Positive Impacts on Health Disparities for Kinship Caregivers Using Technologies New to Them: Lessons Learned about Virtual Peer Support Services Compelled by COVID-19

Background. New York State Kinship Navigator works to improve permanency and stability in kinship families through information, referral, and education services (see www.nysnavigator.org). Kinship caregivers are non-parent relatives, commonly grandparents, or anyone with a positive relationship to the family who cares for a child full time in the absence of a biological parent. Kinship caregivers often have entered their role in response to a family crisis and may experience stress, suffer the consequences of racism and other stigma, have poor mental health, and limited incomes. Approximately 95% of New York State’s kinship caregivers provide care outside the formal foster care system and as a result lack access to many formal foster care benefits and services. In 2018 Kinship Navigator implemented the New York State Kinship Navigator System of Care Project. As part of the project evaluation, University at Albany researchers survey participants and track peer support group services led by peer mentors and delivered by five agencies serving diverse populations in seven counties across the state. In March 2020 the COVID-19 pandemic forced agency staff to transition in-person peer support meetings to online ones, forcing already burdened kinship caregivers to learn how to connect with their peers through digital technologies new to them. Objective. To inform the development of new survey questions to fortify the evaluation research moving forward, this exploratory study examined the relationship between a pandemic-mandated technological change in family service delivery and how this change shaped some kinship caregivers’ access to and benefits received from peer support meetings. Methods. Researchers conducted ten focus groups and two individual interviews between November 2020 and March 2021. Forty-six individuals were interviewed for this study, comprised of kinship caregivers (28), peer mentors (7), case managers (6), and agency leadership (5). The qualitative data collected in the interviews and focus groups were analyzed using systematic text condensation to surface key themes and subthemes. Findings. Themes and subthemes surfaced, among other, included: (Theme 1) transitioning to virtual meetings presented insurmountable hurdles, with subthemes that some kinship caregivers (1a) were unwilling to attend online support groups, (1b) did not have the technology to access online videoconference platforms, (1c) struggled with the technology required to access online videoconference platforms, and (1d) found virtual meetings less beneficial than in-person ones; and (Theme 2) transitioning to virtual meetings was relatively easy, with subthemes that some kinship caregivers (2a) benefitted from the virtual meetings including greater number and availability of meeting sessions, (2b) appreciated the decreased transportation costs, (2c) appreciated childcare cost savings, and (2d) experienced increased personal comfort in sharing problems with and seeking support from people often previously unknown to them. Discussion. The findings suggest that this pandemic-induced technological change in kinship caregiver peer support will likely have a lasting transformative effect post-pandemic on the delivery of family support services, perhaps in a hybrid in-person/virtual form. Study limitations and future directions for research also are discussed

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes