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This study examined the associations of grandparent-grandchild relational closeness and conflict with grandchildren's socioemotional and behavioral problems, including emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. We analyzed primary cross-sectional survey data collected from custodial grandparents in the United States using logistic regression models. The results indicated that grandparent-grandchild relational closeness was significantly associated with lower odds of custodial grandchildren having emotional symptoms, conduct problems, peer problems, and abnormal prosocial behaviors, whereas grandparent-grandchild relational conflict was significantly associated with higher odds of emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. Implications for increasing grandparent-grandchild relational closeness and decreasing relational conflicts among grandparent-headed families are discussed, which might improve grandchildren's socioemotional and behavioral well-being.

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Sleep quality amongst caregivers with disability may have been compounded by the COVID-19 pandemic. We evaluated differences in sleep quality amongst custodial grandparents from a southern state that were identified through state-based Kinship Care support groups coordinators and online. Participants (N = 102) completed the Pittsburgh Sleep Quality Index and self-reported disability statuses. Gamma tests showed a strong negative relationship between disability and sleep duration indicating fewer hours of sleep, higher use of sleep medication and greater sleep disturbances. Disability is not significantly related to sleep latency, sleep efficiency, and daytime dysfunction. T-tests showed no strength of relationship between disability and overall sleep quality. During the first year of the COVID-19 pandemic, custodial grandparents with disability had greater issues with their sleep quality than those without disability. Sleep, as it pertains to its overall preponderant role in maintaining good health, should be examined amongst custodial grandparent caregivers and those with disability.

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BACKGROUND AND OBJECTIVES: Grandparents are key resources in grandchildren care globally. However, mixed findings indicated that multiple role engagement may enhance well-being and bring demands on grandparent caregivers in different contexts. This systematic review examines the association between the intensity of grandparent caregiving and their health and well-being (i.e., physical, mental, cognitive, and life satisfaction) by continent and country/region. RESEARCH DESIGN AND METHODS: Systematic searches were conducted in 4 databases. Peer-reviewed articles with quantitative designs published between 1990 and November 2021 were identified. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies were critically appraised, and their results were narratively synthesized. RESULTS: Sixty-five articles from 29 countries/regions were included. Findings suggested a concave curvilinear relationship between the intensity of grandparent caregiving and their health and well-being, with the optimal caregiving intensity varying across sociocultural contexts. In Europe, Oceania, the Middle East, and South America, providing supplementary or occasional care seems beneficial for grandparents' health and well-being, especially supporting dual-earner families. In East Asia, economic resources appear to buffer the adverse effect of primary care on grandparents' well-being. In the United States, findings vary across ethnicity/race. DISCUSSION AND IMPLICATIONS: Collectively, the intensity of grandparent caregiving, health, and well-being is complicated by grandparents' roles in the family and cultural differences. Acknowledging the bidirectional relationship between well-being and grandparents' capacity for providing care, the well-being as outcome is a limitation. Despite so, this systematic review calls for culturally-tailored family programs to support grandparent caregiving.

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An increasing number of custodial grandparents are raising grandchildren, and intensive childcare is stressful with many negative personal, interpersonal, economic, and health implications. Grandparents' strengths, including resilience, positive caregiving appraisal, and social support should be considered in the face of parenting stress and adversity. Guided by the stress and resilience model, the current study investigated the associations of parenting stress and coping resources with life satisfaction and mental wellness among custodial grandparents (N = 76). Data were collected between December 2020 and April 2021, through collaborations with community-based agencies located in two metropolitan areas, which provide supportive services to custodial grandparents and their families. Findings showed that more parenting stress was associated with less life satisfaction and worse mental health, and that stress management boosted life satisfaction and mental wellness. Grandparents with more informal social support and social service utilization fared better than their counterparts with less social support and no experience of service use. The results of this study suggest that social work interventions should focus on improving stress management to cope with daily and caregiving stressors. Social workers can help with informal social support and formal social services utilization to address caregiving needs among custodial grandparents.

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Whether grandparenting is associated with improved health or well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health or well-being outcomes of grandparenting, concerning (1) custodial grandparent families, where grandparents are raising grandchildren without parental presence; (2) three-generation households, where grandparents are living with adult children and grandchildren; and (3) non-coresiding grandparents, who are involved in the lives of their grandchildren. Review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3868 abstracts across four databases, and by following the PRISMA guidelines, we identified 92 relevant articles (117 studies) that were published between 1978 and 2019. In 68% of cases, custodial grandparenting was associated with decreased health or well-being of grandparents. The few studies considering the health or well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases, involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health or well-being. Despite this, after different robustness checks (counting all nonsignificant results, taking into account the representativeness of the data and causal methodology), the main finding remains the same: the most negative results are found among custodial grandparents and three-generation households and most positive results among non-coresiding grandparents.

