Restaurant kids' meal beverage offerings before and after implementation of healthy default beverage policy statewide in California compared with citywide in Wilmington, Delaware.

OBJECTIVE: In 2019, California and Wilmington, Delaware' implemented policies requiring healthier default beverages with restaurant kids' meals. The current study assessed restaurant beverage offerings and manager perceptions. DESIGN: Pre-post menu observations were conducted in California and Wilmington. Observations of cashiers/servers during orders were conducted pre-post implementation in California and post-implementation in Wilmington. Changes in California were compared using multilevel logistic regression and paired t tests. Post-implementation, managers were interviewed. SETTING: Inside and drive-through ordering venues in a sample of quick-service restaurants in low-income California communities and all restaurants in Wilmington subject to the policy, the month before and 7-12 months after policy implementation. PARTICIPANTS: Restaurant observations (California n 110; Wilmington n 14); managers (California n 75; Wilmington n 15). RESULTS: Pre-implementation, the most common kids' meal beverages on California menus were unflavoured milk and water (78·8 %, 52·0 %); in Wilmington, juice, milk and sugar-sweetened beverages were most common (81·8 %, 66·7 % and 46·2 %). Post-implementation, menus including only policy-consistent beverages significantly increased in California (9·7 % to 66·1 %, P < 0·0001), but remained constant in Wilmington (30·8 %). During orders, cashiers/servers offering only policy-consistent beverages significantly decreased post-implementation in California (5·0 % to 1·0 %, P = 0·002). Few managers (California 29·3 %; Wilmington 0 %) reported policy knowledge, although most expressed support. Most managers wanted additional information for customers and staff. CONCLUSIONS: While the proportion of menus offering only policy-consistent kids' meal default beverages increased in California, offerings did not change in Wilmington. In both jurisdictions, managers lacked policy knowledge, and few cashiers/servers offered only policy-consistent beverages. Additional efforts are needed to strengthen implementation of kids' meal beverage policies.

Meeting Parents' Needs for Education and Preparation following Congenital Heart Disease Diagnosis: Recommendations from a Crowdsourced Study.

OBJECTIVE: This article characterizes the educational needs of parents following fetal or neonatal congenital heart disease (CHD) diagnosis and generates recommendations for meeting these needs. STUDY DESIGN: Online crowdsourcing methods were used to collect qualitative data from 95 parents of children with CHD regarding their needs for education and preparation following fetal or neonatal diagnosis. Data were analyzed using qualitative methods and themes were organized around the substructure of met and unmet needs. RESULTS: Two themes represented consistently met needs, whereas 10 themes represented needs that were either inconsistently met or consistently unmet. Parents reported needing more information about social, emotional, and financial supports, preparation for long-term care, and guidance toward reputable online resources. Parents also provided recommendations for meeting these needs. CONCLUSION: Parents' needs for education and preparation following CHD diagnosis are much broader in scope than what they currently receive. Addressing these may support parental coping and active participation in medical decision-making. KEY POINTS: · CHD counseling after diagnosis may provide opportunities to promote parents' mental health.. · Guidelines recommend that this counseling should include emotional and decision-making support, however, it is unclear what parents actually receive.. · This study found that parents' needs for education and preparation following CHD diagnosis are much broader in scope than what they currently receive..

Coping strategies used by mothers and fathers following diagnosis of congenital heart disease.

