Pandemic-related Stress Research Articles

Examining outcomes for service users accessing the Breaking Free Online computer-assisted therapy program for substance use disorders via a ‘telehealth’ approach: protocol for a two arm, parallel group randomized controlled trial

BackgroundBreaking Free Online (BFO), a computer-assisted therapy (CAT) program for substance use disorders (SUD), has been available across UK treatment services for the past decade and has demonstrated efficacy. The Covid-19 pandemic has contributed to digital and ‘telehealth’ approaches to healthcare delivery becoming more common and accepted, and has in parallel, increased numbers of referrals to SUD services because of the impact pandemic-related stress has had on substance using habits in the general population. Digital and telehealth approaches, such as BFO, have the potential to support the treatment system to meet this increased demand for SUD services.MethodsParallel-group randomized controlled trial of eight-week BFO as an adjunct to standard treatment for SUD, in comparison to standard treatment only, at a National Health Service (NHS) Mental Health Trust in North-West England. Participants will be service users aged 18 years and over with demonstrable SUD for at least 12-months. Interventional and control groups will be compared on multiple measures from baseline to post-treatment assessment at eight-weeks, and then three and six-months follow-up. Primary outcome will be self-reported substance use, with secondary outcomes being standardized assessments of substance dependence, mental health, biopsychosocial functioning and quality of life.DiscussionThis study will examine whether BFO and telehealth support, when delivered as an adjunct to standard SUD interventions, improves outcomes for services users receiving NHS SUD treatment. Findings from the study will be used to inform both developments to the BFO program and guidance around augmenting the delivery of CAT programs via telehealth.Trial registration registered with ISRCTN on 25th May 2021—registration number: 13694016. Protocol version: 3.0 05th April 2022. Trial status: This trial is currently open to recruitment—estimated to be completed in May 2023.

Pandemic play moderates the relation between caregiver stress and child emotional distress in contexts of economic adversity.

It is well-established that caregiver stress is linked to increased emotional distress among children, and recent evidence highlights similar associations between caregiver and child emotional well-being during the coronavirus (COVID-19) pandemic. Examining protective factors and coping mechanisms that are associated with resiliency in the face of pandemic-related stress can highlight potential strategies that may help children adapt to other unexpected hardships outside of a global pandemic. Previous research found that playing about the pandemic moderated an association between caregiver stress and children's emotional distress. However, few studies have explored "pandemic play" among children from low-income households, where pandemic-related stressors were often exacerbated. In the present study, 72 caregivers of Head Start preschoolers between 3 and 6 years of age were surveyed between late 2020 and early 2021. Results revealed that 32% of children engaged in pandemic play frequently. Caregiver stress was positively associated with child emotional distress, but only among children who did not engage in pandemic play frequently. These findings support the idea that child-directed play may be a developmentally appropriate and accessible coping mechanism to reduce the emotional burden of stressful events on children, regardless of economic context.

Parenting amidst COVID-19: Pandemic-related stressors, inequities, and treatment utilization and perceptions.

Many parents of children under age 18 are faced with additional COVID-19 parenting-related stressors and may be experiencing increases in psychological difficulties;however, we have yet to investigate parent's levels of posttraumatic stress symptoms (PTSS) and adjustment disorder. Further, COVID-19 has served as a sobering reminder of the significant public health disparities in our society and it is critical to identify risk factors for poorer clinical outcomes. The primary objectives of the present study were to: (a) determine whether parents are reporting higher levels of pandemic-related stress, PTSS, and adjustment disorder than controls, (b) identify specific individual-level factors (e.g., age, gender, race, number of children, age of children) that may be related to higher levels of stress and symptoms among parents, and (c) report parents' utilization of, and perceived efficacy of, psychological interventions during COVID-19. A U.S. nationally representative sample (N = 2,019) from Qualtrics Data panels was recruited in July-August 2020. Parents endorsed higher levels of stress, PTSS, and adjustment disorder, particularly younger parents. Further, 38.3% of parents reported PTSS above clinical cutoff. Younger participants and persons of color reported higher levels of pandemic-related stress. One-third of parents (33.1%) reported using online mental health services. Taken together, parents may be at greater risk for pandemic stress, PTSS, and adjustment disorder symptoms. Individual-level risk factors, such as age and minority status, are important to consider when understanding COVID-19 stress. Clinical intervention efforts should prioritize trauma-focused treatments for parents, especially those who are younger and identify as a person of color. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

An open trial of VA CONNECT: Caring for Our Nation's Needs Electronically during the COVID-19 Transition.

