Exploring grandparents' psychosocial responses to childhood cancer: A qualitative study.

OBJECTIVE: A childhood cancer diagnosis is a traumatic experience for patients and their families. However, little is known about the effect on grandparents. We aimed to investigate the negative psychosocial impact, coping strategies, and positive outcomes of grandparents of childhood cancer patients in Switzerland. METHODS: We collected data using a semi-structured interview guide and applied qualitative content analysis. RESULTS: We conducted 20 interviews with 23 grandparents (57% female; mean age = 66.9 years; SD = 6.4; range = 57.0-82.4) of 13 affected children (69% female; mean age = 7.5 years; SD = 6.1; range = 1.0-18.9) between January 2022 and April 2023. The mean time since diagnosis was 1.0 years (SD = 0.5; range = 0.4-1.9). Grandparents were in shock and experienced strong feelings of fear and helplessness. They were particularly afraid of a relapse or late effects. The worst part for most was seeing their grandchild suffer. Many stated that their fear was always present which could lead to tension and sleep problems. To cope with these negative experiences, the grandparents used internal and external strategies, such as accepting the illness or talking to their spouse and friends. Some grandparents also reported positive outcomes, such as getting emotionally closer to family members and appreciating things that had previously been taken for granted. CONCLUSIONS: Grandparents suffer greatly when their grandchild is diagnosed with cancer. Encouragingly, most grandparents also reported coping strategies and positive outcomes despite the challenges. Promoting coping strategies and providing appropriate resources could reduce the psychological burden of grandparents and strengthen the whole family system.

Language and communication development and school readiness of children raised by grandparents or in multi-generational homes.

BACKGROUND: One in ten U.S. children lives with a grandparent, and more foster children are being placed in kinship care. OBJECTIVES: Our objective was to compare early language and communication development and school readiness among children raised by grandparents (alone or in multigenerational households) to children raised by parents. METHODS: We included in this cross-sectional study children ages 1-5 years from the 2016-2020 National Survey of Children's Health to examine healthy and ready to learn school readiness outcomes and binary language and communication development (2018-2020 data only) by caregiver type (parent, multigenerational, and grandparent-only) with survey-weighted log-binomial regression adjusted for confounders. We stratified by survey years pre-COVID-19 pandemic versus during. RESULTS: Among 33,342 children, 86.0% (SE = 0.51) of children were 'On-Track' for language and communication development; only 37.2% (SE = 0.68) were 'On-Track' overall for school readiness. Children raised by grandparents or in multigenerational households were more often 'On-Track' for school readiness than children raised by parents, but only upon adjustment for covariates (adjusted prevalence ratio (aPR) for grandparent-only 1.13, 95% confidence interval (CI) 1.11, 1.15; aPR for multigenerational 1.13, CI 1.12, 1.15). Smaller and less consistent differences in prevalence were observed for the other outcomes (language and communication development, school readiness domains of early learning skills, social-emotional development, self-regulation development and physical well-being and motor development). A disparity in school readiness may have emerged during the COVID-19 pandemic; children in grandparent-only households had a lower prevalence of being 'On-Track' for school readiness (aPR 0.71, 95% CI 0.69, 0.73) compared to children in parent households, whereas children in multigenerational households continued to be more often school-ready than children in parent households. CONCLUSION: Large proportions of children across caregiver types were not fully prepared for school. Consideration of key covariates is important because socio-economic disadvantage may mask other advantages grandparent-led and multigenerational households offer children's early development.

More Than Just Treats? Effects of Grandparental Support for Children Growing up in Adversity.