BACKGROUND: Parents of children with congenital heart disease (CHD) exhibit high rates of mental health difficulties, which can influence child developmental and behavioural outcomes. While extensive research has focused on CHD-related stressors that contribute to parental mental health difficulties, few studies have investigated parental coping strategies that may mitigate or heighten risk. This study aimed to identify parental coping strategies following diagnosis of CHD and compare use of coping strategies among different groups (mothers vs. fathers; prenatal vs. postnatal diagnosis). METHODS: A diverse sample of 34 parents (20 mothers and 14 fathers) of young children with CHD participated in semistructured interviews focused on their responses to CHD-related stressors. Coping strategies were identified from qualitative data and categorized according to the COPE Inventory, an instrument that assesses common adult responses to stress. Coping strategies deemed as unique to parenting a critically ill child were identified. χ2 and independent sample t tests evaluated group differences. RESULTS: Parents described using between 1 and 10 different adaptive and maladaptive strategies measured by the COPE Inventory. Most parents (82.35%) also described coping strategies that may be unique to parenting a critically ill child. Mothers were more likely than fathers to report a focus on and venting of emotions (70% vs. 21.43%) and behavioural disengagement (25% vs. 0%). Compared with parents receiving a postnatal CHD diagnosis, those receiving a prenatal diagnosis described a greater variety of coping strategies (6.23 vs. 4.52) and more often reported positive reinterpretation and growth (69.23% vs. 14.29%), behavioural disengagement (38.46% vs. 0%) and denial (38.46% vs. 0%). CONCLUSIONS: Parents of children with CHD utilize a variety of coping strategies, some of which are maladaptive. Interventions tailored to the needs of mothers and fathers of young children with CHD, including those receiving a postnatal diagnosis, are needed to promote adaptive coping and optimize family psychosocial outcomes.

Topical Review: Crowdsourcing as a Novel Approach to Qualitative Research.

OBJECTIVE: To describe a novel, five-phase approach to collecting qualitative data from hard-to-reach populations using crowdsourcing methods. METHODS: Drawing from experiences across recent studies with type 1 diabetes and congenital heart disease stakeholders, we describe five phases of crowdsourcing methodology, an innovative approach to conducting qualitative research within an online environment, and discuss relevant practical and ethical issues. RESULTS: Phases of crowdsourcing methodology are: (I) Preparing; (II) Forming Crowds; (III) Collecting Crowdsourced Data; (IV) Coding and Analyzing Crowdsourced Data; and (V) Generating and Disseminating Findings. Iterative feedback from stakeholders is obtained in all five phases. Practical and ethical issues include accessing diverse stakeholders, emotional engagement of crowd participants, responsiveness and transparency of crowdsourcing methodology, and limited personal contact with crowd participants. CONCLUSIONS: Crowdsourcing is an innovative, efficient, feasible, and timely approach to engaging hard-to-reach populations in qualitative research.

Consumers' Ability to Distinguish Between Milk Types: Results of Blind Taste Testing.

The objective of this study was to assess consumers' ability to correctly identify different types of milk in a blind taste test and correlates of plans to purchase lower fat milk. Adults from 8 supermarkets in low-income neighborhoods tasted 3 types of unlabeled lower fat or fat-free milk samples and guessed the type of each sample. Of the 1074 participants, only 7.6% were able to identify all 3 unlabeled samples correctly. Most adults in this study reported consuming higher fat milk and could not correctly identify milk type by taste alone. Blind taste tests may encourage consumers to drink lower fat milk.

Validity of the Food Insecurity Experience Scale and prevalence of food insecurity in The Bahamas.

INTRODUCTION: Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. METHODS: The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. RESULTS: The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. CONCLUSION: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.

Parent Perspectives on Family-Based Psychosocial Interventions for Congenital Heart Disease.

OBJECTIVES: To identify parents' preferences for goals and structure of intervention programs to support the psychosocial needs of families impacted by congenital heart disease (CHD). STUDY DESIGN: Information about parent priorities for psychosocial programs was obtained in this mixed-methods study conducted at a pediatric hospital in the Mid-Atlantic region of the US. Participants were parents (N = 34; 20 mothers, 14 fathers) of children with CHD between the ages of 1 and 3 years who had cardiac surgery at less than 6 months of age. Qualitative data were excerpts from semistructured interviews. Quantitative data were participant choices regarding their ideal psychosocial program resulting from a card sort. RESULTS: Parents reported that psychosocial interventions should support partnership in their child's care, promote self-care, facilitate communication with providers, prepare parents for challenges after hospitalization, provide education about child neurodevelopment, and help parents engage social support. Parents reported needing formalized support across care, brief intervention models, in-person individualized or small group support, and involvement of multidisciplinary providers and peer mentors in the delivery of interventions. CONCLUSIONS: Parents of children with CHD need psychosocial interventions that empower them to act as primary caregivers and effective advocates for their child. Individualized, formalized, and multidisciplinary approaches to psychosocial care are necessary to best accommodate the dynamic stressors related to parenting a child with CHD and may mitigate the impact of parent mental health problems on child outcomes.

