Health & Human Development
Permanent URI for this communityhttps://scholarworks.montana.edu/handle/1/26
The Department of Health and Human Development is a group of dedicated faculty and staff whose interests, while diverse, center on one central theme: human beings. HHD works to help individuals from early childhood to mature adults though teaching, research, and service programs in both the public and private sectors.
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Item “Death by a Thousand Cuts”: Agriculture Producer Resiliency in the Western United States(Informa UK Limited, 2023-11) Freeman, Brenda; Grocke-Dewey, Michelle U.; Chichester, Lindsay; Breeding, Katherine; Stallones, Lorann; Minter, MonicaObjective: Agricultural producers face a wide array of stress triggers, shocks, and long-term pressures such as drought, flooding, fire, government policies, financial insecurity, and physical injuries. Extant research has revealed that mental health stigma, lack of access to care in rural areas, and negative coping responses (alcohol abuse, suicide, prescription drugs use) exacerbate the challenge of producer responses to short and long-term adversity. Resilience, the traits, processes, and capacities of producers to adapt and transform their approach to farming or ranching, when necessary, in response to stress triggers or long-term pressures, has received less research attention, particularly in the Western United States. The purpose of the study was to apply an interactionist occupational resilience theoretical perspective to the investigation of contextual factors contributing to resilience in Western United States agricultural producers. Methods: Qualitative interviews (45 to 90 minutes) were conducted with agricultural producers (n=51) from Western states and territories. Applied thematic analysis with a phenomenological lens was utilized to analyze interview transcriptions. First and second level coding were conducted to derive themes. Results: The analysis revealed that resilience is based upon the interactions between traits of producers and the context of agriculture. Four themes were generated (Agricultural Life, External Stressors, Traits and Adaptations, and Supports and Resources), supported by subthemes. The themes and subthemes are depicted in an agricultural producer resiliency model. The findings shed light on the equivocal role of neighbors in providing support for each other and the double- edged sword of co-working with family. Conclusions: The findings underscore that social capital is an important mechanism for supporting farmers and ranchers, as those with stronger social resources are more resilient. We recommend more funding to tailor stress and mental health programming to the specifics of agriculture, integration of behavioral health in primary care as a mechanism to increase access to care, and more intentional technical assistance for farmers and ranchers on strategic planning and problem solving.Item Built environment approaches: Extension personnel's preferences, barriers, and facilitators(Frontiers Media SA, 2022-10) Balis, Laura E.; Grocke-Dewey, Michelle U.Introduction: Interventions that modify the built environment can increase population physical activity levels and prevent chronic disease. The national Cooperative Extension System is poised to implement built environment approaches (i.e., pedestrian/bicycle infrastructure and enhanced access to physical activity spaces), but implementation strategies (i.e., methods or techniques to move research to practice) are needed to improve uptake. Effective implementation strategies address relevant barriers and capitalize on facilitators. The purpose of this study was to understand 1) barriers and facilitators to implementing built environment approaches in two state Extension systems, 2) preferences for built environment approaches, and 3) preferences for implementation strategies. Methods: A cross-sectional online survey was used to understand Extension personnel's preferences for and barriers and facilitators to built environment approaches through a mixed-methods study design. This work was informed by anthropological inquiry as the overall research philosophy, and by the Health Impact Pyramid, Leeman et al.'s classification of implementation strategies, and the Consolidated Framework for Implementation Research as the theoretical frameworks. The survey was distributed to eligible Extension personnel (n = 42) in two states. Quantitative data analysis consisted of numbers/proportions and Friedman tests. Qualitative analysis was completed through a rapid deductive approach to quickly produce actionable results. Results: Fourteen respondents (33%) completed the survey. Most had not implemented physical activity interventions in their communities or had implemented only individual-level interventions, though were interested in implementing built environment approaches. Benches, playground improvements, and crosswalks were the most desired approaches, while facilitation, assessing community strengths and needs, and technical assistance were desired implementation strategies. The most common barriers were relative priority and available resources; facilitators were external policy and incentives and implementation climate. Discussion: Extension personnel are receptive to built environment approaches and engaged with community coalitions. Yet, invested parties prefer individual-level interventions, and agents perceive a lack of resources for implementation. Implementation strategies that build capacity in both the Extension system and community coalitions may address these barriers through increasing relative priority and sharing existing resources. This work is a first step toward compiling implementation strategies to address relevant barriers to built environment approaches in community settings.Item Perceived stress, stressors, and preferred stress management strategies among western agricultural producers(American Psychological Association, 2023-05) Grocke-Dewey, Michelle U.; Brennan, Alison; Freeman, Brenda; Weas, Heather; Gutheil, Jessica; Stallones, Lorann; McMoran, DonChronic stress is associated with adverse physical, emotional, and social health outcomes such as increased rates of chronic disease, anxiety, behavioral inhibition, and well-being. In the United States, farmers and ranchers experience some of the highest levels of these adverse health outcomes. This study presents data from the Western Region Agricultural Producer Stress Survey, a survey tool designed to better understand these stressors and desired mitigation techniques. A sample of 767 agricultural producers participated in a survey that gauged their perceived