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In 1980s British feminist artist-photographer Jo Spence used phototherapy to challenge normative and medicalized constructions of the female cancer patient by documenting her illness and was then employed as a consultant by hospitals who, through her work, recognized the need to change physicians' practices and attitudes, which objectified patients. Photovoice, a Community Based Participatory Design method where participants take photographs and combine them with short text narratives, is similar to Spence's artistic method. It has been used widely in health and social work settings. Healthcare professionals are aware of the power of images as catalysts for meaning making in medical encounters with people in pain; as part of multidisciplinary analysis, because images can enhance a person's sense of agency in relation to their pain, especially in clinical contexts. Photographs can also establish a common ground for discussing meaning, therefore Photovoice can make the hidden experience of pain visible through collaborative photo-texts. These are subsequently shared with other patients and healthcare workers to aid them in specialist consultations. However, few studies have addressed gender and race-related health disparities in treating chronic pain. This paper draws on the authors' study with twenty women of color who created photo-text works about their experiences living with and being treated for chronic pain. In this novel online Photovoice study, participants engaged with asynchronous videos created by an artist-professor about the meanings viewers make of a photograph, including how perspective, angle, and lighting can affect the viewer's emotional response to photographs. Participants then deployed Photovoice through six synchronous sessions led by a social work professor with extensive experience designing and facilitating Photovoice studies. The resulting image-text works by study participants address health inequity and argue for health equity as a hallmark of social justice in healthcare by focusing on exposing and reducing healthcare disparities. [ABSTRACT FROM AUTHOR]

Although burnout has been increasingly well studied among medical (nurses, physicians, residents) and mental health providers (psychologists, psychiatrists, social workers), there continues to be a lack of attention on the well‐being of community‐based providers, such as Community Health Workers (CHWs), within the United States. Using cross‐sectional data from 75 CHWs employed in 14 agencies funded through the Maternal and Infant Community Health Collaboratives Initiative (MICHC) in New York, our study examined predictors (anxiety, physical health, adverse childhood experiences, job satisfaction, role certainty, demographic and work characteristics) of burnout, compassion fatigue (CF) and compassion satisfaction (CS). Descriptive statistics were used to characterize our sample and linear regression was employed to investigate the correlates of burnout, CF and CS. Results indicated that CHWs with higher levels of anxiety and lower job satisfaction were more likely to have higher burnout scores. CHWs with higher levels of anxiety, lower job satisfaction and fewer days of poorer health were more likely to report higher CF. Those who worked more than 35 h per week were less likely to report higher CS. The study provides recommendations for organizational‐level interventions to address risk factors of burnout and CF and promote CS among CHWs, such as bolstering supervision, encouraging greater communication, offering recognition/appreciation of CHWs and creating opportunities for self‐care. Findings should be considered when designing organizational‐level preventive measures that mitigate burnout and CF and promote CS. [ABSTRACT FROM AUTHOR]

To explore sociodemographic predictors for concern regarding COVID‐19 transmission and how these factors interact with the identities of others, we conducted a web‐based survey where we asked 568 respondents in the United States to indicate their level of COVID‐19 concern in response to a series of images with short vignettes of masked and unmasked individuals of different racial/ethnic backgrounds. Using a linear mixed effects model, we found that regardless of the race of the image being presented in the vignette, concern regarding COVID‐19 transmission was associated with respondents' older age (b = 0.029, p < 0.001), residing in NYC (b = 0.556, p = 0.009), being heterosexual (b = 1.075, p < 0.001), having higher levels of education, that is, completion of a Bachelor's degree (b = 1.10, p = 0.033) or graduate degree (b = 1.78, p < 0.001), and the person in the vignette being unmasked (b = 0.822, p < 0.001). Asian respondents were more likely than White respondents to be concerned regarding COVID‐19. Individuals who self‐reported themselves to be at high risk for COVID‐19 were more likely to be concerned about COVID‐19 over those who considered themselves to be low risk. These findings highlight the importance of acknowledging interactions between race, mask status, and residency in predicting COVID‐19 concern. [ABSTRACT FROM AUTHOR]

Our cross-sectional study seeks to understand how COVID-19 stigma, race/ethnicity [Asian, Black, Hispanic/Latinx, white] and residency [New York City (NYC) resident vs. non-NYC resident] associated with depression. Our sample includes 568 participants: 260 (45.77%) were NYC residents and 308 (54.3%) were non-NYC residents. A series of multiple linear regression were run to examine the relationship between race/ethnicity, COVID-19 stigma, and depressive symptoms. Irrespective of residency, older age and ever being diagnosed with COVID-19 were negatively associated with depressive symptoms. Stigma and thinking less of oneself significantly associates with depressive symptoms across residency. Our study expects to benefit mental health care providers and public health professionals in designing best practices to mitigate stigma in ongoing or future pandemics. [ABSTRACT FROM AUTHOR]

