4. Discussion
birth and primary language spoken
EVENTS
Our findings indicate that parents with low-income households in the early childhood period during the pandemic suffered significant declines in mental and physical health and emotional support. The largest declines were for parental mental health, which is in alignment with parents’ qualitative descriptions of how the pandemic had impacted them and their family—specifically the challenges of dealing with social isolation and how that impacted their mental health. We also found that parent participation in a clinic-based community health worker intervention for early childhood well-child care visits buffered this observed negative impact on parental mental health but did not significantly buffer the decline in physical health or emotional support.The vast majority of parents in our sample were low-income mothers in the first 24 months postpartum. The postpartum period, even without the pandemic, is a vulnerable period already associated with greater risk of worse maternal health [It is unclear why the pandemic-era decline in parent mental health was buffered by the PARENT intervention, but emotional support and physical health were not. However, it may be that the PARENT coach was able to connect families to existing services for postpartum mental health needs, which tend to focus more on mental health promotion and treatment rather than the provision of emotional support or physical health programs. Additionally, for a majority of the parents who were Latina mothers, the PARENT intervention provided a bilingual, bicultural Latina community health worker available to them for support; this relationship may have also served as an important buffer that reduced the pandemic’s negative impact on parent mental health. While we do not have data to fully understand why certain parent health measures were buffered while others were not, we hypothesize that the resources, referrals, and support that the PARENT coach provided contributed to the differences.A limitation of this study is our inability to differentiate the impact of the early childhood period to that of the pandemic; however, it is important to understand how these life events combined to create an impact on families. Non-response bias may be a concern; however, we obtained a response rate of 80% and observed only slight differences in country of birth and primary language spoken in the home. Another limitation is that we only included three items to assess parental health. Additional objective measures of health and well-being would strengthen the associations we found and could potentially help explain why parent mental health was buffered but emotional support and physical health were not. In addition, the study utilized one open-ended question for the qualitative analysis as opposed to a more extensive interview. The qualitative analysis is therefore limited to what families felt compelled to share with little to no prompting or exploration of the themes they shared.In conclusion, our study documented, among a sample of primarily low-income mothers with young children, significant declines in mental and physical health and emotional support during the pandemic; we found that participation in a clinic team-based approach to preventive care visits using a community health worker buffered the declines in mental health. Our findings support the conceptualization that team-based care is essential to the provision of comprehensive, family-centered preventive care that meets the needs of families during early childhood [