COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US.
COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US.
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美国母亲之间大流行相关的创伤应激的大流行经历和症状。
DOI：
10.1001/jamanetworkopen.2022.47330
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发表时间：
2022-12-01
影响因子：
13.8
通讯作者：
Margolis, Amy
中科院分区：
文献类型：
--
作者：
Bastain, Theresa M.;Knapp, Emily A.;Law, Andrew;Algermissen, Molly;Avalos, Lyndsay A.;Birnhak, Zoe;Blackwell, Courtney;Breton, Carrie, V;Duarte, Cristiane;Frazier, Jean;Ganiban, Jody;Greenwood, Paige;Herbstman, Julie;Hernandez-Castro, Ixel;Hofheimer, Julie;Karagas, Margaret R.;Lewis, Johnnye;Pagliaccio, David;Ramphal, Bruce;Saxbe, Darby;Schmidt, Rebecca;Velez-Vega, Carmen;Tang, Xiaodan;Hamra, Ghassan B.;Margolis, Amy
这项队列研究评估了美国母亲的COVID-19大流行经历与大流行相关创伤应激症状之间的关联。在美国母亲中，与流行病相关的更大困难、应对策略和健康行为变化与流行病相关的创伤性应激症状之间是否存在关联？这项包括11473名参与者的队列研究发现，在社会经济、种族和种族背景不同的母亲中，与流行病相关的困难、应对机制和行为变化更高，与流行病相关的创伤性应激症状更显著相关。这些研究结果表明，在未来检查COVID-19大流行和其他创伤性生活事件的长期结果的研究中，应考虑社会人口因素、压力性生活事件和心理健康后遗症之间的复杂关联。COVID-19大流行对有子女妇女心理健康的主要后果在很大程度上仍然未知。识别和描述参与环境对儿童健康结果影响（ECHO）计划的儿童母亲的集群，这些集群表征了流行病相关的困难、应对机制和行为，并评估流行病相关的困难、应对策略和行为变化与流行病相关的创伤性应激症状之间的关联。这项多中心队列研究调查了2020年4月至2021年8月期间COVID-19大流行期间参与ECHO计划的儿童母亲照顾者的经历。来自62个美国队列的ECHO入组儿童的自我确认的母亲的数据被纳入分析。数据分析时间为2021年11月至2022年7月。主要暴露是母亲健康、卫生保健利用、工作和财务、应对策略和健康相关行为方面的流行病相关变化。通过ECHO研究者设计的自我报告问卷评估暴露。主要结果是流行病相关创伤性应激（PTS）的总症状评分，定义为至少有时或更频繁地认可的项目数量，来自10项自我报告测量。这项研究调查了11473名母亲（平均[SD]年龄：37.8 [7.4]岁; 342例美洲印第安人[2.98%]、378例亚洲人[3.29%]、1701例黑人[14.83%]和7195例白色人[62.71%]; 2184名西班牙裔/拉丁裔[19.04%]），并确定了2个最能表征其COVID-19大流行经历的集群-其中一个集群的特征是生活中断程度较高（例如，工作和医疗），更高的社会隔离，更多的应对行为，以减轻流行病的后果，以及更多的改变他们的健康行为习惯（高变化[1031母亲]）和其他特征的变化较低（低变化[3061母亲]）。高变化集群在社会经济上更为相似，并报告了更高的PTS（平均[SD]症状数量，3.72 [2.44] vs 2.51 [2.47]）。在这两个集群中，更高的流行病相关的困难，应对机制和行为变化与更高的PTS相关，这些关联在低变化集群中更大。在这项对11000多名美国母亲的研究中，社会经济因素、压力性生活事件和心理健康后遗症之间的关联是复杂的。因此，在2019冠状病毒病大流行等公共卫生危机期间针对心理健康的计划、政策和实践，在设计最有效的干预措施以减轻长期后果时，应考虑困难的范围和结构。
This cohort study evaluates the association between COVID-19 pandemic experiences and symptoms of pandemic-associated traumatic stress among mothers in the US. Is there an association between greater pandemic-associated hardships, coping strategies, and health behavior changes with pandemic-associated traumatic stress symptoms among mothers in the US? This cohort study including 11 473 participants found that higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with greater significant symptoms of pandemic-associated traumatic stress in mothers from socioeconomically, ethnically, and racially diverse backgrounds. These findings suggest that the complex associations between sociodemographic factors, stressful life events, and mental health sequelae should be considered in future studies examining the long-term outcomes of the COVID-19 pandemic and other traumatic life events. The primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown. To identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms. This multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program. Data from self-identified mothers of ECHO-enrolled children from 62 US cohorts were included in analyses. Data were analyzed from November 2021 to July 2022. The primary exposures were pandemic-associated changes in mothers’ health, health care utilization, work and finances, coping strategies, and health-associated behaviors. Exposures were assessed via a self-reported questionnaire designed by ECHO investigators. The primary outcome was the total symptoms score of pandemic-associated traumatic stress (PTS), defined as the number of items endorsed at least sometimes or more frequently, from a 10-item self-report measure. The study surveyed 11 473 mothers (mean [SD] age, 37.8 [7.4] years; 342 American Indian [2.98%], 378 Asian [3.29%], 1701 Black [14.83%], and 7195 White [62.71%]; 2184 with Hispanic/Latina ethnicity [19.04%]) and identified 2 clusters that best characterized their COVID-19 pandemic experiences—one characterized by higher life disruptions (eg, to work and health care), higher social isolation, more coping behaviors to mitigate the outcomes of the pandemic, and more changes to their health behavior routines (high change [1031 mothers]) and the other characterized by lower changes (low change [3061 mothers]). The high change cluster was more socioeconomically advantaged and reported higher PTS (mean [SD] number of symptoms, 3.72 [2.44] vs 2.51 [2.47]). Across both clusters, higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with higher PTS, and these associations were greater in the low change cluster. In this study of more than 11 000 US mothers, associations between socioeconomic factors, stressful life events, and mental health sequelae were complex. Accordingly, programs, policies, and practices targeting mental health during public health crises such as the COVID-19 pandemic should consider the range and configuration of hardships in designing the most effective interventions to mitigate long-term outcomes.
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影响因子：
3.6
作者：
LeWinn KZ;Caretta E;Davis A;Anderson AL;Oken E;program collaborators for Environmental influences on Child Health Outcomes
通讯作者：
program collaborators for Environmental influences on Child Health Outcomes
影响因子：
--
作者：
Dongarwar, Deepa;Ajewole, Veronica B;Salihu, Hamisu M
通讯作者：
Salihu, Hamisu M
DOI：
10.15585/mmwr.mm7005a3externalicon
发表时间：
2021-02-05
影响因子：
33.9
作者：
McKnight-Eily, Lela R.;Okoro, Catherine A.;Thomas, Craig
通讯作者：
Thomas, Craig
影响因子：
4.5
作者：
Kim SJ;Lee S;Han H;Jung J;Yang SJ;Shin Y
通讯作者：
Shin Y
影响因子：
10.3
作者：
Fitzpatrick, Kevin M.;Drawve, Grant;Harris, Casey
通讯作者：
Harris, Casey