Black Female Caregivers Research Articles

‘Protecting your body and loving yourself’: strategies Black male caregivers use to protect Black girls sexuality in the USA

Black girls in the USA face disproportionate rates of sexually transmitted infections (STIs), HIV, and sexual violence, prompting research into the sociocultural factors such as adultification, race and gender discrimination, and stereotyped messaging, impacting Black girls’ sexual development. While existing literature finds that Black female caregivers utilise protective strategies to mitigate potential harm to Black girls, little is known about the role of Black male caregivers. This qualitative study employed the Becoming a Sexual Black Woman framework and one-on-one interviews to examine how 30 Black male caregivers of girls conceptualised parental protection and elated strategies. The thematic analysis revealed key themes of: Being a Provider, Being a Present Role Model, Protecting Black Girls’ Bodies, Limiting Exposure to Stereotyped Messages, and Providing Emotional Protection. Black male caregivers navigated traditional gendered expectations and limited resources while utilising parental strategies that reflected patriarchal, sometimes misogynistic, and non-patriarchal ideals and norms. The study highlights the attitudes and beliefs of Black male caregivers regarding protecting Black girls from sexual violence and other related adverse outcomes. The findings offer insights for family-based interventions and programmes that empower Black girls to support their sexual development and health in the USA.

DIFFERENCES IN CAREGIVING BURDEN ACROSS THE INTERSECTIONALITY OF RACE AND GENDER

Abstract Caregivers may be at different risks of various types of burdens by virtue of their gender and racial/ethnic status. This study explored the differences in caregiving burdens among caregivers to people with dementia across the intersectionality of race and gender. Using Round 5 (conducted in 2015) and Round 7 (conducted in 2017) of the National Study of Caregiving and National Health and Aging Trends Study data, the study examined differences in caregiver burdens across and within different gender and racial/ethnic groups, within the realms of financial, emotional, and physical burdens. The sample consisted of 1,206 caregivers who provided services to Medicare beneficiaries. Logistic regressions were performed to assess the three types of burdens each subgroup was experiencing. Results indicated that within the intersectionality framework, compared to White female caregivers, Black male caregivers were 3.3 times (95% confidence interval [CI] 1.77-6.22) more likely to experience financial burden, and Black female caregivers were 54% (95% CI 0.28-0.76) less likely to experience physical burden. Surprisingly, compared to White female caregivers, all the other groups were 37% (95% CI 0.41-0.95) to 71% (95% CI 0.15-0.56) less likely to have emotional burden. The findings highlighted that Black male caregivers are experiencing financial burden and White female caregivers are experiencing emotional burden disproportionately. To develop effective interventions and programs for dementia caregivers, a special focus should be put on monitoring the differences in the types of burdens that the above-mentioned population subgroups experience.

Coping socialization in Black families: A latent profile analysis.

The purpose of the present study was to employ latent profile analysis (LPA) to identify distinct profiles of Black caregivers based on how they socialize their children to cope with stress. Participants included 126 Black female caregivers (Mage = 40.67, SD = 9.73) who provided data on 149 4th-8th-grade children (61% female; Mage = 11.21, SD = 1.52). Caregivers self-reported on socialization of child coping, caregiver support, and caregiver coping behaviors; children reported on caregiver socialization of coping, caregiver support, and child coping. The LPA revealed three distinct socialization profiles: A low diversified socialization profile, an engagement socialization profile, and a high diversified socialization profile. Caregivers in the low diversified socialization profile reported lower levels of primary and secondary engagement and disengagement coping, as well as increased parental support, compared to both the engagement socialization profile and high diversified socialization profile. Furthermore, results revealed that the three socialization profiles did not differ on children's self-report of coping. Results from the present study suggest variability among Black caregivers' coping socialization strategies and additional research is needed to maximize best outcomes for Black youth and their families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Qualitative Study of Caregiver Perspectives on Health Policy Discussions Initiated by Pediatricians.