This study examined whether grandparental support is a protective factor for children's socio-emotional development in the context of adversity. Using longitudinal data from the Millennium Cohort Study, we investigated the effects of grandparental support across development in children with and without adverse childhood experiences (ACEs). Socio-emotional development was assessed with the Strengths and Difficulties Questionnaire when children were aged 3 years (N = 10,186), 5 years (N = 10,412) and 7 years (N = 10,551). Parent-reported grandparental childcare, coresidence and financial help were assessed and parents reported on the occurrence of five ACEs: physical and emotional abuse assessed with the Straus' Conflict Tactics Scale, parental mental illness assessed with the Kessler scale, domestic violence and parental separation. We found that children with relatively higher levels of ACEs showed more prosocial behaviour and less externalizing problems when they received grandparental care compared to non-grandparental (in)formal care, but only at age 3. By age 7, children with higher levels of ACEs receiving grandparental care showed less prosocial behaviour and more externalizing problems. In addition, grandparental financial support at age 3 was related to more externalizing problems. Post-hoc analyses showed that internalizing and externalizing behaviours at age 5 were related to an increased probability of grandparental childcare at age 7, indicating that children's socio-emotional problems trigger grandparental support. Our findings point to a protective effect of grandparental care on children's socio-emotional development at age 3. Our results highlight the importance of going beyond the nuclear family towards the impact of the wider family network when examining children's socio-emotional development. RESEARCH HIGHLIGHTS: Three-year-old children with high levels of adverse childhood experiences (ACEs) show more prosocial behaviour and less externalizing behaviour when they receive grandparental care. Grandparental care has therefore protective effects on young children's socio-emotional development in the context of family adversity. Grandparents respond to children's socio-emotional problems and family adversity by increasing financial support and involvement in care. These findings underscore the importance of going beyond the nuclear family towards the impact of the wider family network when examining children's socio-emotional development.

What matters to migrant women during labor and birth: Chinese mothers' experiences in Switzerland.

BACKGROUND: In Switzerland, foreigners account for 25.3% of the permanent resident population, and the fertility rate of migrant women is higher than that of Swiss women. However, migrant women from non-European countries are more likely to report having negative childbirth experiences than Swiss women. For example, during pregnancy, Chinese migrant mothers often felt dissatisfied with the follow-up pregnancy complications and lacked information on medical procedures and prenatal courses. In this paper, we explored their childbirth experiences in Swiss hospitals and how Swiss healthcare providers supported them. METHOD: A qualitative study employing in-depth, semi-structured interviews was conducted with 14 Chinese mothers and 13 family members. All interviews were audio-recorded, transcribed, and translated into English for data analysis. Thematic analysis was employed to generate a detailed description. RESULTS: Three main themes were extracted from the transcripts: (1) Sense of security, (2) Intrapartum care, and (3) Postpartum needs. CONCLUSIONS: Our study shows Chinese migrant mothers prioritized giving birth in a physically and psychologically safe environment, with pain control and practical and emotional support from their intimate partners. They desired a physiological labor and birth with minimal obstetric interventions. Our research also reveals their postpartum needs, emphasizing the importance of postpartum support and obtaining culturally sensitive care during their postpartum hospital stay. The study adds new knowledge of specific migrant studies in Switzerland, as called for by the Swiss Federal Office of Public Health. The results call for the transcultural care skills training of Swiss healthcare providers to enable migrant women to have a more positive childbirth experience.

Barriers and enablers to promoting grandchildren's physical activity and reducing screen time: a qualitative study with Australian grandparents.

BACKGROUND: With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children's engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children's physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children's physical activity and reducing screen time. The present study sought to explore these perceptions. METHODS: Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis. RESULTS: Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children's fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view). CONCLUSIONS: Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents' age and health status, as well as any environmental barriers, are likely to be well-received.

Grandparental support and maternal depression: Do grandparents' characteristics matter more for separating mothers?

Grandparental support may protect mothers from depression, particularly mothers who separate and enter single parenthood. Using longitudinal Finnish register data on 116,917 separating and 371,703 non-separating mothers with young children, we examined differences in mothers' antidepressant purchases by grandparental characteristics related to provision of support. Grandparents' younger age (<70 years), employment, and lack of severe health problems predicted a lower probability of maternal depression. Depression was also less common if grandparents lived close to the mother and if the maternal grandparents' union was intact. Differences in maternal depression by grandparental characteristics were larger among separating than among non-separating mothers, particularly during the years before separation. Overall, maternal grandmothers' characteristics appeared to matter most, while the role of paternal grandparents was smaller. The findings suggest that grandparental characteristics associated with increased potential for providing support and decreased need of receiving support predict a lower likelihood of maternal depression, particularly among separating mothers.

Direct Observations of Intergenerational Visits and Activities at Six Local Recreational Parks in Victoria, Australia.

