Psychological, social and financial impacts of COVID-19 on culturally and linguistically diverse communities in Sydney, Australia

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Abstract

To explore the psychological, social and financial outcomes of COVID-19—and the sociodemographic predictors of those outcomes—among culturally and linguistically diverse communities in Sydney, Australia.

Design

Cross-sectional survey informed by the Framework for Culturally Competent Health Research conducted between March and July 2021.

Setting

Participants who primarily speak a language other than English at home were recruited from Greater Western Sydney, New South Wales.

Participants

708 community members (mean age: 45.4 years (range 18–91)). 88% (n=622) were born outside of Australia, 31% (n=220) did not speak English well or at all, and 41% (n=290) had inadequate health literacy.

Outcome measures

Thirteen items regarding COVID-19-related psychological, social and financial outcomes were adapted from validated scales, previous surveys or co-designed in partnership with Multicultural Health and interpreter service staff. Logistic regression models (using poststratification weighted frequencies) were used to identify sociodemographic predictors of outcomes. Surveys were available in English or translated (11 languages).

Results

In this analysis, conducted prior to the 2021 COVID-19 outbreak in Sydney, 25% of the sample reported feeling nervous or stressed most/all of the time and 22% felt lonely or alone most/all of the time. A quarter of participants reported negative impacts on their spousal relationships as a result of COVID-19 and most parents reported that their children were less active (64%), had more screen time (63%) and were finding school harder (45%). Mean financial burden was 2.9/5 (95% CI 2.8 to 2.9). Regression analyses consistently showed more negative outcomes for those with comorbidities and differences across language groups.

Conclusion

Culturally and linguistically diverse communities experience significant psychological, social and financial impacts of COVID-19. A whole-of-government approach is needed to support rapid co-design of culturally safe support packages in response to COVID-19 and other national health emergencies, tailored appropriately to specific language groups and accounting for pre-existing health disparities.

Article activity feed

  1. SciScore for 10.1101/2021.10.20.21265299: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: 2.1 Study design: This study involved a self–report cross-sectional survey with 11 language groups, approved by Western Sydney Local Health District Human Research Ethics Committee (Project number 2020/ETH03085).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    2.6 Quantitative analysis: Quantitative data were analysed using IBM SPSS Statistics Version 26.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: This study is novel in its use of both Content Analysis and quantitative analysis to determine if any positive outcomes are to be found in the experiences of a sample of culturally and linguistically diverse people resident in Sydney, New South Wales. It is the largest Australian survey which explores the impacts of COVID–19 for people who speak a language other than English at home. However, it is important to consider that this investigation into “positives” experienced during the COVID-19 pandemic is dependent upon a single survey item administered during a specific and short time—March 21st to July 9th, 2021 when COVID-19 case numbers were low in Australia. Our previous research from June 2020 reports on a time in which most of Australia was leaving strict restrictions, but in our current study case numbers and restrictions were heading in the opposite direction; this may have been reflected in the much lower rate of positives found in this study amongst these communities. It is unknown how the repercussions of lockdown, restrictions and higher risk of COVID-19 may have influenced culturally and linguistically diverse community members in terms of finding positives. It is possible that even fewer participants would have reported positives with continued lockdown, particularly as the communities which we surveyed faced tighter restrictions than the rest of Sydney as the weeks after the survey progressed, including curfews, limits on outdoor exerc...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. SciScore for 10.1101/2021.10.19.21265230: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Study design: This study involved a cross-sectional survey with 11 language groups, approved by Western Sydney Local Health District Human Research Ethics Committee (Project number 2020/ETH03085) Patient and public involvement: This study was co-designed by researchers, bilingual community members and Multicultural Health and Health Care Interpreter Service staff, and informed by the Framework for Culturally Competent Health Research (16).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analysis: Quantitative data were analysed using IBM SPSS Statistics Version 24.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: This study was co-designed by researchers and multicultural health service staff, and enabled through recruitment methods that are inclusive and reduce barriers to participation, such as translated versions of the survey, engagement of interpreters and multicultural health staff who are trusted in their communities, and use of multiple recruitment methods (including through community events and networks). This approach wholly aligns with the Framework of Culturally Competent Health Research (16). However, practical constraints limited the number of languages we could include, and restricted data collection to three regions in Greater Sydney only. We also used convenience sampling methods. To reduce survey length and burden on participants we purposefully selected a small number of items from validated measures or our previous research to explore psychological, social and financial impacts, or co-designed them specifically for this study. Self-report may have introduced recall and social desirability bias. Finally, the results of this study reflect a particular point in time when there were very low numbers of community-acquired cases of COVID-19 in Australia, and for the most part, no government-imposed restrictions on movement and activities in New South Wales. It is likely that psychological wellbeing outcomes and financial and social stress have worsened since the July 2021 outbreak and the imposition of stay-at-home orders, in line with previous...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.