Potential directions for farm stress research: A systematic review of educational interventions to reduce psychosocial stress among farm and rural populations

Background: Despite prevalence of high psychosocial stress and suicide among farm and rural populations, few studies exist that measure effectiveness of stress reduction interventions. Purpose: To (1) compare studies with educational interventions on psychosocial stress as measured by reliable and valid instruments in farm and rural populations and (2) identify educational strategies utilized among effective interventions. Methods: This systematic review was conducted across 4 electronic databases and Google Scholar to identify research that reported outcomes of stress reduction educational interventions among farm and rural populations. Original research articles published in English between January 1980 and October 2020 were included. Literature was excluded that: (1) used cognitive behavioral therapy, (2) reported outcomes of post-traumatic distress disorders, and (3) examined clinical guidelines or policy change. Extracted data included study characteristics, outcomes, and delivery methodology. Findings: Title and abstract screening resulted in 256 manuscripts assessed for inclusion criteria. The final selection of 22 studies were categorized into 2 educational intervention delivery methods: home/community setting or virtual. Fourteen out of 22 studies reported significant stress reduction. Virtual interventions had the most promising impact on psychosocial stress with significant reduction reported in 4 of 6 studies; however, mixed results were found among all delivery methods. Conclusions: Educational interventions may reduce psychosocial stress among farm and rural populations, though important questions remain. We recommend future research should focus on barriers to participation, development of measurement tools, and consistent outcome measurement.