Table 1.

Themes and supporting quotes identified regarding the impact of COVID-19 (N = 357).

Themes	Description	Sample quotes (mild, moderate, severe impact)
Change in Routines	Major changes in daily life for adults and foster youth	- “Less active.” - “School and working from home have been huge adjustments.” - “It's changed absolutely everything for almost everyone.”
Isolation & Loss of Social Support	Loss of access to connections	- “Less access to hobbies that are outside of the home.” - “Major impact on coping skills, exercise routine and socializing with friends and colleagues.” - “Isolation, added responsibility, online school paired with online work is demolishing our peace and confidence.”
School Issues	Loss of in person education and/or difficulties with online education	- “NTI (online school) was very difficult for a special needs child.” - “The children being out of school is causing negative changes in their moods and behaviors as they are becoming bored and unable to socialize.” - “Schooling 5 kids under 10 is very difficult. Unrealistic expectations of work to be completed. Not having computers for all of the kids.”
Work Changes/Stressors	Changes in workplace practices or work access, including loss of employment	- “Not being able to have in person contact with clients.” - “Working from home has taken away the ability to interact with and vent to coworkers in the office setting and I often find myself feeling alone in treating the clients I work with in the foster care system.” - “Work-life balance has been non-existent. Full-time parent and full-time employee at home is impossible to sustain.”
Childcare Issues	Loss of or limitations in access to childcare	- “Finding daycare for fosters was tough.” - “Significant changes to work schedule and the stress of working from home while being in the caregiving role.” - “It took away our support systems. Therapy was delayed and we were overwhelmed working from home and caring for children.”
No Impact/Positive Changes	No impact or improvements in individual or family life secondary to the pandemic	- “Nothing changed.” - “Allowed me to be home with my kids. I have enjoyed that.” - “It has made me really think about what's important and prioritize those areas of my life.” - “It's overall been a good re-set for my family, we are doing quite well.”
Fear of Contagion	Fear or worry regarding contracting or spreading COVID	- “Overall worry for everyone's health and safety.” - “Visits with bio family and their lack of compliance with masks, social distancing, etc. is very stressful because it puts risk on us and the other children living in our home.” - “Constant fear of getting others sick and choosing to stay home and away from family/friends often because of this even if I am not showing any symptoms.”
Negative Child Welfare Impacts	Disruptions in service provision, court proceedings and/or foster family functioning secondary to the pandemic	- “Limited our ability to open our home to more foster children because of uncertainty around school and daycare since my husband and I both work.” - “Delayed court for maybe a year or more.” - “Our foster experience was going as well as it could, then the pandemic hit. Between working from home, schooling from home, change in income, business dissolved, lost our church family which was the majority of our support system, and a teenage son with mental health issues created a perfect storm in our home. The end result was us deciding to disrupt our current placements.”
Financial Problems	Financial difficulties or loss of income	- “My hours have been cut at work.” - “Lost job.” - “I'm getting evicted.”
Mental Health Problems/Stress	Any degree of emotional challenges, distress or specific mental health problems	- “The stress and anxiety on the children is very real. Their lives have been turned upside down.” - “It has made it hard to de-stress. It feels like there are no escapes.” - “Anxiety and fears of the pandemic are never ending.”
Loss of Faith/Trust & Societal Frustrations	Descriptions of the negative impact of sociocultural and/or political issues in the pandemic context	- “It has made me more aware of what is really going on in our government.” - “Frustration with political systems. Impact on family business and interactions with friends.” - “Complete mistrust of government institutions due to incompetent federal leadership, it has made me wonder how I could ever trust a vaccine developed in this country. That is leaving us with an uncertain future and possibly hard decisions to make about who and what institutions to trust.”
Health & Mental Healthcare Access Issues	Disruptions in service provision	- “At first the foster baby could not get his check-ups.” - “Children have not had counseling. They are too young for televisits to be beneficial.” - “DCBS worker has been absent. Very frustrated. Unable to get therapies for foster children and very overwhelmed with virtual learning since I have 5 children.”
PPE & Testing Issues	Issues regarding the use of or access to necessary COVID precautions and resources	- “Making sure I have enough thermometers in the house so if I need to watch that each day that child has his own.” - “The wearing of the mask is not possible for me as it causes me to have a panic attack.” - “Mom who lives in same house probably had virus but no test kits available. Had to self-quarantine in her room.”
Grief & Loss	Impact of deaths and loss related to COVID	- “Saddened to see so much death and loss in the world.” - “My supervisor died from COVID-19.” - “Daughter in law passed away leaving our son to raise their 10 day old daughter.”
Marital Problems	Disruptive impact on marriages in the pandemic context	- “Lack of childcare and things to do on date nights has strained marriage.” - “My spouse and I are having marital troubles. We are on opposite ends of the spectrum when it comes to the beliefs/concerns of the pandemic.” - “All of the above in addition to traumatized children was creating havoc on our marriage and other children.”