Ways parental health and stress shape the parenting of preteens in the rural Ozark Mountains

• Published date: 01 February 2024
• Author: Sarah Oerther,Michelle M. Papachrisanthou
• Date: 01 February 2024
• DOI: http://doi.org/10.1111/fare.12976

INVITED ARTICLE

Ways parental health and stress shape the parenting

of preteens in the rural Ozark Mountains

Sarah Oerther|Michelle M. Papachrisanthou

Trudy Busch Valentine School of Nursing,

Saint Louis University, St. Louis, MO

Correspondence

Sarah Oerther, Assistant Professor, Saint Louis

University School of Nursing, 3525 Caroline

Mall, St. Louis, MO 63104, USA.

Email: Sarah.Oerther@slu.edu and

sarah.oerther@gmail.com

Abstract

Objective: We explore how parental health and stress

shape the rearing of preteen children in the rural Ozark

Mountains.

Background: Identifying concerns that impact preteen par-

ents’health and stress levels may facilitate understanding

ways to promote resilience and happiness for families in

underserved rural communities.

Methods: Using an interpretive phenomenological

approach grounded in Lazarus’s stress and coping para-

digm, the current qualitative study used semistructured

interviews with 20 White parents in the rural area of the

Ozark Mountains who had at least one child born between

2008–2011.

Results: Study participants’stories revealed that stressors

related to parenting preteen children were rooted in stress

from mental health or indirectly tied to social roles, such

as occupational stress or financial constraints.

Conclusion: Interventions and tools need to be developed

that are specific to the culture of rural areas and that focus

on families as an essential part of developing resilience and

happiness and mitigating the adverse effects of stress.

Implications: Interventions focused on families need to

include diverse social factors that impact family resilience

and happiness and include education to increase health lit-

eracy, family supports related to improving connections

between parents and their preteen children, family tax

credits to reduce hardships for parents, a tool for screening

parents for stress, and expansion of telehealth

opportunities.

KEYWORDS

global well-being, happiness, parenting, resilience, rural residency, stress

Author note: The authors declare no conflicts of interest.

Received: 29 June 2022Revised: 25 July 2023Accepted: 11 August 2023

DOI: 10.1111/fare.12976

© 2023 National Council on Family Relations.

Family Relations. 2024;73:171–192. wileyonlinelibrary.com/journal/fare 171

In 2012, the American Academy of Pediatrics (AAP) began an awareness campaign encourag-

ing pediatric providers to promote the practical skills needed for parents to role model behav-

iors that will positively influence their children’s learning and development, known as positive

parenting (Garner & Shonkoff, 2012; Gillespie, 2019). The AAP recommends completing

screening the parent and child for adversities to promote family resilience through positive par-

enting (Garner & Shonkoff, 2012; Gillespie, 2019). Resilience is a protective factor for how the

body and mind react to stress, and resilience involves maintaining effective functioning after a

traumatic event (Seely & Mickelson, 2019). Also, resilience has a significant role in increasing

happiness, defined as a generally constant, positive, and affective trait, that highlights general

life satisfaction and subjective well-being (Bajaj et al., 2022; Delle Fave et al., 2016). Family

resilience is a term used to explain a family’s ability to implement adaptive coping skills, and

family resilience includes the ability of parents to overcome and cope with stressful health,

social, and economic adversities that have an impact on their families (Eales et al., 2021; Yang

et al., 2021). For example, Yancura et al. (2020) found that nonresident grandparents promoted

family resilience by supporting the economic and social functioning of underserved families in

rural areas in the United States.

In underserved rural areas in the United States, families are confronted with economic,

social, and health challenges for which they require more resilience to obtain resources to sur-

vive (Morales et al., 2020). For instance, researchers have found that parents of preteen children

may experience higher levels of mental illness, such as depression and anxiety, as well as parent

reports of decreased satisfaction with their parenting, decreased self-esteem, and a decreased

trust in their competence in comparison to parents of infants (Luthar & Ciciolla, 2016). Addi-

tionally, researchers found there is a substantially increased risk of suicide among adults in rural

areas. Families require more resilience to obtain resources to survive (Morales et al., 2020).

Thus, researchers must create interventions focusing on stress exposure and supporting resil-

ience (Morales et al., 2020).

Residents of rural areas are at increased risk for mental health disorders due to intersecting

economic and social demands (Morales et al., 2020). Families often face many accessibility bar-

riers to medical care, such as availability of health-care providers in rural areas and costs

related to travel for medical care. Families face time constraints as barriers as well (Lister

et al., 2020). Other intersecting barriers for families living in rural areas include families having

low income levels (McCall-Hosenfeld et al., 2014), low levels of educational attainment

(McCall-Hosenfeld et al., 2014), more difficulties in optimizing family- and work-life balance

(Bai et al., 2021), access to life-ending means like firearms (Cantrell et al., 2012), and hesitancy

to seek health-care providers due to stigma surrounding mental health (Morales et al., 2020).

For example, the culture of the rural Ozark Mountains that generally encourages independence

in White families (Edgar et al., 2018) may also further the stigma associated with mental health

or programs that focus on providing resources to support families (Morales et al., 2020). Men-

tal health demands, work demands, and financial constraints of White parents in underserved

rural communities may intersect with parents’capabilities to rear their preteen children, creat-

ing a heightened risk due to insufficient mental health providers.

To advance the awareness of the needs of parents in rural areas, researchers have rec-

ommended that more screening tools (such as tools screening for stress or financial hardships)

and increased use of telehealth are needed to improve care and enhance patient safety and out-

comes (Gillespie, 2019; Morales et al., 2020). Therefore, conducting screenings of rural parents

of preteen children for mental health well-being and experiences of stress related to parenting

has the potential to allow health care, social work, family science, psychologists, Certified Fam-

ily Life Educators (Doherty & Lamson, 2015), and other professionals who interact with fami-

lies to promote resilience (Garner & Shonkoff, 2012; Gillespie, 2019). Screening for adversities

in rural parents can include asking questions or using targeted standardized tools such as the

Adverse Childhood Experiences (ACEs) Questionnaire (Earls, 2018) or the Patient Health

172 FAMILY RELATIONS