African American Grandmothers Research Articles

Healthy Outcomes through Peer Educators: Feasibility of a peer support diabetes prevention programme for African-American grandmother caregivers.

To assess the protocol feasibility and intervention acceptability of a community-based, peer support diabetes prevention programme (DPP) for African-American (AA) grandmother caregivers at risk for diabetes. Grandmother caregivers were randomized in a 2:1 ratio to DPP (active comparator) or DPP plus HOPE (Healthy Outcomes through Peer Educators; intervention). DPP + HOPE incorporated support from a peer educator who met with participants in person or by telephone every week during the 1-year intervention. Outcomes included: (1) recruitment rates, outcome assessment, and participation adherence rates assessed quantitatively; and (2) acceptability of the programme assessed through end-of-programme focus groups. We successfully consented and enrolled 78% (n = 35) of the 45 AA grandmothers screened for eligibility. Eighty percent of participants (aged 64.4 ± 5.7 years) were retained up to Week 48 (74% for DPP [n = 17] and 92% for DPP + HOPE [n = 11]). All grandmothers identified social support, neighbourhood safety, and access to grocery stores as influences on their health behaviours. At Month 12, the active comparator (DPP) group and the intervention group (DPP + HOPE) had a mean change in body weight from baseline of -3.5 ± 5.5 (-0.68, -6.29) kg and - 4.4 ± 5.7 (-0.59, -8.2) kg, respectively. This viable study met the aim of educating and equipping AA grandmothers with the practical and sustained support needed to work toward better health for themselves and their grandchildren, who may be at risk for diabetes. The intervention was both feasible and acceptable to participating grandmothers and their organizations.

An intervention to improve the well-being of families in which African American grandmothers are raising grandchildren: A longitudinal mediation analysis

Children raised by grandparents experience increased emotional distress often related to family circumstances. Drawing on a coping model of family stress, adjustment, and adaptation, we examined a 12-month home-based intervention to improve the well-being of families in which grandmothers are raising grandchildren and longitudinally explored grandmothers' perceived changes in grandchild behavior in relation to their psychological distress levels. The sample consisted of 510 African American custodial grandmother-grandchildren pairs, including children ages 4–16 years. All grandmothers participated in a 12-month, primarily home-based support intervention. The prospective analysis revealed that reported child internalizing and externalizing behavior problems and grandmother psychological distress decreased significantly from baseline to the 12-month follow-up assessment. Grandchild internalizing and externalizing behaviors were positively predicted by grandmothers' baseline and 12-month psychological distress. Concerning mediation, the total effect of baseline grandmother psychological distress on 12-month grandchild internalizing and externalizing behaviors was significant, positive, and significantly mediated by 12-month grandmother psychological distress. Findings also revealed medium effect sizes for the indirect effects. These results suggest that a decrease in psychological distress in grandmothers over the 12-month intervention had a positive effect on grandmothers’ perceptions of grandchildren's internalizing and externalizing behavior problems. Study limitations and future research directions are discussed.

Whites Only: Race and Mobility in Kym Ragusa's The Skin Between Us: A Memoir of Race, Beauty, and Belonging and Claudia Rankine's Citizen: An American Lyric

Whites Only: Race and Mobility in Kym Ragusa's <i>The Skin Between Us: A Memoir of Race, Beauty, and Belonging</i> and Claudia Rankine's <i>Citizen: An American Lyric</i>

Peers empowering peers-feasibility of a peer educator training program to prevent diabetes

BackgroundThis study assessed the feasibility and acceptability of the Healthy Outcomes through Peer Educators (HOPE) training program designed to train African American (AA) grandmothers to serve as peer educators for other AA grandmothers who are at risk for diabetes. The newly trained peer educators will provide the needed encouragement and positive reinforcement essential for successful sustainable health behaviors to grandmothers enrolled in a subsequent Diabetes Prevention Program.MethodsThirty AA women between the ages of 49–72 were enrolled in the pre-post single group study. The participants were required to attend a 2-h Diabetes Prevention Program session every week for 16 weeks. The sessions covered the role of the peer educator and encouraged participants to increase their physical activity and consume more servings of fruits and vegetables daily. We noted the number of participants who successfully completed the training and solicited their perspective regarding the strengths of the program and suggestions to improve the program. The Wilcoxon Signed Ranks Test was performed to evaluate changes in body weight, self-reported physical activity, and fruit and vegetable intake from baseline to week 16.ResultsNinety three percent (n = 28) of enrollees completed the training program. All (n = 28) the peer educator trainees indicated that they would recommend the program to a friend and 93% (n = 26) reported that the program met their needs. The participants (n = 28) felt that the training prepared them to offer support to other grandmothers in their community. A Wilcoxon Signed Ranks Test revealed that participants body weights were significantly lower after completion of the 16 week training program (median = 156.5 lbs., n = 28) compared to baseline (median = 163.0, n = 28), Z = − 4.43, p < 0.05. Fruit and vegetable intake increased significantly (median = 5, n = 28) at week 16 compared to week one, (median = 2, n = 28) Z = 4.46, p < 0.05. Participants were more physically active at week 16 (median = 150 min per week, n = 28) compared to week 1, (median = 30 min per week, n = 28) Z = 4.62, p < 0.05.ConclusionsThe peer educator training component of HOPE was found to be feasible and acceptable as evidenced by our successful recruitment and retention of participants. Participation in the peer educator training program also resulted in improvement in health behaviors.

