The digital divide: An ongoing state of emergency in adult literacy programs

COVID-19 and closures of in-person interactions with support programs, education providers, government services, and consumer offerings have raised concerns that vulnerable populations may not be able to mitigate the effects of the digital divide. Our chapter discusses the digital divide with a focus on programs for adult learners who have not completed high school. These include literacy, high school completion, and vocational programs. We look specifically at Ontario as a case sample that shares similarities with programs across Canada. These programs are operated by community-based non-profits, school boards, and community colleges. They are usually marginalized within the broader education system and have not been considered as part of comprehensive supports and initiatives when schools and post-secondary institutions were closed. The digital inequalities learners experience have parallels in the very programs they attend to mitigate their own digital learning divide. © Springer Nature Switzerland AG 2021. All rights reserved.

The pandemic within systemic injustice: Intersectional cultural dimensions of women's aging, health, and case stories of COVID-19

This book chapter delves into the intersectional cultural dimensions of COVID-19 and explores how pandemics expose and amplify past and current health inequities and disparities for minoritized women. In this chapter, the authors question how gender reflects and intersects with health determinants of oppressed and privileged identities to produce disparate health outcomes, affecting discourse, ideologies, and women's activity as they age. Additionally, issues of racism, classism, ageism, and other "isms" are examined to understand the challenges faced by aging women as they strive to stay healthy. The chapter concludes with case story narratives of women diagnosed with COVID-19, showing the virus' effect on marginalized women aging within a stratified society. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Community Colleges and COVID-19: An Exploration of Challenges and Inequities

COVID-19 drastically changed many aspects of life in the U.S. and most certainly changed standard operating procedures in higher education. Moving all classes completely online created numerous challenges not only for students, but also for faculty. For students, these challenges included issues related to physical and mental health, job loss, and caregiving, as well as access to internet and even access to a home computer. Faculty also faced challenges. For example, many colleges and universities rely on adjunct faculty who are compensated on a course-by-course basis. Although most institutions provided faculty development sessions to make a smooth transition to online teaching, adjunct faculty were not necessarily invited to participate and, when they were, they were not compensated for time spent in these sessions or the additional work incurred to transition and teach in the online environment. This essay explores how community college students and faculty in the basic course responded to the COVID-19 crisis. Specifically, we discuss issues of employment, family responsibilities, and the digital divide as they reveal systemic inequities in the college setting, as well as in society.

Global Mental Health: Where We Are and Where We Are Going.

PURPOSE OF REVIEW: To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice. RECENT FINDINGS: Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.

How can collaboration deliver? A structurational approach to understanding collaboration process and effectiveness

This study examines how a collaboration's internal and external factors interact over time and how the interactions affect the collaboration's process and effectiveness. Using a process-oriented case study, we examine how a voluntary collaboration that had made marginal gains over several years demonstrated significant progress during the COVID-19 pandemic and civil unrest following the murder of George Floyd on May 25, 2020. Drawing on strong structuration theory, we explore the collaboration's internal efforts, changes in the broader environment, and the interplay between them. Our findings reveal that collaboration's internal efforts and external environment enable and constrain each other, which shapes the collaboration's process and effectiveness. Based on these findings, we contribute to a more nuanced understanding of the collaboration process and effectiveness by (1) using a strong structurational approach to demonstrate processual mechanics of connecting processes and structures in collaboration, and (2) highlighting the emergent nature of collaboration and the importance of learning and adaptability for an effective and sustainable collaboration.

Turkish Teachers' Response to the COVID-19 Crisis: Challenges and Opportunities

The present study examined teachers' perceptions of changes in their professional lives brought about by distance education during the COVID-19 outbreak. It was also aimed to explore how this particular global crisis and unprecedented times of education have affected teachers' motivation and their perceptions of the teaching profession. Twenty-two teachers working at different levels and types of K-12 schools in different cities in Turkey were interviewed by utilizing a phenomenological qualitative inquiry method. Our analysis showed that the obligatory transition to distance education created new opportunities and challenges for both teachers and students. While the teachers had emotional exhaustion, stress, and professional difficulties;distance education helped them develop new skills to better integrate educational technologies into classroom teaching. The findings also indicated that the COVID-19 crisis reinforced deep-rooted inequities in the Turkish education context. This study offers several implications for policymakers and educators to plan educational recovery from COVID-19.

