Looking at the Family Stress Model in the Asian Context: A Scoping Review

Family background or home environment can be an indicator of how people’s engagement with the community is manifested. Using the Family Stress Model (FSM) as a lens to evaluate external and internal family impact on a child can be a useful tool in supporting children from different social and economic backgrounds. There has been a growing body of work demonstrating the impact of home stress on youth, specifically via the FSM and children from different cultural groups, but there has not been such a review for Asian communities. This paper is a scoping review following PRISMA standards that describes all current research that has been conducted on Asian communities in relation to the FSM.


Introduction
As the world becomes more globalized with more mixed cultural groups living together, it has become more increasingly important that all members of society are understood.If society can help to mitigate some pressures or stresses from families, it would pay dividends towards the well-being of members of the community (Liu & Sibley, 2019).(Saasa et al., 2021).

Acculturation
Acculturation refers to the process of cultural adaptation that occurs when individuals or groups of people move from one cultural situation to another.Although the idea has been around a long time, the concept was brought to the forefront by Berry (1980), who proposed a framework for understanding acculturation that included four distinct strategies for adapting to a new cultural context: assimilation, separation, integration, and marginalization.Since then, there have been many studies with some other important references in the field of acculturation research that includes (Lee & Yoo, 2004;Chun et al., 2003).

Acculturation and FSM
Research has linked acculturation and the Family Stress Model within various cultural groups.For example, studies have examined the relationship between acculturation and family stress among Latino adolescents (Gonzales et al., 2008;Lorenzo-Blanco et al., 2016;Smokowski et al., 2010;Warner et al., 2010), as well as African American adolescents (Beach et al., 2017), Korean American caregivers (Chae & Takeuchi, 2010), and adults living with diabetes (Seaton et al., 2014;Krause et al., 2014).Some of the most frequently cited studies on this topic include Gonzales et al. (2008), which developed a measure of familismo (or a family loyalty) to examine its relationship with adolescent adjustment, and Smokowski et al. (2010) that found that Latino adolescents' level of acculturation was associated with both family conflict and positive family relationships.Another useful study was Warner et al. (2010) that used the Family Stress Model to examine the impact of acculturative stress and coping strategies on the mental health of Latino adolescents.In European populations, some research has focused on immigrant families and their experiences of stress and acculturation.One often cited study is Okamoto et al. (2014), which examined the role of parent and youth cultural stressors among Turkish immigrant families in Germany.Another article that looked at Turkish immigrants was by Emmen et al. (2013) who considered first generation immigrant mothers and how it related to acculturation and FSM.These studies draw on the Family Stress Model to understand how stressors and cultural factors may impact family functioning and well-being in diverse cultural groups.

Objective
The widespread adoption of the FSM has spurred Masarik and Conger (2017) to do a revised literature review to update the information, and besides the general state of FSM literature review, there have been other literature reviews on Latino (Miller & Csizmadia, 2022) and African American communities (Hill & Witherspoon, 2016).However, after investigation, we noticed that there has not been a literature review on Asians in relation to FSM published.This scoping review has been designed to address the gap in the literature by providing all possible articles connected to FSM and Asian communities.Thus, this research aims to review existing empirical research on the Family Stress Model in relation to Asian communities to answer the following questions: i) What are the characteristics of these studies?ii) What have these studies found?
iii) Are there many connections between FSM and acculturation?iv) What are the gaps and limitations pointed out for future research?

Protocol, Research Plan, and Registration
PRISMA's statement guidelines for scoping reviews was used in conducting this research (Tricco et al., 2018).PRISMA's guidelines were formulated based on an expert panel of approximately 30 members representing different geographic areas and research expertise with experience in conducting, dissemination, and/or uptake of scoping reviews.
The protocol for this paper used the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (Moher et al., 2009), which will be revised by the research team and disseminated to solicit additional feedback.The plan of this scoping review aims to fulfill the following steps: (1) identification of literature, (2) screening and exclusion of duplicates, (3) assessing eligibility, and (4) the inclusion of studies for synthesis and charting (see Figure 1).

Information Sources and Search Strategy
To identify potentially relevant documents, the following bibliographic databases were searched for data from the last 20 years: ERIC, PubMed, PsycNET, ProQuest, and Google Scholar.If full text or abstracts were not available, the research team made efforts to get in contact with the original authors or with the academic library, or to buy the materials available for sale.The search strategies were conducted based on the following terms and booleans values: ("parental acculturation" OR acculturation) AND ("family stress model" OR FSM) AND (asian* OR japan* OR chin* OR thailand* OR philipin* OR korea* OR filipino OR americ* OR canad*).This strategy was reviewed by the research team.With this search, we could discover a total of 968 articles.After removal of duplicated, non peer-reviewed publications published in academic journals, articles in languages other than English, and non-related works to the subject of this study, we were able to pre-screen 500 papers.After screening, we had 275 publications to be further investigated for eligibility analysis.Finally, we were left with 21 studies in the review that met all the criteria for the scoping analysis (see Figure 2).