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OBJECTIVE: We examined how married custodial grandparents from the same household appraise the impact of caring for a grandchild on their sense of self, and how these appraisals are related to their psychological well-being. BACKGROUND: This study is important because there is scant information on how custodial grandmothers and grandfathers both experience their caregiver role, even though 70% of these grandparents are married. METHOD: Four competing measurement and structural models from the combined perspectives of the stress process model and the two-factor model of caregivers' psychological well-being were tested with 193 married grandmothers and grandfathers. RESULTS: The best fitting model was one in which two positive (personal gain and satisfaction) and two negative (loss of self and role captivity) appraisals emerged as distinct first-order constructs. Both negative appraisals correlated highest with negative affect, and both positive appraisals correlated highest with positive affect. The measurement and structural components of this model were largely invariant by grandparent gender. Mean comparisons showed that grandmothers reported significantly higher negative appraisals than grandfathers, with the latter reporting significantly greater perceived gain in the caregiving role. Bivariate correlations between grandmothers' and grandfathers' appraisals were nonsignificant for perceived gain and loss of self and of only moderate magnitude for caregiver satisfaction and role captivity. CONCLUSIONS: Given that appraisals are a core component of coping with stressors, our findings have important practice implications and point to meaningful directions for future research regarding custodial grandparent families.

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Grandparent caregivers report poorer psychological and physical health, but relationship status has been shown to influence burden. The current study investigated depressive symptoms of 3288 grandparents who completed the third wave of the National Survey of Families and Households. The study found that those who are unmarried were more likely to be grandparent caregivers, and female participants reported higher depressive symptoms. Marital status and caregiving status were comparable predictors of depression, but marital status did not buffer the effects of caregiving status on depression. Caregiving status accounted for a significant amount of depressive symptom variance for depression, comparable to marital status and gender. There was a significant difference in depressive symptoms of married and unmarried grandparent non-caregivers but with a significantly lower baseline depression rate than grandparent caregivers. Future research should examine whether making social support options available to unmarried grandparent caregivers who lack informal support from a spouse may improve outcomes.

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Data from two waves of the Social Environment and Biomarkers of Aging Study in Taiwan were analyzed to determine the effects of custodial grandparenting on health in a longitudinal sample. Self-reported measures on respondents' perception of their health, six health biomarkers, the presence of twelve diseases, and a measure of stress were included. Custodial Grandparents (CGPs) were significantly more likely to report worse health than their peers. However, there were no significant differences in biomarkers, and CGPs were only significantly different from non-custodial grandparents (nCGPs) regarding lower respiratory disease. Results suggest that CGPs do not have significantly worse health than nCGPs, but report feeling less healthy. This disparity is suspected to be due to energy levels or stress sources not assessed by the variables in the original study. These results and their implications based upon the stress-coping model elucidate the need to design interventions that incorporate the East Asian cultural values and practices in order to promote better health outcomes for CGP populations overall.

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BACKGROUND AND OBJECTIVES: Grandparents who are raising their grandchildren in the absence of the biological parents, often referred to as custodial grandparents, are prevalent across the United States. The objective of this project was to establish a grounded theory as a tool for practitioners and researchers to understand the experiences of members of grandfamiles. RESEARCH DESIGN AND METHODS: In-depth, unstructured interviews with custodial grandparents and grandchildren from 15 grandfamilies were conducted. Classic grounded theory was the methodology used to ask the question, "What are the challenges within grandfamilies and how do they respond to these challenges?" RESULTS: The theory emerging from the data, Compounding Complexity, provides an explanatory framework of three interrelated categories of factors that affect complexity in grandfamilies: situational, relationship, and emotional complexity. Conflict and change were found to be consistent across the categories of Compounding Complexity. DISCUSSIONS AND IMPLICATIONS: Next steps include adding data from interviews with biological parents to Compounding Complexity and applying the theory. Understanding relationship, situational, and emotional complexity in the context of conflict and change enables practitioners to advance their work with grandfamiies.