Health disparities among rural individuals with mental health conditions: A systematic literature review

There is growing concern about the availability of health care services for rural patients. This systematic literature review evaluates original research on health disparities among rural and urban populations with mental health (MH) conditions in North America. Using the Preferred Reporting Items for Systematic Reveiws and Meta-Analyses guidelines, we used four electronic databases (Pubmed, Cochrane, APA PsycInfo, Web of Science) and hand searches and included original research conducted in the United States or Canada before July 2021 that compared health outcomes of patients with any mental health disorder in rural versus nonrural areas. Both qualitative and quantitative data were extracted including demographics, mental health condition, health disparity measure, rural definition, health outcome measures/main findings, and delivery method. To evaluate study quality, the modified Newcastle-Ottawa Scale was used. Our initial search returned 491 studies, and 17 studies met final inclusion criteria. Mental health disorders included schizophrenia (4 studies), posttraumatic stress disorder (10), mood disorders (9), and anxiety disorders (6). Total sample size was 5,314,818 with the majority being military veterans. Six studies (35.2%) showed no significant rural-urban disparities, while 11 (64.7%) identified at least one. Of those, nine reported worse outcomes for rural patients. The most common disparities were diagnostic differences, increased suicide rates, and access problems. This review found mixed results regarding outcomes in rural patients with mental health disorders. Disparities were found regarding risk of suicide and access to services. Telehealth in addition to in-person outreach to these rural communities may be alternative to impact these outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This critical review of the literature highlights that health disparities such as suicide rates/ideation, access to care, and utilization of mental health services are essential factors that put some subsets of rural patients compared to urban patients at a disadvantage. There is still a significant need for more research post COVID-19 on the use of telepsychiatry and rural health populations with mental health conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Pandemic and Education: Persistent Deepening of Educational Inequalities in Argentina as a Consequence of COVID-19

This paper analyzes the relationship between the structural inequalities that Argentina presents in relation to access to information and communication technologies and their respective impact on the levels of compulsory education, and how the COVID-19 pandemic in this state of affairs deepened the educational inequities among students who had access to a device and the Internet for those who did not have one or had limited use. In this regard, the COVID-19 in Argentina has exposed, if previously unclear, situations of structural vulnerability, which have deeply impacted the national education system, calling into question the pedagogical continuity of students in unfavorable conditions during the time of the pandemic. These territorial inequalities have been consolidated since the beginning of the formation of the Argentine Nation-State and have persisted over time, and the digital gap that currently exists corresponds directly to other socio-economic and geographical gaps. This context of pandemic has made them even more visible, compromising the pedagogical continuity that must be guaranteed to all students during the time that this situation is maintained. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Prioritizing Health Equity in Palliative and End-of-Life Care

The COVID-19 pandemic brought to light significant health disparities in illness and death due to a person's race, ethnicity, and socioeconomic status. Also, those factors cause significant inequities in access to palliative and end-of-life care that remain largely unaddressed. The quality of care people receive once they are given a life-threatening diagnosis or as they approach the end of their life depends upon race, ethnicity, socioeconomic status, and who they love. Such disparities in treatment are unconscionable and must be addressed. They warrant serious attention from policymakers and clinicians as well as focused efforts to find solutions. Copyright 2022 American Society on Aging;all rights reserved.

Social determinants related to COVID-19 infection.

