Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Epidemiol Community Health. 2024 Aug 25;78(10):662-668. doi: 10.1136/jech-2023-221672.
The COVID-19 pandemic upended contexts for families; relatively little work has studied the influence of rapidly changing contexts on the mental health of parents. We aimed to assess the relation between financial strain and schooling modality with the mental health of adults living with school-age children across the pandemic.
Using a large, national sample from the COVID-19 Trends and Impact Surveys (N=1 485 072 responses from November 2020 through June 2022), we used weighted multiple logistic regression with interactions for school semester to estimate changes in the association of frequent feelings of depression and anxiety, respectively, with financial strain and schooling modality, controlling for demographics and state, across time.
In all time periods, financial strain was associated with reporting frequent feelings of depression and anxiety, respectively. The association grew over time (p<0.001) from adjusted OR (aOR) 2.25 (95% CI 2.19, 2.32)/aOR 2.63 (95% CI 2.54, 2.73) in Autumn 2020 to aOR 3.11 (95% CI 3.01, 3.22)/aOR 3.79 (95% CI 3.64, 3.95) in Spring 2022. Living with children in fully online versus in-person schooling was associated with frequent feelings of anxiety and depression symptoms in all time periods, and increased from aOR 1.08 (1.05, 1.11)/aOR 1.06 (1.02, 1.10) in Autumn 2020 to aOR 1.20 (1.10, 1.32)/aOR 1.28 (1.16, 1.42) in Spring 2022.
Associations between financial strain and online-only schooling with poor mental health increased during the COVID-19 pandemic. Policies to support parents in the face of external stressors, such as economic instability and school closures, may improve overall population mental health.
COVID-19 大流行颠覆了家庭环境；相对较少的研究关注快速变化的环境对有学龄儿童的父母心理健康的影响。我们旨在评估金融压力和学校教育模式与大流行期间成年子女心理健康之间的关系。
使用来自 COVID-19 趋势和影响调查（2020 年 11 月至 2022 年 6 月期间的 1485072 份回应）的大型全国性样本，我们使用加权多项逻辑回归，结合学期交互作用，估计在整个时间内，金融压力和教育模式与频繁感到抑郁和焦虑的关联的变化，同时控制人口统计学和州。
在所有时间段，财务压力与报告频繁感到抑郁和焦虑分别相关。这种关联随着时间的推移而增长（p<0.001），从调整后的比值比（aOR）2.25（95%置信区间 2.19，2.32）/aOR 2.63（95%置信区间 2.54，2.73）在 2020 年秋季增加到 aOR 3.11（95%置信区间 3.01，3.22）/aOR 3.79（95%置信区间 3.64，3.95）在 2022 年春季。与完全在线或面对面教育的孩子一起生活与所有时间段的焦虑和抑郁症状有关，并且从 2020 年秋季的 aOR 1.08（1.05，1.11）/aOR 1.06（1.02，1.10）增加到 2022 年春季的 aOR 1.20（1.10，1.32）/aOR 1.28（1.16，1.42）。
在 COVID-19 大流行期间，金融压力和完全在线教育与不良心理健康之间的关联增加。支持父母应对外部压力源（如经济不稳定和学校关闭）的政策可能会改善整体人口的心理健康。
