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1.
Evol Hum Sci ; 6: e7, 2024.
Article in English | MEDLINE | ID: mdl-38516370

ABSTRACT

Ethnic discrimination during pregnancy is linked to maternal psychological distress, adverse birth outcomes and increased offspring morbidity and mortality. An evolutionary perspective reframes offspring health issues as a risk to maternal fitness. We argue that kin may be evolutionarily motivated to buffer psychosocial stressors for the mother during pregnancy. Previously, we found that the relationship of a pregnant woman with her own mother (fetus' maternal grandmother) had a positive association on maternal prenatal psychology, above and beyond her relationship with her fetus' father. Here, we ask if grandmothers buffer mothers' prenatal psychological distress from ethnic discrimination. Using self-report data collected from 216 pregnant Latina women living in Southern California, we found discrimination to be significantly, positively associated with depression, anxiety, and stress in linear regression models. Maternal grandmother communication attenuated the association of discrimination and all three psychological distress measures, adjusting for the mother's relationship with the father. Maternal grandmother emotional support similarly significantly moderated the relationship of discrimination with depression and anxiety. We did not observe any significant interactions for paternal grandmother relationships. Geographic proximity was not a significant stress buffer. Results suggest the important role maternal grandmothers play in perinatal mental health, and that these benefits exist uncoupled from geographic proximity.

2.
Hum Nat ; 35(1): 43-62, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38353866

ABSTRACT

Receiving social support from community and extended family has been typical for mothers with infants in human societies past and present. In non-industrialised contexts, infants of mothers with extended family support often have better health and higher survival through the vulnerable infant period, and hence shared infant care has a clear fitness benefit. However, there is scant evidence that these benefits continue in industrialised contexts. Better infant health and development with allocare support would indicate continued evolutionary selection for allocare. The research reported here used multiple logistic regression analysis to test whether a lack of family and other social support for mothers was associated with an increased risk of developmental delay in 9-month-old infants in the UK Millennium Cohort (analysis sample size, 15,696 infants). Extended family-based childcare during work hours and more maternal time spent with friends were the most influential kin and social support variables: infants of mothers with kin-based childcare versus all other childcare arrangements had a lower risk of developmental delay (OR = 0.61, 95% CIs: 0.46-0.82). Infants of mothers who spent no time with friends when compared with those who saw friends every day had double the odds of delay. Greater paternal involvement in infant care was associated with a lower odds of developmental delay. In conclusion, shared care of infants and social support for mothers may influence fitness-related traits in industrialised societies rather than being factors that influenced selection only in the past and in societies which retain close kin networks and a strong local community focus.


Subject(s)
Developmental Disabilities , Social Support , Humans , Infant , Female , Male , United Kingdom , Mothers/psychology , Child Development/physiology , Adult , Infant Care
3.
J Aging Stud ; 66: 101163, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37704281

ABSTRACT

Grandmothers are the major nonparental unpaid source of childcare in Western societies. Intensive caring for grandchildren may pose challenges to some grandmothers, but also offers an opportunity to refill the 'empty nest' often experienced in mid-life. When grandmothers' intensive involvement in their grandchildren's care decreases significantly or ceases altogether, they may experience a recurrence of the empty nest syndrome. This may be particularly powerful in the familial and pro-natalist Israeli society, where caring for children is a central tenet of femininity. Despite the growing numbers of grandmothers whose intensive involvement in caring for their grandchildren has ended, this transition has been overlooked socially and rarely examined empirically. To fill this void, the present study examined the lived experience of these grandmothers and the relevance of the concept of the 'second empty nest' in this context. Within a phenomenological study, in-depth interviews were conducted with 11 Israeli women whose intensive 'grandmotherhood' (childcare occurring at least three times per week, for at least two hours each day, for a minimum of two years) has ended. These interviews were analyzed according to Moustakas' phenomenological analysis. The analysis revealed four themes: the circumstances of the cessation of intensive childcare involvement; difficulties and challenges experienced; positive aspects associated with it; and behavioral and cognitive strategies utilized to cope with the void in grandmothers' lives. The grandmothers' experiences reveal a significant similarity to that reported by mothers undergoing the empty nest syndrome. Hence, we offer the term 'the second empty nest' to represent the phenomenon of grandmothers' cessation of intensive childcare. Alongside the similarities between the two empty nests, the challenges of the second transition seem more intense than those posed by the first. This is due to the different locations of mothers and grandmothers across the lifespan and the intersection between sexism and ageism that underlies Western societies. Possible practices to assist grandmothers undergoing the second empty nest are suggested.


