Mental Health Stress, Family Resources and Psychological Distress: A Longitudinal Mediation Analysis in African American Grandmothers Raising Grandchildren.

OBJECTIVES: This study examines the effectiveness of a multidisciplinary intervention for African American grandmothers raising grandchildren on the relationship between dichotomized levels of mental health stress (low vs. high) and elevated levels of psychological distress, mediated by perceptions of family resources. METHOD: A nonrandom sample of African American grandmothers (N = 679) was assessed to test the predictive relations among study constructs in the context of a prospective mediational model. RESULTS: Perception of family resources contributes to lower psychological distress among custodial grandmothers exhibiting low and high levels of mental health stress. There was no significant difference in the strength of the mediated effects between the 2 mental health stress groups. CONCLUSION: The findings suggest appropriate resource-focused interventions can enhance grandmothers' subjective assessments of family resources and reduce psychological distress. However, additional research is needed to ascertain the consistency and generalizability of findings.

The "invisible caregiver": multicaregiving among diabetic African-American grandmothers.

PURPOSE: To explore the multicaregiving roles African-American grandmothers assume while self-managing their diabetes. DESIGN & METHODS: This longitudinal, qualitative pilot study explored the challenges of self-managing diabetes among six African-American caregiving grandmothers. Data were collected at 5 times points across 18 months. Content analysis, guided by the Adaptive Leadership framework, was conducted using data matrices to facilitate within-case and cross-case analyses. RESULTS: Although participants initially stated they cared only for grandchildren, all had additional caregiving responsibilities. Four themes emerged which illustrated how African-American caregiving grandmothers put the care of dependent children, extended family and community before themselves. Using the Adaptive Leadership framework, technical and adaptive challenges arising from multicaregiving were described as barriers to diabetes self-management. IMPLICATIONS: When assisting these women to self-manage their diabetes, clinicians must assess challenges arising from multicaregiving. This might require developing collaborative work relationships with the client to develop meaningful and attainable goals.

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.

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.

Depression, Social Support, and Mental Health: A Longitudinal Mediation Analysis in African American Custodial Grandmothers.

Custodial grandparents raising grandchildren experience intense levels of stress that can lead to depression and other forms of psychological distress. Drawing on a coping model of family stress, adjustment, and adaptation, we explored the relationship between depression and mental health quality of life mediated by social support and moderated by grandparent's age. The sample consisted of 667 African American custodial grandmothers, dichotomized into two age groupings, ≤55 (n = 306) and 55 + (n = 361). All grandmothers participated in a 12-month support intervention. The prospective analysis revealed social support was a mediator in the association between depressive symptoms and mental health quality of life for older African American grandmothers; however, this same relationship did not hold for their younger counterparts. Study limitations and future research directions are discussed.

Adaptive Challenges Rising from the Life Context of African-American Caregiving Grandmothers with Diabetes: A Pilot Study.

To understand the challenges arising from the context within which diabetic African-American caregiving grandmothers self-manage their diabetes we used the Adaptive Leadership Framework. Additionally, challenges to retaining this population in a longitudinal study were examined. In this exploratory, longitudinal, qualitative pilot study, data were collected at five time-points over 18 months. We coded the data using content analysis and conducted the within-case and cross-case analyses using data matrices. Lack of awareness of available resources, represented a technical challenge within the life context of these grandmothers and the remaining three themes: family upheaval; priority setting (with subthemes of difficulty meeting basic needs and competing demands); and self-silencing and self-sacrifice represented adaptive challenges. The context of African-American grandmothers' lives created primarily adaptive challenges that were complex and without immediate solutions. Research is needed to develop culturally and contextually appropriate interventions to help this vulnerable group develop capacity for adaptive work.