Fathers of Children With Congenital Heart Disease: Sources of Stress and Opportunities for Intervention.

OBJECTIVES: To examine sources of stress for fathers of children with congenital heart disease and opportunities for intervention to prevent or reduce paternal mental health problems. DESIGN: Qualitative study using online crowdsourcing, an innovative research methodology to create an online community to serve as a research sample. SETTING: Yammer, an online social networking site. SUBJECTS: Geographically diverse sample of 70 parents (25 fathers and 45 mothers) of young children with congenital heart disease. INTERVENTIONS: Participants joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process, and themes regarding sources of stress for fathers of children with congenital heart disease and opportunities for intervention were identified. MEASUREMENTS AND MAIN RESULTS: Four broad themes regarding sources of stress for fathers of children with congenital heart disease emerged from the qualitative data from both mothers and fathers: societal expectations for fatherhood and standards of masculinity, balancing work and family responsibilities, feeling overlooked as a partner in care, and lack of father supports. To begin to address these sources of stress, participants recommended that care teams acknowledge and normalize the impact of congenital heart disease on fathers, provide support for balancing work and family responsibilities, recognize and promote father knowledge and engagement, and provide formal and informal supports for fathers of children with congential heart disease. CONCLUSIONS: Fathers of children with congenital heart disease experience unique sources of stress in the absence of targeted interventions to meet their needs. Care teams play an important role in acknowledging the experiences of fathers and including and engaging fathers in care.

Supporting parenting during infant hospitalisation for CHD.

OBJECTIVE: To characterise the parenting priorities of mothers and fathers of infants hospitalised with CHD and generate recommendations to support parenting during infant hospitalisation. STUDY DESIGN: Through online crowdsourcing, an innovative research methodology to create an online community to serve as a research sample, 79 parents of young children with CHD responded to questions about parenting during hospitalisation via private social networking site. Responses were analysed using qualitative research methods. RESULTS: Three broad themes were identified: (1) establishing a bond with my baby, (2) asserting the parental role, and (3) coping with fear and uncertainty. Parents value provider support in restoring normalcy to the parenting experience during infant hospitalisation. CONCLUSIONS: Care teams can support parenting during infant hospitalisation by promoting parents' roles as primary caretakers and decision-makers and attending to the emotional impact of infant hospitalisation on the family.

Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care.

OBJECTIVE: To inform pediatric critical care practice by examining how mothers and fathers experience the stress of caring for a young child with congenital heart disease and use hospital and community supports. DESIGN: Qualitative study of mothers and fathers of young children with congenital heart disease. SETTING: Tertiary care pediatric hospital in the Mid-Atlantic region of the United States. SUBJECTS: Thirty-four parents (20 mothers, 14 fathers) from diverse backgrounds whose child previously underwent cardiac surgery during infancy. INTERVENTIONS: Subjects participated in semi-structured, individual interviews about their experiences and psychosocial needs at the time of congenital heart disease diagnosis, surgical admission, and discharge to home after surgery. Qualitative interview data were coded, and consistent themes related to emotional states, stressors, and supports were identified. MEASUREMENTS AND MAIN RESULTS: Fathers experience and respond to the stressors and demands of congenital heart disease in unique ways. Fathers often described stress from not being able to protect their child from congenital heart disease and the associated surgeries/pain and from difficulties balancing employment with support for their partner and care of their congenital heart disease child in the hospital. Fathers were more likely than mothers to discuss support from the work environment (coworkers/managers, flexible scheduling, helpful distraction) and were less likely to describe the use of hospital-based resources or congenital heart disease peer-to-peer supports. CONCLUSIONS: This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.