Informal kinship caregivers’ parenting experience

The study explored parenting experiences of informal kinship caregivers who were not currently involved with the public child welfare system. Forty-one informal kinship caregivers participated in an anonymous survey that inquired about their demographic information and parenting experiences. The majority of participants were African American grandmothers in their 50s with a high school diploma and annual household income below $50,000. Approximately 70% of the participants had legal custody of a related child in their care, and were committed to providing a long-term or permanent placement for the child. While financial hardship was the most common challenge participants reported, only 37% of them received governmental assistance. Other challenges included children’s medical and mental health issues, and childcare. Despite these challenges, the majority of participants (82.9%) perceived their kinship caregiving experience as positive or very positive. Forty-two percent of participants acknowledged the bidirectional nature of their relationship with related children. Another positive experience noted was children’s growth and safety. These findings illustrate both common and diverse parenting experiences of informal kinship caregivers. They also highlight limited resources available and accessible for this population. The implications of the study findings are discussed.

Rural grandparenting: A Wellness approach

The study examined the experiences of African American grandmothers living in rural settings providing care to their grandchildren, in the mist of their own chronic health issues. The study explored the health, physical functioning, well-being, support, and resources of these grandmothers. The custodial grandmothers reported challenges and needs which included their own health issues, lack of support, financial concerns, transportation and childcare issues. The findings revealed that developing health education programs and other formal supports focusing on health, and resources have a positive effect on the grandmother’s perceptions regarding their health and support.

The Mental Health Needs of African American Rural Grandparents

The research examined the experiences of African American grandmothers living in rural communities providing care to their grandchildren. The study explored the health, mental health, physical functioning, well-being, support, and resources of these grandmothers. The grandmothers reported challenges and needs which included their own health issues, lack of support and resources, financial concerns, transportation and childcare issues. The findings revealed that developing health education programs and other formal supports focusing on health, mental health and resources have a positive effect on the grandmother’s perceptions regarding their health and support.

The Black Church, an Agency for Learning, Informal Religious Adult Education, and Human Capital Development: A Qualitative Inquiry into Rural African American Primary Caregiving Grandmothers’ Experiences

The Black Church, an Agency for Learning, Informal Religious Adult Education, and Human Capital Development: A Qualitative Inquiry into Rural African American Primary Caregiving Grandmothers’ Experiences

The Health of African American Grandmothers Raising Grandchildren: A Growing Social Problem

The study explored the experiences of African-American grandmothers residing in rural communities caring for their grandchildren, while suffering from chronic health issues. The research examined their physical and emotional health, physical functioning, well-being, social support, and resources of these grandmothers from a Family Development approach. Given the trends of providing care for a grandchild, it is widely recognized that caregivers may experience stress, burden, and the disruption of their well-being and social activities as well as the pressure associated with caregiving roles, responsibilities, and tasks. The grandmothers reported challenges that included stressors such as health issues, financial difficulties, limited support, transportation difficulties, and disruption in social activities. A major finding was that the grandmother’s health did not negatively impact their ability to care for their grandchildren.

Rural grandparenting through a family development lens: Implications for social work practice

ABSTRACT The research explored the experiences of African American grandmothers residing in rural communities caring for their grandchildren, while suffering from chronic health issues. The research examined their health, physical functioning, wellbeing, social support, and resources of these grandmothers from a Family Development lens. Given the trends of providing care for a grandchild, it is widely recognised that caregivers may experience stress, burden, and the disruption of their well-being and social activities as well as the pressure associated with caregiving roles. The grandmothers reported challenges which included stressors such as health issues, financial difficulties, limited support, transportation difficulties, and disruption in social activities. This supports the body of scholarly findings from a national and international perspective in that these grandparents will need additional assistance in this caregiving role. However, a major finding in this study was that the grandmother’s health did not negatively impact their ability to care for their grandchildren.

