Rural Native and European American Custodial Grandparents: Stressors, Resources, and Resilience

Predictors of Supportive Care Needs During Serious Illness: Cross-sectional Analysis of Reservation-Based Informal Caregivers

Native Americans (Indigenous Americans) have high rates of serious illness in the United States. Informal caregivers are heavily relied on in caring for patients in low-resource settings. The needs of caregivers residing on reservations are sorely underreported. Therefore, our objective was to examine relationships between facilitators (communal mastery, cultural identity, and spirituality) and barriers (depression, anxiety, stress, and burden) with supportive care needs among adult informal caregivers in 1 reservation-based community. A cross-sectional survey was distributed in July and August 2022 as part of a larger multimethod, community-based participatory research study. We used descriptive statistics and linear regression models to examine relationships against the primary outcome, the Supportive Care Needs Assessment Tool for Indigenous People. Overall, 127 participants were included; most were female (n = 92, 72.4%), were between 30 and 49 years (n = 57, 44.9%), and had 6 months or less of caregiving experience (n = 41, 32.5%). Higher depression, anxiety, stress, and burden were significantly associated with higher Supportive Care Needs Assessment Tool for Indigenous People scores. Overall, mental health is a significant barrier that may indicate greater supportive care needs among informal caregivers, although further work is needed to differentiate symptoms and their impact on caregiving from a cultural perspective.

Place-based strengths and vulnerabilities for mental wellness among rural minority older adults: an intervention development study protocol

INTRODUCTION

Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial-minority and ethnic-minority older adults compared with their urban white counterparts result in cognitive impairment, comorbidities and increased mortality, presenting a growing public health concern as the United States (US) population ages. These inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, gaps in transportation and safety-net services, and disparities in access to policy-making processes rooted in colonialism. This constellation of factors renders racial-minority and ethnic-minority older adults 'structurally vulnerable' to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as social support, community attachment and a meaningful sense of place. Scholarship on the social determinants of health widely recognises the importance of such place-based factors. However, little research has examined how they shape disparities in depression and treatment specifically, limiting the development of practical approaches addressing these factors and their effects on mental well-being for rural minority populations.

METHODS AND ANALYSIS

This community-driven mixed-method study uses quantitative surveys, qualitative interviews and ecological network research with 125 rural American Indian and Latinx older adults in New Mexico and 28 professional and non-professional social supporters to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among older adults. Data will serve as the foundation of a community-driven plan for a multisystem intervention focused on the place-based causes of disparities in depression. Intervention Mapping will guide the intervention development process.

ETHICS AND DISSEMINATION

This study has been reviewed and approved by the University of New Mexico Health Sciences Center Institutional Review Board. All participants will provide informed consent. Study results will be disseminated within the community of study through community meetings and presentations, as well as broadly via peer-reviewed journals, conference presentations and social media.

Mothers' Perceived Co-Parenting and Preschooler's Problem Behaviors: The Mediating Role of Maternal Parenting Stress and the Moderating Role of Family Resilience

Introduction

Problem behaviors in preschoolers signals social adjustment challenges. This study investigates the mediating role of parenting stress in the relationship between co-parenting and these behaviors, and examines how family resilience impacts this dynamic.

Methods

A detailed survey was conducted with 1279 mothers of 3-6-year-olds in Shanghai, China, focusing on co-parenting, family resilience, parenting stress, and children's behaviors. We employed SPSS 26 for initial tests and the Hayes PROCESS macro in SPSS 23.0 for advanced analysis, using bootstrap methods to assess mediation and moderation effects.

Results

The analysis revealed that maternal parenting stress mediates the relationship between co-parenting and children's problem behaviors. Specifically, unsupportive co-parenting or low levels of supportive co-parenting heightened maternal stress, which in turn increased children's problem behaviors. Family resilience was found to moderate this relationship, buffering the impact of unsupportive co-parenting on maternal stress. High family resilience levels were associated with lower parenting stress, regardless of co-parenting quality.

Conclusion

These findings highlight the importance of enhancing family resilience and supportive co-parenting to mitigate parenting stress and reduce problem behaviors in children. It has practical implications for developing family-centred interventions and policies to strengthen family resilience and co-parenting skills.

Social support and subjective well-being of noncustodial grandparent caregivers in urban China: The mediating roles of generative acts

While social support is generally beneficial, it remains unclear how it directly and indirectly affects subjective well-being among grandparents via generative acts. Multi-stage cluster random sampling was employed in a city in Eastern China, reaching 1013 noncustodial grandparent caregivers of kindergarten children (mean age = 58.3, range: 40-93, female = 71.9%, non-local = 508). Data were analyzed using structural equation modeling (SEM). The results reveal that social support positively affected three indicators of subjective well-being among noncustodial grandparent caregivers. Also, social support worked through agentic generative acts to positively affect life satisfaction and positive affect, while not through domestic generative acts. The present study contributes to grandparent caregiving research in urban China by advancing an integrated framework that considers the mechanism of generative acts. Policy and practice implications are also discussed.

