Grandmothers Raising Grandchildren: Predictors of Healthcare Access and Financial Security During COVID-19

Grandmothers living with or raising grandchildren who had just completed the final data point of an NIH-funded, national, behavioral RCT were asked to complete an additional data collection point to capture the effects of the Covid-19 pandemic on their families’ access to healthcare and financial security. In Spring 2020, 258 grandmothers completed measures of access to healthcare and financial security (3 and 4 item composite scales), family strain, family functioning, and psychosocial and demographic variables. Financial security (Adj. R2=.52) was explained by knowing other grandfamilies; better family functioning; and fewer financial worries, unmet service needs, and depressive symptoms. Access to healthcare (Adj. R2=.24) was explained by being married, employed and having fewer financial worries and unmet service needs. Findings that family functioning, knowing other grandfamilies and depressive symptoms contributed to financial security, and that marital and employment status affect access to healthcare show the importance of support.

The Effects of Situational Peers and Support Groups on the Well-Being of Grandmothers Raising Grandchildren

Grandmothers raising their grandchildren face not only the demands of parenting, but the added burden of parenting a child they did not expect to raise. Similarly, grandmothers living in multigenerational households need to balance expectations and household/caregiving tasks across the generations. As part of a nationwide RCT designed to lessen the stress associated with the caregiving burden of raising grandchildren, we asked 342 grandmothers raising their grandchildren about their engagement with support groups and whether their social network included other grandfamilies. Here, we examine the effect of situational peers and support group engagement on grandmother’s stress, reward, social support, mental health, mindfulness, and resourcefulness. Of our sample, 53.8% (N=184) reported belonging to a support group. The majority of participants (138) belonged to online support groups on Facebook, 41 reported participating in in-person support groups, 3 belonged to both in-person and online support groups, and 8 did not respond. When asked whether and how well our participants knew other families like theirs, 31% (106) said they did not know any, 40.6% (139) knew of at least one, but not well, and 28.4% (97) said they had at least one friend with a family like her own. Knowing other families like their own affected self-appraised stress, but no other outcomes. Grandmothers participating in support groups had lower mindfulness scores, higher stress, and worse mental health scores than grandmothers not participating in support groups, possibly reflecting the higher need for support among those participants.

A Practical Protocol for Reporting Depressive Symptoms in a Clinical Trial of Grandmother Caregivers

Intervention studies conducted in caregivers often focus on improving mental health. Consequently, researchers may discover incidental findings like elevated depressive symptoms. Researchers have an ethical obligation to report incidental findings to participants, but no protocols exist for reporting behavioral health symptoms. This presentation describes a protocol for reporting elevated depressive symptoms to participants, based on the protocol used in a national randomized clinical trial of stress-reduction methods for 348 grandmothers raising grandchildren. Each questionnaire included the CES-D scale and was scored immediately after completion. Based on our previous work showing higher CES-D scores in custodial grandmothers, and the desire to balance the principles of beneficence and nonmaleficence, we established a cut-off score of 30. A registered nurse on the research team called participants with scores over 30 and ascertained whether the participant 1) was aware of the problem and 2) had sought help, and then offered additional resources. Overall, 94 (27%) participants had a CES-D score > 30. The majority (91%) were aware of the problem. About a third of the participants were on medication for their symptoms, and a third were seeing a therapist. Nine participants were not aware they had depressive symptoms. While most of our participants were aware of their depressive symptoms, they were appreciative of our call and several noted that they would speak to their provider. Future studies should consider how to implement a similar protocol to deliver information critical to the mental health of participants.

Social Capital Among Black South African Grandmothers Raising Grandchildren

While the significance of social capital to the well-being of black South African grandmothers raising grandchildren has been well documented, few studies have systemically investigated the sources, types, and patterns of use of social capital in this population. The aim of the current qualitative study is to use the social capital framework to explore how 75 grandmothers accessed and utilized available social capital (i.e., bridging, bonding, and linking) to enhance their own and their families’ well-being. Results from a thematic analysis revealed an inside-out pattern of social capital; bonding and bridging social capital were the most significant sources of immediate support for grandmothers, with relatives providing emotional and instrumental support and neighbors and friends mainly providing informational support. Linking capital (i.e., government and community leaders) helped grandmothers access public resources. Implications for policy and practice are addressed.