ABSTRACT
The purpose of the current study is to understand how the early portion of COVID-19 pandemic impacted the health behaviors of rural families participating in a healthy lifestyles intervention. 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. Structured qualitative interviews with caregivers (n=30) resulted in 5 saturated themes: (a) caregivers reported new or exacerbated mental health concerns and stress among family members, largely due to social isolation and external stressors, (b) caregivers reported feeling out of control of positive health behaviors for themselves and their children, (c) families reported variability in how they handled reductions in schedule demands, ranging from filling time with positive activities to negative behaviors such as snacking, (d) families continuously re-adjusted their approach to parenting, routines, and health behaviors due to internal and external factors, (e) families ate foods that were accessible and convenient, which impacted the health of the family diet. Despite being asked primarily about lifestyle behavior changes, families reported concerns around mental health. Implications are that professionals working with rural children and families, even those without mental health training, may be called upon to help address these concerns especially in these underserved, rural families.
ABSTRACT
Adolescents and young adults (AYAs) with a chronic medical condition (CMC) transition to adulthood with the burden of independently managing their health care. AYAs with a CMC are at elevated risk for depression, and available research suggests that illness-related cognitive appraisals play a critical role in this risk. Bakula et al. (2019) demonstrated that illness stigma and illness intrusiveness are two particularly salient cognitive appraisals (illness stigma -> illness intrusiveness -> depressive symptoms). The present study replicated and extended those findings by testing health anxiety as a mediator between stigma and illness intrusiveness in the serial mediation model (illness stigma -> health anxiety -> illness intrusiveness -> depressive symptoms). College students (N = 97) with a CMC completed self-report measures of illness-related stigma, health-related anxiety, illness intrusiveness, and depressive symptoms. The illness stigma -> illness intrusiveness -> depressive symptoms simple mediation path was significant, ab = .50, 95% CI [0.27-0.73]. The illness stigma -> health anxiety -> illness intrusiveness -> depressive symptoms serial mediation path was also significant, a1d21b2 = 0.16, 95% CI [0.05-0.31]. Illness stigma indirectly related to depressive symptoms through the consecutive influence of illness stigma on health anxiety and health anxiety on illness intrusiveness. The present study replicated and extended findings by Bakula et al. by identifying that illness stigma may elicit anxiety about health and amplify perceived illness intrusiveness, thus increasing depressive symptoms in AYAs with a CMC. These findings further confirm the importance of assessing cognitive appraisals among AYAs with a CMC. When working with AYAs with a CMC who endorse depression, it may be particularly important to assess health anxiety, illness stigma, and illness intrusiveness. (PsycInfo Database Record (c) 2022 APA, all rights reserved)