Acceptance Commitment Therapy Intervention for Custodial Grandfamilies: A Virtual Implementation

Custodial grandfamilies often face challenges, such as psychological distress, parenting burden, and grandchildren showing internalizing and externalizing behaviors. Given their circumstances, effective training and education is critical to provide a supportive family environment for both custodial grandparents and custodial grandchildren. The aim of this study was to develop, pilot and evaluate a psychosocial intervention for custodial grandfamilies. The program, interACT, was implemented virtually due to restrictions related to COVID-19. It is an intervention for custodial grandparents (CGPs) and custodial grandchildren (CGC) to improve psychological wellbeing and life skills. Participant eligibility was determined by grandfamilies having Iowa residency and legal guardianship or custody of an 8-12 year old grandchild. The program utilizes the Acceptance and Commitment Therapy (ACT) framework, focusing on psychological flexibility, acceptance, and psychosocial resilience for CGPs and CGC. The program used techniques such as mindfulness, self-compassion, and decision-making skills. During the pilot program stage, participants were divided into CGPs and CGC groups, and completed self-paced weekly 45 minute long modules through a program website. To enhance online session experience, Extension staff facilitated hour-long Zoom calls to discuss module contents and foster peer connection for both groups. Findings will be available at the conclusion of the pilot program. We expect to find increased psychological well-being and improved life skills for both groups right after the implementation of the ACT. Findings and limitations will be discussed with practical implication for program implementation via virtual delivery for the current custodial families. Future studies could extend current curriculum to other populations.

Current and Future Directions in Minority Aging: Embracing Interdisciplinary Models

Racial/ethnic disparities in health among older adults are well-documented. More research is needed to clarify the complex and multifactorial mechanisms underlying these associations. This symposium will feature research that employs innovative theoretical and methodological approaches to understand the biopsychosocial mechanisms that underlie racial/ethnic disparities in older adults’ health and determine sources of within-group heterogeneity in minority aging. Dr. Forrester will integrate stress biology and intersectionality to demonstrate the importance of stress and resilience (e.g., John Henryism) with biological aging within Black adults participating in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Dr. Brown Hughes will present innovative research using data from the African American United Memory and Aging Project (AA-UMAP) on the importance of Alzheimer’s disease-specific knowledge and perceptions among Black older adults. Dr. Gamaldo will employ a within-race approach to understand how knowledge and perceptions of Alzheimer’s disease and related dementias (ADRD) shape cognitive performance among Black older adults in the AA-UMAP study. Dr. Mitchell will use Health and Retirement Study data to explore the role of midlife stress exposure in accounting for racial disparities in trajectories of cognitive functioning. Drs. Thierry and Farmer will use HRS data to examine how psychosocial resilience (e.g., mastery) affects the relationship between perceived neighborhood conditions (e.g., disorder) and cognition among Black older adults. This work highlights the importance of applying an interdisciplinary lens to move the study of minority aging forward and ultimately, to reduce the unnecessary burden of morbidity and mortality among minoritized groups.

Exploring How Neighborhood Characteristics and Psychosocial Resilience Affect Cognition Among Older Black Adults

Black older adults are at greater risk for poor cognitive health than Whites, and adverse neighborhood conditions may contribute to this disparity. Moreover, limited research examines how resilience is implicated in the relationship between neighborhoods and cognition among Blacks. Using 2006-2016 waves of the Health and Retirement Study, we examine how perceived neighborhood characteristics (physical disorder and social cohesion) and psychosocial resilience (social support, mastery, and sense of purpose) contribute to cognitive functioning among 1,655 Black adults ages 65+. Results from multilevel linear regression models show that greater physical disorder was associated with worse cognitive functioning, and this was attenuated after adjustment for socioeconomic status. We found a positive association between purpose and mastery with cognitive functioning, even after accounting for socioeconomic, psychosocial, and health-related characteristics. Thus, high levels of purpose and mastery may be protective for cognitive functioning among Black older adults in spite of experiencing negative neighborhood contexts.