Subject(s)
Ageism , Humans , Female , Aged , Femininity , Longevity , Mothers , Sexism
4.
Front Sociol ; 8: 1196068, 2023.
Article in English | MEDLINE | ID: mdl-37538352

ABSTRACT

This brief argues that "grandmother-exclusionary bias" - or the side-lining of female elders as change agents within FGM/C programmes - represents a major obstacle to eradication of these practices. Grandmother-exclusionary bias is prevalent within FGM/C policy and programming. Yet, it goes against evidence of the extensive authority and decision-making roles that grandmothers wield in relation to FGM/C in sub-Saharan Africa, and insights from systems theory and meta-evaluations of FGM/C eradication efforts which stress that sustained change requires engaging those who wield authority over gender and social norms. We use postcolonial and decolonial theory to explain the assumptions about grandmothers which underpin grandmother-exclusionary bias. Finally, we provide recommendations for designing grandmother-inclusive, intergenerational community-led programmes based on a strategy empirically proven to shift social norms underpinning FGM/C.

5.
Glob Health Promot ; : 17579759231191494, 2023 Aug 24.
Article in English | MEDLINE | ID: mdl-37615182

ABSTRACT

Grandmothers exist in all societies. Especially in the non-western Majority World, where Elders are both highly respected and responsible for transmitting their knowledge to younger generations, there is extensive anecdotal evidence of Grandmothers' role in health promotion and healing. However, due to Eurocentric and reductionist views of families and communities, in the extensive past research on maternal, child and adolescent health issues across Africa, Asia, Latin America and the Middle East, and in Indigenous societies in North America, Australia and New Zealand, scant attention has been given to the role of Grandmothers. This paper addresses this oversight and supports the imperative to decolonize health promotion in the non-western world by building on non-western worldviews, roles and values. Based on an eclectic body of both published and gray literature, this review presents extensive evidence of Grandmothers' involvement across the life cycle of women and children and of the similar core roles that they play across cultures. While in some cases Grandmothers have a negative influence, in most cases their involvement and support to younger women and children is beneficial in terms of both their advisory and their caregiving roles. For future research and interventions addressing maternal, child and adolescent health, the conclusions of this review provide strong support for: adoption of a family systems framework to identify both gender-specific and generation-specific roles and influence; and the inclusion of Grandmothers in community health promotion programs dealing with different phases of the life cycle of women and children.

6.
Proc Biol Sci ; 290(1999): 20230690, 2023 05 31.
Article in English | MEDLINE | ID: mdl-37253424

ABSTRACT

Grandmother presence can improve the number and survival of their grandchildren, but what grandmothers protect against and how they achieve it remains poorly known. Before modern medical care, infections were leading causes of childhood mortality, alleviated from the nineteenth century onwards by vaccinations, among other things. Here, we combine two individual-based datasets on the genealogy, cause-specific mortality and vaccination status of eighteenth- and nineteenth-century Finns to investigate two questions. First, we tested whether there were cause-specific benefits of grandmother presence on grandchild survival from highly lethal infections (smallpox, measles, pulmonary and diarrhoeal infections) and/or accidents. We show that grandmothers decreased all-cause mortality, an effect which was mediated through smallpox, pulmonary and diarrhoeal infections, but not via measles or accidents. Second, since grandmothers have been suggested to increase vaccination coverage, we tested whether the grandmother effect on smallpox survival was mediated through increased or earlier vaccination, but we found no evidence for such effects. Our findings that the beneficial effects of grandmothers are in part driven by increased survival from some (but not all) childhood infections, and are not mediated via vaccination, have implications for public health, societal development and human life-history evolution.


