Grandmothers raising grandchildren: are they at increased risk of health problems?

Public perception on active aging after COVID-19: an unsupervised machine learning analysis of 44,343 posts

Introduction

To analyze public perceptions of active aging in China on mainstream social media platforms to determine whether the "14th Five Year Plan for the Development of the Aging Career and Older Adult Care System" issued by the CPC in 2022 has fully addressed public needs.

Methods

The original tweets posted on Weibo between January 1, 2020, and June 30, 2022, containing the words "aging" or "old age" were extracted. A bidirectional encoder representation from transformers (BERT)-based model was used to generate themes related to this perception. A qualitative thematic analysis and an independent review of the theme labels were conducted by the researchers.

Results

The findings indicate that public perceptions revolved around four themes: (1) health prevention and protection, (2) convenient living environments, (3) cognitive health and social integration, and (4) protecting the rights and interests of the older adult.

Discussion

Our study found that although the Plan aligns with most of these themes, it lacks clear planning for financial security and marital life.

A study of the effect of number of children on depression among rural older women: empirical evidence from China

The association between early reproductive events and health status in later life has always been of interest across disciplines. The purpose of this study was to investigate whether there was an association between the number of children born in the early years of elderly women and their depression in later life based on a sample of older women aged 65 years and above with at least one child in rural China. Data from the Chinese Longitudinal Healthy Longevity Survey in 2018, this study used the ordinary least square method to conduct empirical research. This study has found a significant correlation between an increase in the number of children and depression in older rural women. When considering the sex of the child, the number of daughters had a greater and more significant impact on depression. Number of children may exacerbate depression of older women through declining self-rated health and reduced social activity, while increased inter-generational support alleviated depression. The association between number of children born and depression also existed in urban older women, though not significant. Therefore, it is suggested to accelerate the improvement of supporting policies related to childbirth, developing a healthy and scientific fertility culture, and improving rural maternal and child health services. Women should be assisted in balancing their roles in the family and in society, and in particular in sharing the burden of caring for children. Targeted efforts to increase old-age protection for older people.

Risk and Protective Factors for African American Kinship Caregiving: A Scoping Review

Background

African American children are disproportionately placed in kinship care, specifically with kin caregivers who have pressing service needs given their relatively poor physical and mental health, and low economic status. Kinship caregivers often face challenges, however, they also show resilience when raising relative children. Although the literature has examined risk and protective factors that affect kinship caregiving, no scoping review has been conducted to summarize these factors as they relate to African American kinship caregivers.

Objectives

This study aims to summarize the risk and protective factors that affect African American kinship caregiving.

Methods

Twenty-six studies were identified from this scoping review. A data template was used to extract information on data/sample, research methods, and risk and protective factors.

Results

This review found that the risk and protective factors in the identified studies can be summarized into four types: child, caregiver, relationship, and legal, cultural or social issues. Caregiver factors were examined from the perspective of physical and behavioral health, parenting, and resources. The most common risk factors were caregivers' low social economic status or great financial need, and caregivers' physical health. The most common protective factor was caregivers' spirituality or religion.

Discussion

This review helps to better understand the risk and protective factors for African American kinship caregivers. Policies should be informed by African American kinship caregivers' unique qualities to provide useful cultural solutions. Evidence based interventions should be developed and provided to African American kinship caregivers to improve their parenting abilities and to provide them with additional resources and supports. Implications for child welfare research are also presented.

Grandparenting Among Māoris of New Zealand: Reflecting on Meanings

Regardless of nation and culture, grandparents have been instrumental in the survival of families and communities as well as the preservation of cultures. This study explored the meaning and roles of grandparenting among Maori grandparents in New Zealand as a possible platform for advancing the conversation on the significance of grandparents in the lives of people across cultures. Participants interviewed included 17 Māori grandparents to great, great grandparents in Aotearoa New Zealand, living in intergenerational homes. A phenomenology approach was used to analyze the data. Five themes were extracted that elucidated the meaning of the roles of grandparenting from the perspective of Māori grandparents: Elders' responsibilities from a cultural perspective; support, resources, and assets; sociopolitical and economic challenges; current state of Elders' and role in family, and benefits and rewards. Implications and recommendations are discussed towards a more systemic and culturally responsive support of grandparents.