The COVID-19 pandemic impacted emotional well-being due to safety concerns, grief, employment impacts, and social interaction limitations. Face-to-face mental health treatment restrictions were especially impactful to veterans who often gain social enrichment from Veterans Health Administration (VHA) care. We present results from a novel group-based telehealth intervention, VA Caring for Our Nation's Needs Electronically during the COVID-19 Transition (VA CONNECT), which integrates skills training and social support to develop a COVID-19 Safety & Resilience Plan. Veterans (n​=​29) experiencing COVID-related stress participated in an open trial of this 10-session, manualized group VHA telehealth intervention. We examined whether COVID-19-related stress, adjustment disorder symptoms, and loneliness decreased, and coping strategy use increased after participation in VA CONNECT. Between baseline and two-month follow-up, participants reported a significant reduction in perceived stress and adjustment disorder symptoms, and an increase in planning coping skills use. Significant changes were not observed in loneliness or other specific coping strategies. Findings may support the utility of VA CONNECT as an intervention for pandemic-related stress and improving certain coping skills. Future research should explore group-based telehealth interventions like VA CONNECT with other populations within and outside of the VA, which have value during major disruptions to face-to-face mental healthcare access.

Living through the pandemic together: Exploring the associations among couples’ communal orientation, self-disclosure, and thriving

The present study tested several pathways detailed in the theory of resilience and relational load (TRRL) in the context of urban couples living together during the COVID-19 pandemic. Fifty cohabitating couples completed a baseline assessment and 7 days of daily diaries. Results indicated that, the more an individual or their partner reported being communally oriented within their relationship at baseline, the greater that individual’s relational thriving each day. Results also revealed that, the more an individual reported being communally oriented, the more they viewed their partner as engaging in self-disclosure each day. Two indirect effects emerged, such that one’s own communal orientation positively predicted their perceptions of their partner’s self-disclosure, which in turn predicted greater individual and relational thriving. These findings and their implications for the TRRL, couples’ communication, and coping with pandemic-related stress are discussed.

Pandemic-Related Stress Among U.S. College Students: Disparities by Gender Identity, Race/Ethnicity, and Sexual Orientation

This study aimed to assess potential disparities in pandemic-related stress associated with gender identity, race/ethnicity, and sexual orientation among college students. We used the 2021 Spring American College Health Association-National College Health Assessment data collected at one large, southeastern university in March of 2021. The sample (n = 659) included 18–32 year-old students who self-identified as cisgender (cis) men, cis women, and transgender/gender nonbinary (TGNB). The majority of students reported being extremely or very concerned with several pandemic-related outcomes, e.g., uncertainty regarding the future. In addition, 47% of students reported witnessing racial/ethnic discrimination as a result of the pandemic, and 43% of students reported increased stress due to the pandemic. For the majority of measures, the negative impact of the pandemic was significantly higher among cis women and/or TGNB students relative to cis men, racial/ethnic minorities relative to non-Hispanic (NH) white students, and sexual minorities relative to heterosexual students. Among diverse racial/ethnic groups, experiencing racial/ethnic discrimination as a result of the pandemic was most commonly reported by NH Asian/Asian American (18%) and NH black/African American (14%) students. Our findings reinforce the importance of needs assessment and future monitoring of mental health and well-being among college students, especially minority students, as they are more likely to be severely impacted by the pandemic. In addition, the study revealed that substantial numbers of students witnessed discrimination against racial/ethnic minorities as a result of the pandemic, suggesting that there is a need for the implementation of additional programs to promote equity, equality, and inclusion among all individuals.

Risk Factors and Protective Factors of Internet Addiction in University Students during the Pandemic: Implications for Prevention and Treatment.

