Intervention scientists have used program theory-driven evaluation to design, implement, and assess the success of intervention programs for decades. However, interventions often are designed without the input of the community for which they are intended. The lack of incorporation of community members’ voices that participate in various intervention programs and the de-emphasis of systemic influences on program outcomes may decrease the extent to which participants experience intended positive outcomes. This often leads to interventions that are irrelevant at best and harmful at worst. Theory of change and logic models are two forms of theory-driven evaluation that can be used in tandem to incorporate community voices into program design and implementation while attending to systemic influences on the program. The following paper presents a stage model process for creating and utilizing both a theory of change and logic model for community-based intervention programs aiming to work with ethnically and racially diverse and immigrant populations.
To curb the spread of COVID-19, the United States has endorsed a variety of public health measures and distributed their content expediently. While these measures are critical for saving the lives of thousands, they may be sources of stress for individuals managing a chronic disease or make disease management more challenging. Forty-five percent of Americans live with chronic disease and already manage a range of everyday stressors related to their disease, making the additional stress produced by this public health guidance and their messages more difficult. Guided by Cohen and colleagues’ Stage Model of Stress and Disease (Cohen et al., 2016) and Ryan and Sawin’s Individual and Family Self-Management Theory (Ryan & Sawin, 2009), this paper identifies the various dimensions of these public health measures that may cause stress and negatively impact individuals managing chronic disease. Further, this paper presents a conceptual model for understanding how these stressors and common stressors associated with managing chronic disease interact and significantly impact chronic disease management. Considering the impact of these stressors on individuals managing chronic disease is paramount to ensure this population is empowered to manage this additional stress healthily and effectively. Recommendations for individuals managing chronic disease and health care professionals working with this population are provided.
The impacts of this pandemic have not been felt equally. The current pandemic has aggravated preexisting prejudices and shed light on long-standing social, economic, and health inequities that have been and continue to be perpetuated by systems of oppression. Psychologists are in a unique position to collaboratively work with marginalized individuals navigating pandemic threat, discrimination, and oppressive systems. This paper presents best practice recommendations for U.S.-based psychologists working with marginalized populations impacted by COVID-19. Psychologists are encouraged to synchronously develop the following three areas of evidence-based practice, as they relate to the impacts of COVID-19: (a) selfreflection and self-awareness in a COVID-19 context (i.e., reflecting on one's identities and one's knowledge and attitudes toward sociohistorical inequities), (b) knowledge acquisition (i.e., adopting an attitude of cultural humility, identifying "emotional contagion," identifying impacts of systemic injustice that may be compounded by COVID-19, and recognizing racial trauma in clients of color), and (c) collaboration with clients (i.e., identify the mental health toll of oppressive systems, explore COVID-19 relevant and culturally responsive methods of healing, encourage virtual community engagement, and incorporate ethnic and racial identity development in personal and professional work). Engaging with these best practice recommendations should result in the psychologist's improved ability to identify and address the consequences of systemic oppression that have been highlighted and exacerbated by COVID-19 on their own behavior and their clients' mental health. Furthermore, psychologists engaged with these best practice recommendations should find themselves better prepared to utilize culturally responsive interventions despite barriers created by COVID-19. Public Significance StatementThis paper presents best practice recommendations for psychologists working with marginalized clients that have been impacted by the COVID-19 pandemic. These concrete best practice recommendations emphasize self-reflection, education regarding how the pandemic has further marginalized clients, and evidence-based culturally responsive psychological intervention that are also responsive to the impacts of COVID-19.
H istorically, immigrants to the United States have experienced social hostility on the basis of race and ethnicity, and this xenophobia continues to persist for many groups in the current political and sociocultural atmosphere (Dominguez et al., 2009;Gee & Ford, 2011). Among the various current immigrant groups that experience these inequitable systems, Black immigrants are particularly understudied. The stress of immigration and acculturation to the United States, compounded by traumatic experiences of racism and discrimination, may lead to racial stress and trauma among Black immigrants. These experiences with racial stress and trauma threaten the health and well-being of this group (Kirmayer et al., 2011). This chapter begins with an overview of the diversity within the Black immigrant population. It then explores various forms of discrimination Black immigrants face upon adjusting to life in the United States and the disparities that systemic racism and discrimination create. The consequences of this continual exposure to racism-racial stress and racialized violence-are summarized. The chapter concludes with a model to better conceptualize racial stress and trauma as experienced by Black immigrants and strategies that this group uses to cope with racism and discrimination while highlighting strengths that enable them to flourish.This chapter is guided by three theoretical perspectives aimed at providing a better understanding of the ways in which systemic discrimination and prejudice constitute racialized violence (Helms et al., 2012) and how exposure
Public health crises that increase the demand for healthcare professionals (HCPs) often result in increased mental distress in HCPs. The current study investigated the specific mental health ramifications of the COVID-19 pandemic on HCPs and perceived support from their places of work. Data was collected from US-based HCPs ( N = 325) working as physicians (21.8%), nurses (26.8%), mental health professionals (MHPs; 30.5%), and allied healthcare professionals (AHPs; 20.9%) from April 2020 to April 2021 amidst the COVID-19 pandemic, using an online self-report survey. Descriptive and correlational statistical analyses assessed worry, stressors, psychological functioning, and perceived support. A majority of participants expressed worry about the pandemic broadly (93%), and approximately half (50.5%) indicated that their degree of worry was moderate to extreme. Respondents worried most about the risk of infection for family and relatives. HCPs reported not having been able to enjoy daily activities (66.9%), losing sleep (43.1%), and feeling constantly under strain (66.9%), compared to usual. Most HCPs indicated a strong desire for clear communication regarding the pandemic and psychological support from their workplaces. This paper provides recommendations to support HCP mental health by both ameliorating distress caused by the COVID-19 pandemic as well as protecting the health and wellness of HCPs more generally. HCPs and institutions that employ them should seek out or provide access to mental health resources and services, engage with or provide opportunities and activities to actively address mental health, and improve communication regarding COVID-19 or other topics HCPs demonstrate interest in.
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