When else but for a conference would you print your data on a giant sheet of paper, roll it securely into a tube to cart onto the plane, then tack it up on an oversized bulletin board in a giant expo hall — all to share with fellow attendees what you learned? 

In this fast-moving digital age, poster sessions at the 2023 APHA Annual Meeting and Expo offer an educational and enjoyable way to discuss your public health passions with colleagues. Who says analog can’t be fun? 

Poster sessions on Sunday covered a variety of topics and public health challenges. Here is just a sample. 

COVID-19 vaccine hesitancy among mothers of young children

 When the Pfizer and Moderna COVID-19 vaccines were approved for children ages 6 months to 5 years old in June 2022, Frederica Jackson wondered what parents thought about the news: “They might be OK with older kids, but is there a discrepancy for younger children?”

After reviewing the literature on vaccine hesitancy, Jackson, a PhD candidate at Indiana University School of Public Health, surveyed 425 U.S. mothers through parenting social media pages. 

Her findings showed that 23% of the mothers indicated their hesitancy toward vaccination for their youngest children. The moms pointed to vaccine safety concerns and uncertainty about vaccine side effects. In open-ended responses, they shared worries about long-term side effects of vaccination, vaccines being relatively new and lacking longitudinal studies, a too-young age range, influence of their significant others, and their desire to “wait and see” whether the vaccine was effective in other children.

“Those who had concerns about the vaccine were twice as likely to be hesitant to vaccinate their children,” she said.

Jackson was surprised to learn where these mothers learned about the COVID-19 vaccine for young children. Only about 15-20% heard the news from their doctor’s office.

“Most people heard from social media (or) their friends, and some people actually said, ‘taking this survey is the first time I’m hearing about this vaccine (for children 6 months to age 5).’”

Jackson said her findings reiterated the need to develop more innovative communication strategies to reach people. She believes the messaging needs to be shared with mothers by their doctors, who they have established relationships with and see more regularly when their child is a newborn and toddler. Community health workers are also critical allies to educate parents about the importance of all types of vaccines, she said.

Harms to children who live with people with substance use disorders

At least 20% of the U.S. adult population has had a parent with alcohol problems, according to data cited in a poster by Ivette Rodriguez Borja, a public health research analyst at RTI International, an independent, nonprofit research institute dedicated to improving the human condition.

Still, RTI researchers recognized that their new national survey on alcohol and drug harms to others didn’t capture the short- and long-term harms that children experience from a parent or other family member’s alcohol or drug use, Rodriguez Borja said. (RTI partners with the Alcohol Research Group on the survey.)

Therefore, the researchers hosted 10 focus groups in five U.S. cities in summer 2022 of family members of individuals with substance use disorders (SUDs). They used thematic analysis to explore child harms the participants had experienced or directly witnessed as a child.

The focus groups identified six complex and interconnecting themes:

1. Role dysfunction (impaired parent-child relationships that lead children to seek attachment elsewhere)
2. Parentification (excessive responsibilities of the child, such as parenting their younger siblings or managing household responsibilities) 
3. Emotional harms
4. Physical health
5. Basic needs
6. Enduring effects

“One of the themes we found that isn’t currently in our survey is being in an unsafe environment,” Rodriguez Borja said. “Living in a place where there are drugs or syringes around can endanger the child. We hope to implement that (question) in our next survey.” 

Rodriguez Borja was surprised to learn that, as children, many of the focus group participants had reached out to religious institutions, law enforcement and child protective services for support.

“But sometimes the harms were intensified because these institutions failed to provide protection for children,” she said. “When you go to those places seeking help…(you might be) taken out of your nuclear home and you go through a lot of movements. You find yourself often in a worse position than when you started.” 

Some participants said when they sought help from religious institutions, those organizations wanted the families to stay together and for parents not to divorce, even in abusive relationships. 

Mental health crisis among Georgia farmers

The mental health of Georgia farmers appears to be related more to financial strain than to social determinants of health, according to Chris Scoggins, director of special projects at the Georgia Rural Health Innovation Center. 

Farmers have among the highest suicide rates of any industry in the U.S. In a previous survey by the center of 1,800 Georgia farmers, 82% of farmers reported moderate level of stress, and 29% reported thinking of dying by suicide at least once per month. Furthermore, 42% of all Georgia farmers reported having thought about dying by suicide at least once in the past 12 months.

Scoggins and fellow researchers set out to test the application of the Social Vulnerability Index (SVI) as a predictor of mental health in agricultural workers. The SVI was developed for use in disaster preparedness and relief efforts. They hypothesized that the index could also be used as an aggregate measure of community vulnerability.

However, “our findings found that the SVI wasn’t very useful for that. After going back and talking with focus groups and our partners in the industry and the farming community, we’re shifting to a working hypothesis of financial stress, more so than social determinants,” Scoggins said. “We still think social determinants probably matter…but financial issues are just washing out all of those because they’re just so overwhelming.” 

One bright spot is that farmers — especially young farmers — are willing and interested in having conversations around mental health, he said. 

“They’ve seen too much of this; they’re seeing the toll that the stress and substance use and negative coping skills have taken on their community, and they’re ready to do something about it.” 

Check out the next poster sessions on Monday and Tuesday.

Photo: Frederica Jackson, on the right, discusses her poster with Sezer Kisa from Norway. Photo courtesy Melanie Padgett Powers.