Determinants of Psychosocial Resilience Resources in Obese Pregnant Women with Threatened Preterm Labor—A Cross-Sectional Study

Background: The purpose of the study was to assess the level of such psychosocial resilience resources as self-efficacy, dispositional optimism, and health locus of control in pregnant women with obesity with threatened premature labor. Methods: The study was performed in the years 2017–2020 in a group of 328 pregnant women hospitalized due to threatened preterm labor and diagnosed with obesity before the pregnancy. The following instruments were applied: the Life Orientation Test, the Generalized Self-Efficacy Scale, and the Multidimensional Health Locus of Control Scale. Results: Obese pregnant women with threatened premature labor have a moderate level of generalized self-efficacy (28.02) and a moderate level of dispositional optimism (16.20). Out of the three health locus of control dimensions, the highest scores were recorded in the “internal control” subscale (26.08). Statistically significant predictors for the self-efficacy variable model included: satisfactory socio-economic standing (ß = 0.156; p = 0.004), being nulliparous (ß = –0.191; p = 0.002), and the absence of comorbidities (ß = –0.145; p = 0.008). Higher levels of dispositional optimism were found in women who were married (ß = 0.381; p = 0.000), reported a satisfactory socio-economic standing (ß = 0.137; p = 0.005), were between 23 and 27 weeks pregnant (ß = –0.231; p = 0.000), and had no comorbidities (ß = –0.129; p = 0.009). Conclusions: Generalized self-efficacy in obese women with threatened preterm labor is associated with satisfactory socio-economic standing, being nulliparous, and the absence of chronic disease. Dispositional optimism in obese pregnant women with threatened preterm labor is determined by their marital status, socio-economic standing, gestational age, and the absence of comorbidities.

Uncertainty, Sex and Sexuality during the Pandemic: Impact on Psychosocial Resilience

The Coronavirus disease 2019 (COVID-19) pandemic has been a global unprecedented health threat. Besides the myriad of effects on public health, the psychosocial implications of the outbreak have been far-fetched. Though the increased prevalence of psychiatric disorders, reduced access to care and social vulnerabilities have been highlighted in literature, the immense impact on sexuality and psychosexual health tends to be silent. The World Health Organization (WHO) defines sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.” Sexual practices and intimacy have been influenced by more ways than one, namely fear of infection, ambiguity about viral spread, misinformation, physical distancing, travel restrictions, intimate partner violence and deprivation of ‘social touch’. The frontline workers, socio-economically impoverished groups, age and sexual minorities are especially affected. Sexual and reproductive rights are compromised due to reduced help-seeking, panic and stigma related to the outbreak. Psychological resilience helps one navigate through stressful situations and assumes a special importance during the ongoing crisis. This chapter reviews the multi-faceted intersections between sexual health and resilience, highlights the possible roles of pandemic-related uncertainty and advocates for certain guidelines to promote and preserve healthy expressions of sexuality for coping during COVID-19.

Impact of COVID-19 on the Health and Well-being of Informal Caregivers of People with Dementia: A Rapid Systematic Review

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, raised worldwide concern. Since then, the COVID-19 pandemic has negatively influenced health and wellness across the globe and caused nearly three million deaths. This study focuses on informal caregivers of people with dementia, a disease that affects about 50 million older adults worldwide and requires much caregiving support. Objective: Examine the current literature on the impact of COVID-19 on the health and well-being of informal caregivers for people with dementia. Method: This rapid review was conducted across five electronic databases for quantitative and qualitative articles published through March 15, 2021. Results: The 10 studies included in this review reported quantitative descriptive data from across the globe; however, no studies existed from the U.S. or East Asia countries. All of the studies examined the psychological rather than physical impact of COVID-19 and highlighted risk and protective factors in the areas of psychosocial (resilience, neuropsychiatric, and social isolation), sociodemographic (gender and education), and environmental (home confinement, living arrangement, and dementia stage). Conclusion: COVID-19 has had a considerable negative impact on the psychological well-being of informal caregivers of people with dementia, namely causing more depression and anxiety than pre-pandemic.

