Interview with Antonio Carlile Holanda Lavor: we must invest in research to learn how to guide families against COVID-19. / Entrevista com Antonio Carlile Holanda Lavor: é preciso investir em pesquisas para aprender como orientar as famílias contra a Covid-19.

In this interview, public health physician Antônio Carlile Holanda Lavor with 57-year career and long and broad experience in the Brazilian Unified Health System (SUS) management, especially in primary health care, talks about his management at the head of the Oswaldo Cruz Foundation unit in Ceará (Fiocruz-CE), from 2008 to the present moment. Known internationally for institutionalizing the Health Worker Program in Ceará in 1987, he discusses the process of implementing Fiocruz-CE and the role of research in guiding the work of the Family Health Strategy during the COVID-19 pandemic.

Nesta entrevista, Antônio Carlile Holanda Lavor, médico sanitarista, com 57 anos de carreira, longa e ampla experiência na gestão do Sistema Único de Saúde (SUS), em especial na atenção primária à saúde, fala sobre sua gestão a frente da unidade da Fundação Oswaldo Cruz no Ceará (Fiocruz-CE), a partir de 2008 até o momento atual. Conhecido internacionalmente por haver institucionalizado o Programa Agentes de Saúde no Ceará em 1987, ele discute sobre o processo de implantação da Fiocruz-CE e o papel da pesquisa na orientação do trabalho da Estratégia Saúde da Família durante a pandemia de Covid-19.

Construction of the historical-regulatory standard of the Expanded Family Health Center. / Construção do referencial histórico-normativo do Núcleo Ampliado de Saúde da Família.

This paper discusses the historical construction of the Expanded Family Health Center (NASF, in Portuguese), based on the analysis of 17 documents edited by the Ministry of Health (MH) between 2005 and 2021. This is a qualitative study of documental review that seeks to understand how the regulations and official instructive manuals have been shaping the way NASF teams operate. It proposes to divide the NASF construction process into five periods: previous movements (2003 to 2007); support guidelines (2008 to 2011); the universalization of nasf (2012 to 2015); expansion of support (2016 to 2018); and the dismantling of NASF? (2019 to 2021). The results show changes in guidelines over the years of the team's existence, especially in relation to the matrix support concept and its two dimensions: technical-pedagogical and clinical care. This study also demonstrates the effects of the Previne Brasil Program on the NASF, which resulted in the reduction of 379 teams in 2020 and 2021. Added to this scenario is the SARS-CoV-2 pandemic, which may be repositioning NASF interventions in the Brazilian Unified Health System (SUS, in Portuguese).

Este artigo discute a construção histórica do Núcleo Ampliado de Saúde da Família (NASF), a partir da análise de 17 documentos editados pelo Ministério da Saúde entre os anos de 2005 e 2021. Trata-se de um estudo qualitativo de revisão documental que busca compreender como as normativas, cadernos instrutivos e notas técnicas oficiais vêm dando contorno ao modo de operar das equipes do NASF. Propõe-se a divisão do processo de construção do NASF em cinco períodos: movimentos antecedentes (2003 a 2007); diretrizes do apoio (2008 a 2011); universalização do NASF (2012 a 2015); ampliação do apoio (2016 a 2018); e o desmonte do NASF? (2019 a 2021). Os resultados apontam mudanças de orientação ao longo dos anos de existência da equipe, especialmente em relação ao conceito do apoio matricial e suas duas dimensões, técnico-pedagógica e clínico assistencial. O estudo demonstra ainda os efeitos do Programa Previne Brasil sobre o NASF, que se materializaram na redução de 379 equipes nos anos de 2020 e 2021. Soma-se a esse cenário a pandemia do SARS-CoV-2, que pode reposicionar as intervenções do NASF no Sistema Único de Saúde.