Local parks offer outdoor spaces for active play; they provide a common attractive space in which grandparents and grandchildren can interact and engage in physical activity. This study investigated how multigenerational active spaces within local parks were being used by older people, their grandchildren, and other age groups. METHOD: This study was an observational design using direct observations of park visitors over three consecutive months and an intercept survey of a subsample of older visitors in six community parks in Victoria, Australia. The number of visitors, activity interaction, type of accompaniment (e.g., intergenerational, family, group), and physical activity level were recorded and reported descriptively. RESULTS: A total of 5,373 visitors were observed with 43.3% (n = 2,327) children and 10% (n = 537) older people. Most visitors attended with company (55.9%-97.7%), with older people's most common accompaniments being intergenerational groups (n = 164, 30.5%). Within the observed intergenerational instances, 35% were older people and 45.1% children. Most people from all age groups were observed to be physically active (≥78%). Survey respondents (n = 48) reported attending the park alone (47.9%) or with company (e.g., 22.9% grandchildren, 12.5% a partner/friend). Approximately a third of respondents reported exercising with their grandchildren in the designated space. DISCUSSION: A large proportion of older visitors were observed with intergenerational accompaniment in local parks, with most grandparents and their grandchildren observed to be physically active. The active spaces, which include multigenerational outdoor equipment, may be an attractive setting for both children and older adults to foster intergenerational interaction and engagement in physical activity.

Associations of caring for grandchildren and great-grandparents with depressive symptoms and life satisfaction in Chinese grandparents: The moderating roles of urban-rural residence and social participation.

This study aims to investigate the associations of caring for grandchildren and/or great-grandparents with depressive symptoms, as well as life satisfaction in Chinese grandparents, and analyze the moderating roles of urban-rural residence and social participation. A nationally representative sample of 2973 grandparents in families with great-grandparents and grandchildren were selected from the 2018 China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression (CESD-10) and the single-item were used to measure depressive symptoms and life satisfaction. Social participation included participation in social and intellectual activities. The binary logistic regression model was employed to explore the relationship between caring and depressive symptoms, as well as life satisfaction in the whole participants, different urban-rural residence, and social participation groups, respectively. Caring was associated with depressive symptoms and life satisfaction (p < 0.05). A significant interaction existed between caring and urban-rural residence for depressive symptoms (interaction p = 0.029) and life satisfaction (interaction p = 0.027). Significant interactions were also found among caring, urban-rural residence, and social activities with depressive symptoms (interaction p = 0.025). In urban, caring for both was negatively related to depressive symptoms for the non-social activists, while in rural, caring for great-grandparents was positively associated with depressive symptoms for social activists (p < 0.05). Any new policy design related to preventing and reducing the possibility of mental disorders in Chinese grandparents should be tailored to heterogeneous subgroups who live in different rural-urban and social activities participation.

The role of duty, gender and intergenerational care in grandmothers' parenting of grandchildren: a phenomenological qualitative study.

OBJECTIVES: The aim of this study was to describe grandmothers' experiences of taking care of their grandchildren in terms of their care-giving tasks, motivations and emotions. METHODS: A qualitative phenomenological study was conducted. Purposive sampling was used, based on the relevance of the research question. Seventeen participants were included, women ≥ 65 years old, grandmothers who care for their grandchildren at least 10 h per week and who attended the Nursing units of the Primary Care Health Centers (Madrid Public Health Service). Seventeen in-depth interviews were conducted. The interviews were audio-recorded, transcribed verbatim and thematic analysis was carried out from the perspective of hermeneutic phenomenology. For the analysis, the Excel program was used to organize and share the coding process. Also, we followed COREQ guidelines. RESULTS: Four main themes were identified: (a) Care out of obligation, where participants feel an obligation to help their children by caring for grandchildren, regardless of their number, and prefer to do so voluntarily; (b) Care out of responsibility, where grandmothers see their role as a responsibility that includes saving costs by caring for grandchildren and facilitating their children's work life balance; (c) Care as a social duty, reflecting a moral commitment inherited from their mothers to help future generations; and (d) Construction of care from a gender perspective, where grandmothers, as women, primarily assume the care and upbringing of grandchildren. DISCUSSION: Our results contribute to increase knowledge about childcare provided by grandmothers to their grandchildren. Grandmothers become fundamental pillars of families by helping their children balance family and work. Behind this care there is a strong sense of obligation, duty and generational responsibility. Grandmothers' help presents differences in the distribution of tasks and care by sex. Identifying factors that motivate grandmothers to care for their grandchildren helps nurses to perform higher quality comprehensive care.