This study was aimed at identifying the social determinants related to COVID-19 infection in South Korea. This secondary analysis used data from the 2020 Community Health Survey, a nationwide sample taken to understand the health status of Korean residents. The participants were 220 970 adults 19 years of age or older. COVID-19-related social determinants were age, education level, marital status, household income, hypertension, eating habits, social support, and regional income. The risk of COVID-19 infection increased in those who were under 40 years, were high school graduates or higher, were single, had a household income over US$ 4166.7, ate breakfast 5-7 times a week, had three or more helpers during COVID-19, and lived in a region with above-average income. Hypertension reduced the risk of COVID-19 infection. In conclusion, adults with high socioeconomic activity showed a high risk for COVID-19 infection, which was assumed to include only adults living in residential housing in the community. Further studies are required to include adults living in long-term care or communal living facilities, known to be frequently infected with the corona virus.

Lingering and glaring health disparities amidst COVID-19

The COVID-19 pandemic highlighted the long-standing health disparities between racial and ethnic groups within the United States. Racism is the root cause of the disparities and inequities that have been largely unaddressed. The nursing profession has a responsibility to recognize and understand, from both historical and present contexts, how racism is embedded in structures and institutions and contributes to disproportionate health outcomes. Thus, there is a call to action for nurses to engage in antiracist activism at both the individual and institutional levels to address the public health crisis of racism and to adhere to ethical theories that are the foundation of nursing. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

The Generative Mechanisms of Financial Strain and Financial Well-Being: A Critical Realist Analysis of Ideology and Difference

Background: Rapid, strategic action is required to mitigate the negative and unequal impact of the coronavirus disease 2019 (COVID-19) pandemic on the financial well-being (FWB) of global populations. Personal financial strain (FS) worsened most significantly among systematically excluded groups. Targeted government-and community-led initiatives are needed to address these inequities. The purpose of this applied research was to identify what works for whom, under what conditions, and why in relation to community and government initiatives that promote personal and household FWB and/or address FS in high-income economies. Methods: We employed a critical realist analysis to literature that reported on FWB/FS initiatives in high-income countries. This included initiatives introduced in response to the pandemic as well as those that began prior to the pandemic. We included sources based on a rapid review. We coded academic, published literature (n = 39) and practice-based (n = 36) reports abductively to uncover generative mechanisms – ie, underlying, foundational factors related to community or government initiatives that either constrained and/or enabled FWB and FS. Results: We identified two generative mechanisms: (1) neoliberal ideology;and (2) social equity ideology. A third mechanism, social location (eg, characteristics of identity, location of residence), cut across the two ideologies and demonstrated for whom the initiatives worked (or did not) in what circumstances. Neoliberal ideology (ie, individual responsibility) dominated initiative designs, which limited the positive impact on FS. This was particularly true for people who occupied systematically excluded social locations (eg, low-income young mothers). Social equity-based initiatives were less common within the literature, yet mostly had a positive impact on FWB and produced equitable outcomes. Conclusion: Equity-centric initiatives are required to improve FWB and reduce FS among systemically excluded and marginalized groups. These findings are of relevance now as nations strive for financial recovery in the face of the ongoing global pandemic. © 2023 The Author(s);Published by Kerman University of Medical Sciences.

Social Inequalities in Mental Health and Self-Perceived Health in the First Wave of COVID-19 Lockdown in Latin America and Spain: Results of an Online Observational Study.

COVID-19 lockdowns greatly affected the mental health of populations and collectives. This study compares the mental health and self-perceived health in five countries of Latin America and Spain, during the first wave of COVID 19 lockdown, according to social axes of inequality. This was a cross-sectional study using an online, self-managed survey in Brazil, Chile, Ecuador, Mexico, Peru, and Spain. Self-perceived health (SPH), anxiety (measured through GAD-7) and depression (measured through PHQ-9) were measured along with lockdown, COVID-19, and social variables. The prevalence of poor SPH, anxiety, and depression was calculated. The analyses were stratified by gender (men = M; women = W) and country. The data from 39,006 people were analyzed (W = 71.9%). There was a higher prevalence of poor SPH and bad mental health in women in all countries studied. Peru had the worst SPH results, while Chile and Ecuador had the worst mental health indicators. Spain had the lowest prevalence of poor SPH and mental health. The prevalence of anxiety and depression decreased as age increased. Unemployment, poor working conditions, inadequate housing, and the highest unpaid workload were associated with worse mental health and poor SPH, especially in women. In future policies, worldwide public measures should consider the great social inequalities in health present between and within countries in order to tackle health emergencies while reducing the health breach between populations.