Meanings of mourning for people who faced the death of a family member due to covid-19 / Significados do luto para pessoas que enfrentaram a morte de um familiar por covid-19 / Significados del luto para personas que enfrentaron la muerte de un familiar por covid-19

Objetivo: compreender os significados do luto para as pessoas que enfrentaram a morte de um familiar devido a COVID-19. Método: estudo qualitativo, do tipo ação-participante, fundamentado nos pressupostos de Paulo Freire. Participaram 16 familiares, residentes no litoral de Santa Catarina, Brasil. Realizou-se um Círculo de Cultura de modo virtual, seguindo as etapas do Itinerário Freireano. Resultados: os participantes significaram que a vivência do luto do familiar, devido a COVID-19, tirou-lhes a oportunidade de se despedir do ente querido. A pandemia também lhes tirou o emprego, as aulas presenciais dos filhos, encontros, casamentos, abraços e sorrisos. Mas também significaram que trouxe aprendizado, com fortalecimento da espiritualidade e família. Conclusão: o significado do luto permeou inúmeras perdas, restringindo a vivência das etapas do luto. Contudo, houve maior busca pela espiritualidade e religião, com valorização da família e da vida.

Objetivo: comprender los significados del luto para las personas que enfrentaron la muerte de un familiar debido a COVID-19. Método: estudio cualitativo, del tipo acción-participante, fundamentado en los presupuestos de Paulo Freire. Participaron 16 familiares, residentes en el litoral de Santa Catarina, Brasil. Se realizó un Círculo de Cultura de modo virtual, siguiendo las etapas del Itinerario Freireano. Resultados: los participantes significaron que la vivencia del luto del familiar, debido a COVID-19, les quitó la oportunidad de despedirse del ser querido. La pandemia también les quitó el empleo, las clases presenciales de los hijos, encuentros, matrimonios, abrazos y sonrisas. Pero también significaron que trajo aprendizaje, con fortalecimiento de la espiritualidad y familia. Conclusión: el significado del luto ha permeado numerosas pérdidas, restringiendo la vivencia de las etapas del luto. Sin embargo, hubo mayor búsqueda por la espiritualidad y religión, con valoración de la familia y de la vida.

Objective: to understand the meanings of mourning for people who faced the death of a family member due to COVID-19. Method: qualitative study, action-participant type, based on the assumptions of Paulo Freire. Participants were 16 family members living on the coast of Santa Catarina, Brazil. A Culture Circle was held in a virtual way, following the stages of the Freire's Itinerary. Results: the participants meant that the experience of mourning the family, due to COVID-19, took them the opportunity to say goodbye to their loved one. The pandemic also took away their jobs, their children's face-to-face classes, meetings, weddings, hugs and smiles. But it also meant that it brought learning, with strengthening of spirituality and family. Conclusion: the meaning of mourning permeated countless losses, restricting the experience of the stages of mourning. However, there was a greater search for spirituality and religion, with appreciation of family and life.

Family context as a double-edged sword for psychological distress amid the COVID-19 pandemic with the mediating effect of individual fear and the moderating effect of household income.

Background: The COVID-19 pandemic drives psychological distress. Previous studies have mostly focused on individual determinants but overlooked family factors. The present study aimed to examine the associations of individual and family factors with psychological distress, and the mediating effect of individual fear and the moderating role of household income on the above associations. Methods: We conducted a population-based cross-sectional survey on Chinese adults in Hong Kong from February to March 2021 (N = 2,251) to measure the independent variables of anti-epidemic fatigue, anti-epidemic confidence, individual and family members' fear of COVID-19, and family well-being (range 0-10), and the dependent variable of psychological distress (through four-item Patient Health Questionnaire, range 0-4). Results: Hierarchical regression showed that anti-epidemic fatigue was positively (ß = 0.23, 95% CI [0.18, 0.28]) while anti-epidemic confidence was negatively (ß = -0.29, 95% CI [-0.36, -0.22]) associated with psychological distress. Family members' fear of COVID-19 was positively (ß = 0.11, 95% CI [0.05, 0.16]) while family well-being was negatively (ß = -0.57, 95% CI [-0.63, -0.51]) associated with psychological distress. Structural equation model showed that individual fear mediated the above associations except for family well-being. Multi-group analyses showed a non-significant direct effect of anti-epidemic confidence and a slightly stronger direct effect of family well-being on psychological distress among participants with lower incomes, compared to those with higher incomes. Conclusion: We have first reported the double-edged effect of family context on psychological distress, with the positive association between family members' fear of COVID-19 and psychological distress fully mediated by individual fear and the negative association between family well-being and psychological distress moderated by income level. Future studies are warranted to investigate how the contagion of fear develops in the family and how the inequality of family resources impacts family members' mental health amid the pandemic.

