers to the exhaustion and distress caused by the demands of caring for others. CF occurs in a variety of helping professions, including physicians, nurses, educators, social workers and animal caregivers, and is known to adversely impact both caregivers’ quality of life and the care they provide. This study assessed the prevalence, risk and protective factors, coping strategies and support programs for CF in chimpanzee caregivers (N = 123) at accredited sanctuaries and zoos in the United States. Online survey results revealed that 91.06% of chimpanzee caregivers experienced CF at some point in their careers. Common CF symptoms were exhaustion, frustration, anxiety, depression, and apathy. Perceived factors influencing CF included being understaffed, lacking resources and training, poor relationships with coworkers and supervisors, and financial insecurity. Commonly reported coping strategies were talking to someone, having pets, self-care, and getting away from work. 20.33% of caregivers reported having institutional support programs available to them, however they were rarely viewed as helpful and 32.52% of respondents were unsure about program availability. Overall, our findings suggest that, like other caregiving professionals, chimpanzee caregivers are susceptible to CF and may benefit from new or updated support programs that continue to build a ‘culture of care’ that meets employee, animal, and facility needs.

Anxiety trajectories from pregnancy to one-year postpartum and their contributors during the COVID-19 pandemic

ABSTRACT Background Anxiety in the peripartum period (pregnancy through one-year postpartum) has negative impacts on mothers and infants. During the COVID-19 pandemic, high rates of anxiety were reported worldwide, but trajectories for how these symptoms change longitudinally in the peripartum period remain unknown. Methods A total of 1,411 women who were pregnant during the second U.S. COVID-19 surge completed four study questionnaires between December 2020 and March 2022, including assessments of anxiety symptoms (GAD-7) and individual and community-level contributors. Latent Class Growth Mixture Models (LCGMM) were used to identify anxiety trajectories, and multinomial logistic regression was used to identify contributors to class membership. Results Three classes of anxiety symptom trajectories were identified. Class 1 (n = 956, 67.8%) experienced minimal/mild anxiety throughout the peripartum period. Class 2 (n = 362, 25.7%) experienced initial moderate anxiety that remained stable. Class 3 (n = 93, 6.6%) experienced initial moderate anxiety that increased to severe in the postpartum period. Stress and history of mental health diagnosis contributed to higher initial levels of anxiety and ongoing social support contributed to lower levels of anxiety. In addition, financial insecurity increased the risk of belonging to Class 3. Conclusions Screening for anxiety symptoms and psychosocial vulnerabilities in the peripartum period is vital, as is early intervention. This is especially the case among women with limited financial and social resources who may experience chronic or worsening anxiety as they transition to parenthood.