Grandparenting, Social Relations, and Mortality in Old Age

Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study (N = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.

Salivary Markers of Stress in Grandparents Rearing Grandchildren in Rural Appalachia: The Role of Mental Health, Religiosity, and Social Support

This study examines changes in salivary cortisol and alpha-amylase among grandparents rearing grandchildren in rural Appalachia. Grandparent-caregivers experience greater stress than non-grandparent-caregivers. Participants included 20 grandparent-caregivers and a child for which they cared, who completed questionnaires assessing family functioning and mental health via interview. Grandparent-caregivers provided morning saliva samples once a year for two years. For grandparent-caregivers low in social support and religiosity, grandparent-caregiver depressive symptoms, child depressive symptoms, and child stress were associated with increased grandparent-caregiver salivary alpha-amylase. For grandparent-caregivers high in social support and religiosity, child depressive symptoms, child stress, and child aggression were associated with increased grandparent-caregiver cortisol.

Housing needs of grandparent caregivers: grandparent, youth, and professional perspectives

This qualitative study examined the housing needs of grandparent caregivers and the youth in their care in New York State. Nine focus groups were conducted separately with grandparent caregivers (n = 46) and youth (n = 34), and interviews were conducted with key informants (n = 17) knowledgeable about housing and issues. Housing needs of greatest priority, contextual differences, and potential barriers to securing housing and social services were identified. Key themes indicated that housing challenges stem from four problem domains: the experience of poverty, which creates affordability challenges that trap grandparent caregivers and their grandchildren in unsuitable homes and unsafe neighborhoods; physical challenges of aging grandparents, which require specific housing accommodations; changes in family composition when taking in grandchildren, which necessitate moving out of prior accommodations or changing housing plans due to regulatory issues; and obstacles to obtaining needed benefits, including a lack of information, burdensome application processes, ineligibility, and a shortage of resources. These issues are discussed with implications for policy and practice.

The Health of the Nation's Custodial Grandfathers and Older Single Fathers: Findings From the Behavior Risk Factor Surveillance System

Two important parent groups are solo grandfathers and single fathers raising children alone. The health of male caregivers raising children has received little attention by scholars. Investigating the health of single male caregivers raises awareness about their physical vulnerability. This study uses the 2012 Behavioral Risk Factor Surveillance System to compare health characteristics of 82 solo grandfathers with 396 single fathers aged 50 years and older. The findings suggest that grandfathers exhibited a high prevalence for various health conditions, including diabetes (44%), heart attack (27%), chronic obstructive pulmonary disease (23%), and stroke (6%). Almost half of grandfathers rated their health as fair/poor (47%), and nearly two in five had functional limitations (38%). Although older single fathers had better health characteristics than grandfathers, their health profile was poorer than population norms. Logistic regression analysis suggests that solo grandfathers are more at risk for poor health outcomes than older single fathers. Practice interventions to minimize health risks are discussed.

Effects of Social Support and Volunteering on Depression Among Grandparents Raising Grandchildren

Guided by a stress-buffering model, this study examined the effect of the caregiver stress on depressive symptoms, specifically the moderating effects of social support and volunteering on the relationship between stress and depressive symptoms among grandparent caregivers. The 2010 Health and Retirement Survey included a sample of 1,973 grandparent caregivers who reported their stress scores. Findings suggest that positive social support and volunteering significantly moderated the relationship between stress and depressive symptoms. In particular, the study revealed that perceived quality of relations may help grandparent caregivers cope with their ongoing stress and enlarged social interaction may buffer the increase of negative stressor outcomes.

