Date of Award

Fall 1-7-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Health

First Advisor

Dr. Kathleen Baggett

Second Advisor

Dr. Brian Barger

Third Advisor

Dr. Betsy Davis

Abstract

INTRODUCTION: Social support is a protective factor against depression (Szkody et al., 2020). Current social support literature within the western epistemology of research failed to include the voices of Black mothers to provide a meaningful cultural context within which to view this protective factor (Spates, 2012). The COVID-19 pandemic has exacerbated adversities, including maternal depression, which is experienced disproportionately among Black mothers (Bailey & Moon, 2020; Farewell et al., 2020). Research within Black communities indicates the importance of social networks (e.g., extended kin) (Hunter et al., 2019). However, this literature does not focus on Black mothers living with depression during a pandemic. To address limitations in the social support literature, this study uses qualitative productive methods to bring forth cultural stories (McDonnell, 2014), and provide a richer context within which to view existing social support literature.

METHODS: Twelve Black mothers were drawn from a mobile parenting intervention study targeting maternal postpartum depression. Mothers independently took photographs, among which they presented the most important image during a group discussion. Three groups of mothers, three in each group, were brought together via Zoom to discuss their selected photograph relative to their social support experiences during the pandemic. Recorded transcripts from the orientation calls and productive group discussions were coded using open coding, to generate categories (Corbin & Strauss, 1990) and identify common social support foci (e.g., family, school) which informed the subsequent individual interviews. During individual interviews each mother created a cultural map of support as she: (1) examined direct quotes for each support grouping; (2) selected quotes that resonated the most with her experience; (3) provided a theme name for each group of quotes she selected; (4) ranked-ordered each theme; and (5) created a cultural map displaying each theme in the shape of her choice. Next, mothers created a Western-based ecological map to display the number, quality, and direction of support for social connections in their network (Hartman, 1978). Bronfenbrenner’s (1992) social-ecological model, which provides a framework for viewing social ecologies was used to situate common and unique themes identified during the individual interviews. The result was an aggregated cultural map portraying the variability in strengths and struggles mothers experienced relative to social support during the pandemic. In contrast, the aggregated ecological map illustrated the number of mothers that identified various types of social connections (e.g., partner, church), the quality of those connections (e.g., strong, weak), and the directionality of support. After the cultural and ecological maps were separately aggregated, all participants were invited to view and discuss the two aggregate maps. Six mothers participated in individual feedback calls to discuss the similarities, differences, usefulness, and the resonant stories in each of these maps.

RESULTS: Nine categories of social support emerged from productive group discussions centered on participant-generated photographs including (1) characteristics of support systems; (2) identity as a mother; (3) impact of the pandemic on children and schools; (4) experiences of being sick with, and fearful of, COVID-19; (5) mental health and coping; (6) impact of the pandemic on work; (7) community service; (8) stressors exacerbated by a pandemic; and (9) systemic issues. Individual interviews generated 91 themes including 38 (42%) were related to villages and support systems (e.g., people, school, work), 20 (22%) pertained to the new normal (e.g., virtual platforms), 18 (20%) related to identity (e.g., being a mother), 12 (13%) pertained to coping mechanisms, and 3 (3%) related to negative experiences during the pandemic (e.g., financial hardship). Ecological map data that on average, participants reported 11.8 different connections (range = 6 – 16). Across maps, 32 (37%) of connections were family (e.g., relatives, partner), 30 (35%) pertained to community-based connection (e.g., work, church), 15 (18%) were related to personal friends, 7 (8%) pertained to therapeutic connections (e.g., social, mental health), and 2 (2%) were related to community resources (e.g., material supports). Overall, 57 (66%) of connections were positive and 29 (34%) were negative. A total of 66 (77%) were bidirectional and 20 (23%) were unidirectional. Participants who compared the aggregated cultural and aggregated ecological maps, reported that the cultural map portrayed the diversity of strengths and struggles that Black postpartum mothers experienced during the pandemic while the ecological map displayed the people with whom mothers could access support. Most mothers stated that the cultural map was a more authentic representation of their experiences relative to social support during the pandemic. All mothers reported that cultural maps and ecological maps could be used together to understand the complete story of how Black mothers define and experience social support during a pandemic.

DISCUSSION: Given the exclusion of Black women’s voices in Western research and its conceptualizations, this is the first study to pair productive methods, which emphasizes cultural stories, with a Western eco-map assessment of social support to understand the culturally rich context of support for Black mothers living with depression during the pandemic. While findings indicate that some emergent themes identified in this study relate to themes in the existing literature (e.g., church, family), this study revealed that the social support experiences of Black mothers with depression during a pandemic are not monolithic. Rather their social support experiences are diverse and nuanced.

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