Confronting COVID-19 in under-resourced, African American neighborhoods: a qualitative study examining community member and stakeholders’ perceptions
- 21 January 2021
- journal article
- research article
- Published by Taylor & Francis Ltd in Ethnicity & Health
- Vol. 26 (1), 49-67
- https://doi.org/10.1080/13557858.2021.1873250
Abstract
The purpose of this study was to examine perceptions of COVID-19 related to prevention, coping, and testing of African American residents in under-resourced communities in Alabama. Guided by the PRECEDE-PROCEED model, virtual focus groups were conducted in five urban and rural Alabama communities using secure Zoom meetings. Community residents and stakeholders (N = 36 total) participated; meetings were audio- and video-recorded, transcribed, and analyzed according to Thematic Analysis. Themes were organized by the PRECEDE portion of the model in Predisposing, Reinforcing, and Enabling barriers and facilitators in three focus areas: prevention, coping, and testing. Prevention barriers included apathy, difficulty with social distancing, lack of information, mixed messages from authority figures, and lack of personal protective equipment (PPE). Prevention facilitators included concerns about contracting COVID-19, clear and consistent messages from trusted sources, contact tracing, and the provision of PPE. Coping barriers included food insecurity, mental health issues, isolation, economic hardships, lack of health care access, and issues with virtual schooling and church services, which were exacerbated by the inability to connect to the internet. Facilitators to coping included religious faith, increased physical activity, and a sense of hope. Testing barriers included misunderstanding, fear, mistrust, testing restrictions, and location of testing sites. Facilitators to testing included incentives, clear information from trusted sources, convenient testing locations, and free tests. Gaining community members’ perspectives can identify barriers and facilitators to prevention, coping, and testing and potentially improve outcomes. While addressing the social determinants of health (e.g. income, education, medical trust) would be an effective path by which to diminish health disparities related to COVID-19, there is an urgent need to mitigate the spread and severity of COVID-19 in vulnerable populations. Interventions should focus on downstream determinants, such as those emerging from our study.Keywords
Funding Information
- National Institute on Minority Health and Health Disparities (U54MD000502)
This publication has 32 references indexed in Scilit:
- The Social Determinants of Chronic DiseaseAmerican Journal of Preventive Medicine, 2017
- A Comparison of Black and White Racial Differences in Health Lifestyles and Cardiovascular DiseaseAmerican Journal of Preventive Medicine, 2017
- Alcoholic beverages, obesity, physical activity and other nutritional factors, and cancer risk: A review of the evidenceCritical Reviews in Oncology/Hematology, 2016
- The health gap: the challenge of an unequal worldThe Lancet, 2015
- City racial composition as a predictor of African American food desertsPublished by SAGE Publications ,2015
- Social Determinants of Health EquityAmerican Journal of Public Health, 2014
- Current Issues and Future Directions in Research into the Stress ProcessHandbooks of Sociology and Social Research, 2012
- The Social Determinants of Health: Coming of AgeAnnual Review of Public Health, 2011
- Understanding African Americans’ views of the trustworthiness of physiciansJournal of General Internal Medicine, 2006
- The legacy of Tuskegee and trust in medical care: is Tuskegee responsible for race differences in mistrust of medical care?2005