Prior studies suggest that pediatricians believe discussing health policy issues with families is important. Caregiver preferences on these discussions, however, have not been examined. We explored circumstances in which caregivers may be receptive to discussing health policy issues with pediatricians. We conducted 26 semistructured interviews with mostly Black female caregivers at 3 urban academic pediatric primary care practices. Using both structured and open response questions, we explored 4 primary content areas: 1) caregivers' perspectives on discussing health policy issues in pediatricians' offices; 2) which health policy topics caregivers may prefer to discuss; 3) factors that render policy discussions in the clinic inappropriate to caregivers; and 4) which communication modalities caregivers prefer. Interview transcripts were coded and analyzed using content analysis. Themes that emerged from interviews included: 1) pediatricians are perceived as trusted information sources on health policy; 2) caregivers want to talk with pediatricians about children's health insurance policy changes; 3) time constraints are a barrier to health policy discussions; 4) caregivers prefer to discuss health policy topics during well-child visits; 5) caregivers want the option to opt-out of these conversations; 6) preferred modalities for communicating about health policy issues, including printed materials and health fairs or educational events. Caregivers expressed a satisfactory view of pediatricians discussing directly relevant health policy issues, including congressional debates on health insurance, in the primary care setting. Our findings highlight other caregiver preferences for engaging families in health policy discussions, including the timing of these conversations.

The Role of Secondary Care Networks, Gender, and Race on Primary Caregiver Burden

In addition to primary caregivers, many older adults receive care from secondary care networks (SCN), which include family members and friends. Literature rarely considers support that SCN provided to primary caregivers. This study examines: (a) the association between SCN support and primary caregiver burden, and (b) the intersectional effects of gender (male/female)-race (White/Black) identities of primary caregivers on the association. A cross-sectional study using data from 2015 National Health and Aging Trend Study (NHATS) and National Study of Caregiving (NSOC) was conducted. A total of 967 older adults, 967 primary caregivers, and 2253 secondary caregivers were selected. SCN support was measured by (a) care domain overlap, and (b) proportion of caregiving by SCN. Negative binomial regressions on overall and split samples estimated main effects of SCN support and the intersectional effects of gender and race. Both SCN-related variables were associated with primary caregiver burden, but significant three-way interaction was only found between gender, race, and proportion of caregiving by SCN. Black female caregivers reported heaviest burden and having SCN support was associated with lower risk of being burdened. Whereas Black male caregivers reported lightest burden and SCN support was not associated with their perceived burden. Our findings support the positive role of SCN in reducing stress of primary caregivers, and demonstrate that positive impacts of SCN support vary across gender-race groups. The results indicate a strong need for support programs aimed at promoting cooperation among family caregivers for burden reduction, especially families with female and Black primary caregivers.

Caregiving Burden Among Caregivers of People With Dementia Through the Lens of Intersectionality.

Caregivers may be at different risks of various types of burdens by virtue of their gender and racial/ethnic status. This article explores the differences in caregiving burdens across the intersectionality of race and gender. Using Round 5 (conducted in 2015) and Round 7 (conducted in 2017) of National Study of Caregiving and National Health and Aging Trends Study data, the study examined differences in caregiver burdens across and within different gender and racial/ethnic groups, within the realms of financial, emotional, and physical burdens. The sample consisted of 1,206 caregivers who provided services to Medicare beneficiaries. Logistic regressions were performed to assess the 3 types of burdens each subgroup was experiencing. Results indicated that within the intersectionality framework, compared to White female caregivers, Black male caregivers were 3.3 times (95% confidence interval [CI] 1.77-6.22) more likely to experience financial burden, and Black female caregivers were 54% less likely to experience physical burden. Surprisingly, compared to White female caregivers, all the other groups were 37% (95% CI 0.41-0.95) to 71% (95% CI 0.15-0.56) less likely to have emotional burden. The findings highlighted that Black male caregivers are experiencing financial burden and White female caregivers are experiencing emotional burden disproportionately. To develop effective interventions and programs for dementia caregivers, a special focus should be put on monitoring the differences in the types of burdens that the above-mentioned population subgroups experience.