Perspectives of Urban Corner Store Owners and Managers on Community Health Problems and Solutions.

INTRODUCTION: Urban corner store interventions have been implemented to improve access to and promote purchase of healthy foods. However, the perspectives of store owners and managers, who deliver and shape these interventions in collaboration with nonprofit, government, and academic partners, have been largely overlooked. We sought to explore the views of store owners and managers on the role of their stores in the community and their beliefs about health problems and solutions in the community. METHODS: During 2013 and 2014, we conducted semistructured, in-depth interviews in Philadelphia, Pennsylvania, and Camden, New Jersey, with 23 corner store owners/managers who participated in the Healthy Corner Store Initiative spearheaded by The Food Trust, a nonprofit organization focused on food access in low-income communities. We oversampled high-performing store owners. RESULTS: Store owners/managers reported that their stores served multiple roles, including providing a convenient source of goods, acting as a community hub, supporting community members, working with neighborhood schools, and improving health. Owners/managers described many challenging aspects of running a small store, including obtaining high-quality produce at a good price and in small quantities. Store owners/managers believed that obesity, diabetes, high cholesterol, and poor diet are major problems in their communities. Some owners/managers engaged with customers to discuss healthy behaviors. CONCLUSION: Our findings suggest that store owners and managers are crucial partners for healthy eating interventions. Corner store owners/managers interact with community members daily, are aware of community health issues, and are community providers of access to food. Corner store initiatives can be used to implement innovative programs to further develop the untapped potential of store owners/managers.

Consumer taste tests and milk preference in low-income, urban supermarkets.

OBJECTIVE: To explore shoppers' responses to the taste of different types of cow's milk in a blind taste test and to examine their willingness to purchase lower-fat milk as part of an in-store marketing intervention. DESIGN: Participants were recruited on-site in the supermarket to participate in a blind taste test of three varieties of cow's milk and asked to guess what type they sampled. SETTING: The taste testing was conducted as part of the Healthy Retail Solution (HRS) intervention that took place in four large supermarkets in Philadelphia, PA, USA over the course of six months. SUBJECTS: Adults (n 444) at participating Philadelphia supermarkets. RESULTS: The majority of participants at all stores reported typically purchasing higher-fat milk. Forty per cent of participants reported buying whole milk, 38 % purchased milk with 2 % fat. Very few participants correctly identified all three milk samples during the taste test (6·9 %) and a majority of participants were unable to identify the type of milk they self-reported typically purchased. CONCLUSIONS: Most consumers could not accurately distinguish between various types of milk. Taste testing is a promising strategy to introduce lower-fat milks to consumers who have not tried them before. Campaigns to purchase skimmed, 1 % or 2 % milk may result in significant energy reduction over time and can serve as a simple way to combat overweight and obesity.

In an urban neighborhood, who is physically active and where?

Previous research has shown differences in adult physical activity (PA) levels within urban population, in what types of activities they participated, and where they were active. A sample of 514 urban Philadelphia adult residents was surveyed about level and location of PA. A majority (55.6%) of survey participants reported being vigorously or moderately active or walking enough to meet PA guidelines. A significantly higher proportion of men (vs. women), younger (vs. older) adults and people who were employed (vs. unemployed) met the PA guidelines. Most participants (87.5%) reported walking at least once within the previous week, while 79.3% reported engaging in moderate or vigorous activity. Of the participants who reported being moderately or vigorously active, 64.0% were physically active in indoors only, 22.6% were active in outdoors only, and 13.4% were active in both indoors and outdoors. Significantly fewer black women were active outdoors, compared to all other race/sex combinations (odds ratio = 0.43, p-value < 0.01). In this diverse sample of urban residents, outdoor PA was significantly less frequently reported than indoor PA, particularly for Black women. These findings could help inform urban PA interventions.