Subject(s)
Grandparents , Measles , Smallpox , Humans , Finland , Family , Measles/prevention & control
7.
Evol Hum Behav ; 44(1): 30-38, 2023 Jan.
Article in English | MEDLINE | ID: mdl-37065817

ABSTRACT

Grandmothers are often critical helpers during a mother's reproductive career. Studies on the developmental origins of health and disease demonstrate how maternal psychological distress can negatively influence fetal development and birth outcomes, highlighting an area in which soon-to-be grandmothers (henceforth "grandmothers") can invest to improve both mother and offspring well-being. Here, we examine if and how a pregnant woman's mental health- specifically, depression, state-anxiety, and pregnancy-related anxiety- is influenced by her relationship with her fetus' maternal and paternal grandmother, controlling for relationship characteristics with her fetus' father. In a cohort of pregnant Latina women in Southern California (N = 216), we assessed social support, geographic proximity, and communication between the fetus' grandmothers and pregnant mother. We assessed maternal mental health with validated questionnaire-based instruments. We find that both social support from and communication with the maternal grandmother were statistically associated with less depression, while no paternal grandmother relationship characteristics were statistically significant in association with any mental health variable. These results align with the idea that maternal grandmothers are more adaptively incentivized to invest in their daughters' well-being during pregnancy than paternal grandmothers are for their daughters-in-law. Results suggest that the positive association of maternal grandmothers with mothers' mental health may not hinge on geographic proximity, but rather, potentially function through emotional support. This work represents a novel perspective describing a psychological and prenatal grandmaternal effect.

8.
J Women Aging ; 35(6): 513-525, 2023.
Article in English | MEDLINE | ID: mdl-36976632

ABSTRACT

The purpose of this study was to explore the associations between social determinants of health, health behaviors, and physical and mental health among African American and Hispanic caregiving grandmothers. We use cross-sectional secondary data from the Chicago Community Adult Health Study, originally designed to understand the health of individual households based on residential context. In a multivariate regression model, discrimination, parental stress, and physical health problems were significantly associated with depressive symptoms in caregiving grandmothers. Considering the multiple sources of stress experienced by this grandmother sample, researchers should develop and strengthen contextually relevant interventions for improving the health of caregiving grandmothers. Healthcare providers must be equipped with skills to address caregiving grandmothers' unique needs related to stress. Finally, policy makers should promote the development of legislation that can positively influence caregiving grandmothers and their families. Expanding the lens through which caregiving grandmothers living in minoritized communities are viewed can catalyze meaningful change.


Subject(s)
Grandparents , Humans , Grandparents/psychology , Cross-Sectional Studies , Social Determinants of Health , Health Behavior , Outcome Assessment, Health Care , Intergenerational Relations
9.
J Women Aging ; 35(5): 465-475, 2023.
Article in English | MEDLINE | ID: mdl-36256528

ABSTRACT

It is estimated that around half of all kinship carers in the UK are grandparents. International studies show that when broken down by gender, these carers are predominantly grandmothers. However, there is little research exploring the gender dimensions of kinship carers' experiences. Drawing on data from qualitative interviews with 27 grandparent kinship carers, this article highlights the gendered context in which the grandparents we spoke to found themselves. The grandparents - the majority of whom were grandmothers - described lives filled with multiple unpaid caring commitments and demands. We discuss the ways that gender norms, roles and stereotypes, alongside economic models and policies that invisiblise women's care work, shaped the experiences of the grandmothers who took part in our research. We argue that, despite their undeniable determination and commitment to love, nurture and care for their grandchildren in very difficult circumstances, and the money they are saving the state in doing so, grandmother kinship carers are penalized in multiple ways. Economically, emotionally, socially, physically and practically, grandmother kinship carers are unsupported and undervalued. We need a social, economic and cultural shift around the value of care and a redistribution of care work across genders. The situations of grandmother kinship carers need to be part of this shift, so that grandmothers who care for their grandchildren are no longer penalized, and all kinship carers are properly supported and valued.