The Diabetic Health of African American Grandmothers Raising their Grandchildren

PURPOSE

The purpose of this study is to compare the health of primary caregiving African American grandmothers with diabetes with African American women with diabetes who were not primary caregivers.

DESIGN

Using a comparative, descriptive, cross-sectional design, 34 African American primary caregiving grandmothers were compared with 34 non-caregiving women with diabetes mellitus; women aged 55-75 years were recruited for this study throughout the central Arkansas.

METHODS

To measure the overall health, data on blood pressure, body mass index measurements, HbA1c levels, total cholesterol, and urine protein and creatinine levels were collected from all the participants.

RESULTS

Statistically significant differences between the caregivers and non-caregivers groups in systolic pressure (t = -3.42, P = 0.001) and diastolic pressure (t = -3.790, P = 0.000) and urine protein (W = 294.00, P = 0.000) were noted. Additionally, a clinically significant difference in HbA1c was noted between groups.

CONCLUSION

Differences in systolic and diastolic pressures, urine protein, and clinically significant differences in HbA1c suggest that African American primary caregiving grandmothers with diabetes mellitus may have more difficulty in maintaining their diabetic health than non-caregiving African American women.

Chronic Pain in Older African American Grandparent Caregivers

African American grandparent caregiving is increasing, and evidence shows that grandparent caregiving influences health and its management. As older adults age, their potential of experiencing chronic pain increases, and this is profound given that physiological research shows that African Americans, aside from aging, may have a predisposition for developing chronic pain. Research shows older African Americans experience significant chronic pain, but few have discussed the implications of managing chronic pain in older African Americans who have added parental responsibility. Many older African Americans receive home healthcare services and there is a unique role for home healthcare clinicians in caring for this vulnerable population. This article discusses the impact of pain on caregiving, challenges in pain management, and practice and policy implications to assist home healthcare clinicians maintain the safety and protection of both the older grandparent and grandchildren.

Child Only Kinship Care Cases:The Unintended Consequences of TANF Policies for Families Who Have Health Problems and Disabilities

The passage of the Personal Responsibility Work Opportunities Reconciliation Act (PRWORA) in 1996 changed the way America sought to help its most vulnerable citizens. The Temporary Assistance for Needy Families (TANF) legislation required families to work first. Many families with young children found the stringent requirements of TANF too restrictive for their needs. In this study a number of TANF customers were either physically ill or suffered mental health problems thus preventing them from finding suitable employment. Additionally they may have children who have health problems, which preclude the parent from work activity. Faced with time limits these families may rely on relatives or fictive kin to assume the responsibility of receiving TANF grants for the children so that they may avoid sanctions and possible loss of support for their children. These arrangements are called child-only cases. Given that poverty is related to neglect and neglect may result in out of home placement, these children are at risk for child welfare intervention. Child welfare systems look to kin to assume the responsibility of child rearing to reduce the number of children especially African American children who enter care. However, TANF and informal arrangements for kin to take care of children result in substantially less money for families. An evaluation of TANF is needed to determine if this legislation provides an adequate system for caring for needy families and children. doi:10.1300/J045v22n03_04.

Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents' physical and emotional capacities.

Resourcefulness training for grandmothers: preliminary evidence of effectiveness

In this pilot study of 102 grandmothers raising grandchildren, we used a quasi-experimental, repeated measures design to examine effects of resourcefulness training reinforced by expressive writing (journaling) or verbal disclosure (digital voice recording) in reducing stress and depressive symptoms and enhancing quality of life. Resourcefulness training was compared with expressive writing, verbal disclosure, and attention control conditions. Both the expressive writing and verbal disclosure methods for reinforcing resourcefulness training were more effective than the other three conditions in reducing stress and depressive symptoms and improving quality of life. No difference was found between the two reinforcement methods. Grandmothers may benefit from learning resourcefulness skills and from practicing them in ways that best fit their needs and lifestyles.