Relationships and processes of families during the COVID-19 lockdown as told by mothers / Relaciones y procesos de familias en confinamiento por COVID-19 narradas por madres / Relações e processos de famílias em confinamento por COVID-19 narrados por mães

Introducción: El estado de alarma que provoco COVID-19, obligó a que se tomaran medidas sociales de restricción, esperando reducir los contagios, incluyendo el confinamiento, que impactó diversos aspectos de la vida humana, ha tenido efecto considerable en la dinámica familiar, provocando que permanezcan en casa acrecentando el afrontamiento de las situaciones de crisis, experimentando un proceso de transición a nuevas formas de vida. Objetivo: analizar las relaciones y procesos que viven las familias ante el confinamiento por COVID-19 narradas por las madres. Materiales y métodos: estudio cualitativo de teoría fundamentada, se realizaron entrevistas a profundidad a cinco madres de familia. Resultados: los resultados obtenidos emergieron de una categoría central "adquisición de nuevas formas de vida" y tres categorías que la sustentan: 1. Afrontando el inicio de la pandemia; 2. Adaptando la nueva normalidad en familia y 3. Adoptando las consecuencias de la pandemia en la vida cotidiana. Discusión: El proceso que han mostrado las familias mexicanas ante el COVID-19 se vive diferente al de otros países, la convivencia en los hogares fue de las afectadas ya que se compromete la libertad con la que viven día a día. Conclusión: Las participantes expresaron que durante la pandemia por COVID-19, la familia vivió un proceso de transición para poder adquirir nuevas formas de vida, las cuales incluían hábitos, costumbres y estructuras que cubrieran sus necesidades requeridas en ese momento, este proceso incluyó diferentes etapas (afrontamiento, adaptación y adopción).

Introduction: The state of emergency caused by COVID-19 forced the adoption of social restriction measures to reduce contagion, including lockdowns. They impacted various aspects of human life and considerably affected family dynamics by causing families to remain at home, increasing the coping of crisis, and experiencing a transition to new ways of living. Objective: To analyze the relationships and processes experienced by families during the COVID-19 lockdown as told by mothers. Materials and Methods: A qualitative grounded theory study was conducted using in-depth interviews with five mothers. Results: The results obtained emerged from a core category, "acquisition of new ways of living," and three categories that support it: 1) Coping with the pandemic onset, 2) adapting to the new normal in the family, 3) embracing the pandemic consequences in everyday life. Discussion: The process that Mexican families have gone through with COVID-19 has been different from that of other countries; living together at home was affected since their freedom to live day to day as they did was compromised. Conclusion: The participants expressed that, during the COVID-19 pandemic, the family underwent a transition process in order to acquire new ways of living, which included habits, customs, and structures that met their needs at that time; this process included different stages (coping, adaptation, and adoption).

