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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要/摘要美国农村和农业社区的心理健康危机日益严重，其中包括高抑郁症、自杀和药物滥用的发生率（Reidhead et al., 2020），对经济和生活造成巨大影响预期后果（Stein et al., 2017）。社会孤立（即很少接触的客观标志）。其他人）和孤独（即感知到的孤立）被广泛认为是健康的重要决定因素（Cornwell & Waite，2009）和自杀意念（Klonsky & May，2015），特别是在农村人口中（Henning- Smith 等人，2018b）。存在性隔离（EI）是第三种类型的人际隔离，定义为主观隔离。感觉其他人不理解自己的主观经历（Helm 等人，2019 年研究表明）。 EI 与孤独和社会孤立有本质上的不同，包括相对于孤独的增量有效性在预测抑郁症和自杀意念方面（Helm 等人，2020）发现了相似之处。 EI 与农村心理健康状况之间的差异（即男性患病率较高，心理健康服务、与支离破碎的文化认同和社区疏远的联系），表明 EI 可能是农村心理健康结果的有效预测因素，但尚无研究对此进行检验。不同类型隔离的更普遍作用，以及 EI 在农业和农村地区的具体经验人口，使我们对农村心理健康的理解存在显着差距。填补这一空白，并为确定未来有针对性的干预措施提供基础见解。与密苏里大学扩展部合作，拟议的研究将采用多种方法确定农村地区人际隔离类型、心理健康和药物使用之间的关系参与者将从现有的农民、牧场主和农业社区数据库中招募。现有 MU Extension 外展计划确定的农场家庭将进行初步横断面研究。评估人际隔离、心理健康、物质使用、社区对心理的耻辱感健康状况以及对心理健康服务的态度，以确定患病率和基线关系人际隔离、社会耻辱和心理健康之间的关系将是这个初始样本的一个子集。招募进行纵向评估，以检查人际交往之间的时间和中介路径隔离、心理健康和药物使用是初始横截面的附加且独立的子集。将招募样本来完成个人经历的定性测量，包括孤立、心理健康、和社区耻辱，以更深入地了解农村和农业的生活经历与 NIH 增进对健康障碍和 NIMHD 的了解的使命一致。拟议研究的使命是支持改善少数族裔健康和减少健康差距的研究将加深人们对人际隔离如何导致农村和农村地区心理健康危机的了解农业社区，旨在为未来有针对性的干预措施提供见解。