African American caregiving grandmothers: results of an intervention to improve health indicators and health promotion behaviors

The purpose of this study was to examine the efficacy of an intervention to improve the health of grandmothers raising grandchildren. A pre- and post-test design was employed with 504 African American grandmother participants. The intervention included monthly home-based visitation by registered nurses (RNs) and social workers, participation in support groups and parenting classes, referrals for legal services, and early intervention services for children with special needs. The Health Risk Appraisal was used to assess health indicators and health promotion behaviors. A comparison of pre- and post-test scores indicated significant (p < .002) changes in the desired direction for a number of health indicators and health promotion behaviors, including blood pressure, annual routine cancer screenings, frequency of weekly exercise, and improved dietary intake, as well as participants' perception of their health and life satisfaction. No improvements were observed in the proportion of participants who were obese or overweight.

Resourcefulness training for grandmothers raising grandchildren: is there a need?

Grandmothers raising grandchildren may experience stress that adversely affects their health and, thus, they may benefit from interventions to promote resourcefulness. Before conducting definitive tests about the effectiveness of resourcefulness training (RT), it is essential to determine the need for the training. This study of 126 grandmothers examined baseline resourcefulness, attrition rates from the resourcefulness training, and perceived need for RT. Baseline resourcefulness scores indicated that 72% of the grandmothers had more than a moderate need for RT. Reasons for attrition were unrelated to perceived need. After receiving RT, 88% perceived that they needed it. The results support testing RT effectiveness as the next step.

Use of Community and School Mental Health Services by Custodial Grandchildren

We examined patterns and predictors of the perceived need, use, and unmet need for mental health services by custodial grandchildren within both the school-based and community-based delivery sectors. Data were self-reported by a national sample of 610 custodial grandmothers providing full-time care to grandchildren ages 6 to 17 in the absence of biological parents. Although overlapping use of services across both sectors was common, the overall use of school-based services (51%) was higher than that of community-based services (37%). Using theAndersen Social and Behavioral Model (1995) the following shared predictors of mental health service use across both sectors by custodial grand-families emerged: grandchildren's externalizing symptoms, having other grandchildren in the household with medical or psychiatric diagnoses and corresponding use of services in the other sector. Predictors were largely the same regardless of whether analyses were conducted with families recruited by probability or convenience based sampling methods. Findings suggest the necessity to coordinate and integrate the availability and implementation of mental health services for custodial grandchildren across different delivery sectors.

Empowerment: a framework to develop advocacy in african american grandmothers providing care for their grandchildren

Purpose. Based on a review of the literature, this paper presents a unique and innovative model that offers an empowerment framework, which may be used to develop advocacy in African American (AA) grandmother caregivers. This proposed framework centers on education as a catalyst to the empowerment process in these grandmothers. Application of this model has potential to guide the practice of healthcare providers as they assist these caregivers in managing their own lives. Methodology. Various empowerment definitions and research were used to develop this empowerment framework. Discussion. This framework offers an empowerment education program for AA grandmothers providing care for their grandchildren on topics that they feel are necessary to appropriately care for themselves and their grandchildren. Outcomes of this empowerment education are to develop skills within these grandmothers so that they will be able to advocate for themselves, their grandchildren, and others within their communities. This education will ultimately produce skillful AA grandmothers who will develop abilities to empower themselves and other AA grandmothers who are in similar circumstances.