Introdução: O estado de alarme causado pela COVID-19 obrigou à adoção de medidas de restrição social, na esperança de reduzir o contágio, incluindo o confinamento, que impactou vários aspetos da vida humana, tem tido um efeito considerável na dinâmica familiar, fazendo com que a permanência em casa aumente o enfrentamento com situações de crise, vivenciando um processo de transição para novos modos de vida. Objetivo: analisar as relações e processos que as famílias vivenciam diante do confinamento por COVID-19 narrado pelas mães. Materiais e métodos: estudo qualitativo de grounded theory, foram realizadas entrevistas em profundidade com cinco mães. Resultados: os resultados obtidos emergiram de uma categoria central "aquisição de novas formas de vida" e três categorias que a sustentam: 1. Enfrentando o início da pandemia; 2. Adaptando-se ao novo normal em família e 3. Abraçando as consequências da pandemia na vida cotidiana. Discussão: O processo que as famílias mexicanas mostraram diante do COVID-19 é vivido de forma diferente do de outros países, a convivência em casas foi uma das afetadas, pois a liberdade com a qual convivem no dia a dia está comprometida. Conclusão: Os participantes expressaram que durante a pandemia do COVID-19, a família passou por um processo de transição para poder adquirir novos modos de vida, que incluiu hábitos, costumes e estruturas que cobriam suas necessidades exigidas naquele momento, esse processo incluiu diferentes etapas (enfrentamento, adaptação e adoção).

Mental health in biological disasters: From SARS to COVID-19.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. AIM/OBJECTIVE: This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. RESULTS: In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and psychoeducation were also discussed. Issues concerning cultures and religions are also emphasized in the management plans. CONCLUSION: Biological disaster like SARS and COVID-19 not only has strong impact on mental health in those being infected and their family, friends, and coworkers, but also affect wellbeing in general public. There are evidenced that clear and timely psychoeducation, psychological first aid and psychological debriefing could amileorate negative impact of disaster, thus might also be helpful amid COVID-19 pandemic.

Development and Validation of the Chinese Family Resilience Scale in Families in Hong Kong.

Family resilience is an important protective factor mitigating the negative impact of adversities on individuals and families. As there are very few validated measures of family resilience in the Chinese context, we have developed the Chinese Family Resilience Scale (C-FRS) based on the family resilience framework of Froma Walsh. In this paper, we outline the development and the validation of the C-FRS with reference to the socio-cultural context of Hong Kong. Based on content validation involving family experts, the initial 51 items were assessed in terms of their relevance, clarity, and representativeness. The results showed that these items possessed adequate content validity. In order to validate the 51-item measure, we examined its convergent validity, its factorial validity, and its internal consistency based on the responses of 1020 Chinese families (N = 2858 participants). After removing the items with unsatisfactory psychometric properties, we retained 35 items in the final scale. The results showed that the C-FRS scores were significantly related to family functioning, thus providing support for its convergent validity. This study also provided support for the conceptual model of Walsh (i.e., three high-order domains involving nine primary indicators). Most importantly, the measurement invariance tests showed that the dimensions of the C-FRS were invariant among fathers, mothers, and adolescent children. As the findings support the reliability and the validity of the 35-item C-FRS, we suggest that this measure can be objectively used to assess family resilience in Chinese communities.

The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China.

Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

The Moderating Role of Family Resilience on the Relationship between COVID-19-Related Psychological Distress and Mental Health among Caregivers of Individuals with Eating Disorders in Post-Pandemic China.

COVID-19 has amplified long-standing emotional distress for vulnerable families. While abundant research highlights the importance of resilience under adverse circumstances, little has been undertaken to understand its effectiveness in helping caregivers of individuals with eating disorders (ED) navigate pandemic-related challenges. This paper presents findings of a cross-sectional study investigating the effects of COVID-19-related life disruptions (COLD) and COVID-19-related psychological distress (CORPD) on caregivers' depression, anxiety and stress, as well as the moderation role of individual resilience (IR) and family resilience (FR) during the post-pandemic period in China. A total of 201 caregivers of individuals experiencing ED participated in our online survey from May 2022 to June 2022. The association between pandemic-related stressors (i.e., COLD and CORPD) and mental health conditions were confirmed. FR moderated the relationship between CORPD and mental health outcomes, while IR independently contributed to low emotional distress. We call for intervention programs strengthening caregivers' FR and IR, which might benefit both patients and caregivers' well-being in the post-pandemic period.