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OBJECTIVES: Do support and coping strategies moderate the link between stress and life satisfaction among grandparent caregivers? BACKGROUND: Grandparents raising grandchildren often experience stress, which may compromise their subjective well-being. Thus, it is important to understand the role of support and coping as protective or promotive factors in relation to grandparent caregivers' resilience (i.e., life satisfaction). METHODS: Grandparent caregivers (N = 74) reported their daily hassles, life satisfaction, social support, and coping. RESULTS: These grandparent caregivers are a vulnerable population in terms of stress and limited social support and coping. Structural equation modeling supported direct, promotive effects of social support and coping on life satisfaction, but not moderation. CONCLUSION: Despite high levels of stress, half of the grandparent caregivers were satisfied with their lives, which was explained by their social support and coping skills. Some grandparents who assume this role likely would benefit from interventions that promote social support and coping skills.

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Native American grandparents by tradition are expected to play a role in rearing grandchildren. However, in many Native grandfamilies, grandparents are rearing grandchildren not by choice or tradition, but as the result of family crises that necessitated grandparent intervention. European American grandparents have likewise been called to rear their grandchildren when their adult children are unable or unwilling to perform parental duties. Less is known about these custodial grandparents' resilience pathways, particularly among rural grandfamilies. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, this study examined the relationships between stressors, resources, and resilience among rural Native and European American custodial grandparents. Correlates of resilience were economic stress and stress management. Significant interactions were found between economic stress and government assistance and economic stress and stress management, indicating complex resilience pathways. Implications of study findings for research and intervention are discussed.

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Grandparents in rural Appalachia with primary caregiving responsibilities for their grandchildren often struggle with high levels of stress, inadequate resources, and poor physical and mental health. However, implications for children of being raised by grandparents rarely have been examined, particularly in terms of stress biomarkers. The present study investigated salivary C-reactive protein, interleukin-6, and tumor necrosis factor alpha in a small sample of children (N = 20) aged 5 to 18 years being reared by grandparents in two rural counties in Kentucky, a region well known for its resource scarcity. Saliva samples were collected from children 30 min after waking at two time points spaced one year apart. Grandparents and children completed a series of questionnaires via interview. Children's internalizing symptoms were related to greater markers of inflammation over time. Grandparent stress and poor mental health were also related to greater inflammation, while grandparent positive parenting and religiosity were associated with lower inflammation.

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BACKGROUND AND OBJECTIVES: In this manuscript, we update the literature over the last decade in addressing several new content areas that have emerged in the grandfamilies literature, along with issues that are still important to understanding grandparents raising their grandchildren today. RESEARCH DESIGN AND METHODS: The social science and gerontological literature since 2004 was accessed, reviewed, organized topically, and integrated, based upon an exhaustive PsychINFO literature search. RESULTS: Our review indicates an ongoing and/or growing emphasis on (a) the strengths of grandparent raising grandchildren, (b) diversity among grandfamilies along a number of parameters, (c) the social-interpersonal, cultural, and policy-related contexts of grandfamilies, (d) process-focused research, (e) parenting, parenting skills, and family relationships, (f) grandparent psychological distress, (g) targets for and the efficacy of interventions with grandfamilies, and (h) methodological issues relevant to the study of grandfamilies. IMPLICATIONS: We discuss the implications of our findings in terms of more completely understanding grandfamilies along a number of parameters, as well as presenting specific recommendations for future research and practice.

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We know little about custodial grandparents of children with autism spectrum disorder (ASD) who offer a vital social safety net. 117 custodial grandparents of children with ASD from 37 states completed an online survey with open-ended questions about their "greatest challenges and joys" as grandparent. Grounded theory analysis revealed four categories of experience (Issues with Adult Children, Caregiving Burden, Coping, & Wisdom) explained by 15 themes. Grandparents' stressors encompassed custody issues, ASD problem behaviors like tantrums and eloping, insufficient ASD services, financial burden, 24/7 caregiving demands, social isolation, and fears for the future. Grandparents' coping included celebrations of progress, unconditional love, faith, and a positive focus. Grandparents' wisdom included patience and insight. Recommendations to support these caregivers are provided.

