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: 10707963
• 负责人: JAMIE ARNDT
• 金额: $ 19.3万
• 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 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10707963
• 关键词: Address; Agriculture; American; Attitude; Collaborations; Communities; Community Health; County; Cross-Sectional Studies; Data; Databases; Economics; Elements; Family; Farm; Feeling; Feeling suicidal; Funding; Future; Goals; Health; Health Resources; Health behavior; Health behavior and outcomes; Intention; Intervention; Knowledge; Life; Life Expectancy; Link; Loneliness; Measures; Mental Depression; Mental Health; Mental Health Services; Methodology; Methods; Mission; Missouri; National Institute on Minority Health and Health Disparities; Outcome; Participant; Pathway interactions; 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; Suicide; Textiles; United States Department of Agriculture; United States National Institutes of Health; Universities; Woman; Work; agricultural community; experience; farmer; health determinants; improve minority health; insight; interest; member; men; novel; outreach program; pressure; programs; psychologic; recruit; rural America; social; social disparities; 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 在美国的农村和农业社区中，精神健康危机日益严重，包括高 抑郁症、自杀率和药物使用率(Reidhead等人，2020年)，有相当大的经济和生活 预期后果(Stein等人，2017年)。社会孤立(即，很少接触的客观标志 其他人)和孤独(即感觉到的孤立)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)。存在隔离是第三种类型的人际隔离，被定义为主观隔离 感觉他人不理解自己的主观体验(Helm等人，2019年)。研究表明 EI与孤独和社会隔离有本质上的不同，包括对孤独的递增效度 在预测抑郁症和自杀意念方面(Helm等人，2020年)。最近的研究发现了相似之处 精神分裂症和农村精神健康状况之间的关系(即男性患病率较高，意向较低 利用心理健康服务，与支离破碎的文化认同和社区疏远联系在一起)， 提示EI可能是农村心理健康结果的有效预测因子。然而，还没有研究检验过 不同类型的隔离在更广泛的范围内的作用，以及EI在农业和农村中的具体经验 这给我们对农村心理健康的理解留下了很大的差距。这项拟议的研究旨在 以填补这一空白，并为确定未来有针对性的干预措施提供基础性见解。通过 与密苏里大学分校合作，拟议的研究将利用多种方法 了解农村居民人际隔离类型、心理健康与物质使用的关系 和农业社区。参与者将从现有的农民、牧场主和 通过现有的墨尔本大学推广推广计划确定的农场家庭。初步的横断面研究将 评估人际隔离、心理健康、物质使用、社区对精神疾病的污名 健康和对精神健康服务的态度，以确定患病率和基线关系 在人际隔离、社会耻辱和心理健康之间。此初始样本的子集将是 被招募进行纵向评估，以检查人际关系之间的时间和中介路径 与世隔绝、精神健康和药物使用。初始横截面的附加且独立的子集 样本将被招募来完成个人孤立经历、心理健康、 和社区污名，以加深对农村和农业生活经历的理解 社区成员。与NIH增加对健康障碍和NIMHD的了解的使命一致 这项拟议的研究旨在支持改善少数群体健康和减少健康差距的研究 将增加对人际隔离如何导致农村和农村地区精神健康危机的理解 农业社区，目的是为未来有针对性的干预提供见解。