10.
J Gerontol B Psychol Sci Soc Sci ; 78(3): 456-468, 2023 03 04.
Article in English | MEDLINE | ID: mdl-36130180

ABSTRACT

OBJECTIVE: Guided by a life-course perspective, we examine the nature of daily life among custodial grandmothers (CGM) through documenting daily positive and negative affect, reporting daily negative and positive events, and emotional reactivity/responsiveness to daily negative and positive events. We also examine whether CGM age, adverse childhood experiences (ACEs), and social relationship quality with grandchild are associated with each indicator. METHODS: We applied multilevel models to 200 CGM (Mage = 61, SD = 5.66) who were recruited from across the United States and completed a daily survey for 14 consecutive days prior to commencing a randomized clinical trial. RESULTS: Older age and reporting fewer ACEs were associated with better overall and less variability in daily well-being. Positive events were reported on 83% of days and negative events were reported on 56% of days. Daily well-being was lower when a negative event was reported and higher when a positive event was reported. Reporting more ACEs was associated with greater exposure to daily negative events and stronger gains in daily well-being when a daily positive event was reported. Older age was associated with lesser declines in daily well-being on days when a negative event was reported. DISCUSSION: In accordance with the life-course perspective, our findings illustrate how the timing of being a CGM (age) and the cumulative nature of development (ACEs) affect daily well-being and negative and positive events for CGM. Our discussion focuses on resources to consider when building resilience-focused interventions for promoting the health and well-being of CGM.


Subject(s)
Grandparents , Humans , United States , Surveys and Questionnaires
11.
Women Birth ; 36(2): e263-e269, 2023 Mar.
Article in English | MEDLINE | ID: mdl-35963836

ABSTRACT

BACKGROUND: Almost all babies are breastfed in Papua New Guinea (PNG); yet appropriate breastfeeding practices are not always followed. AIM: To explore the perspectives of first-time mothers in rural PNG on how the language and discourse of grandmothers about infant feeding influence their breastfeeding practices. METHODS: A critical discourse analysis (CDA) approach was used to theoretically frame the analysis of twenty first-time mothers' narratives. FINDINGS: Analysis revealed three themes: (i) prescribed knowledge repository, (ii) social control and dominance, and (iii) disapproval and role conflict, which provides an understanding of grandmothers' differing views and positions on infant feeding practices and their influence on breastfeeding. CONCLUSION: This study shows that grandmothers remain influential in infant feeding practices in rural PNG. There appears to be a societal expectation that empowers grandmothers in the maternal decision-making processes regarding breastfeeding practice. Grandmothers' influence includes the early introduction of complementary foods to infants less than six months old. Interventions aimed at promoting, protecting, and supporting breastfeeding need to include grandmothers.


Subject(s)
Breast Feeding , Grandparents , Infant , Female , Humans , Rural Population , Papua New Guinea , Health Knowledge, Attitudes, Practice , Mothers
12.
BMC Public Health ; 22(1): 1364, 2022 07 16.
Article in English | MEDLINE | ID: mdl-35842646

ABSTRACT

BACKGROUND: Given the importance of the first 1000 days of a child's life in terms of laying the foundations for healthy growth and development, parents are a logical target group for supporting health-related practices with regard to young children. However, little attention is paid to the influence of the wider social community on the health and development of young children during this crucial period. This includes grandmothers, who often have a significant influence on health-related practices of their grandchildren. The aim of this study was therefore to explore the influence of grandmothers on health related practices of their grandchildren during the first 1000 days, from the perspectives of both grandmothers and mothers with a Turkish background. METHOD: This qualitative study in the Netherlands collected data during focus group discussions with grandmothers (N = 3), interviews with grandmothers (N = 18) and interviews with mothers (N = 16), all with a Turkish background. Data was collected in the period between June 2019 and April 2021 and analysed using a thematic content analysis. RESULTS: The influence of grandmothers and the wider social community on health related practices during the first 1000 days of a child's life is substantial and self-evident. The support of grandmothers is often rooted in various socio-cultural norms and practices. The mothers of young children can experience the guidance and pressure they receive from grandmothers and the wider social community as quite stressful. Conflicting views and practices tend to arise between grandmothers and mothers when a grandmother babysits. Both mothers and grandmothers often find it difficult to discuss these differences openly, for fear this might lead to a family conflict. CONCLUSION: This study shows that grandmothers and the wider social community play an influential role in supporting a healthy first 1000 days of a child's life. The strong involvement of grandmothers may lead to tension between the mothers and grandmothers when their ideas about healthy practices are not in agreement and may lead to unhealthy practices. In targeting this wider social community, it is important to consider the various socio-cultural factors that underlie the advice, support, practices and beliefs of the individuals involved.


