Objectives: Grandparents are increasingly the primary caregivers to grandchildren, with approximately 5.5 million children under the age of 18 living with a grandparent in the U.S. This paper will: 1) present intervention adaptations required to meet the needs of grandparent caregivers; 2) compare the results across treatment conditions on family risk and protective factors, child behavior, and child well-being; and, 3) demonstrate how assessment measures can be integrated into a program informing clinical practice and research.
Methods: Targeted families included grandparent caregivers who were caring for grandchildren between the ages of 5-11 years residing in Baltimore City, specifically targeting Baltimore’s Westside Empowerment Zone. Eligibility criteria for the program included: (a) a referrer’s concern that at least one of the 19 neglect subtypes (e.g., unsafe housing conditions, inadequate supervision, inadequate/delayed health care), was occurring at a low level (not yet reportable to CPS) or a perceived risk for one of these subtypes; (b) at least two additional risk factors for neglect related to the child (e.g., behavior problem; physical, developmental, or learning disability; more than three children) or the caregiver/family (e.g., unemployment/overemployment, mental health problem, drug or alcohol problem, domestic violence, homelessness); (c) no current CPS involvement; and, (d) willingness to participate in the program. Although families were permitted to have prior involvement with CPS, families were excluded from the program if they were involved with CPS at the time of the referral.
Using an experimental dismantling design, 120 intergenerational families were randomly assigned to either no treatment (i.e., Information & Referral) or one of three Family Connections intervention groups: (1) FC intervention for three months (FC3); (2) FC for six months (FC6); or, (3) FC for six months enhanced with legal and health services intervention (FC6+). All intervention groups were assessed for risk and protective factors, child behavior, and child-well-being at baseline, at the end of services, six months following the end of services, and 12 months from baseline. The no treatment group was assessed at the same intervals as FC3. Multi-level models were used to account for the nested structure of the data (i.e., observations nested within individuals) because the intraclass correlation ranged from 0.55 to 0.73 based on unconditional models.
Results: While child behavior scores decreased for all treatment groups in the expected direction, changes were small and not statistically significant between treatment conditions; however, significant changes were found for risk and protective factors, and overall child well-being for the treatment condition that received Family Connections for six months (FC6).
Conclusions: Grandparents who assume a caregiving role often report increased distress, social isolation, depression, and deteriorating health following the addition of children to their households. GFC targets intergenerational families at risk for neglect and responds to their unique strengths and needs, through the identification, development, and delivery of services tailored to grandparent caregivers thus mediating the negative consequences of caregiving and promoting family well-being. Based on the results of this paper, for grandparents caring for grandchildren, treatment conditions lasting for six months provides the most benefit for reducing risk factors, increasing protective factors, and enhancing both child behavior and well-being.
Prevention and family intervention programs , Participation of children and families in child welfare interventions