Literacy, Learning, and Human Capital Development among Rural African American Grandmothers

ABSTRACT The focus in this study was to understand the learning experiences of rural grandmothers caring for their grandchildren. Specific attention was given to the informal learning activities in which primary caregiving grandmothers engaged that contributed to their human capital development and how they used informal learning as a means of intergenerational learning, teaching, and interacting with the children in their care. Ten grandmothers were purposely selected and interviewed. Data analysis revealed two themes: (a) faith literacy: interpersonal and intergenerational learning and collaborating; and (b) school literacy: interpersonal and intergenerational learning and collaborating. I conclude with a discussion for research and practice.

African American Grandmothers as Caregivers: Formal and Informal Learning and the Benefits to the Children in their Care

African American Grandmothers as Caregivers: Formal and Informal Learning and the Benefits to the Children in their Care

Grandma’s Hands: Memories of Hair Styling Interaction with African American Grandmothers

ABSTRACTAfrican American grandmothers frequently take on a caregiving role of their grandchildren and this intergenerational exchange is often inclusive of hair care. Nineteen African American women recalled memories of their grandmothers and the hair care process. The narratives themes included family bonding rituals, words of affirmation and positive touch, disapproval and criticism, and aggressive styling. The findings suggest that hair stories and hair care can be used as an entry point into better understanding African American family dynamics and intergenerational cultural transmission.

The Wages of Worship, Religious Education, and Human Capital Development in the Black Church: Voices From Rural African American Primary Caregiving Grandmothers

Grandmothers are often referred to as the spiritual learners and leaders within families and often pass their religious teachings on to their children and grandchildren. This qualitative study investigated learning and human capital development among rural African American grandmothers ( n = 10) caring for their grandchildren. The findings revealed the participants’ perception of the Black Church, an agency for learning. The findings further revealed the benefits of religious education in learning communities and how the skills the participants acquired through such engagements contributed to their human capital development, thereby indicating the wages of worship. Finally, findings indicated how the participants utilized religious teachings to support the development of the children in their care.

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

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. 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. 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. 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.

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.

The Diabetic Health of African American Grandmothers Raising their Grandchildren.

PURPOSEThe 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.DESIGNUsing 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.METHODSTo 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.RESULTSStatistically 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.CONCLUSIONDifferences 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.

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.

Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing

An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence. This qualitative interview-based study was conducted in a high-poverty community in rural Georgia. In-depth interviews were conducted with African American grandparent caregivers and key informants from local community-based organizations. A key informant assisted in identifying initial interview participants, and then snowball sampling was used to recruit additional participants. Interview questions were grouped under five domains (intrapersonal, interpersonal, community, organizational, and policy), according to the levels of the SEM. Iterative content analysis of interview transcripts was utilized. Transcripts were coded to identify text segments related to each domain of the SEM, which were grouped together for analysis by domain. Reflexive memo-writing aided in development of themes, and data quality was assessed using Lincoln and Guba's trustworthiness criteria. Rural African American grandparent caregivers faced a range of challenges to health. Direct physical challenges included chronic pain that interfered with sleep and daily functioning, mobility issues exacerbated by child care, and the pressure of managing their own medical conditions as well as their grandchildren's. Financial scarcity added to their vulnerability to poor health outcomes, especially when caregivers would forego purchase of medications or visits to the doctor because of expenses related to their grandchildren. In addition, lack of child care made health appointments and hospitalizations logistically difficult. Emotional strain was common as grandparent caregivers struggled to protect their grandchildren in communities where rates of drug use, HIV, and incarceration were high. Caregivers worried about their mortality and the related consequences for their grandchildren. Chronic stress, which is linked to a number of poor health outcomes, was self-reported by most rural grandparent caregivers. In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact.

Rationales for Support That African American Grandmothers Provide to Their Children Who Are Parenting Adolescents.

African American grandmothers are known to be a major source of support for their children who are parenting adolescents, but little is known about why they provide support. The purpose of this study was to describe the kinds of support provided by African American maternal and paternal grandmothers to their parenting adolescents and the reasons for giving support. In all, 10 maternal and 10 paternal grandmothers were recruited from one low-income African American community to participate in this cross-sectional, qualitative, descriptive study. Grandmothers provided support due to love and concern for their adolescent parenting children and their grandchildren. Grandmothers were influenced by their own past experiences and by the adolescent's personality and behavior. School nurses and school health clinic personnel are tactically positioned within the lives of families with parenting adolescents and can help facilitate the provision of support that allows adolescent parents to successfully transition to adulthood and assume adult roles.