Racial and ethnic health disparities in the incidence and severity of Coronavirus Disease 2019 (COVID-19) have been observed globally and in the United States. Research has focused on transmission, hospitalization, and mortality among racial and ethnic minorities, but Long COVID-19 health disparities research is limited. This study retrospectively evaluated 195 adults who survived COVID-19 associated acute respiratory distress syndrome (C-ARDS) in New York City from March-April 2020.
View Article and Find Full Text PDFIntroduction: For people living with HIV/AIDS, care is commonly delivered through Differentiated Service Delivery (DSD). Although people with multidrug-resistant tuberculosis (MDR-TB) and HIV/AIDS experience severe treatment associated challenges, there is no DSD model to support their treatment. In this study, we defined patterns of medication adherence and characterized longitudinal barriers to inform development of an MDR-TB/HIV DSD framework.
View Article and Find Full Text PDFBackground: Highly effective, short-course, bedaquiline-containing treatment regimens for multidrug-resistant tuberculosis (MDR-TB) and integrase strand transfer inhibitor (INSTI)-containing fixed dose combination antiretroviral therapy (ART) have radically transformed treatment for MDR-TB and HIV. However, without advances in adherence support, we may not realize the full potential of these therapeutics. The primary objective of this study is to compare the effect of adherence support interventions on clinical and biological endpoints using an adaptive randomized platform.
View Article and Find Full Text PDFBackground: Highly effective, short course, bedaquiline-containing treatment regimens for multidrug-resistant tuberculosis (MDR-TB) and integrase strand transfer inhibitor (INSTI)-containing fixed dose combination antiretroviral therapy (ART) have radically transformed treatment for MDR-TB and HIV. However, without advances in adherence support, we may not realize the full potential of these therapeutics. The primary objective of this study is to compare the effect of adherence support interventions on clinical and biological endpoints using an adaptive randomized platform.
View Article and Find Full Text PDFSocial work is an essential workforce integral to the United States' public health infrastructure and response to COVID-19. To understand stressors among frontline social workers during COVID-19, a cross-sectional study of U.S-based social workers (N = 1,407) in health settings was collected (in June through August 2020).
View Article and Find Full Text PDFSocial workers have engaged in promotive, preventive, and intervention work throughout the COVID-19 pandemic. Given that social workers are disproportionately women, and the essential nature of practice during the pandemic, how social workers experience caretaking and financial stressors warrants examination. Data are drawn from a larger cross-sectional survey of U.
View Article and Find Full Text PDFSocial work has been a part of the essential workforce historically and throughout the COVID-19 pandemic, yet lack recognition. This work explores the experiences and invisibility of social workers within the pandemic response. Data are drawn from a large cross-sectional survey of US-based social worker from June to August of 2020.
View Article and Find Full Text PDFBackground: This study assesses the relationship between managerialism and health among human service workers.
Methods: A total of 2154 New York City human service workers participated in an electronic survey that included validated measures of a system of work organization (the Organizational Commitment to Managerialism scale [OCTM]) and a work stressor (the Effort Reward Imbalance scale [ERI]), and single items about physical, mental, and behavioral health. Controlling for demographic variables, logistic regression models were used to predict health outcomes assess the potential role of ERI as a mediator.
Background: Novel regimens have revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment; however, medication adherence remains challenging and poorly characterized. We hypothesized that bedaquiline adherence, measured using electronic dose monitoring, would predict MDR-TB treatment outcomes.
Setting: This is a prospective cohort study conducted in KwaZulu-Natal, South Africa.
Int J Environ Res Public Health
December 2021
Home care aides are a rapidly growing, non-standard workforce who face numerous health risks and stressors on the job. While research shows that aides receive limited support from their agency employers, few studies have explored the wider range of support that aides use when navigating work stress and considered the implications of these arrangements. To investigate this question, we conducted 47 in-depth interviews with 29 home care aides in New York City, focused specifically on aides' use of support after client death.
View Article and Find Full Text PDFWorkers engaged in reproductive labor-the caring work that maintains society and supports its growth-contribute to societal health while also enduring the harms of precarious labor and substantial work stress. How can we conceptualize the effects of reproductive labor on workers and society simultaneously? In this commentary, we analyze four types of more relational and less relational careworkers-homeless shelter workers, school food workers, home care aides, and household cleaners-during the COVID-19 pandemic. We then make a case for a new model of societal health that recognizes the contributions of careworkers and healthy carework.
View Article and Find Full Text PDFWhile social workers have served as frontline workers responding to the needs of vulnerable populations during COVID-19 pandemic, little is known about how social work professionals themselves have been impacted. This article explored the impact of COVID-19 on social work professionals' mental health, physical health, and access to personal protective equipment (PPE). This was a cross-sectional web-based survey of social workers practicing in the United States (N = 3,118); data on demographic and workplace characteristics, physical and mental health, and safety concerns were collected between June and August of 2020.
View Article and Find Full Text PDFThe workplace has been a neglected element in the national response to the opioid crisis. This ignores that workplace safety and health and drug policies have become important factors in opioid use disorder among workers. This results from physical or emotional pain related to workplace injuries, illnesses, and stress, and through punitive workplace drug policies, failure to address stigma, and inadequate access to treatment and recovery resources.
