Purpose: To understand how the COVID-19 pandemic impacted the health behaviors of rural families participating in a healthy lifestyles intervention. Methods: Caregivers of rural children participating in a healthy lifestyles intervention were invited to participate in a structured interview regarding how the COVID-19 pandemic affected their family and family health behaviors. Interviews were transcribed and the research team conducted a rigorous inductive thematic analysis. Findings: Structured qualitative interviews with caregivers (n=30) resulted in 5 saturated themes: (1) caregivers reported new or exacerbated mental health concerns and stress among family members, largely due to social isolation and external stressors, (2) caregivers reported feeling out of control of positive health behaviors for themselves and their children, (3) families reported variability in how they handled reductions in schedule demands, ranging from filling time with positive activities to negative behaviors such as snacking, (4) families continuously re-adjusted their approach to parenting, routines, and health behaviors due to internal and external factors, (5) families ate foods that were accessible and convenient, which impacted the health of the family diet. Conclusions: Despite being asked primarily about lifestyle behavior changes, families reported concerns around mental health. Specifically, families reported the COVID-19 pandemic increased mental health symptoms, such as caregivers and child stress and child behavioral problems. Regarding health behaviors, families reported variability in family meals, increases in unstructured time and increases in family centered activities such as cooking or exercising together. Families also reported challenges unique to their rural status, such as accessibility to fresh groceries.
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Copyright (c) 2022 Keisha England, Bethany Forseth, Maheen Bangash, Rohit Bhagat, Megan Murray, Dana Bakula, Ann M. Davis, PhD, MPH, ABPP