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INTRODUCTION: The purpose of this descriptive report is to provide the first representative information on the sociodemographic profile and the prevalence of mental and physical health conditions of two "at-risk" groups of Latino caregivers: solo grandparent caregivers and single parents. METHODS: The 2012 Behavior Risk Factor Surveillance System was used to compare five dimensions of health on a sample of Latino solo grandparents and Latino single parents, raising their grandchildren/children alone. Bivariate and logistic regression comparative analyses were conducted on study measures. RESULTS: Latino solo grandparents have a high prevalence of chronic health conditions, including arthritis (51%), depression (40%), diabetes (34%), and asthma (34%). Latino single parents have lower but troubling health risks, including depression (22%), diabetes (14%), and asthma (14%). Differences between the two groups were largely due to the grandparents older age. DISCUSSION: Latino solo grandparents have a high prevalence of several chronic medical conditions. The prevalence of disorders is much lower for Latino single parents, although they too have disturbing health risks. CONCLUSION: Latino solo grandparents perform their parenting role under intense physical and emotional strain. Health professionals can be instrumental in facilitating interventions that affect the well-being of this expanding family group.

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A recent increase in children living with grandparents places more children at increased risk for emotional, psychological, or behavioral problems. This study used the Resiliency Model of Family Stress, Adjustment, and Adaptation to examine how children's living situation, parental monitoring, child's resourcefulness, and perceived support affect depressive symptoms and perceived family functioning. Of participants, 36% ( n = 56) lived with their parents only, 44% ( n = 69) lived with a grandmother as their primary caregiver, and 20% ( n = 31) lived in a multigenerational household. Results indicate parental monitoring and support affected perceptions of family functioning. Subjective support and resourcefulness affected depressive symptoms. No effects were found from living situation and demographic factors. Resourcefulness had the strongest effect on depressive symptoms, with a 3-point decrease in symptoms for each incremental increase in resourcefulness. This study provides insight into factors influencing children's depressive symptoms and perceived family functioning, and provides direction for the development of future interventions.

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Despite increased interest in parenting among custodial grandmothers (CGM), there is scant research on assessing their parenting practices. With CGMs as informants we examined the factor structure for five self-report scales developed as measures of parental nurturance and discipline with birth parents, and then tested for measurement invariance by grandchildren's age (4 - <7 versus ≥7 - 12). We also examined concurrent validity for these scales according to the Family Stress Model. Data were from 343 CGMs (M = 58.45, SD = 8.22) enrolled in a randomized clinical trial caring for grandchildren (GC) aged 4 to 12 (M = 7.81, SD = 2.56). Discipline was assessed by three scales from the Parental Behavior Inventory (Consistency, Effective, and Punitive). Nurturance was assessed by the Positive Affect Index and the Supportive Engaged Behavior scale of the Parenting Practice Interview. Confirmatory factor analysis (CFA) revealed that these scales were best represented as five distinct yet covarying factors (RMSEA = .055; SRMR = .07). Follow-up CFAs within each GC age group supported this model, with only few changes suggested by the corresponding diagnostic tests. A model with these changes was then examined for measurement invariance by CG age group, with complete measurement invariance found and all items loading onto their respective factors significantly. The five scales also correlated as expected with indices of CGM psychological distress and GC adjustment. We conclude that the scales examined here can be used meaningfully with CGM as respondents.

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Despite growing numbers, the nutrition practices and attitudes of skipped-generation(s) kinship caregivers regarding feeding the dependent children in their care have not been examined. In this qualitative study, transcriptions of semi-structured interviews with 19 female and four male skipped-generation(s) Kansas caregivers (ages 47 to 80, 92% non-Hispanic whites, 83% female, 78% grandparents and 22% great-aunt or great-grandparent caregivers; caring for a range of one to four children, ages three to 18, for an average of nine years) were content analyzed for how their nutrition-related practices and attitudes had changed since parenting the first time. Sub-themes regarding practices included: being more nutrition and food safety conscious now, and shifting their child feeding style. The children seemed to be adversely affected by an on-the-go lifestyle and the use of more electronics. Caregivers described their sources for child feeding advice as being based mostly on information from their mothers, physicians, and their past parenting experiences. Sub-themes for attitudes included opinions that nutrition and safe food handling are important and that nutritious food is expensive. They preferred printed or video nutrition education materials and wanted to receive information through organizations they trusted. This population could benefit from education on: infant, child, adolescent, and sports nutrition; feeding "picky eaters"; healthful recipes, "fast foods" and packaged foods; quick, inexpensive meals and snacks low in fat, sugar, and salt; limiting sedentary time; family meals; using food thermometers; and intergenerational gardening and cooking.

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