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Objectives The disproportionate impact of coronavirus (COVID-19) on African Americans along with associated inequities in social determinants of health (SDOH) and racism increase their vulnerability to the psychosocial impact of COVID-19. This qualitative study applied the socio-ecological model (SEM) to explore psychosocial stressors, coping styles, and needs to improve psychosocial health among unique subgroups of African Americans in early pandemic stages. Methods Sixty-two African Americans (16 parents, 15 young adults, 16 essential workers, and 15 individuals with underlying medical conditions) participated in qualitative, semi-structured interviews between May and September 2020. Interview data were analyzed based on the SEM using thematic analysis. Results The majority (84%) reported being stressed with parents having the highest level. Four themes emerged : (1) our COVID-19 pandemic state of mind, (2) top stressors in the early stages of the COVID-19 pandemic, (3) coping strategies during COVID-19, and (4) needs during the COVID-19 pandemic to reduce stress. While there were similarities, different stressors were experienced among subgroups, which yielded different coping styles and needs from stakeholders across multi-levels to improve their psychosocial health. Conclusions Findings suggest current and future pandemic response plans need targeted strategies across multiple levels of influence to address the psychosocial impact of the COVID-19 pandemic on African Americans.

Introduction Black individuals in the USA continue to be underrepresented in clinical trials with low participation rates in COVID-19 research studies. Identifying participation barriers is necessary as we develop more vaccines and other treatments to address SARS-CoV-2 and associated sequelae. The purpose of this explorative, qualitative study is to apply the theory of planned behavior to understand motivators and barriers to COVID-19 research participation at the early stages of the COVID-19 pandemic. Understanding these factors is important to ultimately lead to increased vaccination rates among Black individuals, especially in strategies that increase preparedness in response to public health emergencies. Methods A phenomenological qualitative study design was conducted between May and September 2020 among 62 Black participants. The participants were purposefully selected from vulnerable subgroups of the Black population: essential workers, young adults, parents, and individuals with underlying medical conditions. An inductive-deductive content analysis approach was used to analyze the interview data. Results Majority (54.8%) reported willingness to participate in COVID-19 research. The following themes emerged from the interviews: (1) positivity toward research exists yet fear and distrust remain; (2) views toward COVID-19 research vary; (3) motivators to COVID-19 research participation; (4) barriers to COVID-19 research participation; and (5) potential strategies to increase COVID-19 research participation. Conclusions Based on our findings, majority of the participants reported willingness to participate in research with observational research being the most commonly cited type of research. Providing data on the attitudes and perspectives of Black individuals and their intentions for COVID-19 research participation using TPB informs intervention targets for healthcare providers and policy makers for an equitable emergency response. Our results suggest improved communication on the research process, research opportunities, and participant testimonial through trusted sources could increase the likelihood of participation. This is especially important as we continue through the pandemic and new treatments for COVID-19 vaccines become readily available.

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Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup’s unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.