Selection of Sources, Screening, and Eligibility Criteria
After the search was concluded, results were exported into Zotero, and once duplicates were removed, the data was exported into an excel sheet.Then, to increase consistency and calibration among reviewers, the reviewers reviewed the eligibility of the publications by discussing the results and amending the data extraction before beginning the full screening for this review.Reviewers worked in pairs evaluating the titles, abstracts, then full text of all publications identified by the search for potentially relevant publications.Through discussion and consensus, the researchers solved disagreements on study selection.Characteristics of the sources of evidence used in screening and eligibility criteria can be seen in Table 1.Because screening and eligibility were conducted by two reviewers, their consensus over each criterion was calculated with the Kappa agreement score for measuring interrater reliability (Cohen's kappa) respecting at least a moderate to a good level of agreement of .60 to .80 (McHugh, 2012): K= (Pagree-Pchange)/(1-Pchance), where Pagree is the proportion of trials in which judges agree and Pchance the proportion of trials in which agreement could be expected due to chance.A data-charting form was jointly developed by the two reviewers to determine which variables to extract.The two reviewers independently charted the data, discussed the results, and continuously updated the data-charting form in an iterative process.Any disagreements were resolved through discussion between the two reviewers.The variables that were extracted from the included papers in the scoping review are: (1) country of origin, (2) Pre-screened: After duplicates excluded: 942 After Thesis removed: 932 (10 items removed) After Manuscript removed: 931 (1 item removed) After non-English papers removed: 831 (100 items removed) After book and book chapters removed: 817 (14 items removed) After nonrelated articles removed for example FSM used for "Federated States of Micronesia" or "Free School Meals" not "Family Stress model: 500 (317 items removed) Records pre-screened: 500 objective of the study, (3) findings, (4) theoretical approach, (5) sample characteristics (i.e., size, gender distribution, and age), ( 6) instruments used for assessment if any, (7) data collection process, (8) data analysis process, (9) topic, (10) antecedent, outcome(s), correlated or associated variables, (11) definition of the term, (12) publication type, (13) research method, ( 14) study design, (15) limitations, and ( 16) suggestions from authors for future research.

Synthesis of Results
The results describing methods of handling and summarizing the data that was charted.We reported the frequency of categories chosen by the data chart and organize themes based on the evaluation of the studies (see Table 2).Then, a narrative synthesis was produced to organize and describe the studies according to their topic or focus and to answer the research questions of this scoping review.A note on the participants, all the articles, except for Kolopaking et al. (2011), that collected intensive qualitative interviews had large datasets with a participant range from 156 on the low-end to 9,350 on the high-end.When removing the lowest and highest sets, the average number of participants for the other 19 articles was 689 participants.et. al., 2012;McConnell et. al., 2010;Xing et. al., 2019;Yeung, et. al., 2011;Zhang, 2012;Zhang, 2014 6-11 et. al., 2014;Benner & Kim, 2010;Sun et. al., 2015;Yu et. al., 2020;Zhang et. al., 2020;Zietz et. al., 202216-18 years old 3 Hou et. al., 2016;Jia et. al., 2021;Mistry et. al., 2009other or NA 5 Kolopaking et. al., 2011;Lee et. al., 2022;Shin et. al., 2022;Yeung & Chan, 2010;Zheng et. al., 2019

FSM & Acculturation
The goal of the research was to find articles that directly linked Asians with FSM, and if there were further connections to FSM and acculturation.Although all articles found did focus on FSM, most of the research did not specifically look at direct relationships with acculturation in the way that the following articles did.These articles could be divided into two main areas, acculturative stress connected to immigrant families and adolescent perspectives of family stress.

Acculturative Stress and Immigrant Families
Benner and Kim (2010) explored the developmental outcomes of Chinese American adolescents using FSM.The study found that family stressors, such as economic hardship and acculturation gaps, were associated with increased adolescent behavioral and emotional problems.Positive parent-child relationships and supportive family environments were found to buffer these negative effects.Similarly, Hou et al. (2016) found that parental acculturative stressors were associated with increased parent-child conflict, which in turn was related to higher levels of adolescent depression and anxiety.Yu et al. (2020) examined the effects of family financial stress and primary caregivers' levels of acculturation on children's emotional and behavioral problems among humanitarian refugees in Australia.The study found that family financial stress was associated with higher levels of emotional and behavioral problems among children.The effects of family financial stress were moderated by primary caregivers' levels of acculturation, with higher levels of acculturation buffering the negative effects of financial stress on children's outcomes.

