Families living in rural communities in the United States face unique circumstances that may hinder or promote their health and well-being, such as higher rates of poverty and unemployment, rising inequality, lower life... [ view full abstract ]
Families living in rural communities in the United States face unique circumstances that may hinder or promote their health and well-being, such as higher rates of poverty and unemployment, rising inequality, lower life expectancy, and higher incidence of chronic conditions. Rapid increases in the rural Hispanic populations have also lead to challenges as communities adapt to language differences and new demands on health and education services. The ways in which these trends hinder or provide opportunities for families can be influenced by other contextual factors such as racism and discrimination, access to governmental services, and cultural barriers. In employing the bioecological systems framework, this qualitative study aims to identify circumstances and behaviors at various levels of human ecology that contribute to health outcomes among a sample of rural low-income mothers of Latino and non-Latino White children. Our questions are: What do mothers perceive as opportunities and challenges to assisting their children to ensure the healthiest life possible? What are the health strategies that they use to help their children have the healthiest life possible?
Secondary data analysis was used to explore the enablers and barriers to health among a sample of rural low-income mothers of Latino and non-Latino White children from the Rural Families Speak about Health multi-state project. We utilize a subsample of participants who completed qualitative interviews at Wave 2 (N = 85). We first narrowed the sample to include only families with children that could be identified as Latino or non-Latino White (n = 38). In order to facilitate a careful analysis of interview transcripts (which ranged from 60-120 pages), we strategically selected a subsample of participants so that the various states of residence, degrees of economic hardship, and health statuses of children were equally represented (n = 21).
Data were coded using MAXQDA software. As the interviews covered a wide variety of topics and had already been coded for health, we (the first and second authors) examined these segments first. Codes were developed based on existing literature, theory, as well as through identifying enablers and barriers as they emerged from the data. We corroborated our interpretations of the data with each other in an effort to come to an agreement. Using this initial coding scheme we then assigned each code to the appropriate level of the bioecological model. Next, we coded the full transcripts and made adjustments to the coding scheme as necessary. In the next phase of the analysis we will examine the coded data for patterns, with particular attention to any differences by race-ethnicity, levels of economic hardship, and child health status. To enhance the validity and trustworthiness of the conclusions, triangulation of findings will be reached by comparing transcripts and quantitative data. Findings will be organized by system level in order to better understand how proximal and distal factors relate to health and wellbeing, and to inform policy and practice at different levels of the human ecology.
