When the world shifted abruptly in March 2020, so too did the research programs of many Duke scholars.
Faculty members in myriad fields began gathering real-time data about the pandemic, including several scholars who analyzed various aspects of its psychological impact and are working to bring help to those most affected.
Here are a few examples:
The COVID-19 Family Study and Coping Together Program
Eve Puffer, assistant professor of psychology and neuroscience and global health, has spent much of her career building therapeutic programs to improve family wellbeing and mental health in under-serviced communities in sub-Saharan Africa. Puffer had long been interested in bringing some of those approaches to under-resourced areas of the United States. When the pandemic arrived – halting her team’s travel and introducing new levels of stress for families nationwide -- she knew the time had arrived.
During the first six months of the pandemic, Puffer and postdoctoral associate Amber Rieder, along with graduate students Savannah Johnson, Justin Rasmussen, and Kaitlin Quick, surveyed parents of children ages three to 16 in 17 southern states to learn more about their wellbeing. The results included evidence of significant levels of depression and anxiety symptoms among parents; parent concerns about social, emotional and behavioral difficulties in children; and reports of deteriorating partner and parent-child relationships within families.
Armed with this data, the team is now working with other faculty members and students on a project funded by DGHI and Bass Connections to adapt the approaches proven in Kenya for use in North Carolina through a network of local community partners including churches and non-profits. DGHI Research Professor Rae Jean Proeschold-Bell has also joined as a faculty co-lead of the project, bringing expertise in NC community partnerships and positive emotion-building approaches to further strengthen the program.
In May, up to 50 families in Durham and surrounding communities will begin the Coping Together program, meeting virtually with trained facilitators from the community partner organizations. In the eight-week program, adapted in collaboration with community partners, families will participate in a series of activities designed to address stress, strengthen relationships, reduce family conflict and improve problem-solving techniques.
“COVID has highlighted the disparities in access to mental health resources in the U.S. which are exacerbated in low-income, rural, Black, Latinx, and sexual and gender minority populations,” said Rieder. “Peer or lay provider models are a proven way to address the overwhelming demand for family support services, especially during this ongoing global crisis. We are hopeful that with a reciprocal innovation approach, our work from low-resource settings will translate well to the current pandemic context here in North Carolina.”
Effects on Service-Industry Workers
Sanford School of Public Policy Professor Anna Gassman-Pines and colleagues had just launched a survey of hourly service-industry workers with young children when the United States shifted into lockdown in March 2020. The survey allowed Gassman-Pines to measure the effects of the pandemic in real time, revealing the immediate impacts of the pandemic on vulnerable families in terms of both mental health and economic hardship.
Parents reported a quick deterioration in their own mental wellbeing, including more frequent “negative moods” as early as March 14, the day after the first major restrictions in response to COVID-19 were announced. The majority of the survey participants also experienced multiple hardships, including household job loss, income decline, caregiving burden and illness soon after restrictions were implemented.
A fall 2020 follow-up survey in Philadelphia, where all schooling had been remote since March, revealed the struggles parents faced trying to balance remote schooling with employment: 10% of parents in the sample group had dropped out of the workforce, largely due to the need to care for young children and support remote schooling. Most days, 25% of families reported that school and childcare did not go as they thought it would that day, indicating high levels of family disruption.
Gassman-Pines notes in particular the risk to families experiencing multiple hardships concurrently, including economic strain, schooling and caregiving challenges, or illness-related stress. “That is really when we see the absolute highest levels of mental health problems for both parents and the young children in those families.”
Especially when paired with existing racial disparities in employment and economic status, and the disproportionate effects of COVID itself on minority communities, “these stressors are really accumulating and leading to a tremendous need for mental health supports and services,” Gassman-Pines added.
Gassman-Pines and colleagues have recommended pediatricians screen children for potential mental health effects of the pandemic, and advocated for economic and social support for families experiencing pandemic-related hardships.
“In many ways the pandemic has laid bare the challenges that existed before for low-wage and service-industry workers,” said Gassman-Pines. “For example, the idea that someone experiencing serious illness who needs to take time off from work should have some sort of paid leave in order to still be able to pay their bills. The pandemic has made it even more clear that paid family and medical leave has been a crucial missing piece of our safety net, and that people who have to take time off for illness, or to care for an ill family member, should have a means to keep paying their bills.”
Mental Health Effects within the University Community (Project ROUSE)
In a study of wellbeing and coping among Duke employees, Duke scholars have found high levels of anxiety and depression symptoms despite an overall lower risk of COVID-19 infection or economic insecurity.
Soon after the onset of the pandemic, Duke faculty members Rachel Kranton and Don Taylor formed a team including Professors Tyson Brown and Duncan Thomas to launch Project ROUSE (Reopen Our University Safely and Effectively). The study measures Duke employees’ experiences living and working through the pandemic in order to learn about effects on well-educated, working adults and their families.
“My family and I have struggled with the uncertainty, unpredictability and the isolation that has come with COVID-19,” said Brown. “As a researcher, it also made me want to understand how the pandemic is affecting others in our community. We are incredibly grateful to the Duke community for participating in this scientific study.”
More than 5,000 Duke faculty, staff and student employees responded to the team’s surveys that have asked about health and well-being, work and family. The team is currently inviting participants to complete a follow-up survey.
In the first research paper released using data collected in Fall 2020, the team found high levels of reported depression symptoms, particularly among younger adults and those who said that the demands of work often interfered with family responsibilities. Three-quarters of participants reported problems with anxiety and difficulty concentrating.
Overall, more than 40% of participants reported symptoms that put them at risk of moderate depression, and 25% reported symptoms indicating risks of severe depression. Many people reported that getting work done was tougher and required more effort than before the pandemic.
The team found the highest rates of depression symptoms among people younger than 25 and among students employed by the university, whose responses indicated higher risk of depression than faculty or staff.
“We should be particularly attentive to what our students and younger colleagues are going through,” said Kranton.
Preliminary results from the follow-up survey currently underway indicate high rates of reported depression symptoms have persisted even as vaccinations have become widely available. Some participants report symptoms that are worse than six months ago. “COVID has been accompanied by an epidemic of psychological distress that is widespread in the population,” said Thomas. “While there is light at the end of the COVID-19 tunnel, it is imperative that we learn whether depression symptoms persist beyond the end of the pandemic and mitigate their impacts over the long-term.”
Financial Support for this Work
The COVID-19 Family Study and Coping Together are supported by funding from the Charles Lafitte Foundation Program in Psychological Research at Duke University (COVID-19 Family Study), the Duke Global Health Institute (Coping Together Intervention), and the Bass Connections program (Coping Together Intervention).
Gassman-Pines’ work is supported by funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (Grant #1R21HD100893-01), the National Science Foundation (Award # SES-1921190), the Russell Sage Foundation (Grant #1811-10382) and Washington Center for Equitable Growth.
Project ROUSE is supported by funding from Duke University’s Social Science Research Institute and Trinity College of Arts & Sciences.