Abstract TU135: Stress Among Parents and Caregivers of Children with and without Chronic Health Conditions: the Young Hearts Study

Abstract

Background: Approximately a quarter of children in the United States have at least one chronic condition. Caring for a child with a chronic condition can place significant emotional as well as financial strain on parents or caregivers. Thus, we examined the association between child chronic condition status and parental stress and whether financial or food security moderated this relationship. Methods: We utilized data from the Young Hearts Study. Parents completed surveys, which included their stress level and their child’s medical history. We included all children ages 0-17 with complete baseline surveys. Parental stress was measured using the Perceived Stress Scale (PSS-4) and scored from 0-16. Chronic condition status was defined as parent report of at least one chronic condition (e.g., asthma, heart disease, epilepsy, or ADHD or autism) or no chronic condition. Financial security was assessed using two questions that assessed the ability to pay for basic expenses and medical costs. Food security was assessed using the Six-Item USDA Food Security Scale. We used linear regression to assess the association between a child’s chronic condition status and the parent’s stress level, serially adjusting for age, sex, race, ethnicity, insurance, household income, financial security, and food security. Moderation was tested using interaction terms. Results: Of 5,310 included children, 1,976 had a chronic condition, 49.1% were female, 48.7% were non-Hispanic White, with an average age of 8.1 (SD=5.3) years. Parents of children with a chronic health condition reported higher stress than parents of children without a chronic condition (5.4, SD=3.3 vs. 4.6, SD=3.1). Parents of children with a chronic condition were less likely to report being financially (48.2% vs 59.7%) and food (65.7% vs 75.1%) secure. In fully adjusted models, having a child with any chronic health condition was associated with a 0.45 (95% CI=0.29, 0.62) point higher stress score. We observed no moderation by financial or food security (p > 0.05). Discussion: Parents and caregivers of children with chronic conditions experience higher burdens of stress and stressors, including financial and food security. Adjusting for financial and food security attenuates but does not eliminate the association between child chronic condition status and parental stress, highlighting the complex support needs of parents of children with chronic health conditions.