While the prevalence rates of Internet addiction (IA) amongst young people during the pandemic are disturbing, few studies have investigated the risk and protective factors of IA in Hong Kong university students under COVID-19. In this study, we examined the relationship between COVID-19-related stress and IA and the role of psychological morbidity and positive psychological attributes in the relationship. In summer 2022, 978 university students completed a survey assessing pandemic-related stress, psychological morbidity, and positive psychological attributes. While psychological morbidity was indexed by depression, post-traumatic stress disorder, and suicidal behavior, positive psychological attributes included life satisfaction, flourishing, adversity beliefs, emotional competence, resilience, and family functioning measures. Results showed that stress and psychological morbidity positively predicted IA, and psychological morbidity mediated the association between stress and IA. Positive psychological attributes negatively predicted stress and IA, and mediated the connection between stress and IA. Positive psychological attributes moderated the mediating effect of psychological morbidity on the relationship between stress and IA. In addition to theoretical contributions, this study contributes to IA prevention and treatment: reducing psychological morbidity and promoting positive psychological attributes are promising strategies to address IA issues in young people.

The impact of the pandemic on the perception of stress and danger, and the adjustment of psychiatric and general medical staff of German military hospitals.

The COVID-19 pandemic changed not only the working conditions but also the private conditions we live in. Health care professionals especially were confronted with multiple stressors, e.g., the risk of infection, lack of staff, and high workloads. To estimate some of the pandemic-related impacts this anonymous personnel survey was conducted in two German military hospitals (Hamburg and Berlin). This study presents a comparative analysis of the hospital staff in general vs. the psychiatric personnel (N = 685) at two measurement time points (MTPs) in April 2021 (n = 399) and December 2021 (n = 286). The survey contains the German version of the Covid Stress Scale (CSS) to assess the perceived level of pandemic-related stress, the Patient Health Questionnaire (German Version: PHQ-D) to screen for three major mental disorders, and the adjustment disorder-New Module (ADNM) to estimate the problems of adaptation to change. The results showed a process of adaptation over the two MTPs with significant stress reduction at MTP2 in the general staff. The psychiatric staff did not report significantly higher pandemic-related symptoms. Quite the contrary, not only did the CSS show significantly lower xenophobia, traumatic stress, and compulsive checking, but the PHQ also showed lower stress symptoms and somatic symptoms at both MTPs. Also, the ADNM scores delivered evidence for a more effective adaptation process in psychiatric personnel (e.g., depressive mood, avoidance, anxiety). The presented results must be interpreted while taking the unique situations of German military clinics into account. The supply of protective material was sufficient and there was no dramatic shortage of psychiatric staff during the pandemic. The inpatients were quite often (40%) elective treatments for trauma-related disorders, which could be discontinued in the case of a COVID-19 infection. The results of this study showed good adaptative skills among the psychiatric staff in military hospitals, which could be interpreted as a sign of good resilience. This might have led to lower stress-related symptoms during the COVID-19 pandemic.

Pandemic-Related Stress and Resilience Among Latinx Mothers with a History of Depression: Differences by Immigration Status.

This study explores the impact of the COVID-19 pandemic on low-income, Latinx mothers in Southern California with a history of depression, including undocumented mothers and members of mixed status families. Drawing participants from a parent study that provided a maternal depression intervention to Head Start mothers (n = 119), this mixed method study integrates qualitative and quantitative data in a convergent design. Thirty-four mothers completed semi-structured qualitative interviews and standardized questionnaires in the fall of 2020. Mothers shared overwhelming economic difficulties, with the majority reporting that their family income decreased and half reporting that they were unable to pay for housing. Stressors were compounded for undocumented mothers and members of mixed-status families who were excluded from major relief programs. Stress affected maternal mental health, and mothers with precarious status reported differences in functioning. Mothers also identified positive ways that they coped with adversity. Results show that Latinx mothers with a history of depression, particularly mothers with precarious immigration status, continue to suffer considerable economic, social, and emotional impacts of the COVID-19 pandemic. Social workers can support the human rights of this population by advocating for financial relief, food assistance, and the expansion of medical-legal partnerships and physical and mental health services.

Coping With Pandemics: A Historical Perspective About Society's Tools to Deal With Global Infectious Diseases.

Throughout history, society has dealt with several devastating pandemics. Our objective is to analyze society's coping mechanisms to deal with pandemic-related stress in history congruent with the values of the time. For that purpose, we have carefully selected some of the most significant pandemics based on their impact and the available psychosocial literature. After a brief introduction, society's coping tools are reviewed and analyzed for the Antonine Plague, the second bubonic plague, the third cholera pandemic, the Spanish flu, the HIV pandemic, and the COVID-19 pandemic. Despite occurring at different times in history, parallels can be established in the study of society's psychological reactions among different pandemics. Magical thinking, political skepticism, fake accusations, and discrimination of minorities are recurrent reactions in society among different pandemics in history.