Assessment of awareness about COVID-19 disease and vaccine uptake.

OBJECTIVE: To evaluate the awareness of individuals about coronavirus disease-2019 disease and vaccines during the pandemic. METHODS: The descriptive, cross-sectional survey-based study was conducted at family health centres in the Bursa province of Turkiye from July 1 to 7, 2021. The face-to-face survey of registered individuals had 20 items that measured coronavirus disease-2019 and vaccines. The scale was named the Coronavirus Disease-2019 and Vaccine Awareness level. It was carried out by family physicians using an online weblink. The Cronbach alpha coefficient was 0.87. Data was analysed using SPSS 25. RESULTS: Of the 228 subjects, 129(56.6%) were males and 99(43.4%) were females. The overall mean age was 27.82±10.28 years. Awareness levels were high with a mean value of 2.41±0.31. Female participants were more aware than males (p=0.04) and those with monthly income between 2000-10000 Turkish lira had lower awareness level compared to other income groups (p=0.03). Marital status (p=0.32), education level (p=0.49) comorbidities (p=0.23), regular drug usage (p=0.13) and exercise status (p=0.24) did not affect the awareness levels. Non-smokers were more aware than the smokers (p=0.01). CONCLUSIONS: The level of awareness about coronavirus disease-2019 and its vaccine was higher in the female gender and non-smokers, it was lower in the middle-income group.

Protection Motivation During COVID-19: A Cross-Sectional Study of Family Health, Media, and Economic Influences.

BACKGROUND: Protection motivation to practice preventive behaviors is necessary for sustained mitigation during coronavirus disease 2019 (COVID-19); however, limited research exists on the ecological sources of influence for COVID-19 protection motivation. AIM: To explore sources of influence (family health, media consumption, and loss of work hours) on COVID-19 protection motivation. METHOD: An online quantitative survey of U.S. adults (N = 501) aged 18 years or older was administered using Qualtrics with participants recruited through Amazon Mechanical Turk. Data were collected on constructs related to the protection motivation theory and theory of planned behavior as well as sources of influence and intention to socially distance and socially isolate during COVID-19. Constructs were further defined through exploratory and confirmatory factor analyses. Structural equation modeling was used to determine relationships between constructs. RESULTS: A two-factor model was identified with threat appraisal as one factor and subjective norms appraisal, coping appraisal, and behavioral intention loading as another factor. Higher news media consumption and loss of work hours due to COVID-19 were both significant predictors of increased threat appraisal. Family healthy lifestyle and family health resources were significantly related to increases in the subjective norms, coping appraisal, and behavioral intention appraisal factor. CONCLUSIONS: Family health, news media consumption, and loss of work hours are associated with COVID-19 protection motivation. COVID-19 protection motivation might be enhanced through policies and messaging that can affect ecological sources of influence.

Effect of a Virtual Home-Based Behavioral Intervention on Family Health and Resilience During the COVID-19 Pandemic: A Randomized Clinical Trial.

