<h3>Methods</h3> Children (N= 97; 8-18 years old; 63.9% Hispanic, 22.7% Black, 13.4% White) were recruited for this study through a pediatric hospital, children's bereavement camps, support groups, snowball sampling, and personal contacts. IRB approval was obtained from Florida International University, and Nicklaus Children's Hospital through WIRB. Inclusion criteria included having experienced the death of a parent, grandparent, brother, or sister within the past two years, able to read and write English, and currently in their age appropriate grade level in school +/- 1 year. Exclusion criteria included: 1) conditions that render a child unable to participate verbally; 2) living in foster care before or after the death; 3) history of psychiatric conditions; and 4) death of more than one family member in the previous 2 years because the child will be dealing with multiple deaths at the same time. One child from each eligible family participated in the study. Measures from Child included the Child Depression Inventory, Spiritual Coping Strategies Scale, and the Hogan Inventory of Bereavement. Parents completed a demographic form. Differences in children's use of Spiritual and Religious Coping subscales were measured with 2-sample t-tests by child age, gender, participation in religious rituals and practices, and oneway ANOVA with Scheffe post-hoc comparisons for race/ethnicity, and relationship of child to the deceased. Pearson's product moment correlations were used to determine relationship between spiritual coping strategies and the outcomes of grief, personal growth, anxiety, and depression, and were also used to determine grief and the outcomes of personal growth, anxiety, and depression. <h3>Results</h3> Children's greater use of spiritual coping, but not religious coping, and greater grief were significantly related to greater personal growth and greater anxiety. Children who participated in religious rituals used less religious coping strategies than children who did not participate. Younger age and being Black were significantly related to greater anxiety. <h3>Discussion</h3> The results of this multicultural/multiethnic study provide insight regarding the effects of children's spiritual coping after parent, grandparent, or sibling death on their grief, personal growth, and mental health which has not been widely studied and the knowledge base is limited. Learning how children's spiritual coping strategies increases their personal growth and age and racial differences that exist with respect to grief and anxiety in bereft children will enhance the health care provider's knowledge base regarding the grieving process in children. Further research is needed to determine if children's spiritual coping strategies remain related to greater personal growth more than two years after the deaths.
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