Examining pandemic stress and mental health among a community-based sample of sexual minority women in Los Angeles County

ABSTRACT In partnership with community stakeholders, the present study aimed to gather descriptive data on pandemic-related stress and its association with mental health outcomes among a community sample of self-identified sexual minority women (SMW) in Los Angeles County (N = 84; Mage = 35.61). The sample was comprised solely of women (i.e. self-identified gender identity as woman, including cisgender and transgender women). Data were collected in April 2021, the ‘third wave’ of the COVID-19 global pandemic. Los Angeles experienced some of the highest COVID-19 incidence rates in the United States. Yet, there was a significant lack of COVID-19 data on SMW, thus making it difficult to address the specific needs of this community. Background data were collected on pre-existing health conditions and COVID-19 infection history. Data were specific to COVID-19 stressors in the areas of mental health, financial strain, social isolation and health and discrimination concerns. Findings revealed that mental health concern was strongly associated with financial strain (r = .63, p < .01), social isolation (r = .62, p < .01) and health and discrimination concerns (r = .63, p < .01), thus demonstrating the wide-ranging negative impact of pandemic stressors on the mental health of SMW in Los Angeles during the third wave of COVID-19. Recommendations for future research, practice and policy implications are discussed.

Longitudinal Associations Between COVID-19 Stress and the Mental Health of Children With ADHD

Objective: To investigate the longitudinal associations between COVID-19 induced stress (related to COVID-19 restrictions/changes), attention-deficit/hyperactivity disorder (ADHD) symptoms, oppositional symptoms, and mental health outcomes (negative affect, anxiety, depression, and irritability) in children with ADHD during the COVID-19 pandemic. Method: Parents of 140 Australian children with ADHD (aged 5–17 years) completed an online survey in May 2020 during stay-at-home restrictions and 12-months later. Results: Baseline COVID-19 stress was associated with increased total ADHD symptom severity (β = .21, p = .007) and hyperactivity/impulsivity symptoms (β = .23, p = .002) at 12-months, after accounting for covariates (i.e., child age, gender, ADHD medication, socio-economic status, and baseline symptoms). Despite some indication of associations between baseline COVID-19 stress and 12-month oppositional symptoms and negative affect, these were attenuated when adjusting for baseline symptoms. Conclusions: The study provides initial evidence of the medium-term impacts of pandemic-related stress for children with ADHD.

Ingestion of Illicit Substances by Young Children Before and During the COVID-19 Pandemic

Information about the trend in illicit substance ingestions among young children during the pandemic is limited. To assess immediate and sustained changes in overall illicit substance ingestion rates among children younger than 6 years before and during the COVID-19 pandemic and to examine changes by substance type (amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids) while controlling for differing statewide medicinal and recreational cannabis legalization policies. Retrospective cross-sectional study using an interrupted time series at 46 tertiary care children's hospitals within the Pediatric Health Information System (PHIS). Participants were children younger than 6 years who presented to a PHIS hospital for an illicit substance(s) ingestion between January 1, 2017, and December 31, 2021. Data were analyzed in February 2023. Absence or presence of the COVID-19 pandemic. The primary outcome was the monthly rate of encounters for illicit substance ingestions among children younger than 6 years defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code(s) for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids. The secondary outcomes were the monthly rate of encounters for individual substances. Among 7659 children presenting with ingestions, the mean (SD) age was 2.2 (1.3) years and 5825 (76.0%) were Medicaid insured/self-pay. There was a 25.6% (95% CI, 13.2%-39.4%) immediate increase in overall ingestions at the onset of the pandemic compared with the prepandemic period, which was attributed to cannabis, opioid, and ethanol ingestions. There was a 1.8% (95% CI, 1.1%-2.4%) sustained monthly relative increase compared with prepandemic trends in overall ingestions which was due to opioids. There was no association between medicinal or recreational cannabis legalization and the rate of cannabis ingestion encounters. In this study of illicit substance ingestions in young children before and during the COVID-19 pandemic, there was an immediate and sustained increase in illicit substance ingestions during the pandemic. Additional studies are needed to contextualize these findings in the setting of pandemic-related stress and to identify interventions to prevent ingestions in face of such stress, such as improved parental mental health and substance treatment services, accessible childcare, and increased substance storage education.