Continuity in Socialization Styles: Typologies of Socialization in the Different Life Stages of Older People.

The purpose of this research was to identify the socialization styles of the older person (such as authoritative, indulgent, authoritarian, and negligent) in three different roles: (1) nowadays as a grandparent, (2) considering the style used to educate their own children in the past; and (3), considering the socialization style they received when they were children. The sample (317 people over 65 years old with at least one grandchild aged up to 16 years old participated) received the questionnaire on socialization styles in those roles. The results showed the predominance of the indulgent style in their role as grandparents. Almost 80% showed intergenerational continuity between at least two roles, with the exception of those with a neglectful style. Continuity in socialization style is crucial to understanding the dynamics within family relationships, which have highly durable intergenerational ties.

Experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province.

A qualitative, descriptive contextual design study was conducted to explore and describe the experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province. A non-probability, purposive sampling was used to select 12 Primary Health care nurses based in the Primary health care facilities within Tshwane District. An in-depth interview was used to collect data and Giorgio's five (5) steps were followed during data analysis. Ethical consideration was adhered to by ensuring confidentiality, anonymity, and privacy. All participants signed the consent form to indicate their willingness to participate in the study. Findings of the study revealed the following themes: Primary health care nurses (PHCNs) experiences of sexual and reproductive health communication, and PHCNs experiences of factors facilitating sexual reproductive health (SRH) communication. From the findings it can then be concluded that PHCNs understand facilitating factors to promote open communication with grandparents regarding SRH.

Une étude contextuelle qualitative et descriptive a été menée pour explorer et décrire les expériences des infirmières de soins de santé primaires concernant la promotion de la communication sur la santé sexuelle et reproductive avec les grands-parents dans le district de Tshwane, province de Gauteng. Un échantillonnage non probabiliste et raisonné a été utilisé pour sélectionner 12 infirmières de soins de santé primaires basées dans les établissements de soins de santé primaires du district de Tshwane. Un entretien approfondi a été utilisé pour collecter les données et les cinq (5) étapes de Giorgio ont été suivies lors de l'analyse des données. Des considérations éthiques ont été respectées en garantissant la confidentialité, l'anonymat et la vie privée. Tous les participants ont signé le formulaire de consentement pour indiquer leur volonté de participer à l'étude. Les résultats de l'étude ont révélé les thèmes suivants : les expériences des infirmières de soins de santé primaires (PHCN) en matière de communication sur la santé sexuelle et reproductive, et les expériences des PHCN sur les facteurs facilitant la communication sur la santé sexuelle et reproductive (SSR). À partir des résultats, on peut alors conclure que les PHCN comprennent les facteurs facilitant la promotion d'une communication ouverte avec les grands-parents concernant la SSR.

Grandparents' Experiences of Childhood Cancer: A Qualitative Study.

A child's cancer diagnosis has a significant impact on the lives of grandparents. Grandparents experience the stress of worrying about both their adult children and their grandchildren. Our study aimed to explore the lived experience of grandparents of children diagnosed with cancer. A qualitative design involving semi-structured interviews was used and data were analyzed using reflexive thematic analysis. Twenty grandparents aged 41 to 77 years were interviewed. Six themes were identified: (a) Diagnosis: changing everything; (b) Aspects of treatment: A different world; (c) Sandwich generation; (d) Family: Worrying about everyone; (e) Balancing work; and (f) It's like suddenly a door opens. Our study demonstrates the life-changing impact of having a grandchild diagnosed with cancer. It expands on existing knowledge and shows that, due to an aging population and demographic changes, some grandparents must juggle the demands of caring for aging family members and working while supporting adult children and grandchildren.

Making a way out of no way: The importance of improving financial instability among African American kinship care families.

Close attention should be given to the increased reliance on kinship care to provide out-of-home care for vulnerable children and youth because although these families have various strengths, they also frequently face financial instability and experience material hardship. Living in poverty and experiencing material hardship are linked to an array of negative outcomes, including physical and mental health problems, elevated parental stress, and children's academic difficulties and social and behavioral problems. This study examined African American families who are providing informal kinship care with the aim of developing a nuanced understanding of the financial characteristics, challenges, and coping strategies of these families. Data for this study were obtained from two sources: (1) an exploratory sequential mixed-method pilot study and (2) the National Financial Capability Study. It was found that most caregivers in the pilot reported their family resources were only seldom or sometimes adequate to cover their household's basic needs. Some caregivers reported being unaware of public benefits and community resources available for kinship care families, and they had difficulties navigating the system. Additionally, family members' love and support for each other helped them to cope with financial instability. Using a nationally representative dataset, predicted probabilities for three types of financial instability were higher among households with demographic characteristics of kinship care families including difficulty covering expenses, having income that exceeds expenses, and having emergency savings. Implications for practice, policy, and future research are discussed.