Surrogate mothers: aboriginal grandmothers raising grandchildren in Taiwan

The purpose of this qualitative study was to understand the experiences of Taiwanese aboriginal grandmothers when raising their grandchildren. Adopting a phenomenological approach, interviews were conducted with 15 Taiwanese aboriginal grandmothers who served as primary caregiver to a grandchild or grandchildren. Data were analyzed using Giorgi's phenomenological method. Four themes emerged from the data analysis, reflecting the parenting experience of grandmothers: using aged bodies to do energetic work: represented the physical effects of raising grandchildren; conflicting emotions: reflected the psychological effects of raising grandchildren; lifelong and privative obligation: described the cultural and societal beliefs of raising grandchildren; and coping strategies for raising grandchildren outlined methods the grandmothers used to cope with parenting their grandchildren. The results of this study offers insights into surrogate parenting within an underresearched group in Taiwan and will enable health care providers to be more aware of the physical, emotional, and social effects of the role of grandparent parenting.

Cushioning, weathering, place, and community in rural grandmother-mothering

Place influences rural women's health when distance and lack of anonymity contribute to a reluctance to seek care. A qualitative design was used to explore relationships between place and the health of rural grandmothers raising grandchildren. The study generated findings concerning theory related to perceptual experience of rurality, identifying "Cushioning," as a basic social concept and "Weathering," "Paradoxical Place," and "Community Mothering" as subconcepts. Physical and mental wear and tear, distance, isolation and unraveling community mothering undermined "Cushioning" and reflected in self-health neglect narratives. Findings underscore the importance of place to the health of rural women raising grandchildren.

"Give me some sugar!" the diabetes self-management activities of African-American primary caregiving grandmothers

PURPOSE

To compare the diabetes self-management activities of African American primary caregiving grandmothers before and after the initiation of caregiving and to compare the diabetes self-management activities of African American primary caregiving grandmothers to diabetic women who were not caring for their grandchildren.

DESIGN

Using a cross-sectional, descriptive design, 68 African American women 55 to 75 years of age were recruited as part of a larger study examining the impact of caregiving responsibilities on the diabetic health of African American primary caregiving grandmothers. Each participant was asked the frequency of their performance of six self-management activities. Caregiving grandmothers were asked about these activities before and after the initiation of caregiving.

RESULTS

Dependent and independent t-tests with Bonferroni correction were used to analyze the data. Statistically significant differences were noted in diet (t=4.400, p=.000) and self-monitoring of blood glucose (SMBG; t=3.484, p=.001) before and after the initiation of caregiving. For the caregiver versus non-caregiver comparison, statistically significant differences were noted in SMBG (t=-3.855, p=.000) and eye examinations (t=-3.211, p=.001).

CONCLUSIONS

The findings provide preliminary data to support further research examining the self-management activities of diabetic African American primary caregiving grandmothers. Diabetic African American primary caregiving grandmothers may have a decreased ability to integrate self-management activities into their daily patterns of living. Additional research is needed to determine what factors prevent this population from performing these tasks routinely.

CLINICAL RELEVANCE

African American primary caregiving grandmothers were found to have more difficulty performing some of their self-management activities, which may severely impact their overall diabetic health.

Grandmothers raising grandchildren: results of an intervention to improve health outcomes

PURPOSE

To examine the impact of an intervention to improve the health of grandmothers raising grandchildren in parent-absent homes.

DESIGN

A longitudinal, pretest-posttest design.

METHODS

The sample was composed of 529 female caregivers with a mean age of 56.7 years (range 38-83) who were predominantly low-income African Americans. Data were collected prior to the intervention and again at 12 months when the intervention was complete. The intervention involved home visitation by registered nurses and social workers, as well as other support services. The Short Form-36 was used to assess physical and mental health, using eight multi-item scales.

RESULTS

A comparison of pre- and posttest mean scores on the SF-36 indicated significantly (p < .003) improved mean scores for vitality, physical effects on role functioning, emotional effects on role functioning, and mental health. No significant differences were found for other attributes.

CONCLUSIONS

These preliminary findings suggest that grandmothers raising grandchildren may benefit from a home-based intervention designed to improve health attributes. Implications for nursing practice, policy, and research are presented.

CLINICAL RELEVANCE

The health of grandmother caregivers is critical to their ability to parent grandchildren successfully. Nurses practicing in a variety of settings are in a unique position to identify and address the health challenges of grandmothers who are raising grandchildren.