View Article and Find Full Text PDFSince the mid-1970s, neoliberal policies have relied on privatization and other tactics to down-size the state, transforming human service organizations in the process. The impact of this approach, also known as managerialism, has not been examined in addiction treatment, where the opioid epidemic has intensified the need for services. Using qualitative semi-structured interviews, we explore how managerialism has affected the workforce, service delivery, and the quality of care in New York City addiction treatment programs.
View Article and Find Full Text PDFBackground: There is little evidence of patient acceptability for drug-resistant tuberculosis (DRTB) care in the context of new treatment regimens and HIV co-infection. We aim to describe experiences of DRTB-HIV care among patients in KwaZulu-Natal province, South Africa.
Methods: In this qualitative study using Bury's framework for chronic illness, we conducted 13 focus groups at a tertiary hospital with 55 patients co-infected with DRTB and HIV (28 women, 27 men) who were receiving new bedaquiline-based treatment for DRTB, concurrent with antiretroviral therapy.
Background: In generalized drug-resistant tuberculosis (DR-TB) human immunodeficiency virus (HIV) epidemics, identifying subpopulations at high risk for treatment failure and loss to care is critically important to improve treatment outcomes and prevent amplification of drug resistance. We hypothesized that an electronic dose-monitoring (EDM) device could empirically identify adherence-challenged patients and that a mixed-methods approach would characterize treatment challenges.
Methods: A prospective study of patients with DR-TB HIV on antiretroviral therapy (ART) initiating bedaquiline-containing regimens in KwaZulu-Natal, South Africa.
During the last three decades in both the United States and Europe, neoliberal policies, especially privatization, have restructured services in ways that dramatically affect the capacity of human services workers and agencies to serve all clients. Privatization means not only transforming public programs such as Social Security, but also managerialism-the incorporation of business principles, methods, and goals into public and nonprofit human services organizations. Few researchers have looked at the impact of market-based managerialism (focused on productivity, accountability, efficiency, and standardization) on social work's mission and the effectiveness of human services workers and organizations.
View Article and Find Full Text PDFSince the novel coronavirus disease (COVID-19) first emerged in December 2019, there have been unprecedented efforts worldwide to contain and mitigate the rapid spread of the virus through evidence-based public health measures. As a component of pandemic response in the United States, efforts to develop, launch, and scale-up contact tracing initiatives are rapidly expanding, yet the presence of social work is noticeably absent. In this paper, we identify the specialized skill set necessary for high quality contact tracing in the COVID-19 era and explore its alignment with social work competencies and skills.
View Article and Find Full Text PDFCarework-the paid and unpaid work in healthcare, education, childcare, mental health, elder care, families, and social services-is linked by the social and ethical obligation to care for vulnerable populations and is a major economic sector and important source of employment internationally. This special issue of New Solutions focuses on understanding working conditions and workplace health and safety in carework professions and for seeking solutions to these dilemmas. As members of the Carework Network Steering Committee, we reflect on the importance of the topics raised in this special issue and describe next steps for carework research and scholarship.
View Article and Find Full Text PDFWorkplace violence is a serious and surprisingly understudied occupational hazard in social service settings. The authors of this study conducted an anonymous, Internet-based survey of Massachusetts social service agencies to estimate the incidence of physical assault and verbal threat of violence in social service agencies, understand how social service agencies collect data on workplace violence, and identify disparities in who is at risk in terms of staff education and training level and the work setting. The study gathered general descriptions of each agency and compiled incidence data on workplace violence that were collected by agencies in fiscal year 2009.
View Article and Find Full Text PDFDrug-resistant tuberculosis (TB) is an occupational hazard for health-care workers (HCWs) in South Africa. We undertook this qualitative study to contextualize epidemiological findings suggesting that HCWs' elevated risk of drug-resistant TB is related to workplace exposure. A total of 55 HCWs and 7 hospital managers participated in focus groups and interviews about infection control (IC).
View Article and Find Full Text PDFTo determine whether women in KwaZulu-Natal, South Africa, with drug-resistant tuberculosis (TB) were more likely than men to have extensively drug-resistant TB, we reviewed 4,514 adults admitted during 2003-2008 for drug-resistant TB. Female sex independently predicted extensively drug-resistant TB, even after we controlled for HIV infection. This association needs further study.
View Article and Find Full Text PDFBackground: Nosocomial transmission has been described in extensively drug-resistant tuberculosis (XDR-TB) and HIV co-infected patients in South Africa. However, little is known about the rates of drug-resistant tuberculosis among health care workers in countries with high tuberculosis and HIV burden.
Objective: To estimate rates of multidrug-resistant tuberculosis (MDR-TB) and XDR-TB hospitalizations among health care workers in KwaZulu-Natal, South Africa.
Many researchers have explored how neoliberal restructuring of the workplace has reduced the standard of living and increased workplace stress among private sector employees. However, few have focused on how neoliberal restructuring of public policy has had similar effects on the public sector workforce. Using original case study research, the authors examine how two iconic pieces of neoliberal policy--the 1996 welfare reform bill in the United States and the GEAR macroeconomic policy in South Africa--affected public/nonprofit human service workers in New York City, United States, and public sector nurses in KwaZulu-Natal, South Africa.
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