Importance: Virtual home-based interventions may bolster protective factors, such as family health and resilience, during stressors such as the COVID-19 pandemic; however, their effectiveness is unknown. Objective: To examine the effectiveness of a virtual health coaching intervention on family health and resilience during the pandemic. Design, Setting, and Participants: In this parallel-group, single-site randomized clinical trial, 123 parents and their 2- to 8-year-old children were enrolled at a pediatric clinic or community partner site in Tennessee from March 10 to August 11, 2021. Follow-up surveys were completed between June 29 and November 11, 2021. Interventions: All participants received 11 weekly cooking videos and associated home-delivered groceries. The intervention group also received 12 weekly, 30-minute virtual health coach sessions. Main Outcomes and Measures: The primary outcome was the validated 6-item (range, 6-30) Family Healthy Lifestyle Subscale (FHLS) scores. The secondary outcome was the validated 6-item (range, 0-6) Family Resilience and Connection Index (FRCI) scores. Outcomes were determined a priori and evaluated at baseline and 12-week follow-up. A priori independent t tests and multivariable tobit regression models assessed intervention effects, and post hoc, secondary interaction models assessed whether effects differed over baseline outcomes. Results: Among the 123 enrolled families, 110 (89%) were included in the primary analyses (parent mean [SD] age, 35.1 [8.2] years; 104 [95%] female; 55 [50%] non-Hispanic Black; child mean [SD] age, 5.2 [1.7] years; 62 [56%] male). Intervention-control group mean differences were nonsignificant for follow-up FHLS scores (0.7; 95% CI, -0.6 to 2.0; P = .17) and FRCI scores (0.1; 95% CI, -0.5 to 0.6; P = .74). Tobit regression model intervention effects were nonsignificant for FHLS scores (0.9; 95% CI, -0.3 to 2.2; P = .15) and FRCI scores (0.4; 95% CI, -0.2 to 1.1; P = .17). Post hoc, secondary models found no significant interaction for FHLS scores (1.3 increase per 5-point decrease; 95% CI, -0.2 to 2.7; P = .09), with significant intervention associations for baseline scores of 6 to 23. The interaction was significant for FRCI scores (0.4 increase per 1-point decrease; 95% CI, 0.01 to 0.8; P = .047), with significant intervention associations for baseline scores of 0 to 3. Conclusions and Relevance: In this randomized clinical trial of families with young children, weekly virtual health coaching did not detectably improve family health and resilience. Post hoc, secondary results provided preliminary evidence of potential effectiveness among families with low baseline scores. Trial Registration: ClinicalTrials.gov Identifier: NCT05328193.

Parent-Child Relationships, Digital Media Use and Parents' Well-Being during COVID-19 Home Confinement: The Role of Family Resilience.

Research has provided substantial evidence on the role of parents' well-being in the quality of parent-child relationships and children's adjustment. Parents' stress and parental couple conflict have been linked to children's adverse developmental outcomes. However, little is known about the factors that affect parents' well-being when coping with multiple stressors such as those brought by the recent COVID-19 global pandemic. Our study intended to examine the predictors of parental well-being by looking at the contextual factors of COVID-19 home confinement, i.e., the use of digital media and parents' domestic workload, and family resilience in two countries: Ireland and Italy. Additionally, the age and number of children were controlled as potential variables impacting parents' well-being. A three-step hierarchical regression analysis was applied. The results showed that family resilience was a very strong predictor of parents' well-being after controlling for any other variable. Parental couples' conflict over the use of technology predicted lower levels of parents' well-being, while, notably, parent child-conflict and domestic workload were not associated with parents' well-being. Additionally, the age of children did play a role: the higher the mean age of children in the family the better the parents' well-being. The findings are discussed in the light of cross-country differences and their implications for research and practice.

Family Health of Patients With Heart Failure and Their Family Members Before and During the First COVID-19 Lockdown.

Background: Family health plays a vital role in the self-care and lifestyle modifications in families living with heart failure. Objective: To investigate the family health of patients with heart failure and their family members before and during the first COVID-19 lockdown. Method: This was a cross-sectional study design. We included 34 participants before and 34 participants during the first COVID-19 lockdown. Independent t-tests were conducted for comparison of the mean scores of the family health and its dimensions. Results: There was no significant difference between the total score of family health during the first COVID-19 lockdown compared to before the first COVID-19 lockdown in patients and family members. However, the values and ill-being dimensions of family health in patients and ill-being dimension in family members were significantly decreased during the first COVID-19 lockdown. Conclusion: This study indicated the positive and negative impacts of COVID-19 lockdown on family health. Implications for Nursing: Our results may help nurses to identify vulnerable patients with a low level of family health to tailor the best support to them.