The health of caregiving grandmothers: a rural-urban comparison

PURPOSE

The purpose of this study was to compare the characteristics of rural versus urban caregiving grandmothers along with their physical and mental health status.

METHODS

A secondary analysis of data produced from the first wave of a longitudinal study of 485 Ohio grandmothers was conducted. Health status was measured using the SF-36 Health Survey and the 20-item CES-D depression scale. Rural-urban classification was made using Rural Urban Commuting Area (RUCA) codes based on resident ZIP codes, identifying 97 rural and 388 urban grandmothers in the sample.

FINDINGS

The rural and urban grandmothers were similar in age, educational level and employment status; however, 90% of the rural grandmothers compared with 60% of the urban grandmothers were white. Rural grandmothers were most likely to have traditional nonresidential relationships with their grandchildren. Approximately 38% of both the rural and urban grandmothers served as primary caregivers for their grandchildren, but a lower percentage of rural grandmothers lived in multigenerational homes. There was no significant difference between the rural and urban grandmothers in relation to physical or mental health. Among rural grandmothers, primary caregivers had significantly lower levels of mental health compared with the other caregiver groups.

CONCLUSIONS

These findings suggest that rural and urban grandmothers have similar levels of physical and mental health, despite differences in demographics and caregiving arrangements. Health promotion efforts with rural caregiving grandparents are indicated, addressing both mental and physical health.

Family-based care and psychological problems of AIDS orphans: does it matter who was the care-giver?

The purpose of this study is to compare psychological symptoms among double AIDS orphans (i.e. children who lost both of their parents to HIV/AIDS) who were in the care of different family-based caregivers (i.e. surviving parent, grandparents, other relatives, and non-relatives) before they were replaced in orphanages. The participants include 176 double AIDS orphans from four AIDS orphanages in rural China. Prior to being replaced in AIDS orphanages, these children had received family-based care by different caregivers, which included surviving parent (38%), grandparents (22%), other relatives (19%), and non-relatives (22%). The psychological measures include traumatic symptoms, depression, and loneliness. Both bivariate and multivariate analyses suggested that children who were previously cared for by non-relatives scored significantly higher in traumatic symptoms, depression, and loneliness scales than children who were previously cared for by their surviving parent, grandparents, and other relatives. Children in the care of grandparents reported the best scores on all psychological measures among children in the care of non-parent relatives. Multivariate analysis, controlling for children's gender, age, length in orphanages, number of household replacements, and total duration of replacement, revealed that the type of caregivers was significantly associated with psychological problems. Results in the current study suggest that children under the care of their grandparents reported the best psychological outcomes when their parents were unable to care for them because of AIDS. Appropriate psychological support and counseling services are needed for AIDS orphans who were either currently or previously under non-relative family-based care in China.

Emotional and behavioral problems of Chinese left-behind children: a preliminary study

OBJECTIVE

To examine the behavioral and emotional problems and their correlates in left-behindchildren (LBC) in the Hunan Province of China.

METHODS

A sample of 1,274 schoolchildren (48.7% girls; 12.4 +/- 2.2 years old) completed the Strength and Difficulties Questionnaire and their current caregivers completed questionnaires about caregiver/bio-parent's demographics and teachers' involvement with the family.

RESULTS

There were 629 (49%) children with a history of being left behind, of which 486 were currently cared for by a relative (RLC) and 41 by a non-relative (NRC). As much as 102 had a past history of being left behind, but were currently living with one or more biological parents at the time of the survey (PLB). A total of 645 (51%) children had no history of being left behind and were included as controls. LBC had significantly more psychopathology and less pro-social behaviors than the controls. These differences, with the exception of more hyperactivity and less pro-social behaviors, disappeared after adjusting for age, education and socioeconomic status of the children, parents/caregivers, and the involvement of the teachers. The psychopathology of LBC was significantly inversely correlated with these variables. Long duration and being left behind at a younger age were significantly associated with more psychopathology. Overall, NRC showed more psychopathology, followed by PLB and then RLC. However, with the exception of pro-social behaviors, after adjusting for demographic variables and duration of being left behind, all differences disappeared.

