This study showed a substantial increase in parents’ stress from before to during COVID-19, with even greater stress for families with a job loss / furlough and decreased family income during the pandemic. The majority of parents reported that it was difficult to continue parenting in the same way as they did prior to COVID-19, and the most common factors that influenced parenting were changes in children’s daily structure and routines, worry and anxiety around COVID-19, and demands related to children’s online schooling at home. To manage these parenting difficulties, most parents found that doing family activities together, keeping in touch with family / friends virtually, and keeping children on a daily routine were effective. These findings highlight the need to address the increasing stress that families are experiencing and provide adequate resources to manage parenting stress during COVID-19.
About one-in-five parents reported high stress, while three-in-four parents reported an increase in parenting-specific stress during COVID-19. Other studies have found that stress is a common reaction to this pandemic27 and that parents are experiencing more stress than non-parents.18 Disseminating research findings that show many parents have increased stress during this time can help to normalize parents’ feelings of stress and provide reassurance that other parents are likely feeling the same way. To support parents during these unprecedented times, public health messaging should continue to promote healthy ways for coping and provide information on managing stress for parenting-specific challenges. For example, organizations like the CDC, WHO, UNICEF, and others have collaborated to provide open access, online resources in 90 different languages on evidence-based strategies for managing parenting stress during COVID-19.28 This includes resource sheets on topics such as “Parenting Teens”, “Parenting in Crowded Homes and Communities”, “Family Harmony at Home”, and “Keeping Calm and Managing Stress.” Future research should examine if families are using resources such as these, and if they are helping to mitigate stress. Furthermore, policymakers at multiple levels (e.g., local, state, schools, employers) should consider the potential impact of COVID-19 policy changes on parents’ stress and include thoughtful resources to help mitigate this impact (e.g., providing coordinated strategies for parents to help mitigate the impact of school closures). There is a dire need for coordinated efforts among policymakers to prioritize these systemic changes to can reduce the impact of COVID-19 on parents and families.
For some parents, prolonged periods of high stress may result in substantial mental health impacts including greater depression, anxiety, and reduced quality of life.29 High amounts of stress have also been associated with maladaptive behavior changes, including substance abuse, eating behavior changes, and excessive alcohol consumption.29 Given potential for a looming mental health crisis, adequate access to quality mental and behavioral health care is of paramount importance. Yet, prior to COVID-19, access to mental health resources did not meet the needs (neither the quality or quantity) for millions of Americans,30 with particular concern about inadequate access for families with Medicaid. Furthermore, healthcare costs have long been a significant barrier to providing mental health resources for those who are uninsured.31 During COVID-19, millions of Americans have become unemployed and lost employer-provided insurance, further reducing access to mental health resources. In this study, parents with a job loss / furlough reported a greater increase in stress during COVID-19; thus, families who are more likely to need these mental health resources may not be able to access them. In response to this, the Centers for Medicare & Medicaid Services have expanded access to telehealth services, including the provision of mental health, during COVID-1932 and The National Alliance on Mental Illness has provided a COVID-19 resource and information guide for finding free in-person and online mental health support. While these initiatives represent initial strategies to address the increased mental health concerns, additional public health and policy response are urgent to prevent an impending mental health crisis.34
When parents were asked which factors influenced their parenting during COVID-19, the most common response was a change in children’s daily structure and routines. Most children thrive under a well-planned, predictable routine, which makes them feel safe and secure, contributes to healthy habits, and leads to less problematic behaviors.35 Structure and routines also benefit parents by helping them to feel organized and in control, which increases parenting competence and reduces daily stress.35 About half of families in this study reported keeping children on a daily routine was effective in managing parenting difficulties during COVID-19. During this time of unpredictability in a rapidly changing environment, it can be difficult for families to keep a consistent daily routine. Parents who are experiencing high stress and have not yet created a daily routine at home may benefit from creating a schedule together with their children, and parents who have established a daily routine need flexibility to adapt to the ever-changing circumstances. It is important for parents to receive guidance on the importance of creating daily structure and routines, as well as education on how to best create adaptable routines with their child.
Routines may include designated time for children’s online schooling, which was another common factor that parent felt greatly impacted their parenting. During COVID-19, many parents have had to take on the additional role of teaching their children from home, amongst other work and household tasks. Many parents expressed that limited time due to these work and household demands was a common stressor, and two-thirds of parents report that children’s online schooling impacted their parenting. Many parents are understandably overwhelmed by the many responsibilities and roles they have had to take on; for example, one parent mentioned that, “juggling all responsibilities at the same time instead of getting dedicated time for different responsibilities,” impacted their parenting. In addition to parents having to cope with these changes, children are also coping with the lack of sociability from friends and structure that school and extracurricular activities provided. In fact, just over half of parents reported that children’s desire to be with friends have impacted their parenting during this pandemic. Doing family activities together at home and connecting with family and friends virtually are ways to help with coping, bonding, and providing sociability in an environment that limits outside social interactions.4,5,28
Another common stressor among parents was managing worry and anxiety around COVID-19. These findings are similar to another study that found reading / hearing about the severity and contagiousness of COVID-19 was the most commonly experienced stressor among a sample of US adults.36 With an abundance of information available, it is important for families to stay informed, yet also limit the amount and source of information that may be causing anxiety. Organizations such as the CDC and WHO recommend taking breaks from listening to the news and reading about COVID-19, including posts on social media.4,5 Just under half of parents in this study reported that controlling the information they seek on COVID-19 and finding ways to effectively manage their anxiety were effective in reducing parenting difficulties. Data from this study suggest that other ways in which parents effectively managed their anxiety and stress included engaging in hobbies and exercise, such as going on family walks, taking time for themselves, and adapting their mental outlook.
Limitations of this study include the use of a self-reported questionnaire on which parents’ stress prior to COVID-19 was retrospectively reported. Obtaining baseline measures of parents’ perceived stress was not feasible given the sudden onset of this pandemic. To minimize recall bias, this survey was administered only a few months after the start of COVID-19, yet responses could be biased in unmeasured ways. This study used items that had not been previously validated to assess factors influencing parenting and effective strategies to manage parenting difficulties. This methodological decision was made in order to address the research question related to stressors and parenting strategies specific to COVID-19, rather than more general stressors or strategies that are included in existing questionnaires. Response options provided may not have encompassed all possible stressors and coping strategies. To overcome this limitation to some extent, a response option of “other” was included where parents could provide an alternative response. These “other” responses represent only a small percentage of respondents, yet they provide rich data and a unique, detailed perspective on some of the stressors and coping strategies that parents were using. Other limitations include the use of a convenience sample of mostly mothers with limited racial / ethnic diversity (i.e., mostly White) that is not a nationally representative sample of all US parents, thus limiting generalizability of these findings; however, this sample did provide a diversity across family income and parent education. Lastly, parental stress could have varied across geographical locations where different policies were enforced at the time of survey completion. Larger, more nationally representative data sets, such as the Stress in America Poll,18 should be referenced for changes in stress across a broader US population and by location.