This study examined predictors to mask mandate support and racial justice protest participation across Asian (n = 103), Black (n = 102), white (n = 102) New York City residents, using binary logistic regressions. Participants with positive feelings about the racial justice movement were more likely to participate in the protests. White and Asian respondents were more likely to support the mask mandates over Black respondents. Asian respondents were less likely to participate in public protests over white respondents. Our findings offer a model for social workers to understand how race, political participation and COVID-19 intersect to create racially just responses to health and justice matters. [ABSTRACT FROM AUTHOR]

In this article, we critically engage the "dual pandemics" framing of this special issue. We first consider the key assumptions of this popular frame, specifically the conceptualization of racism as a pandemic, and examine limitations of medicalizing racism. We follow with an introduction of the term syndemic, coined by public health scholar Merrill Singer, and discuss how the language of syndemics might accurately characterize the synergism and interconnectedness of racism and COVID-19. We conclude by applying syndemic theory to offer insights and opportunities for social work research, practice, and policy from a racial justice lens. [ABSTRACT FROM AUTHOR]

COVID-19 has served to exacerbate existing health disparities and inequities, most—if not all—of which can be traced to the social determinants of health (SDOH) that affect specific populations and communities. Essential to health and health systems long before, community health workers are experts in addressing SDOH in community-based settings; however, they have yet to be mobilized as part of the COVID-19 response both in the US and internationally. We use data from our mixed-methods study with supervisors (n=6), Executive Directors (EDs) (n=7), and CHWs (n=90) to describe the critical role that CHWs can play to assist in response to COVID-19 using New York State's (NYS) as a case example. Building on these findings, we raise specific CHW workforce issues and propose recommendations for how to mobilize this workforce in national pandemic response efforts. [ABSTRACT FROM AUTHOR]

Many individuals who are vulnerable to HIV infection and People Living with HIV (PLWH) experience fragmented prevention and care. Prevention and care service integration, pivotal for the HIV care continuum, depends on relationships among service providers and agencies offering HIV services. Case managers, counselors, and peer educators often work together to provide integrated services through interprofessional collaboration (IPC) in HIV prevention and care. Although these providers have distinct job titles, they typically offer complementary services on the HIV care continuum. To better train and allocate professional development resources for these providers, research is needed to assess the overall differences between provider-type and their demographics, intrapersonal factors, and job characteristics most likely to predict IPC engagement. We administered a cross-sectional survey to 75 counselors, 80 peer educators, and 112 case managers in 36 agencies in New York City. We performed a series of linear mixed effects models. Most of the HIV-service providers identified as Black and female and had been working for their agencies for less than a year. Knowledge and skills, self-efficacy, understanding of the community, and greater work hours (> 35 hours) were significant predictors of endorsement of IPC. Peer educators compared to case managers were more likely to reflect on the process as they provide myriad services. Eliciting perspectives from providers allows us to explore interventions, both intra-agency (trainings, greater exposure to collaborative initiatives, and supervision) and interagency (retention programs and websites promoting provider collaboration), that could facilitate IPC engagement and integrated services across the HIV care continuum. [ABSTRACT FROM AUTHOR]

Expansion of the Community Health Worker (CHW) workforce has become a national priority. It is critical to understand CHW strengths and individual challenges, associated professional development needs, and the utility of specific strategies that may meet needs from the perspectives of those who employ, manage, and supervise this growing workforce. Through a community-partnership with eight member organizations of the Association of Perinatal Networks of New York, we conducted two focus groups with 7 Executive Directors and 6 CHW Supervisors. Data were analyzed according to the six steps of thematic analysis. Analyses revealed seven salient themes across three superordinate categories of strengths, individual challenges, and mechanisms of support. Two strengths-related themes pertained to shared lived experiences/identities and commitment to client engagement, acquiring concrete resources and making referrals. Three themes emerged in the individual challenges category: boundary management, client empowerment, and documentation/reporting. Two support-related themes emphasized the need for skills-based training and supervision. CHWs are a critical component of the US health workforce given their core strengths, c2ommitment, and community connections. Challenges related to navigating boundaries, use of empowerment-focused approaches and effective documentation require skills-based training and trauma-informed workplace-based supports. Supervision is an effective mechanism through which CHWs receive support needed to optimize job performance. [ABSTRACT FROM AUTHOR]