Grandparenting and life satisfaction of the aged in rural areas: A study in Kalia Upazila of Narail District.

In rural Bangladesh, older adults generally enjoy their role as grandparents and spend their leisure and inactive periods (non-involvement in income-generating activities) with their grandchildren. The life satisfaction of the older adults partly lies in their role-playing as grandparents. The aim of this study was to examine the impact of caring for grandchildren on the life satisfaction of the older adults in rural areas. A survey method was used to conduct the study, and the age of the participants was 60 years and above. Four Mohollas of Kalia Upazilla of Narail district were selected purposively, and 253 older adults (123 male & 130 female) were chosen by using a purposive sampling technique. An interview schedule (containing both open and close-ended questions) was used to collect data in the months of November and December 2018. The findings showed that activities with grandchildren and caregiving roles depended on the age structure, and families with more household income were found to enhance the life satisfaction with grandparenting. There was a significant association between the life satisfaction of older adults and their grandparenting role. By identifying some dimensions of family involvement and socio-demographic conditions, this research aims to provide a deeper understanding of the dynamics of how grandparenting impacts the life satisfaction of older adults in rural areas of Bangladesh. The results might help to minimize the shortfalls of policy regarding the well-being of the older adults by focusing on their social and psychological needs. This will ensure aging is in place for everyone.

Exploring self-care practices of African American informal kinship caregivers.

African American caregivers providing informal kinship care are vulnerable to chronic stress. Research has indicated stress increases individuals' risk for many adverse physical and mental health outcomes, including cardiovascular disease, Alzheimer's disease and depression. Given the adverse outcomes related to stress, identifying mechanisms to help these caregivers lower and manage their stress is critical to their overall health and well-being. This pilot qualitative study aimed to explore the self-care practices of 12 African Americans providing informal kinship care using a phenomenological approach. Three themes emerged: (a) behaviours to manage stress levels, (b) support network reminding caregivers to take care of themselves and (c) prioritizing my own needs. Specifically, our findings indicate that some caregivers have high-stress levels and engage in maladaptive coping behaviours. The children they cared for reminded them to take care of themselves by attending doctors' appointments or getting their nails done. Nevertheless, some caregivers prioritized their needs by participating in positive self-care behaviours, such as listening to jazz and gospel music and exercising. Prevention and intervention programs that focus on improving caregivers' health should consider the role of self-care practices.

Patience with foster children as a major problem for grandparents in the role of kinship carers aged 60 + and the psychosocial determinants of this deficit.

Kinship care represents the most prevalent form of foster care in Poland. Most commonly, the role of kinship carers is taken on by grandparents, who may struggle with various problems, needs and deficits in this role. The aim of this study was to investigate the problem of patience in kinship carers aged 60 + and its impact on deficits in the performance of roles and duties.Methods Seventy-five foster grandparents (63 female, 84%) aged from 61 to 97 years (M = 69,12; SD = 6.22) were investigated in north-western Poland in 2018 and 2019. The study was based on the diagnostic survey method.Results Psychological disposition, functioning, health problems and parental needs and deficits were assessed using standardised psychometric scales and tools self-constructed for this research study. A lack of patience with foster children was reported by 46.7% (n = 35) of the respondents. Patience deficits corresponded with a significantly lower sense of coherence, especially in the manageability domain (p < 0.001) and such stress coping strategies as lower positive reappraisal (p = 0.016) and seeking of emotional support (p = 0.025), as well as a greater tendency for suppression of activities (p = 0.014) and venting of emotions (p = 0.035). Relatively permanent personality traits and general self-efficacy were not differentiated by patience with children.Conclusions The results suggest that patience - so important for biological and foster parents - is related to psychological competencies that can be improved through psychoeducation and skills-training, which may be beneficial for improving foster carers' effectiveness.

Respect Your Elders: Generativity and Life Satisfaction in Caregiving Grandparents.

