Abstract: The Impact of Disparities in Rural Maternal Emotional Health and Wellbeing: Perception of Rural Mothers in a Majority Minority Community (Society for Social Work and Research 29th Annual Conference)

Schedule:

Friday, January 17, 2025

Redwood A, Level 2 (Sheraton Grand Seattle)

* noted as presenting author

Sarah Bledsoe, PhD, Associate Professor, Co-Director National Initiative for Trauma Education and Workforce Development, University of North Carolina at Chapel Hill, Chapel Hill, NC

Caroline Martin, MSW, MPH, Research Assistant, University of North Carolina at Chapel Hill, NC

Anna Fetter, PhD, Postdoctoral Research Fellow, University of North Carolina at Chapel Hill, NC

Tony Locklear, Doctoral student and community advisory board member, University of North Carolina at Greensboro, NC

Adam Englert, MSW, Social Work Doctoral Student, University of North Carolina at Chapel Hill, NC

Brittany Gordon, MA, Community Based Co-Investigator, Robeson County Health Care Corporation, NC

Erica Little, Director, University of North Carolina at Pembroke, NC

April Oxendine, MPH, Community Based Co-Investigator, Robeson County Department of Public Health, NC

Amber Waake, MSW, Project Manager, University of North Carolina at Chapel Hill, NC

Leah Daniel, MSW, MPH, Project Manager, University of North Carolina at Chapel Hill, NC

Janice Oxendine, Community Advisory Board Member, Robeson County Health Care Corporation, NC

Nicole Huggins, MSW, Research Assistant, Community Advisory Board Member, University of North Carolina at Pembroke, NC

Alexandra Locklear, Community Advisory Board Member, Robeson County Community, NC

Andres Escobar, Research Assistant, University of North Carolina at Chapel Hill, NC

Ann Schindler, Graduate Research Assistant, University of North Carolina at Chapel Hill School of Social Work, NC

Kiva Jordan, Graduate Research Assistant, University of North Carolina at Chapel Hill School of Social Work, NC

Background: Reducing disparities and improving maternal mental health is one of the most immediate and efficient ways to improve health and developmental outcomes for young children/families and, thereby, reduce associated life course health disparities. Residing in rural areas increases risk for experiencing health and developmental inequities including emotional health and wellbeing. To address these inequities in rural maternal health, holistic approaches including strengths, resilience and mothers’ lived experiences and environments are needed.

Using critical race and feminist methodologies, we conducted an exploratory, qualitative study to answer two questions: What are rural mothers’ challenges and strengths regarding emotional health and well-being for themselves and their families? What do they need to promote their well-being and their famiily’s well-being? This foundational knowledge is necessary for sustainable social change and health equity and will inform the development of interventions to address disparities in rural maternal emotional health and wellbeing.

Methods: This study uses community based participatory research in partnership with a rural majority racial/ethnic minority community. Thirty semi-structured interviews were conducted in 2023/24 with: rural birthing people self-identified as mothers; pregnant or with a child under age five. Fifty percent of mothers self-identified as Black/African American, 38.9% Indigenous, 5.8% Latina, and 5.6% White/Caucasian. Over 50% of mothers had an annual household income under $10,000, 16.7% were in partnered, and 39% had education beyond high school.

The interview guide was developed collaboratively with the community advisory board (CAB) based on a previous PhotoVoice study. Interviews were conducted in person or via Zoom by graduate level social workers and transcribed verbatim. Transcript checking, reflexivity, triangulation, member checking, and negative case analysis ensured trustworthiness of data. Grounded theory was used to develop deductive codes and data was coded to saturation by one author. Codes were analyzed by two authors and both reviewed by the CAB. Analysis wer used to generate overarching and sub themes.

Results: Overarching themes identified strengths and areas for growth. An ecosystems approach was applied to identify strength subthemes: Individual Strengths; Family/Interpersonal Relationships; Faith, Service, and Community Support. Resilience and self-reliance emerged as dominant individual strengths. Local programs and faith-based support were critical community strengths. Areas for growth subthemes included: Practical Needs; Policy Needs; Community Needs; Individual Needs; Mental Health Needs, and Interpersonal Relationship Needs. Policies rural community needs often created barriers in accessing quality health/mental health services. Quotes will be shared to support themes.

Discussion: This study represents rich data from lived expertise of rural mothers. Though limited by location, findings mirror many reported challenges faced by rural mothers/families and those surviving poverty and discrimination. Implications for practice include mothers’ desire for professional and peer support and resource sharing to improve emotional health. The study identifies gaps in mental health programming, communication of existing resources/services, and policies supporting health equity for rural mothers, children and families.