Subject(s)
Grandparents , Female , Focus Groups , Humans , Mothers , Netherlands , Qualitative Research
13.
Curr Dev Nutr ; 6(5): nzac045, 2022 May.
Article in English | MEDLINE | ID: mdl-35611354

ABSTRACT

Background: Positive Deviance/Hearth (PDH) is an internationally recognized nutrition rehabilitation program. However, nutritional improvements are inconsistent across contexts. It is unclear if variations are due to differences in program design, implementation, utilization, or other contextual factors. Furthermore, few PDH programs have addressed the high time and work burdens of caregivers and volunteers. To address this, the study integrated interactive voice calling (IVC) with PDH. Objectives: A program impact pathway (PIP) analysis was used to evaluate the secondary outcomes of facilitators, barriers, and contextual factors that influenced the design, implementation, and utilization of a Positive Deviance/Hearth-Interactive Voice Calling program to improve the nutritional status of children in Cambodia. Methods: A PIP analysis was done on data collected through in-depth interviews with caregivers (n = 32), key informant interviews with volunteers (n = 16) and project staff (n = 3), and surveys of project staff (n = 5). Results: In the design phase, facilitators included quality training, technical support and design tools, community mobilization, and linkage to existing health services. Barriers included poor community mobilization. For the implementation phase, facilitators were good volunteer knowledge, follow-up tools and guidance, supervision, and spot checks of volunteers. Barriers were lack of time and overworked older caregivers. For the utilization phase, facilitators included family and volunteer support and access to phones, whereas barriers were lack of support, time, and financial resources; low levels of education and old age of caregivers; and inconsistent phone use. Contextual factors included food insecurity and increased childcare responsibilities of grandmothers due to migration of mothers. Conclusions: The PIP analysis identified facilitators, barriers, and contextual factors that may affect the design, intervention, and utilization of IVC interventions for health and nutrition behavior change and elements to consider when designing and implementing them. When implementing child nutrition programs in Cambodia, supporting interventions addressing mental health and time and resource constraints of elderly caregivers should also be included.This trial was registered at clinicaltrials.gov as NCT03399058.

14.
Psychol Sch ; 2022 Apr 29.
Article in English | MEDLINE | ID: mdl-35572175

ABSTRACT

While negative impacts of COVID-19-related remote instruction on children continue to emerge, it appears that vulnerable students will disproportionately bear the burden. One such vulnerable population is children being raised by grandparents. The purpose of this mixed methods study was to gain insight into custodial grandmothers' (CGMs) experiences of their grandchildren's remote instruction, as well as individual and contextual factors associated with these experiences. A national sample of 315 CGMs, drawn from two randomized clinical trials, completed an online survey in Spring of 2020. Results of a thematic analysis and supplemental quantitative analyses revealed three themes. First, access to technology and instructional supports were critical to the success of remote instruction, with barriers being difficulties using technology and poor-quality remote instruction. Next, grandchild socioemotional difficulties, and fit with remote instruction, were central to their engagement and success with remote instruction. Finally, CGMs experienced multiple stressors related to managing the demands of remote instruction, work, and family. Challenges associated with remote instruction were related to pre-pandemic difficulties such as grandchild problems and CGM depressive symptoms. Collectively, the results highlight how multiple adversities may have amplified grandchildren's existing vulnerability to negative outcomes. Implications are addressed, including strategies for supporting children raised by grandparents beyond the COVID-19 pandemic.

