The Impact of the COVID-19 Pandemic on Healthy Lifestyles in Rural Families
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Keywords

COVID-19
Rural
Family
Health Behaviors
Pediatric obesity

Abstract

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.    

https://doi.org/10.51250/jheal.v2i1.30
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References

World Health Organization. WHO announces COVID-19 outbreak a pandemic. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/whoannounces-covid-19-outbreak-a-pandemic.

Donohue JM, Miller E. COVID-19 and school closures. Jama. 2020;324(9):845-847.

EducationWeek. Map: Coronavirus and School Closures in 2019-2020. Accessed May 3, 2021, https://www.edweek.org/leadership/map-coronavirus-and-school-closures-in-2019-2020/2020/03

Kazak AE, Alderfer M, Enlow PT, et al. COVID-19 Exposure and Family Impact Scales: Factor Structure and Initial Psychometrics. Journal of pediatric psychology. 2021;

Sanderson J, Brown K. COVID-19 and Youth Sports: Psychological, Developmental, and Economic Impacts. International Journal of Sport Communication. 2020;1(aop):1-11.

Lee SJ, Ward KP, Chang OD, Downing KM. Parenting activities and the transition to home-based education during the COVID-19 pandemic. Children and Youth Services Review. 2021;122:105585.

U.S. Bureau of Labor Statistics. TED: The Economics Daily image. Accessed April 22, 2021, https://www.bls.gov/opub/ted/2020/unemployment-rate-rises-to-record-high-14-point-7-percent-in-april-2020.htm

Parker K, Minkin R, Bennett J. Economic fallout from COVID-19 continues to hit lower-income Americans the hardest. Pew Research Center. 2020:21.

FAO (Nations Food and Agriculture Organization of the United Nations). Rural youth and the COVID-19 pandemic. 2020;

Eberhardt MS, Ingram DD, Makuc DM. Urban and rural health chartbook: Health, United States, 2001. 2001;

Clark RA, Eckert KA, Stewart S, et al. Rural and urban differentials in primary care management of chronic heart failure: new data from the CASE study. Medical Journal of Australia. 2007;186(9):441-445.

Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005‐2008). The Journal of Rural Health. 2012;28(4):392-397.

Davis AM, Beaver G, Gillette MD, et al. iAmHealthy: Rationale, design and application of a family-based mHealth pediatric obesity intervention for rural children. Contemporary clinical trials. 2019;78:20-26.

Morgan DL, Krueger RA, Scannell AU. Planning focus groups. Sage; 1998.

Kozhimannil KB, Interrante JD, Henning-Smith C, Admon LK. Rural-urban differences in severe maternal morbidity and mortality in the US, 2007–15. Health affairs. 2019;38(12):2077-2085.

Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry research. 2020:113264.

Organization WH. Mental health and psychosocial considerations during the COVID-19 outbreak, 18 March 2020. 2020.

Campion J, Javed A, Sartorius N, Marmot M. Addressing the public mental health challenge of COVID-19. The Lancet Psychiatry. 2020;7(8):657-659.

Thomas KC, Ellis AR, Konrad TR, Holzer CE, Morrissey JP. County-level estimates of mental health professional shortage in the United States. Psychiatric Services. 2009;60(10):1323-1328.

Reed Abelson. Doctors Are Calling It Quits Under Stress of the Pandemi. Accessed May 3, 2021, https://www.nytimes.com/2020/11/15/health/Covid-doctors-nurses-quitting.html

Zulman DM, Wong EP, Slightam C, et al. Making connections: nationwide implementation of video telehealth tablets to address access barriers in veterans. JAMIA open. 2019;2(3):323-329.

Tarlow KR, McCord CE, Du Y, Hammett J, Wills T. Rural mental health service utilization in a Texas telepsychology clinic. Journal of clinical psychology. 2020;76(6):1004-1014.

Keeler H, Sjuts T, Niitsu K, Watanabe-Galloway S, Mackie PF-E, Liu H. Virtual mentorship network to address the rural shortage of mental health providers. American journal of preventive medicine. 2018;54(6):S290-S295.

Siegel A, Zuo Y, Moghaddamcharkari N, McIntyre RS, Rosenblat JD. Barriers, benefits and interventions for improving the delivery of telemental health services during the coronavirus disease 2019 pandemic: a systematic review. Current Opinion in Psychiatry. 2021;

Balanzá-Martínez V, Kapczinski F, de Azevedo Cardoso T, et al. The assessment of lifestyle changes during the COVID-19 pandemic using a multidimensional scale. Revista de psiquiatria y salud mental. 2021;14(1):16-26.

Centers for Disease Control and Prevention. Rural Communities. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/rural-communities.html

KansasHealthMatters. Students Eligible for the Free Lunch Program. Accessed May 3, 2021, https://www.kansashealthmatters.org/indicators/index/view?indicatorId=416&periodId=1523&localeId=19

Davison KK, Charles JN, Khandpur N, Nelson TJ. Fathers’ perceived reasons for their underrepresentation in child health research and strategies to increase their involvement. Maternal and child health journal. 2017;21(2):267-274.

Davis AM, Canter KS, Pina K. The importance of fathers in pediatric research: These authors are on to something important. Translational behavioral medicine. 2019;9(3):570-572.

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