Individual Psychosocial Resilience, Neighborhood Context, and Cardiovascular Health in Black Adults

Background: Despite well-documented cardiovascular disparities between racial groups, within-race determinants of cardiovascular health among Black adults remain understudied. Factors promoting cardiovascular resilience among Black adults in particular warrant further investigation. Our objective was to examine whether individual psychosocial resilience and neighborhood-level cardiovascular resilience were associated with better cardiovascular health in Black adults, measured utilizing Life’s Simple 7 (LS7) scores. Methods: We assessed LS7 scores in 389 Black adults (mean age, 53±10 years; 39% men) living in Atlanta, Georgia. A composite score of individual psychosocial resilience was created by assessing environmental mastery, purpose in life, optimism, resilient coping, and depressive symptoms. Neighborhood-level cardiovascular resilience was separately determined by the census tract-level rates of cardiovascular mortality/morbidity events. Generalized linear mixed regression models were used to examine the association between individual psychosocial resilience, neighborhood cardiovascular resilience, and LS7 scores. Results: Higher individual psychosocial resilience was significantly associated with higher LS7 (β=0.38 [0.16–0.59] per 1 SD) after adjustment for sociodemographic factors. Similarly, higher neighborhood-level cardiovascular resilience was significantly associated with higher LS7 (β=0.23 [0.02–0.45] per 1 SD). When jointly examined, high individual psychosocial resilience (>median) was independently associated with higher LS7 (β=0.73 [0.31–1.17]), whereas living in high-resilience neighborhoods (>median) was not. The largest difference in LS7 score was between those with high and low psychosocial resilience living in low-resilience neighborhoods (8.38 [7.90–8.86] versus 7.42 [7.04–7.79]). Conclusions: Individual psychosocial resilience in Black adults is associated with better cardiovascular health.

Psychological resilience and cardiovascular disease? A systematic review of the literature

Background Psychosocial resilience is the capacity of responding positively to stressful events in life. We performed a systematic review of the literature to find whether resilience has any protective effect on cardiovascular disease (CVD) or mortality. Methods We searched Pubmed and Prospero systematic Review Registry using terms resilience, psychological or resiliency or resilience or resilient or hardiness, cardiovascular or stroke or or myocardial infarction or CVD or mortality or hospitalization. The references of each included paper were also searched for relevant studies. Longitudinal studies conducted on all populations, in English, with no time restriction were searched. They were included in the review if they examined resilience as primary exposition, and mortality for all causes, mortality for CVD, CVD events and hospitalization as outcomes and if they were longitudinal. Results The search identified 1,471 studies, of which only 8 were retained and fully examined based on the study design reported in the abstract, and 3 met all the inclusion criteria. Two studies on 237,879 young Swedish men showed that lower resilience compared with the highest (scores from an interview) resulted associated with both coronary heart disease (HR = 2.61, 95%CI:2.52-2.70) and stroke risk (HR = 1.54, 1.40-1.70) in adulthood (follow up 23 yrs). A third study on 2,765 postmenopausal Afro-American women showed that a modified Brief Resilience Scale was not associated with CVDs (lowest vs highest quartile, HR = 0.95, 95%CI:0.63-1.42; follow up 12.5 yrs). Conclusions There is not sufficient evidence of a protective attitude of resilience towards CVD: only 3 studies were eligible, with heterogeneity in sample size, exposures to stressors and scales used to measure resilience, and with resilience data available only at baseline. Further studies are necessary, since resilience is a powerful concept, and, if proved protective, might be improved in populations to ameliorate CV health. Key messages No clear association between resilience and CVD risk has been shown in literature. This is the first systematic review on the topic and further research is needed to broaden our understanding of the relation between resilience and CVD.