stress levels, sources of stress, desired stress management topics, and preferred methods of receiving information. Workload, financial worries, and lack of time presented as the top stressors. Women averaged higher levels of both perceived stress and stressor pileup than men. Interest in stress management topics also differed significantly by gender and age, with men more interested in parenting classes and support groups, and younger producers more interested in nutrition/cooking classes. The most preferred methods for receiving information were online options. Data suggest that, on average, producers across the Western region of the United States are experiencing a medium level of stress. While this is concerning, producers expressed interest in learning more about a variety of topics to help them manage their stress and improve their well-being. Better understanding of agricultural producers’ preferences for stress management topics, as well as their preferred dissemination methods, is critical in terms of providing this often underserved population with appropriate mental health assistance.Item Food insecurity among households with children during the early months of the COVID-19 pandemic(Lyson Center for Civic Agriculture and Food Systems, 2023-06) Houghtaling, Bailey; Haynes-Maslow, Lindsey; Andress, Lauri; Hardison-Moody, Amnie; Grocke-Dewey, Michelle U.; Holston, Denise; Patton-Lopez, Megan; Pradhananga, Nila; Prewitt, T.; Shanks, Justin; Webber, Eliza; Byker Shanks, CarmenUnderstanding impacts of the COVID-19 pandemic among households with children is necessary to design appropriate public health responses that protect food and nutrition security. The objective of this research was to understand predictors of food insecurity during the COVID-19 pandemic among households with at least one child (<18 years), including whether foods reported as out-of-stock were associated with the likelihood of food insecurity. An online survey using validated measures and open-ended questions was distributed to a convenience sample in five states—Louisiana, Montana, North Carolina, Oregon, and West Virginia—during the early months of the COVID-19 pandemic (April through September of 2020). Predictors of food insecurity (race/ethnicity, age, marital status, education, federal nutrition assistance program participation, number of adults and children in the household, rurality, and missing foods when shopping) among households with children during the COVID-19 pandemic were modeled using logistic regression (p < 0.05, a priori). To further illuminate household experiences during this time, two researchers independently coded open-ended survey question data using inductive and deductive approaches to construct themes. Households with children had increased odds of experiencing food insecurity during the COVID-19 pandemic if they had the following characteristics: Hispanic ethnicity; age between 25 and 44 years; additional adult household members; economic hardship; SNAP/WIC participation; being widowed, divorced, or separated; and reporting foods not available when shopping. Participants described mainly negative changes to dietary patterns and practices as a result of the COVID-19 pandemic. They also described food security challenges and ideas for improving food security. Consistent with other data collected and analyzed during the height of the COVID-19 pandemic, this study contributes findings that emphasize the need for enhanced public health responses and emergency preparedness measures that protect food and nutrition security. Because of the increased short- and long-term consequences including exposure to adverse circumstances, impaired learning, risks to mental health, and poor health outcomes, ensuring an adequate food supply is especially important for households with children.Item Built environment approaches: Extension personnel's preferences, barriers, and facilitators(Frontiers Media SA, 2022-10) Balis, Laura E.; Grocke-Dewey, Michelle U.Introduction: Interventions that modify the built environment can increase population physical activity levels and prevent chronic disease. The national Cooperative Extension System is poised to implement built environment approaches (i.e., pedestrian/bicycle infrastructure and enhanced access to physical activity spaces), but implementation strategies (i.e., methods or techniques to move research to practice) are needed to improve uptake. Effective implementation strategies address relevant barriers and capitalize on facilitators. The purpose of this study was to understand 1) barriers and facilitators to implementing built environment approaches in two state Extension systems, 2) preferences for built environment approaches, and 3) preferences for implementation strategies. Methods: A cross-sectional online survey was used to understand Extension personnel's preferences for and barriers and facilitators to built environment approaches through a mixed-methods study design. This work was informed by anthropological inquiry as the overall research philosophy, and by the Health Impact Pyramid, Leeman et al.'s classification of implementation strategies, and the Consolidated Framework for Implementation Research as the theoretical frameworks. The survey was distributed to eligible Extension personnel (n = 42) in two states. Quantitative data analysis consisted of numbers/proportions and Friedman tests. Qualitative analysis was completed through a rapid deductive approach to quickly produce actionable results. Results: Fourteen respondents (33%) completed the survey. Most had not implemented physical activity interventions in their communities or had implemented only individual-level interventions, though were interested in implementing built environment approaches. Benches, playground improvements, and crosswalks were the most desired approaches, while facilitation, assessing community strengths and needs, and technical assistance were desired implementation strategies. The most common barriers were relative priority and available resources; facilitators were external policy and incentives and implementation climate. Discussion: Extension personnel are receptive to built environment approaches and engaged with community coalitions. Yet, invested parties prefer individual-level interventions, and agents perceive a lack of resources for implementation. Implementation strategies that build capacity in both the Extension system and community coalitions may address these barriers through increasing relative priority and sharing existing resources. This work is a first step toward compiling implementation strategies to address relevant barriers to built environment approaches in community settings.