707 - A longitudinal qualitative study on changes in quality of life for families with young children during COVID-19

Publication Number: 707.3852

Destiny K. Clark, Health Systems Science Department, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States; Chloe Leder, UCLA Mattel Childrens Hospital, Los Angeles, CA, United States; Rebecca N. Dudovitz, UCLA, Los Angeles, CA, United States; Lindsey R. Thompson, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States; Bergen B. Nelson, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Lorena Porras-Javier, UCLA Mattel Childrens Hospital, Los Angeles, CA, United States; Paul J.. Chung, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA, United States

Background: The COVID-19 pandemic disrupted routines and created new challenges for families with young children. While prior research has explored these effects, primarily focusing on well-being or mental health, less is known about how families’ narratives about the pandemic evolved over time, especially as families entered a period of relative recovery while facing ongoing uncertainty.

Objective: This study aims to describe the evolving challenges experienced by diverse families with young children during the pandemic.

Design/Methods: This longitudinal study analyzes data from parents participating in the AMP study, a randomized trial of telephone-based developmental screening and care coordination in Los Angeles, California. Parents of children, aged 1 to 3.5 years at enrollment, completed a telephone interview with research staff at baseline and 6 months later. We compared responses to an open-ended question: Please describe in your own words how the COVID-19 pandemic has affected you and your family. Interviews were conducted roughly from the pandemic’s initial wave (September 2020) to progressive recovery (September 2021). Responses were transcribed in English or Spanish and coded, using thematic analysis, to identify qualitative themes. Responses were compared across time points and coded to identify shifts in experiences. The codebook was iteratively refined, and key themes and subthemes were tested for interrater reliability, with Kappa values ranging from 0.84 to 0.93.

Results: 361 parents, primarily Spanish-speaking and of low income, responded at both time points. Parents described how initial challenges worsened over time despite the improving trajectory of the pandemic, creating a complex web of challenges that portray an overall decline in their quality of living. The themes depicting these shifts—(1) Family and Community Dynamics (e.g., children’s social regression), (2) Education and Care (e.g., permanent loss of childcare), (3) Financial Well-Being (e.g., long-term employment disruptions), (4) Hope (e.g., vaccines), and (5) Health (e.g., COVID-induced fear, illness, and loss)—were interconnected. Health served as a primary hub impacting and being impacted by all other themes.

Conclusion(s): Parents and children faced persistent challenges adapting to COVID-19 and struggled to achieve a sense of normalcy due to ongoing concerns around infection, although improvements like vaccines created long-term optimism. This showcases the importance of long-term monitoring for families recovering from major shocks and ongoing adaptations in interventions to improve their quality of life.

Table 1. Socio-demographics of Participants (total N=361)


Table 2. Major Themes and Exemplar Quotes
A summary of qualitative findings with emergent themes and exemplar quotations. The experiences of COVID-19 for families with young children are summarized into five main themes: Health and Wellness, Family and Community Dynamics, Education and Care, Financial Wellbeing, and Hope.

Figure 1. The Interplay Between Health & Wellness and Key Themes
This figure illustrates the interconnected impacts of Health & Wellness and related themes: Education & Care, Family & Community Dynamics, Financial Wellbeing, and Hope. The arrows showcase the reciprocal influence between Health & Wellness and each theme, highlighting shifts in mental and physical health, education and care, family dynamics, and financial stability due to factors associated with a fear of infection and vaccinations. While some families regained stability in their social bonds and had renewed hope due to vaccinations, others faced challenges, like job loss, limited social connections, and increased childcare needs due to a fear of infection and isolation.