Adolescent Perceptions
Iruka et al. ( 2012) investigated family investment and stress models and their relationship to children's school readiness across five cultural groups (European American, African American, Spanish speaking Hispanics, English speaking Hispanics, and Asian Americans).Although the paper was not purely focused on one culture group, the authors did break down the information by group thus allowing readers to see the Asian data.Because of this reason we decided to keep this article in the review.The study found that family investment was positively associated with children's school readiness across all cultural groups.However, the effects of family stressors varied across cultural groups, suggesting the importance of considering cultural context in understanding family stress and its impact on child development.Mistry et al. (2009) investigated the relationship between family economic stress and academic well-being among Chinese Americans.The study found that higher levels of economic strain were associated with lower academic achievement and increased depressive symptoms among Chinese American youth.
Looking at these studies, it can be suggested that family stressors due to acculturation issues can significantly impact the development and well-being of immigrant families and their children.Positive parent-child relationships, supportive family environments, and cultural context should be considered in efforts to promote positive outcomes for immigrant families.

FSM & Family Relationships
Most of the research that considered FSM in Asian communities focused heavily on FSM with its connections to interpersonal relationships within the family.The following articles will be organized into these themes: income or s socioeconomic status (SES), parental self-efficacy, material hardship, and parental education.

Income/SES
Jia et al. ( 2021) conducted a study to investigate the relationship between socioeconomic status (SES) and risk-taking behavior among Chinese adolescents through the lens of FSM.The authors found that higher SES was associated with lower levels of risk-taking behavior among Chinese adolescents, and this relationship was partially mediated by psychological and self-control.It could be said that Kim and Um's (2018) work was similar because they investigated the relationships between family income, parental depression, and adolescent aggression in South Korea using a latent growth mediation model.The authors found that lower family income was associated with higher levels of parental depression, which in turn was associated with higher levels of adolescent aggression.These findings suggest that family income may indirectly influence adolescent aggression through parental depression.Both studies suggest that improving parental mental health, psychological well-being of children, and self-restraint of adolescents from lower SES backgrounds may be an effective way to reduce aggression or risk-taking behaviors.
Although not directly related to Asian specific populations, Zietz et al. ( 2022) conducted a longitudinal examination of the Family Stress Model of Economic Hardship across seven countries, including the Philippines, China, Indonesia, South Korea, Turkey, Ukraine, and the U.S. The authors examined the associations between family economic hardship, parental depression, and child internalizing and externalizing behaviors, and tested whether these associations were moderated by country-level economic development.The authors found that family economic hardship was associated with parental depression, which was linked to child internalizing and externalizing behaviors; these behaviors were found to be more noticeable in countries with lower levels of economic development.These findings are similar to the previous two studies mentioned in this section because they address how economics impacts parent's mental health, which then influences children's behavior.Xing et al. (2019) investigated the role of parental warmth and harsh discipline in the relationship between family SES and Chinese preschoolers' inhibitory control.The authors found that higher SES was associated with higher levels of parental warmth, which in turn was associated with better inhibitory control.In contrast, harsh discipline did not mediate this relationship.These findings suggest that parental warmth may be an important mechanism through which family SES influences inhibitory control in Chinese preschoolers.The study highlighted the importance of positive parenting practices, particularly in the context of low SES families.
3.2.2Self-Efficacy Kolopaking et al. (2011) conducted the only qualitative focused study in this scoping review in which they explored maternal self-efficacy in the home food environment among low-income mothers of nutritionally at-risk children in Indonesia.The study involved in-depth interviews with mothers who were asked about their self-efficacy in providing healthy food for their children and the challenges they faced.The study revealed that the mothers faced multiple challenges in providing healthy food for their children, such as limited availability and affordability of healthy food options, lack of time, and conflicting priorities.Sun et al. (2015) examined the relationship between family material hardship and problem behaviors among Chinese adolescents using a moderated mediation analysis.The authors found that this relationship was partially mediated by working on self-esteem and depression.The authors also found that the effect was stronger for boys than for girls.These findings suggest that interventions aimed at reducing the impact of material hardship on problem behaviors among Chinese adolescents should consider the psychological mechanisms involved, as well as the gender differences in this relationship.