CONCLUSIONS

LBC are at risk to develop emotional/behavior problems, particularly if they are left behind early in life, for longer periods, in the care of young caregivers or nonrelatives with poor education and low socioeconomic status, and with less teacher support. Strategies to prevent the development of psychopathology and its amelioration, and governmental policies to decrease the rates of LBC are warranted.

A home-based nutrition and physical activity intervention for grandparents raising grandchildren: a pilot study

Five African American grandparents raising their grandchildren participated in a home-based nutrition and physical activity intervention. The primary goals were to increase grandparents' knowledge and skills in selecting and preparing healthy foods and to increase the grandparents' and grandchildren's physical activity levels. Results revealed that grandparents' concerns regarding their chronic diseases and desire to prevent health problems in their grandchildren served as motivators. Following the intervention, grandparents scored higher on nutrition and physical activity knowledge and their self-efficacy improved, although most health status indicators remained unchanged. Self-reported changes included walking more, reading food labels, and switching to a healthier type of fat.

Relationship between depression and specific health indicators among hypertensive African American parents and grandparents

African Americans are at greater risk for hypertension than are other ethnic groups. This study examined relationships among hypertension, stress, and depression among 120 urban African American parents and grandparents. This study is a secondary analysis of a larger nurse-managed randomized clinical trial testing the effectiveness of a telemonitoring intervention. Baseline data used in analyses, with the exception of medication compliance, were collected at 3 months' follow-up. Health indicators, perceived stress, and social support were examined to determine their relationship with depressive symptoms. A total of 48% of the variance in depressive symptomology was explained by perceived stress and support. Health indicators including average systolic blood pressure explained 21% of the variance in depressive symptomology The regression analysis using average diastolic blood pressure explained 26% of the variance in depressive symptomology Based on study results, African Americans should be assessed for perceived stress and social support to alleviate depressive symptomology.

Risk of psychological difficulties among children raised by custodial grandparents

OBJECTIVE

Although custodial grandchildren are believed to be at greater risk of emotional and behavioral problems than children in general, scant research has examined this important public health issue.

METHODS

This study involves data from 733 custodial grandmothers participating in a study funded by the National Institute of Mental Health on custodial grandparenting and 9,878 caregivers from the 2001 National Health Interview Survey (NHIS) who completed the Strengths and Difficulties Questionnaire (SDQ) in reference to target children between ages four and 17. These two data sets were used to determine if custodial grandmothers report greater emotional and behavioral difficulties, as measured by the SDQ, for custodial grandchildren than do caregivers of children from the NHIS normative sample.

RESULTS

Custodial grandchildren fared worse than children from the NHIS sample across all domains measured by the SDQ subscales, regardless of the child's gender and whether reporters were recruited by population-based or convenience sampling methods. Comparisons within the sample of 733 custodial grandmothers showed that higher levels of difficulties were reported when grandmothers were caring for boys, were recruited by convenience versus population-based sampling, and were white. Comparisons of the banded scores computed for each SDQ subscale suggested that custodial grandchildren have different cutoff points than children in the general population for a likely diagnosis of a psychiatric disorder.

CONCLUSIONS

Similar to other children in kinship care arrangements, custodial grandchildren are reported by their caregivers to have higher levels of behavioral and emotional disturbances than children in the overall U.S. population.

Risk of psychological difficulties among children raised by custodial grandparents

OBJECTIVE

Although custodial grandchildren are believed to be at greater risk of emotional and behavioral problems than children in general, scant research has examined this important public health issue.