Underserved and Undermeasured: a Mixed-Method Analysis of Family-Centered Care and Care Coordination for Low-Income Minority Families of Children with Autism Spectrum Disorder.

This study examined how a racially and socioeconomically diverse group of caregivers of children with autism spectrum disorder (ASD) responds to national standard measures of family-centered care (FCC) and care coordination (CC) and what aspects of quality care are missing from these measures. Based on survey and interview data collected from 70 caregivers who have a child with ASD that receive services at a community-based autism clinic located in Atlanta, GA, we compared proportions of answers to FCC and CC questions to national and state representative data using chi-square analyses and contextualized our findings through a thematic analysis of qualitative interviews. Compared to national- and state-level data, the Atlanta autism clinic data had a higher percentage of participants who identified as Black, relied on public health insurance, and lived below 200% of the federal poverty line. The Atlanta autism clinic responses were significantly more positive in four measures of FCC but significantly less effective in two CC measures, including a lower reported percentage who received CC and greater reported percentage who needed extra help. Qualitative data revealed a range of positive meanings and challenges associated with FCC and identified areas of help needed beyond CC, including physical and mental health care and emotional connection, especially for low-income single Black female caregivers. Our mixed-method approach identified strengths in FCC, barriers to CC, and suggestions for developing more pragmatic questions in national surveys that address experiences of quality-of-care among low-income, racial minority families of children with ASD.

Differences within Differences: Gender Inequalities in Caregiving Intensity Vary by Race and Ethnicity in Informal Caregivers.

Among the 50+ million informal caregivers in the US, substantial gender, racial/ethnic, and socioeconomic disparities in caregiving intensity are well-documented. However, those disparities may be more nuanced: gender disparities in caregiving intensity may vary by race/ethnicity (White, Black, and Hispanic) and socioeconomic status (SES). We used data from the 2011 National Study of Caregiving and applied generalized linear models to estimate associations between three measures of caregiver intensity (ADLs, IADLs, and hours caregiving/month) and the three sociodemographic factors with their interaction terms. Black female caregivers provided significantly higher levels of care than White females and males for both IADL caregiving and hours/month spent caregiving. Black caregivers spent an average of 28.5 more hours/month (95%CI 1.7-45.2) caregiving than White caregivers. These findings highlight the need to understand the complex disparities within population subgroups and how intersections between gender, race/ethnicity, and SES can be used to develop effective policies to reduce disparities and improve caregiver quality-of-life.

A Black feminist approach for caseworkers intervening with Black female caregivers

ABSTRACT The disproportionate representation of Black children in the child welfare system, and its implications for Black female caregivers, must be understood through a critical perspective that considers their historical, social and cultural context. It has been posited that Black feminist philosophy and ideology may be a useful perspective for understanding risk factors that contribute to the disproportionate numbers of Black women who are involved in the child welfare system. Additionally, this perspective offers a practice framework that assists child welfare caseworkers to effectively engage, assess, and intervene with Black women and their families. In this article, we provide a brief overview of Black women’s disproportionate involvement in the child welfare system through a historical-trauma lens, review existing child welfare casework practice models, and discuss the need for an engagement in child welfare public consciousness for Black female caregivers. Further, we propose a culturally relevant casework practice model grounded in Black feminist principles. A case vignette is provided.