Moving from policy to implementation: a methodology and lessons learned to determine eligibility for healthy food financing projects.

Public health obesity prevention experts have recently emphasized a policy systems and environmental change approach. Absent, however, are studies describing how practitioners transition from policy adoption to implementation. In the realm of food policy, financing programs to incentivize healthy food retail development in communities classified as "underserved" are underway at the local, state, and national levels. Implementing these policies requires a clear definition of eligibility for program applicants and policy administrators. This article outlines a methodology to establish eligibility for healthy food financing programs by describing the work of The Food Trust to coadminister programs in 3 distinct regions. To determine program eligibility, qualitative assessments of community fit are needed and national data sources must be locally verified. Our findings have broad implications for programs that assess need to allocate limited public/private financing resources.

Pandemic-Era WIC Participation in Wilmington, Delaware: Participants' Experiences and Challenges.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic including financial concerns, a national infant formula shortage, and rising food costs. To mitigate these challenges, the United States Department of Agriculture implemented WIC program waivers and flexibilities aiming to simplify program operations (e.g., remote appointments and food package substitutions). However, little is known about WIC participants' perceptions of these changes and their impact on in-store benefit redemption. As such, this study aimed to characterize how pandemic-related events impacted Delaware WIC participants' shopping experiences and program perceptions. The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign, and open-ended questions regarding WIC program participation experiences during the pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that WIC participants benefitted from the pandemic program's flexibilities. However, they continued to experience burdensome shopping trips as well as concerns about their ability to feed their families due to infant formula shortages and inflation. These findings indicate the importance of extending existing WIC flexibilities and providing continued support for both participants and WIC-authorized retailors.

Barriers and facilitators to discussing parent mental health within child health care: Perspectives of parents raising a child with congenital heart disease.

This study aimed to identify barriers and facilitators to discussing parent mental health within child health care for parents of children with congenital heart disease (CHD). Seventy-nine parents of young children with CHD who received care across 40 hospitals in the United States responded to questions about barriers and facilitators to discussing their mental health with their child's health care providers. Responses were analyzed using qualitative research methods. Parents described multiple barriers: (1) belief that parent mental health support was outside the care team's scope of practice, (2) perceived expectation to "stay strong," (3) fear of negative judgment or repercussion, (4) individual preferences for communication/support, (5) desire to maintain care resources on their child, (6) perceived need to compartmentalize emotions, and (7) negative reactions to past emotional disclosure. Parents also described several facilitators: (1) confidence in the care team's ability to provide support, (2) intentional efforts by the care team to provide support, (3) naturally extroverted tendencies, and (4) developing personal connections with health care providers. It is important that health care providers normalize the impact of child illness on the family and create an environment in which parents feel comfortable discussing mental health challenges.

WIC Participants' Perceptions of the Cash-Value Benefit Increase during the COVID-19 Pandemic.

Recent changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash-Value Benefit (CVB), which provides participants with money to spend on fruits and vegetables, have the potential to reduce disparities in healthy food access and food insecurity that were exacerbated by the COVID-19 pandemic. However, few studies have examined how the changes to the CVB allotment that occurred during the pandemic influenced WIC participants' perceptions of the benefit or their fruit and vegetable purchasing and consumption. To address this gap, we conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign food insecurity screener, and open-ended questions regarding perceptions of the CVB increase and its influence on participants' fruit and vegetable purchasing and consumption. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that higher CVB allotments increased WIC participants' purchasing and consumption of fruits and vegetables, increased the frequency of their shopping occasions, and enhanced their dietary variety. Our findings also suggest that WIC participants highly value the increased CVB. Consequently, maintaining the increased CVB allotment could improve the nutritional outcomes of low-income mothers, infants, and children participating in WIC.