Material Hardship
Yeung and Chan (2010) examined family functioning in Chinese families living in an impoverished neighborhood in Hong Kong.The authors found that family functioning was negatively associated with family poverty and parental psychological distress and positively associated with child social competence.Yeung et al. (2011) again investigated the mediating role of parental psychological health in the relationship between family poverty and child outcomes in Chinese families in Hong Kong.Higher levels of poverty were associated with poorer parental psychological health, which in turn was linked to higher levels of behavior problems and lower academic achievement in children.Both articles suggest that addressing parental psychological health may be an important target for interventions aimed at mitigating the negative impact of poverty on child outcomes in Chinese families living in impoverished contexts.
As it can be seen, these articles linked parental stress due to economic issues to children's behaviors and mental wellness.The next section will look at how FSM impacts the family outcomes further through education.

FSM & Education
This section can be divided into two main categories, which are parental education and its relation to FSM outcomes and family stress's influence on children's academic performance.

Parental Education
Zhang (2012) examined the effects of parental education and family income on mother-child and father-child relationships in China.The author found that parental education was positively associated with father-child and mother-child relationships, while family income was only positively associated with father-child relationships.It suggests that parental education may be a key factor in promoting positive family relationships and environments in Chinese families with young children, while family income may have a more limited impact.Later, Zhang et al. (2020) examined the effects of family economic hardship on child outcomes in China.The authors found that family economic hardship was negatively associated with child academic achievement, social competence, and mental health, and that this relationship was partially mediated by family functioning and parental psychological distress.The authors also found that the effects of family economic hardship on child outcomes were stronger for families with lower levels of parental education, thus implying that the more educated the parents, the better the family is resistant to hardship.Zhang's (2014) article investigated the relationship between family income, parental education, parent-child conflict, and internalizing and externalizing psychopathology in Chinese children aged 2-3 years old.The study found that parental education had a direct effect on parent-child conflict.The authors suggested that family interventions aimed at reducing parent-child conflict may be effective in reducing psychopathology in young children.

Child Academic Outcomes
Bae et al.'s (2014) article explored the relationship between family SES, academic achievement, family processes, and adolescents' use of time in South Korea.The study found that family SES is related to academic achievement, and that family processes (e.g., parental monitoring, emotional support) and adolescents' use of time mediate this relationship.The authors suggested that enhancing family processes and promoting positive time use could be effective ways to reduce the achievement gap between families with lower or higher SES.
All of these articles are connected to education, by either how the parent's education level influenced family situations or how family hardship negatively influenced children's academic achievement.In these studies, family socioeconomic status and family processes were found to be related to child outcomes.These findings support the importance of reducing family stressors, specifically for families with lower educational levels, and promoting positive family environments to improve child outcomes.

FSM & New Approaches
While conducting the scoping review there were four articles that did look at FSM and Asian families, but they took a different approach that introduced new aspects to the conversation.Since there was still a narrative link to FSM in each article they were included.The general topics were social support, child development, and violence.
3.4.1 Social Support Lee et. al. (2022) investigated the impact of economic hardship on partner conflict during the COVID-19 pandemic in South Korea.They found that financial hardship was linked to conflict through parenting stress and marital satisfaction, highlighting the importance of understanding the complex pathways through which stressors can impact family dynamics.Similarly, McConnell et. al. (2010) explored the impact of financial hardship on child difficulties and the moderating effect of perceived social support.They found that financial hardship was linked to child difficulties through parenting stress and family functioning, but perceived social support moderated the relationship between financial hardship and parenting stress.Both articles emphasized the importance of social support as a protective factor for families experiencing economic hardship.Shin et. al. (2022) examined the impact of family socioeconomic status on child language outcomes in South Korea.Using a combined analysis of the FSM and the family investment model (FIV), they identified pathways through which family SES, parent characteristics, and early experiences influence child language outcomes.This study highlighted the importance of considering both family stress and family investment in connection to the impact on child development.

Violence
Zheng et al. (2019) investigated the relationship between financial strain and intimate partner violence against married women in China.They used FSM to explore the pathways through which financial strain leads to intimate partner violence and found that they are linked through psychological distress and relationship dissatisfaction.These findings suggest that economic stressors can have serious consequences for intimate partner relationships and highlight the need for interventions to address financial strain to prevent domestic violence.
As mentioned, these articles took on new approaches in how they used FSM to study Asian families, which can potentially lead to further studies that are similar in focus or theme.

Conclusion
When we began this scoping review, we set out to find any articles that were related to Asians and FSM.As the project was being developed, we came up with the following questions and will discuss the answers below: i) What are the characteristics of these studies?
ii) What have these studies found?
iii) Are there many connections between FSM and acculturation?iv) What are the gaps and limitations pointed out for future research?