Erikson's theory of psychosocial development defines generativity as the drive to benefit future generations and leave a legacy. Generativity has been shown to predict life satisfaction, but generative concern and action can be impacted by factors such as perceived respect from younger generations. This study utilized caregiving grandparents aged 40 and older to assess the extent to which perceived respect mediated the relation between generativity and life satisfaction. Perceived respect from a grandchild mediated the relation between generative concern expressed by caregiving grandparents and life satisfaction after controlling for demographic variables that have been shown to influence heterogeneity and overall well-being in caregiving grandparent samples. These findings suggest that the relation between life satisfaction and generativity in grandparents may depend, in part, on perceived respect from grandchildren, intimating that the implications of generativity may be influenced by the perceived appreciation of its recipients.

Lost support, lost skills: Children's cognitive outcomes following grandparental death.

OBJECTIVE: This study examines the implications of grandparental death for cognitive skills in middle childhood. METHOD: This study uses data from the Future of Families and Child Wellbeing Study (N = 2479) to estimate ordinary least squares regression models of the associations between grandparental death and subsequent cognitive skills among children in middle childhood. RESULTS: Experiencing a grandparental death between ages 5 and 9 is associated with boys' lower reading, verbal, and math scores at age 9, with associations most notable for Black and Hispanic boys; grandparental death before age 5 has minimal influence on boys' cognitive skills at age 9. There is little indication that grandparental death adversely affects girls' cognitive skills. CONCLUSION: The numerous and persistent implications of grandparental death for boys' cognitive skills merit greater recognition of grandparental death as a source of family instability, stress, and ultimately inequality in child development.

Mental health and parenting demands among grandparent caregivers of young U.S. children.

Substance abuse epidemics and changes in incarceration and foster care policies have recently placed more young children in grandparent custody. Grandmothers bear much of this caregiving responsibility. Our objective was to compare grandparent caregivers of preschool-aged children (grandparent(s) only or in multigenerational households) to parent caregivers, by caregiver sex, in their mental health, available emotional support, and capacity to manage parenting demands. Using U.S. National Survey of Children's Health data (2016-2019), we used survey-weighted logistic regression models adjusted for socio-demographic confounders and conducted sub-group analyses by caregiver sex. Among 30,046 families with a child aged 1-5 years, 776 (4.1%) were grandparent-only, 817 (3.3%) multigenerational, 28,453 (92.7) parent-headed (weighted percentages). Most caregivers (78.7%) were in Excellent/Very Good mental health, but grandfathers in grandparent-only households were less so. Despite being more likely to parent alone, caregivers in grandparent-only households had about twice the odds of having a source of emotional support (adjusted prevalence odds ratio [aPOR] = 2.07; 95% confidence interval [CI] 1.12, 3.83). Grandmothers, in particular, had greater odds of handling day-to-day parenting demands (aPOR = 2.40, 95% CI 1.35, 4.27) and of reporting rarely/never feeling angry with the child in their care (aPOR = 2.77, 95% CI 1.53, 5.01), compared to mothers in parent households. Caregivers in multigenerational households displayed no differences as compared to parents except for grandfathers in multigenerational households who were more likely often bothered by the child. Despite increasing demands on grandparents, they generally reported faring as well as or better than parent caregivers, especially grandmothers. Their prior experience and social support may make them resilient.

Implementing a Grandfamily Intervention During the COVID-19 Pandemic: Responses and Adaptations.

The COVID-19 pandemic complicated efforts to deliver interventions to marginalized populations at risk of contracting COVID-19. Grandfamilies are one such group. GRANDcares Plus (GC+) is an intervention designed to help grandfamilies build resilience. It was scheduled to launch shortly after the COVID-19 pandemic began and consequently was heavily influenced by the pandemic. This paper discusses responses and adaptations made in implementing GC+ during the pandemic. Primary information sources included facilitators, COVID-19 information outlets, grandfamilies, and the project site coordinator. As a result, adaptations were made to facilitator training, CDC guidelines/recommendations were employed, potential participants needs and concerns were considered, and additional strategies were incorporated to support grandfamilies. This knowledge translational article contributes to social work by providing insights into identifying, managing, and responding to unexpected challenges. Given the increasing occurrences of unanticipated crises, it is crucial to develop and maintain effective tools for sustainable deliveries of services during difficult times.