METHODS

This study involves data from 733 custodial grandmothers participating in a study funded by the National Institute of Mental Health on custodial grandparenting and 9,878 caregivers from the 2001 National Health Interview Survey (NHIS) who completed the Strengths and Difficulties Questionnaire (SDQ) in reference to target children between ages four and 17. These two data sets were used to determine if custodial grandmothers report greater emotional and behavioral difficulties, as measured by the SDQ, for custodial grandchildren than do caregivers of children from the NHIS normative sample.

RESULTS

Custodial grandchildren fared worse than children from the NHIS sample across all domains measured by the SDQ subscales, regardless of the child's gender and whether reporters were recruited by population-based or convenience sampling methods. Comparisons within the sample of 733 custodial grandmothers showed that higher levels of difficulties were reported when grandmothers were caring for boys, were recruited by convenience versus population-based sampling, and were white. Comparisons of the banded scores computed for each SDQ subscale suggested that custodial grandchildren have different cutoff points than children in the general population for a likely diagnosis of a psychiatric disorder.

CONCLUSIONS

Similar to other children in kinship care arrangements, custodial grandchildren are reported by their caregivers to have higher levels of behavioral and emotional disturbances than children in the overall U.S. population.

Grandparents Raising Grandchildren: A Response to a Nutrition and Physical Activity Intervention

This pilot study explored the impact of an educational program on nutrition and physical activity knowledge of urban African-American grandparents raising their grandchildren. The program was integrated into a community-based intervention, Project Healthy Grandparents, and was implemented during the first 15 minutes of 10 grandparent support groups and parenting classes. Subjects included 22 grandparents who attended at least six sessions and completed pre- and posttests of nutrition and physical activity knowledge. Participants' posttest scores were significantly higher than their pretest scores (P<0.05), indicating an increase in knowledge. Eighteen grandparents provided insights about diet and physical activity and barriers to lifestyle changes during an audiotaped focus group. Based on analysis of the focus group's discussion, three major influences on healthful eating and physical activity emerged, including financial considerations, presence of grandchildren in the home, and preference for traditional cultural foods. Themes from the focus group were consistent with responses on the nutrition and physical activity knowledge test. Satisfaction with the program was very high and no specific recommendations for improvements were made. Results can guide future nutrition interventions for this target group and potentially contribute to grandparents' improved health and ability to care for their grandchildren.

Research on the Caretaking of Children of Incarcerated Parents: Findings and Their Service Delivery Implications

This paper reviews research findings on caretaking-related problems associated with the absence of parents from the home following incarceration. It focuses on the impact of incarceration on the welfare and adjustment of urban African American children and on the assumption of caretaking responsibilities by other caretakers, principally maternal grandmothers. Noting the complex situational difficulties involved and the potential burdens associated with surrogate parenting in general, and with this population in particular, the service-provider implications of this parenting arrangement are considered in this review. Findings indicate that problems associated with incarceration of parents tend to be intergenerational and vary considerably in complexity and severity. To the extent that they impact the children involved, these issues should be addressed in coordinated service delivery focusing on prevention.

Different pathways to a common destiny:grandparent caregivers in the district of columbia

Nationwide, grandparents raising grandchildren is a growing phenomenon. In the District of Columbia, 19% of children under age 18 live in kincare-headed households. This compares to 8% nationally. This article reports on findings from an AARP focus group study of 40 grandparents raising grandchildren in the District of Columbia. It tells the stories of individuals who have traveled different pathways to arrive at their common destiny of being a grandparent caregiver. It primarily uses the voices of African American grandmothers and grandfathers to address the resources and challenges they face as they care for and care about their grandchildren. Through hearing their stories, AARP crafted nine recommendations aimed at improving the quality of life of District of Columbia grandparents raising grandchildren. The article reports on recommendations emerging from the research and reinforces the need for collaboration among various stakeholders to address the fragmented service delivery system. doi:10.1300/J045v22n03_13.