Stress, Coping, and Quality of Life Among Custodial Grandparents

An increasing number of custodial grandparents are raising grandchildren, and intensive childcare is stressful with many negative personal, interpersonal, economic, and health implications. Grandparents' strengths, including resilience, positive caregiving appraisal, and social support should be considered in the face of parenting stress and adversity. Guided by the stress and resilience model, the current study investigated the associations of parenting stress and coping resources with life satisfaction and mental wellness among custodial grandparents (N = 76). Data were collected between December 2020 and April 2021, through collaborations with community-based agencies located in two metropolitan areas, which provide supportive services to custodial grandparents and their families. Findings showed that more parenting stress was associated with less life satisfaction and worse mental health, and that stress management boosted life satisfaction and mental wellness. Grandparents with more informal social support and social service utilization fared better than their counterparts with less social support and no experience of service use. The results of this study suggest that social work interventions should focus on improving stress management to cope with daily and caregiving stressors. Social workers can help with informal social support and formal social services utilization to address caregiving needs among custodial grandparents.

AVÓS CUIDADORES DE NETOS: ANÁLISE DO PERFIL E INTENSIDADE DOS CUIDADOS

RESUMO Objetivo: identificar o perfil e a intensidade de cuidado dos avós para com os netos. Método: estudo descritivo, transversal, por amostra aleatória sistematizada, utilizado questionário semiestruturado e empreendida análise exploratória descritiva. Realizado no município do Triângulo Mineiro - Brasil, 2019. Resultados: entrevistados 392 avós cuidadores de netos, maioria mulheres (87,5%), aposentadas (67,3%), ensino fundamental incompleto (52,8%), hipertensas (71,9%) e problemas visuais (69,4%). O motivo principal de cuidado foi pelos pais trabalharem e a intensidade de cuidado junto aos netos foi intensiva. Conclusão: considera-se que a relação de cuidado entre avos e netos é um aspecto invisível à produção científica e na estruturação de programas de saúde, apesar de seus impactos à condição de saúde dos idosos. O estudo amplia a visão aos mesmos sendo necessário o desvelar deste tema para que se possa efetivamente integrá-los e fortalecer políticas públicas e sociais, notadamente no setor saúde, dado ser um fenômeno emergente.

GRANDPARENTS THAT TAKE CARE OF GRANCHILDREN: ANALYSIS OF THE CARE PROFILE AND INTENSITY

ABSTRACT Objective: to identify the profile and intensity of the care provided by grandparents to grandchildren. Method: a descriptive and cross-sectional study by means of systematized random sampling, with application of a semi-structured questionnaire and execution of descriptive exploratory analysis. It was conducted in 2019 in the municipality of Triângulo Mineiro - Brazil. Results: a total of 392 grandparents caring for grandchildren were interviewed, mostly women (87.5%), retired (67.3%), with incomplete Elementary School (52.8%), hypertensive (71.9%) and with vision problems (69.4%). The main reason for the caregiver role was the fact that the parents had to work, and intensity of the care provided to the grandchildren was high. Conclusion: it is considered that the care relationship between grandparents and grandchildren is an invisible aspect to the scientific production and in the structuring of health programs, despite its impacts on older adults’ health status. The study broadens their visibility, with the need to unveil this topic so that it is possible to integrate them and strengthen public and social policies, especially in the health sector, given that it is an emerging phenomenon.

ABUELOS CUIDADORES DE NIETOS: ANÁLISIS DEL PERFIL E INTENSIDAD DEL CUIDADO

RESUMEN Objetivo: identificar el perfil y la intensidad del cuidado que realizan los abuelos de sus nietos. Método: estudio descriptivo, transversal, con muestreo aleatorio sistemático, mediante cuestionario semiestructurado y análisis descriptivo exploratorio. Realizado en el municipio del Triángulo Minero - Brasil, 2019. Resultados: se entrevistó a 392 abuelos que cuidaban a sus nietos, la mayoría eran mujeres (87,5 %), jubiladas (67,3 %), con primaria incompleta (52,8 %), hipertensión (71,9 %) y problemas visuales (69,4 %). La principal razón para que cuiden de ellos era que los padres trabajaban y la intensidad del cuidado de los nietos era intensiva. Conclusión: se considera que la relación de cuidado entre abuelos y nietos es un aspecto invisible en la producción científica y en la estructuración de programas de salud, a pesar de los impactos que tiene en la condición de salud de los adultos mayores. El estudio amplía la visión sobre los mismos dado que es necesario dilucidar este tema para que puedan ser efectivamente integrados y fortalecer las políticas públicas y sociales, especialmente en el sector salud, dado que se trata de un fenómeno emergente.