A Reflection on the Relationship Between Place and Health:: Understanding Undergraduate Student Experiences and Priorities During the COVID-19 Pandemic.

Environment and setting have a large influence on matters of population health, and college is a critical place for students, shaping both health and education. College students across the nation were impacted by the COVID-19 pandemic, and changes at universities left many anxious, isolated, and coping with social, emotional, and educational impacts. Objective: To perform a data analysis of the qualitative responses garnered through the Student Return to Campus Survey administered at the University of Delaware (UD) in Spring 2020, and to identify common themes of student experiences and priorities during the pandemic years to inform future recommendations for health crisis management. Methods: The study utilized secondary data analysis from an online student experience survey of 2,941 Freshman, Sophomore, and Junior students from the 2020-2021 academic year. Results: Qualitative analysis revealed a set of common outstanding themes influencing the college pandemic experience, including: Quality and Accessibility of Education in a Virtual Learning Environment; Quality of Student Life; Mental Health During the Pandemic; Thoughts and Attitudes About Vaccination Policies, Masking, Testing, and COVID Guidelines; Priorities and Considerations About the Return to Campus; and Overall Feelings About the Pandemic at UD. Conclusions: Student experiences were influenced by academic, social, emotional, and financial factors, which were often described with great intensity, and were at times contradictory. Students emphasized struggles with transitioning to and with virtual learning, the quality of campus resources, financial responsibilities, family health, and personal health. The results also shed light on the importance of communication with the campus community and the desire for students to express opinions during a crisis. Health Policy Implications: The results of this study have implications for crisis management for college campuses and planning for future responses to unanticipated events and ongoing COVID-19 mitigation efforts.

Encouraging Healthier Food and Beverage Purchasing and Consumption: A Review of Interventions within Grocery Retail Settings.

This review identifies the most promising intervention strategies for promoting the purchase and consumption of healthier items within U.S. grocery retail settings, with a particular focus on those strategies that may be most effective when implemented within SNAP-authorized retail settings. Searches of nine electronic databases, as well as forward and backward searches, yielded 1942 studies. After being screened, 73 peer-reviewed academic articles were identified for inclusion. Of these, 33 analyzed single-component interventions, while 40 assessed multi-component interventions. The following unique intervention types were considered as evaluated in these studies for their ability to increase healthy item purchasing and consumption: (1) nutrition scoring, (2) nutritional messaging, (3) non-nutritional messaging, (4) endcaps and secondary placement, (5) point-of-sale interventions, (6) increased stocking, (7) food tasting and demonstrations, (8) nutrition education, and (9) placement on shelf interventions. Nutritional scoring and nutritional messaging emerged as the most rigorously tested and effective intervention strategies. Other strategies warrant more research attention. Simple intervention strategies, as opposed to complex ones, yield the most successful results and minimize shopper burden. Therefore, these strategies should be reviewed for policy implementation within SNAP-authorized grocery retailers.

Short report: Social support access among single caregivers with children on the autism spectrum.

BACKGROUND: Caregivers of children with autism are more likely to experience parenting stress than parents of neurotypical children. Research on parenting stress focuses on partnered caregivers and little is known about the comparative social support experienced by single caregivers. AIM: To explore differences in perceived social support between single versus partnered caregivers of adolescent and adult children on the autism spectrum. METHODS AND PROCEDURES: A cross-sectional, quantitative study using the ENRICHD Social Support Instrument (ESSI) as a measure of perceived social support. Univariate and multivariable analyses were conducted to examine the association between caregiver relationship status and perceived social support. OUTCOMES AND RESULTS: There were statistically significant associations between relationship status and perceived social support, with single caregivers perceiving less social support than partnered caregivers (p < .001). CONCLUSIONS AND IMPLICATIONS: Single caregivers of adolescent and adult children on the autism spectrum perceive less social support than partnered caregivers. Service providers should routinely evaluate the support access of this single caregivers and target support services to address the distinct needs of this population.