Photovoice was used among 4 HIV providers and 4 managers at a NYC community-based HIV organization to engage in critical dialogs about the way they experience burnout and self-care measures taken. The study's objective was to empower participants to change aspects of their organizational culture and advocate for better working conditions to mitigate burnout. Common themes around causes of burnout were: perfectionism, isolation, multitasking, conflict in relationships. Common themes around self-care practices were: physical activity, recreational activities, being in nature, spirituality, self-expression, food/drinks, social support. The study offers strategies to social service agencies to inspire providers to create organizational change. [ABSTRACT FROM AUTHOR]

Objective: This study examined the perspectives of 18 health care providers (nurses, consultant doctors, residents, radiologists, and physiotherapists) and 18 patients regarding best practices for patient‐centred care (PCC) in a free private hospital in Pakistan, studying the congruence between provider and patient perspectives. Methods: Six focus group interviews (FGIs) were conducted from January to March 2017: three with providers and three with patients. Focus group interviews were audio‐recorded and transcribed verbatim. A deductive approach was used to analyse the data using the key dimensions of Scholl's framework, which was then complemented with constant comparison analysis to explore variability and similarity among participants across the six focus groups. Results: Findings indicated that providers and patients acknowledged maintaining a collaborative relationship with patients by using empathy. Patients and providers agreed that providers allocated time to counsel the patient and alleviated their fears. Family involvement was seen as a key indicator in decision making for patients. Some discrepancies were found between patient and provider perceptions of inhibitors to PCC, notably a lack of teamwork exhibited by providers and continuity of care offered postdischarge. Conclusions: We recommend practices of PCC that are congruent with non‐Western settings where religion and family play a primary role in matters dealing with patients' illnesses. Our findings suggest the need for recurrent training to improve teamwork among providers; questioning the implicit agreement of patients who may be vulnerable to decision making of authoritarian figures in their family; and the inclusion of peer‐support workers or community health workers to offer aftercare support to patients in their home. [ABSTRACT FROM AUTHOR]

The New York State Talent Development Consortium at the Office for People with Developmental Disabilities (OPWDD) mandated developmental disability programs to train and evaluate direct service providers (DSPs) on seven core competencies.  Utilizing community-based participatory research (CPBR) - an approach where clients, providers, and researchers share their knowledge and experience to identify study areas, formulate research questions, and use results to improve practice - a needs assessment was conducted by a New York-based developmental disability program to inform a training curriculum.  Six focus groups were conducted from a purposive sample of 14 DSPs, and 19 managers/supervisors. Staff identified skills that corresponded with six out of seven competencies. Staff recommended hands-on training on: appropriate communication to deal with individuals with severe disabilities; professionalism; person-centered care; and education on terminology in behavioral health plans, medication, and mental health illnesses. Empowering DSPs through CBPR allows for a training curriculum catered toward staff needs, which may be well-received and utilized. The CBPR process employed may be beneficial to other agencies within the intellectual and developmental disabilities field, particularly at a time when the demand for nonlicensure providers such as DSPs is increasing, and there is a need to train them to render quality and effective services. [ABSTRACT FROM AUTHOR]

COVID-19 has served to exacerbate existing health disparities and inequities, most-if not all-of which can be traced to the social determinants of health (SDOH) that affect specific populations and communities. Essential to health and health systems long before, community health workers are experts in addressing SDOH in community-based settings; however, they have yet to be mobilized as part of the COVID-19 response both in the US and internationally. We use data from our mixed-methods study with supervisors (n=6), Executive Directors (EDs) (n=7), and CHWs (n=90) to describe the critical role that CHWs can play to assist in response to COVID-19 using New York State's (NYS) as a case example. Building on these findings, we raise specific CHW workforce issues and propose recommendations for how to mobilize this workforce in national pandemic response efforts., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS-psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil. Chi-squares, t-tests and multivariate regression analyses examined differences in socio-demographics, caseload, engagement in evidence-based practices (EBPs), and transdisciplinary collaboration between providers who reported providing high levels of patient-centered mental health care and those who did not. In multivariate regression models, components of transdisciplinary collaboration were significantly associated with providers' perceptions of patient-centered mental health care (p < 0.05). CHWs were also significantly more likely to report providing patient-centered care than physicians and nurses. EBP engagement and sociodemographics were not associated with perceptions. Results suggest that training efforts to improve patient-centered mental health care in Brazil could build upon CHWs' skills and focus on transdisciplinary collaboration. Findings may inform practice in other countries with similar health care systems.