15.
BMC Womens Health ; 22(1): 65, 2022 03 09.
Article in English | MEDLINE | ID: mdl-35260142

ABSTRACT

BACKGROUND: This 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. METHODS: Thirty 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. RESULTS: Ninety 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. CONCLUSIONS: The 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.


Subject(s)
Diabetes Mellitus, Type 2 , Exercise , Aged , Diabetes Mellitus, Type 2/prevention & control , Feasibility Studies , Female , Health Behavior , Humans , Middle Aged , Peer Group , Power, Psychological
16.
Curr Dev Nutr ; 6(2): nzac003, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35224418

ABSTRACT

BACKGROUND: Family members influence maternal, child, and adolescent nutrition and are increasingly engaged in nutrition interventions and research. However, there remain gaps in the literature related to programmatic experiences and lessons learned from engaging these key influencers in nutrition activities. OBJECTIVES: This research aimed to document global health professionals' experiences engaging family members in nutrition activities, and their perceived barriers, facilitators, and recommendations for nutrition activities that engage family members. METHODS: Global health and nutrition professionals were invited to complete an online survey about their experiences engaging family members in nutrition activities. The survey included 42 multiple-choice questions tabulated by frequency and 4 open-response questions, which were analyzed thematically. RESULTS: More than 180 respondents (n = 183) in 49 countries with experience engaging fathers, grandmothers, and other family members in nutrition activities participated in the survey. Participants highlighted the importance of conducting formative research with all members of the family system and using participatory processes in intervention design and implementation. Respondents reported engaging family members increases support for recommended behaviors, improves program sustainability, and facilitates family and community ownership. Some respondents also shared experiences with positive and negative unintended consequences when engaging family members; for example, one-fifth of participants reported that mothers were uncomfortable with involving men in discussions. Common challenges centered on limited resources for program delivery, not involving all influential family members, and traditional gender norms. Recommendations included incorporating family members in the project design phase and ensuring sufficient project resources to engage family members throughout the project lifecycle. CONCLUSIONS: Surveying global health professionals provides an opportunity to learn from their experiences and fill gaps in the peer-reviewed literature to strengthen intervention design and implementation. Community ownership and sustainability emerged as key benefits of family engagement not previously reported in the literature, but responses also highlighted potential negative unintended consequences.

17.
Am J Biol Anthropol ; 179(3): 444-459, 2022 11.
Article in English | MEDLINE | ID: mdl-36790606

ABSTRACT

OBJECTIVES: Breast-feeding is sensitive to somatic, hormonal, behavioral and psychological components of maternal capital. However, through grandmothering, older women may also influence breast-feeding by transferring informational resources to their daughters. We hypothesized that mothers with prolonged instrumental support from their own mother are more likely to have received advice and to have favorable attitudes/practices regarding breastfeeding, compared to those lacking such support, with implications for the grandchild's somatic capital. METHODS: We recruited 90 mother-infant dyads (52 with grandmaternal support, 38 without) in Merida, Yucatan, Mexico. All children were first-borns, aged ~2 years. Anthropometry and body composition were assessed. Data on grandmother's breastfeeding advice and maternal breastfeeding duration were obtained by questionnaire. Maternal attitudes to breast-feeding were assessed using the Iowa Infant Feeding Attitude Scale. RESULTS: Women with instrumental support were more likely to have received grandmaternal advice during pregnancy/infancy on exclusive breast-feeding duration (60% vs. 37%, p = 0.033) and the type of first complementary food (81% vs. 47%, p = 0.001). However, women with support had a less favorable attitude to breastfeeding than those without and breastfed their children for less time (median 5 vs. 10.5 months, p = 0.01). No group differences were found in children's length, weight, skinfolds or lean mass z-score. DISCUSSION: Although grandmothers providing instrumental support provided advice regarding breastfeeding, their attitudes may reflect issues beyond nutritional health. Advice of maternal grandmothers did not promote extended breastfeeding, however the differences in breastfeeding attitudes were not associated with the children's nutritional status. Grandmothers should be included in public health interventions promoting breastfeeding.