The impact of pandemic-related stress on attentional bias and anxiety in alexithymia during the COVID-19 pandemic

The COVID-19 pandemic had negative consequences for mental health, yet it is unknown how and to what extent the psychological outcomes of this stressful event are moderated by individual traits. Alexithymia is a risk factor for psychopathology, and thus likely predicted individual differences in resilience or vulnerability to stressful events during the pandemic. This study explored the moderating role of alexithymia in the relationships of pandemic-related stress with anxiety levels and attentional bias. The participants were 103 Taiwanese individuals who completed a survey during the outbreak of the Omicron wave. Additionally, an emotional Stroop task including pandemic-related or neutral stimuli was used to measure attentional bias. Our results demonstrate that pandemic-related stress had a lesser impact on anxiety in individuals with a higher level of alexithymia. Moreover, we found that in individuals with higher exposure to pandemic-related stressors, a higher level of alexithymia indicated less attentional bias toward COVID-19-related information. Thus, it is plausible that individuals with alexithymia tended to avoid pandemic-related information, which could temporarily relieve stressors during the pandemic.

'Remoteness was a blessing, but also a potential downfall': traditional/subsistence and store-bought food access in remote Alaska during the COVID-19 pandemic.

This study employs a strengths-based approach to assess food access in remote Alaska during the COVID-19 pandemic, identifying both the negative consequences of the pandemic on store-bought and subsistence/traditional food access and compensatory strategies used. As a part of a larger study on the impacts of COVID-19 on daily life remote Alaskan communities, study data presented here were collected through key informant interviews (KII) and state-wide online surveys from 21 September 2020 to 31 March 2021 among remote Alaska community members. This study was conducted with residents of remote communities in Alaska, defined as those off the road system. Remote communities often have small or no grocery stores and rely on subsistence or traditional sources of food. KII participants (n 36) were majority female (78 %) and Alaska Native (57 %). Survey participants (n 615) were also majority female, 25-54 years old and most had had some post-secondary education or training. Survey and interview data revealed that the pandemic had significant negative impacts on store-bought food access in remote Alaskan communities. Individuals also shared that locally available and wild harvested foods acted as a buffer to some of the loss of access to these store-bought foods, with some people sharing that the harvesting of wild and traditional foods served as a coping strategy during times of pandemic-related stress. The results from this study demonstrate that the remoteness of some Alaskan communities has been both a source of vulnerability and protection in terms of food access.

Maternal pandemic-related stress during pregnancy associates with infants' socio-cognitive development at 12 months: A longitudinal multi-centric study.

Prenatal maternal stress is a key risk factor for infants' development. Previous research has highlighted consequences for infants' socio-emotional and cognitive outcomes, but less is known for what regards socio-cognitive development. In this study, we report on the effects of maternal prenatal stress related to the COVID-19 pandemic on 12-month-old infants' behavioral markers of socio-cognitive development. Ninety infants and their mothers provided complete longitudinal data from birth to 12 months. At birth, mothers reported on pandemic-related stress during pregnancy. At infants' 12-month-age, a remote mother-infant interaction was videotaped: after an initial 2-min face-to-face episode, the experimenter remotely played a series of four auditory stimuli (2 human and 2 non-human sounds). The auditory stimuli sequence was counterbalanced among participants and each sound was repeated three times every 10 seconds (Exposure, 30 seconds) while mothers were instructed not to interact with their infants and to display a neutral still-face expression. Infants' orienting, communication, and pointing toward the auditory source was coded micro-analytically and a socio-cognitive score (SCS) was obtained by means of a principal component analysis. Infants equally oriented to human and non-human auditory stimuli. All infants oriented toward the sound during the Exposure episode, 80% exhibited any communication directed to the auditory source, and 48% showed at least one pointing toward the sound. Mothers who reported greater prenatal pandemic-related stress had infants with higher probability of showing no communication, t = 2.14 (p = .035), or pointing, t = 1.93 (p = .057). A significant and negative linear association was found between maternal prenatal pandemic-related stress and infants' SCS at 12 months, R2 = .07 (p = .010), while adjusting for potential confounders. This study suggests that prenatal maternal stress during the COVID-19 pandemic might have increased the risk of an altered socio-cognitive development in infants as assessed through an observational paradigm at 12 months. Special preventive attention should be devoted to infants born during the pandemic.