What Are the Characteristics of These Studies?
The general study characteristics that were covered in Table 2 showed that the majority of the studies focused on Chinese populations either living in China or abroad with a focus on financial issues in relation to FSM and Asian communities.Most of the studies where cross sectional with surveys from adolescents and parents.There has been development of new ideas when connecting FSM to Asians which tended to come from scholars focused on Koreans who are considering education and child development.

What Have These Studies Found?
All of the studies have concluded that intervention would be beneficial for families who are undergoing difficulties related to stress or interpersonal dynamics.Although there were not many direct claims of what specific intervention is required, statements of more family support and research into such issues was recommended.

Are There Many Connections Between FSM and Acculturation?
As stated, there were five articles that looked at FSM and acculturation.Three of these articles looked at immigrant families and how acculturation was connected to stress at home.The other two articles examined the perceptions of second-generation adolescents and how homelife impacted them.

What Are the Gaps and Limitations Pointed Out for Future Research?
This next section had more depth which requires two subsections which are "Limitations noted by authors" and "Gaps found in this study".In the subsection "Limitations noted by authors" we will briefly discuss what the article authors mentioned as limitations that they found to be an issue in their work.In the "Gaps found in this study" subsection we will cover what we have seen as areas that are lacking in the research and what would be beneficial to be studied further.

Limitations Noted by Authors
When discussing their limitations, the articles that had cross-sectional designs (14 out of 21), stated that a weakness in their research was that their data was only collected at one point in time through surveys.Besides the cross-sectional aspect, when considering the self-reporting of the limitations, the authors' main issues could be lumped into general categories of datasets.The main problems listed in their datasets were reporting, relationships, sample groups, parent focus, and measurements.
The first limitation discussed was that much of the data was collected through self-reporting (Benner & Kim, 2010;Jia et al., 2021;Shin et al., 2022;Sun et al., 2015;Yu et al., 2020;Zhang et al., 2020), which the authors mentioned as a possible blind spot due to people's ability to not be honest.Relationships were brought up by two articles (Kim & Um, 2018;McConnell et al., 2010) where they stated that investigating connections to others and their relationships with the participants may have been useful.Next, the participant sample groups were mentioned as a potential limitation (Xing et al., 2019;Yeung et al., 2011;Zhang, 2012;Zhang, 2014;Zietz et al., 2022) because of the lack of diversity in the participants, i.e., all from the same neighborhood and/or SES background.Parental focus was brought up (Iruka et al., 2012;Lee et al., 2022;Zheng et al., 2019) as an issue because the children were not studied or given voice in the research.Finally, measurements were mentioned (Bae et al., 2014;Hou et al., 2016;Kolopaking et al., 2011;Mistry et al., 2009;Yeung & Chan, 2010) because the authors argued that they could have used different tools or styles of research, such as including qualitative data.Although financial focus was the first usage of FSM (see Conger et al., 2010), since FSM has become mainstream, there have been dynamic approaches towards its application.We would argue that there could be additional research in these specific areas: immigrant families to Asian communities, Asian countries, and acculturation.

Immigrant Families
Most current papers are written focusing on either Asians in western countries or Asians in their home countries.This could be a rich source of data by considering different groups that move to Asia, for example, refugees, people from starkly different cultures such as Africa, examining the stereotypical westerner living in Asia, and finally considering one Asian cultural group living in a different Asian country with noticeable cultural differences, such as Filipinos living in Japan.Considering such peoples living in Asia would provide a new way to use the FSM and provide new insights into the research.

Asian Countries
Currently there is much focus on China, Korea and Asians in western countries, there is very little work focusing outside of that.It would be useful to have more data from other Asian countries and cultures because Asia is a large and diverse area, it would be beneficial to see if FSM does apply universally or is only applicable for specific groups or peoples?If more research is done in different countries, it would not only expand the knowledge base, but it would also provide data that would allow comparisons across different groups.

Acculturation
Using the acculturation lens has two potential areas of interest.The first would be to look at international acculturation as mentioned in the immigrant section, and the second would be examining domestic acculturation.An example of domestic acculturation would be investigating a Chinese person from rural China living in Shanghai.Both types of research would be useful in developing the FSM further, as well as provide new types of research in the area.

Figure 1 .
Figure 1.PRISMA flowchart of article selection and usage

Figure 2 .
Figure 2. Document removal and journal articles kept

4. 5
.2 Gaps Found in This Study When looking at the four main areas of research (i.e., FSM & Acculturation, FSM & SES, FSM & Education, and FSM & New Approaches) in connection to Asian families, the bulk of the research is focused on economics.

Table 1 .
Systematic scoping review eligibility criteria for inclusion and exclusion of studies

Table 2 .
General study characteristics