Systematic review of the barriers and facilitators to dietary modification in people living with type 2 diabetes and pre-diabetes from South Asian ethnic populations.

AIMS: Lifestyle and dietary modification are effective in the prevention and management of Type 2 diabetes Mellitus (T2DM). However, South Asian (SA) populations living in Western countries have low adherence rates to healthcare advice and experience poor diabetes control and clinical outcomes compared with the general population. This systematic review aimed to summarise the barriers and facilitators of dietary modification within people from South Asian (SA) ethnicity with T2DM or pre-diabetes. METHODS: A systematic search of PubMed, Web of Science and Scopus generated 3739 articles, of which seven were included. Qualitative and quantitative data were inputted utilising COVIDENCE. Qualitative data were analysed by thematic analysis. RESULTS: Thematic analysis identified three facilitators: (1) cultural sensitivity, (2) health education and (3) support networks. Barriers include (1) healthcare inequity, (2) cultural insensitivity, (3) social pressures, (4) misconceptions and (5) time constraints. Good access to health care and motivation were the most common facilitators discussed. Misconceptions on T2DM management and cultural insensitivity contributed to the majority of barriers discussed. CONCLUSIONS: Culturally tailored interventions could improve adherence to diet modification in people with T2DM from SA ethnicity. Interventions involving the application of social media to challenge intergenerational stigmas and misinformation, distributing culturally appropriate resources and providing diets tailored to the SA palate could help.

An Implementation of a Community-Engaged, Group-Level Mental Health Pilot for Black and Latina Transgender Women.

The primary aim is to assess the implementation of an eight-session, group therapy pilot for Black and Latina transgender women in Chicago in terms of implementation outcomes regarding intervention effectiveness, acceptability, appropriateness, and feasibility. The Exploration Preparation Implementation Sustainment (EPIS) framework guided implementation processes, including community engagement as an implementation strategy, and an implementation taxonomy was used to evaluate outcomes of acceptability, appropriateness, and feasibility, in addition to intervention effectiveness regarding anxiety and community connectedness. Two rounds of the pilot were completed in 2020, during the COVID-19 pandemic, at a community-based organization serving LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) youth on Chicago's West Side. Participants (N = 14) completed a baseline and postintervention assessment and evaluations after each of eight intervention modules. Descriptive statistics show improvement across measures of anxiety and community connectedness, and high mean scores across domains of acceptability, appropriateness, and feasibility. Pilot findings indicate intervention effectiveness, acceptability, appropriateness, and feasibility to address mental health and social support of Black and Latina transgender women. Additional resources are needed for transgender community-engaged mental health programs and research to establish core and adaptable intervention elements, scaled-up evidence for clinical effectiveness, and, most importantly, to improve mental health outcomes and the sustainability of such interventions.

Recovery and Resilience in the Canal Community: Economic Impacts and Solutions During the COVID-19 Pandemic.