Correlates of stress are interactive and not unidimensional: Evidence from U.S. college students early in the COVID-19 pandemic.

Studies have investigated various aspects of how the COVID-19 pandemic has impacted college students' well-being. However, the complex relationships between stress and its correlates have received limited attention. Thus, the main objective of this study is to evaluate multiplicative associations between stress and demographic, lifestyle, and other negative emotion factors during the pandemic. We used data from a survey with 2,534 students enrolled in seven U.S. universities and analyzed such data with generalized additive Tobit models and pairwise interaction terms. The results highlighted associations and interactions between myriad factors such as students' social class, income, parental education, body mass index (BMI), amount of exercise, and knowing infected people in the student's communities. For instance, we found that the associations between feeling irritable and sad due to the pandemic were interactive, resulting in higher associated stress for students with higher levels of parents' education. Furthermore, associations between taking precautionary actions (i.e., avoiding travel and large gatherings) and stress varied with the intensity of negative feelings (i.e., sadness and irritability). Considering these interaction terms, the results highlighted a great inequality in pandemic-related stress within low income, lower social class, and higher BMI students. This study is among the earliest that employed a stratified approach with numerous interaction terms to better understand the multiplicative associations between different factors during the COVID-19 pandemic.

Mental health during the COVID-19 pandemic: Stress and strain profiles in the German population.

Clinical observations indicate that people frequently display stress-related behavior during the COVID-19 pandemic. Although numerous studies have been published concerning pandemic-related psychological distress, systematic data on the interrelationships between stress sensitivity, personality, and behavioral characteristics of people are still lacking. In the present cross-sectional online survey study, we applied a German version of the COVID Stress Scales (CSS) and standard psychological questionnaires to systematically identify the complex interplay between stress sensitivity, gender, and personality in the modulation of quality of life and mental health in the German population (N = 1774; age ≥ 16 years). A CSS-based cluster analysis revealed two clusters characterized by higher and lower stress levels. Study participants in each cluster differed significantly with respect to neuroticism, extraversion, agreeableness, quality of life, depression, and anxiety. Females were significantly overrepresented in the higher stress cluster, while there was an overrepresentation of males in the lower stress cluster. Neuroticism was identified as a risk factor and extraversion as a protective factor for enhanced pandemic-related stress responses. For the first time our data show a taxonomy of factors, which modulate pandemic-related stress sensitivity and warrant consideration as key indicators of quality of life and psychological distress during the COVID-19 pandemic. We suggest that our data may advise governmental regulation of pandemic-related public health measures, to optimize quality of life and psychological health in different groups of the population.

“You have to continue doing the work”: Black women essential workers coping amidst the dual pandemics of COVID-19 and racism

This study sought to examine the experiences of Black women essential workers and their perspectives on wellbeing and coping during the dual pandemics of COVID-19 and structural racism. We used a qualitative approach and purposive sampling techniques to interview 22 essential workers who identified as Black women. Research took place in a large southeastern portion of the United States. Data collection included a brief demographic questionnaire and individual interviews. Thematic and content analysis were used to identify themes and quantify the types of mechanisms used to cope with the pandemics. Four themes were identified to reflect these essential workers’ experiences coping with the pandemics: pervasive distress; varied responses to emergent events; mechanisms for survival; and the persistent obligation to remain strong. Predominant coping mechanisms included the use of social support, faith and spirituality, and increased food consumption. Despite concerns related to imminent threats to their health, widespread uprisings against police brutality, and shifts in caretaking responsibilities, these women’s narratives demonstrated a persistent obligation to remain strong. Moreover, contextual factors related to their roles as essential workers and caretakers, such as others’ reliance on them, contributed to the necessity for survival and their display of strength during such turbulence. These findings highlight the emotional toll essential workers experienced while managing their work-related responsibilities and navigating caregiving roles. Future research should focus on the development of culturally relevant coping strategies to mitigate unwanted effects from pandemic-related stress and dismantling systems of oppression to improve general wellbeing for essential workers and their families.

Ethnic Differences In The Relationship Between Pandemic-Related Stress And Bodily Pain: Results From The Oklahoma Study Of Native American Pain Risk (OK-SNAP)

Ethnic Differences In The Relationship Between Pandemic-Related Stress And Bodily Pain: Results From The Oklahoma Study Of Native American Pain Risk (OK-SNAP)