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Supporting the wellbeing of grandparents raising grandchildren can decrease behavioural problems among grandchildren

Chan KL, Chen M, Lo KM, Chen Q, Kelley S, Ip P. The effectiveness of interventions for grandparents raising grandchildren: A meta-analysis Research on Social Work Practice. 2019; 29(6): 607-617.

Review question

•      How effective are intervention programs designed for grandparents raising their grandchildren?

Background

•      In recent years, the prevalence of grandparents providing primary care for their grandchildren has risen substantially worldwide.

•      In 2012, approximately 2.7 million grandparents in the United States were primary caregivers of their grandchildren. In Australia, about 11% of children have lived in a three-generation household during their early childhood.

•      The extent to which grandparents are involved in the care of their grandchildren varies substantially across geographies and cultures.

•      Social problems such as parental incarceration, teen pregnancy, adult drug abuse, family violence, and housing crises have contributed to the increasing number of multigenerational and skipped-generation households. The increased demands of women in the workplace have also contributed to this trend.

•      The aim of this systematic review is to present the effectiveness and characteristics of intervention programs for grandparents raising their grandchildren, specifically looking at their effects on grandparenting skills as well as both the grandparents’ and grandchildren’s wellbeing.

How the review was done

•      Review authors conducted a detailed search of six research databases for eligible studies published before April 2018.

•      Searches using titles, key words, and abstracts were performed based on combinations of two groups of terms: (1) grandparent caregiver, custodial grandparents, and grandparents/grandmothers/grandfathers raising grandchildren and (2) intervention, training, and support groups.

•      Manual searches of the references section of related studies were conducted to identify further studies for inclusion.

•      Grey literature resources such as conference abstracts, dissertations, and unpublished studies were also searched for additional studies.

•      A total of 335 papers were retrieved and screened for the review, 20 of which were included.

•      The authors received no financial support for the research, authorship, and publication of this article.

What the researchers found

•      Because custodial grandparents experience many different challenges related to their caretaking responsibilities, most interventions examined multiple outcomes related to grandparents’ wellbeing, using various tools to assess the effectiveness of programs.

•      Programs included group-based programs with supportive components (for example, discussion of group members’ sense of stigma and concerns about the future of their families); educational components (for example, social supports, common stressors and cognitive/behavioural coping strategies; identifying and managing conflict; parent skills; information on legal options and availability for social services; community-based initiatives and collective advocacy). Other programs focused on parenting skills training and psychosocial adjustment of grandchildren (grief, depression, and anger), on custodial grandparent parental efficacy and grandchild relationship quality. Other programs offered case management and counselling (to address housing, interventions with social and health agencies, benefits counselling, special education, summer camp for the grandchildren, and respite services); support groups (to address grandchildren’s needs, and help grandparents to take care of themselves, including stress reduction, relaxation, nutrition, and own health needs). Some programs provided training in the use of positive parenting strategies, building a positive-parenting team with the parent, and coping strategies to manage unhelpful emotions.

•      The wellbeing of grandparents were examined in multiple dimensions of health, including mental health (for example, stress, depression, and anxiety) and physical health as related to their role as child caregivers.

•      In general, it was found that interventions were effective in improving grandparents’ wellbeing. Interventions were found to be most successful in enhancing the resources and social support of grandparents. Small improvements were seen in mental health, physical health, life satisfaction and empowerment, and grandparents’ relationships with family members.

•      The review also found that the intervention programs had a positive effect on grandparents’ parenting skills; a reduction in behavioural problems of grandchildren were also seen after the grandparents attended the program.

Conclusion

•      In summary, the findings of this systematic review demonstrate that the included intervention programs had positive effects on grandparents’ well-being, although the effect on different wellbeing outcomes varied greatly.

•      The authors stress that more analysis of high-quality evidence is needed to find out what works in an intervention program and to facilitate the implementation of effective interventions.