BACKGROUND: Public health pandemics, such as COVID-19, not only impact the physical health and wellbeing of communities but also often have far-reaching effects on their social, psychological, environmental, and economic welfare. The coronavirus pandemic has highlighted the significant inequities experienced among those who are Black, Indigenous, and People of Color (BIPOC), especially in the areas of housing instability, unemployment, and debt accrual. This study investigates the socioeconomic impacts of COVID-19 on residents of the Canal neighborhood ("The Canal"), a low-income Latinx community in Marin County, California. This study also uplifts mitigation strategies already underway to facilitate post-pandemic recovery efforts. METHODS: This study utilized a mixed-methods, community participatory approach in which community leaders from a local nonprofit, Canal Alliance, administered a survey assessing the impact of COVID-19 on Canal residents. Additionally, community stakeholders including nonprofits, small businesses, and public officials were interviewed, and their field notes were analyzed through exploratory open coding. RESULTS: On a macro level, the data showed that Canal residents were severely impacted by COVID-19 in the form of massive job loss (61.2% of respondents were unemployed or underemployed) as well as financial stress related to eviction, housing instability, and debt accrual (78.8% of respondents struggled to cover rent and often had to borrow money from friends and family). CONCLUSIONS: In spite of the severe socioeconomic impacts of COVID-19 on The Canal, there is a significant opportunity for recovery and growth because of an overwhelming investment by residents, community-based organizations, and public officials to support those who have been financially impacted by the pandemic. Some key areas of policy focus include expansion of affordable housing, pandemic-resistant workforce development, and restructuring of social services to increase accessibility. This report will explore recommendations related to strategic funding of community-based programs as well as short-term and long-term solutions for economic recovery.

All Shades of Anxiety: A Review of Therapeutic and Psychotropic Considerations for Child and Adolescent Youth of Color.

The literature on anxiety in Black, Indigenous, and other persons of color youth is a developing area. This article highlights distinct areas for the clinician to consider in working with these populations. We highlight prevalence and incidence, race-related stress, social media, substance use, spirituality, the impact of social determinants of health (including COVID-19 and the Syndemic), as well as treatment considerations. Our aim is to contribute to the readers' developing cultural humility.

African American Faith Communities and Public Health: Working at the Intersections of COVID-19

The unprecedented global disruption caused by COVID-19 has illuminated structural racism and systemic inequities in healthcare, public health, and socioeconomic status. How these inequities are addressed will influence whether we can control or stop the pandemic. Prioritizing collaboration and equity and investing financial and social capital into community leadership is essential to mitigating and addressing both the short- and long-term repercussions of COVID-19. Through analysis of, and evidence from, the lived experiences of a national network of African American pastors, the authors recommend four strategies to expedite recovery from the pandemic in the African American community and to promote enduring beneficial societal change: (1) public health and faith communities should initiate and maintain ongoing relationships that are based on trust;(2) recognition and acknowledgement by public and health care organizations that faith community leaders possess unique knowledge of their communities;(3) inclusion of faith community leaders as full partners when planning and strategizing, making decisions, solving problems, and developing policies that affect community wellbeing;and (4) use of an intersecting approach that recognizes the multifactorial realities of COVID-19 and uses remedies that effectively address existing and new problems in a comprehensive, long-term manner.

A qualitative analysis of COVID-19 vaccination intent, decision-making, and recommendations to increase uptake among residents and staff in six homeless shelters in Seattle, WA, USA

COVID-19 vaccines mitigate severe disease, yet uptake remains low among people experiencing homelessness (PEH) despite the risk of transmission in congregate settings like homeless shelters. This study evaluated retrospective COVID-19 vaccination intent and decision-making between March 2020-October 2021 to identify modifiable factors to improve vaccine acceptance among PEH. We conducted 31 semi-structured interviews and eight focus group discussions across six homeless shelters in Seattle-King County, Washington. Residents and staff aged >= 18 years were recruited through purposive sampling for interviews and convenience sampling for focus groups. Thematic analysis was conducted. Participants reported that too much contradictory and changing information about COVID-19 vaccines led to confusion. Information deemed trustworthy contributed to individual's knowledge and in some cases changed their vaccination intent. While many intended to get vaccinated without external motivators, others were motivated by incentives and requirements. Despite intention to vaccinate, participants reported barriers to COVID-19 vaccine access including availability of vaccine doses, timely eligibility for vaccination, and availability of appointments. Participants presented recommendations to improve COVID-19 information content and dissemination, access, and use of incentives in shelter settings. Future research should test recommended vaccination strategies rooted in the voices and experiences of PEH to determine feasibility and effectiveness in shelter settings.