Caregiving, Mortality, and Mobility Decline<subtitle>The Health, Aging, and Body Composition (Health ABC) Study</subtitle>

Although caregivers report more stress than noncaregivers, few studies have found greater health decline in older caregivers. We hypothesized that caregivers may be more physically active than noncaregivers, which may protect them from health decline. The sample included 3075 healthy adults from the Health, Aging, and Body Composition (Health ABC) Study. They were aged 70 to 79 years in April 1997 to June 1998 and resided in Memphis, Tennessee, or Pittsburgh, Pennsylvania. Caregivers (680 [22.1%]) were participants who provided regular care or assistance for a child or a disabled or sick adult. Outcomes included all-cause mortality and incident mobility limitation (defined as difficulty walking one-quarter mile or climbing 10 steps on 2 consecutive semiannual contacts) during 8 years. Total physical activity included daily routine, exercise, and caregiving activity. Overall, 20.6% of caregivers died and 50.9% developed mobility limitations vs 22.0% and 48.9% of noncaregivers, respectively. Associations differed by race and sex. Mortality and mobility limitation rates were 1.5 times higher in white caregivers (eg, among white female caregivers, adjusted hazard ratio for mortality, 1.6; 95% confidence interval, 1.0-2.5) but not for black female caregivers vs noncaregivers (adjusted hazard ratio for mortality, 0.9; 95% confidence interval, 0.5-1.4). Physical activity mediated these associations in most race-sex groups. High-intensity caregivers (ie, caregiving > or =24 hours per week) had elevated rates of decline when adjusted for physical activity but lower rates when not adjusted for activity. Older white caregivers have poorer health outcomes than black female caregivers. Physical activity appears to mask the adverse effects of high-intensity caregiving in most race-sex groups.

Antihypertensive use and adherence and blood pressure stress response among black caregivers and non-caregivers

For this secondary analysis, a sample of 69 caregivers and 86 non-caregivers was selected from a primary study. Study purposes were to compare antihypertensive use, ambulatory blood pressures, and the association of caregiver status with adherence with antihypertensives of hypertensive black female caregivers and noncaregivers. Caregivers and noncaregivers were comparable in their antihypertensive use, blood pressures, and nonadherence reasons. Prescribed antihypertensives followed the Joint National Committee on Prevention, Detection, Evaluation VI guidelines. “Forgetting to take medications” and “careless about taking medications” were the most common reasons for non-adherence. These findings contradict previous findings among white caregivers and non-caregivers and suggest different practice implications.

Effective Sampling of Rare Population Elements

Efficacious sampling methods are needed to recruit representative samples of under-represented research populations. The purpose of this article is to describe and evaluate a step-by-step methodological approach for sampling rare populations (e.g., Black female caregivers and noncaregivers). Using the Medicare Enrollment Database, the researchers conducted a reverse screening strategy and a case-control design to obtain a systematic random sample of the caregivers. After revision of the recruitment strategy and referral goals, the researchers recruited 202 caregivers and 206 noncaregivers. The proportion of elders with caregivers was 11.8 percent compared with a projected yield of 8 percent. Lessons were learned regarding efficiency in sampling methodology, including the importance of having the potential participants respond to an open-ended question regarding their understanding of the study participation, providing agencies with detailed specifications of requested lists, and not allowing the obtained list to age. This article provides a road map for sampling rare populations.

Development and Testing of a Measure of Perceived Caregiver Rewards in Adults

Assessment of the rewards of caregiving is pertinent to a holistic view of the caregiving experience and design of health promotion interventions for caregivers. Few measures of caregiver positive appraisals exist. This paper describes the development and pilot testing of the Picot Caregiver Rewards Scale (PCRS) for adult caregivers. Derived from the choice and social exchange theory, caregiver interviews, and literature, 25 items compose the scale. Psychometric testings of the PCRS were conducted in a nonrandom sample of 83 Black female caregivers and a random sample of 256 Black and White female and male caregivers. Alphas of .83 and .88 demonstrated acceptable internal consistency of the revised 16-item PCRS. Construct validity was demonstrated by support of hypothesized relationships with caregiving demands, palliative coping, depression, and caregiver burden, as well as confirmatory factor analysis. Further psychometric study of the PCRS is recommended.