Subject(s)
Breast Feeding , Grandparents , Pregnancy , Child , Infant , Humans , Female , Aged , Breast Feeding/psychology , Mexico , Mothers/psychology , Infant Nutritional Physiological Phenomena
18.
Aging Ment Health ; 26(2): 250-262, 2022 02.
Article in English | MEDLINE | ID: mdl-33393377

ABSTRACT

It is increasingly recommended that hypothesis-generating studies be conducted after initial RCTs in order to identify moderators of differential treatment efficacy on individual outcomes. Such analyses are important because they help clarify the best inclusion and exclusion criteria or choice of stratification for maximizing power in subsequent RCTs, reduce the chances of discarding interventions that may appear to lack efficacy when only average treatment effects are taken into consideration, and facilitate the matching of individual clients to treatment alternatives. We identified predictors and moderators of treatment-related change in psychological distress among custodial grandmothers (n = 343) assigned within a prior RCT to behavior parent training (BPT), cognitive behavior therapy (CBT), or information only control (IOC) conditions. Latent change scores in psychological distress were estimated for each grandmother across pre-test to post-test and pre-test to six months, as indicated by self-reported and clinical ratings of depression and anxiety symptoms. These estimates served as outcomes in classification and regression tree analyses conducted separately within the CBT and BPT conditions to identify predictors of treatment efficacy. Matched groups based upon identified predictors were then formed across all RCT conditions, and Predictor × RCT Condition interactions were computed to test for moderation of differential treatment efficacy. Grandmother age was the only predictor and moderator of BPT efficacy at both measurement points, whereas multifaceted predictors and moderators emerged for CBT which varied by time since treatment.


Subject(s)
Cognitive Behavioral Therapy , Grandparents , Psychological Distress , Anxiety , Humans , Treatment Outcome
19.
J Women Aging ; 34(6): 757-772, 2022.
Article in English | MEDLINE | ID: mdl-34265228

ABSTRACT

Most grandparents raising grandchildren are embedded in a network of family members who either help them carry out the caregiving task or complicate that role. This study examined how grandmothers described family relationships, that is, with the grandchild's parents, grandmother's spouses/partners, and other relatives. Data were drawn from 457 weekly journal entries submitted by 129 grandmother caregivers. Using thematic analysis, a three-person team coded using NVIVO 12. Grandmothers described three overarching relationship themes: managing conflicted relationships with the grandchild's parents, balancing relationships with their spouse/partner, and maintaining relationships with other relatives. Implications for practice are provided.


Subject(s)
Grandparents , Caregivers , Family , Family Relations , Humans , Intergenerational Relations
20.
New Dir Child Adolesc Dev ; 2021(180): 95-116, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34826337

ABSTRACT

Grandmothers are important in Chinese families. This study explored the early emerging mother-grandmother-infant network and its association with child's socioemotional development in multigenerational families in a non-WEIRD country. The analytic sample included 60 children (T1: Mage  = 6.5 months) and their caregivers residing in Beijing. Measures used were the Strange Situation Procedure (SSP), the Lausanne Trilogue Play (LTP), the Maternal Behavior Q-Sort (MBQS), and the Infant-Toddler Social and Emotional Assessment. Structural equation and path modeling revealed that (1) more grandmaternal neutral/watching coparenting behaviors at the first assessment were related to more secure infant-mother attachment relationships at the second assessment (T2: Mage  = 1 year); (2) maternal sensitivity at T2 was a partial mediator between earlier undermining and neutral/watching coparenting behaviors and young children's externalizing problems at the final assessment (T3: Mage  = 2 years). Findings are discussed in terms of the roles played by mother-grandmother coparenting network in the children's socioemotional development.


Subject(s)
Grandparents , Problem Behavior , Child , Child Behavior/psychology , Child, Preschool , China , Female , Humans , Infant , Longitudinal Studies , Parenting/psychology
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