Unpacking the contribution of interpersonal isolation on mental health in rural and agricultural communities

揭示人际隔离对农村和农业社区心理健康的影响

• 批准号: 10528184
• 负责人: JAMIE ARNDT
• 金额: $ 22.82万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10528184
• 关键词: Address; Agriculture; American; Americas; Attitude; Attitude to Health; Collaborations; Communities; Community Health; County; Cross-Sectional Studies; Data; Databases; Depression and Suicide; Economics; Elements; Family; Farm; Feeling; Feeling suicidal; Foundations; Funding; Future; Goals; Health; Health Resources; Health behavior; Intention; Intervention; Knowledge; Life; Life Expectancy; Link; Loneliness; Measures; Mental Health; Mental Health Services; Methodology; Methods; Mission; Missouri; National Institute on Minority Health and Health Disparities; Outcome; Participant; Pathway interactions; Play; Population; Positioning Attribute; Prevalence; Process; Qualitative Methods; Reduce health disparities; Research; Research Support; Role; Rural; Rural Community; Rural Population; Sampling; Social Interaction; Social isolation; Stigmatization; Substance abuse problem; Textiles; United States Department of Agriculture; United States National Institutes of Health; Universities; Woman; Work; agricultural community; experience; farmer; improve minority health; insight; interest; member; men; novel; outreach program; pressure; programs; psychologic; recruit; rural America; social; social disadvantage; social stigma; stressor; substance use; trend

PROJECT SUMMARY / ABSTRACT There is a growing mental health crisis among rural and agricultural communities in the U.S., including high rates of depression, suicide, and substance use (Reidhead et al., 2020), with substantial economic and life expectancy consequences (Stein et al., 2017). Social isolation (i.e., objective markers of little contact with others) and loneliness (i.e., perceived isolation) are widely recognized as important determinants of health (Cornwell & Waite, 2009) and suicide ideation (Klonsky & May, 2015) particularly in rural populations (Henning- Smith et al., 2018b). Existential isolation (EI) is a third type of interpersonal isolation defined as the subjective feeling that others do not understand one’s own subjective experiences (Helm et al., 2019). Research suggests EI differs in substantive ways from loneliness and social isolation, including incremental validity over loneliness in predicting depression and suicide ideation (Helm et al., 2020). Recent research has identified parallels between the EI and rural mental health landscapes (i.e., greater prevalence among men, less intention to utilize mental health services, associations with a fragmented cultural identity and community alienation), suggesting EI may be a potent predictor of rural mental health outcomes. Yet no research has examined the role of different types of isolation more generally, and the experiences of EI specifically, in agricultural and rural populations, leaving a notable gap in our understanding of rural mental health. The proposed research seeks to fill this gap and provide foundational insights toward identifying avenues for future targeted interventions. By partnering with the University of Missouri Extension, the proposed research will utilize a multi-method approach to identify the relationships between types of interpersonal isolation, mental health, and substance use in rural and agricultural communities. Participants will be recruited from an existing database of farmers, ranchers, and farm families identified by existing MU Extension outreach programs. An initial cross-sectional study will assess interpersonal isolation, mental health, substance use, perceived community stigma towards mental health, and attitudes towards mental health services to identify the prevalence and baseline relationships between interpersonal isolation, social stigmas, and mental health. A subset of this initial sample will be recruited for longitudinal assessments to examine temporal and mediational pathways between interpersonal isolation, mental health, and substance use. An additional and independent subset of the initial cross-sectional sample will be recruited to complete qualitative measures of personal experiences with isolation, mental health, and community stigma to develop a deeper understanding of the lived experiences of rural and agricultural community members. Consistent with NIH’s mission to increase understanding of health barriers and NIMHD’s mission to support research that improves minority health and reduce health disparities, the proposed study will increase understanding of how interpersonal isolation contributes to the mental health crisis in rural and agricultural communities, with the goal of providing insights toward avenues for future targeted interventions.

项目摘要 /摘要 美国农村和农业社区之间的心理健康危机日益严重，包括高 抑郁症，自杀和物质使用率（Reidhead等，2020），具有丰富的经济和生命 预期后果（Stein等，2017）。社会隔离（即，与之接触的客观标记 其他）和孤独感（即，感知的孤立）被广泛认为是健康的重要决定者 （Cornwell＆Waite，2009年）和自杀想法（Klonsky＆May，2015年），尤其是在农村人口（Henning- Smith等，2018b）。存在隔离（EI）是定义为主观的第三种人际隔离 感觉到别人不了解自己的主观经历（Helm等，2019）。研究建议 EI以实质性的方式不同于孤独和社会孤立，包括对孤独的增量有效性 在预测抑郁和自杀的想法时（Helm等，2020）。最近的研究确定了相似之处 在EI和粗糙的心理健康景观之间（即，男性的患病率更高，较少的意图 利用心理健康服务，与文化身份分散和社区疏远的协会）， 表明EI可能是粗糙心理健康结果的潜在预测指标。但是没有研究检查 不同类型的隔离的作用更普遍，并且在农业和农村中特别是EI的经验 人群，在我们对粗暴心理健康的理解中留下了显着的差距。拟议的研究寻求 填补这一空白并为确定未来目标干预措施的途径提供基本见解。经过 拟议的研究将与密苏里大学扩展公司合作，将采用多方法的方法 确定农村人际隔离，心理健康和物质使用的类型之间的关系 和农业社区。参与者将从现有的农民，牧场主和 现有的MU扩展外展计划确定的农场家庭。最初的横断面研究将 评估人际隔离，心理健康，药物使用，对心理的感知社区污名 健康，并致力于精神卫生服务以确定流行率和基线关系 在人际隔离，社会污名和心理健康之间。该初始样本的一个子集将是 招募进行纵向评估，以检查人际关系之间的临时和中介途径 隔离，心理健康和底物使用。初始横截面的另一个独立子集 样本将被招募，以完成隔离，心理健康， 和社区污名，以更深入地了解农村和农业的现场经历 社区成员。与NIH的使命一致，旨在提高对健康障碍和NIMHD的理解 拟议的研究 将增加对人际隔离如何促进农村心理健康危机的理解 农业社区的目的是为未来的目标干预措施提供见解。