The Delivery of Patient Care in Ontario's Family Health Teams during the First Wave of the COVID-19 Pandemic.

OBJECTIVE: The objective of this paper was to identify continuations and changes in care delivery methods in primary care teams during the COVID-19 pandemic. DESIGN: The study used a cross-sectional, web-based survey comprising close-ended and open-ended questions. SETTING: The setting comprised family health teams (FHTs) across Ontario, Canada. PARTICIPANTS: The participants included executive directors of FHTs or designates of their choosing. SURVEY: Descriptive statistics were derived from responses to close-ended questions, and responses to open-ended questions were coded using thematic analysis. RESULTS: With 93 participants, the response rate was 48%. Participants reported the continuation of in-person care, the implementation of virtual care across FHTs and collaboration within these teams and their communities.

Family Health among Families with Primary School Children during the COVID Pandemic in Thailand, 2022.

Despite evidence suggesting that the COVID pandemic has negatively affected the mental health and well-being of school aged children and parents, there are limited studies describing the state of family well-being. This study aimed to use the family health lens to assess the well-being of Thai families with primary school children and to identify its associated factors. A cross-sectional survey was conducted during January and March 2022, a period of school closure when onsite education was replaced by online education from time to time. The family health scale (FHS) questionnaire survey was carried out among 701 parents of Thai families with primary school children. The questionnaire comprised 10 questions regarding family belief, health, relationships, financial security, and housing environment. Independent variables included: (1) parental/household factors; (2) online learning related issues; (3) children's mental health; and (4) parents' health behaviors. Multinomial logistic regression was undertaken. Results showed that half of Thai families (54.6%) reported having moderate health status. Factors that were associated with lower levels of family health, such as poor or moderate levels, included families with a child that had mental health problems (adjusted odd ratio (AOR) = 5.0 [95% CI = 2.6-9.5] for poor v. excellent, and AOR = 2.7 [95% CI = 1.9-4.0] for moderate v. excellent), single parents (AOR = 2.5 [95% CI = 1.2-5.2] for poor v. excellent), a higher number (≥3) of children (AOR = 2.1 [95% CI = 1.0-4.0] for moderate v. excellent), and smoking parents (AOR = 6.5 [95% CI =1.2-34.8] for poor v. excellent). During health emergencies, health policy for providing adequate assistance to single parents, especially those that have a child with mental health problems, is of utmost importance. The design of health promotion activities and interventions should be targeted not only at single families, but also families with higher numbers of children and parents who smoke at home.

Exploration of Multilevel Barriers and Strategies That Affected Early COVID-19 Vaccination and Testing in Rural Latino Communities in Southwest Florida.

The COVID-19 pandemic has disproportionately impacted multiple racial and ethnic minority groups, including Latinos residing in rural communities. Low rates of vaccination and testing combined with social determinants of health have contributed significantly to this disparate impact. Given the needs and constraints unique to rural Latino migrant and immigrant communities, this qualitative study examined multilevel barriers and strategies that affect COVID-19 vaccination and testing uptake among these communities in southwest Florida. Four focus groups (n = 25) were conducted between March and April 2021 with various key stakeholders, including rural Latino community members, local leaders, and community health workers ('Promotoras de Salud'). Themes that aligned with barriers to COVID-19 vaccination and testing included fear, lack of control, misinformation, lack of accessibility, and institutional/policy issues; themes that aligned with strategies to improve COVID-19 vaccination and testing uptake included faith, taking care of self, and community and family resilience. Recommendations for improving future pandemic responses for rural Latino communities include incorporating multiple levels of intervention, such as consideration of the role of the family, involving trusted community members, and ensuring the development and implementation of fair and consistent policies.