GIFT: Web Based Resourcefulness Training for Grandmother Caregivers

GIFT：针对祖母照顾者的基于网络的足智多谋培训

• 批准号: 9174383
• 负责人: Carol M. Musil
• 金额: $ 52.41万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-20 至 2020-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9174383
• 关键词: Affect; Age; American; Buffers; Caregivers; Caring; Characteristics; Child; Coping Skills; Data; Demographic Factors; Depressed mood; Development; Drug usage; Economics; Education; Educational Intervention; Elderly; Employment Status; Equation; Family; Foundations; Health; Home environment; Hour; Household; Household Heads; Income; Individual; Intervention; Intervention Studies; Journals; Knowledge; Link; Marital Status; Measures; Mediating; Mental Depression; Mental Health; Mission; Modeling; Online Systems; Outcome; Parents; Population; Problem Solving; Psyche structure; Psychological reinforcement; Race; Randomized; Randomized Clinical Trials; Reporting; Research; Research Design; Resources; Rewards; Risk; Sampling; Self-Administered; Social support; Spouses; Stress; Structure; Testing; Time; Training; Transcend; Underemployment; Unemployment; Vulnerable Populations; Woman; Women' s Group; Work; base; caregiving; comparison group; coping; cost; demographics; depressive cognitions; depressive symptoms; experience; grandchild; grandparent; improved; peer; physical conditioning; post intervention; randomized trial; skills; social; stress symptom; therapy design; web-accessible

GIFT: Web Based Resourcefulness Training for Grandmother Caregivers The number of grandparent-headed homes has increased over the past two decades, primarily due to parental drug use leading to family instability, and an increase in multigenerational homes due to continuing effects of the economic downturn in 2008 and sustained unemployment and underemployment. Most grandmothers living with grandchildren report elevated stress and strain and are at risk of depression and poorer overall health than their non-caregiving peers. Stress and depressive symptoms can have a cascading effect on the family, creating an increased risk for problems in family functioning. The presence of positive coping skills, such as resourcefulness, may reduce or moderate the negative effects of caregiving and family-related stress on the well-being of the grandmother and her family. We have shown that face-to-face resourcefulness training in older adults, including grandmothers, improves both mental and physical health. The purpose of this study is to extend our previous face-to-face resourcefulness intervention to a web-based format focused on grandmothers who are either raising grandchildren or living in multigenerational homes and helping with their care, and to test its effects on health in this randomized clinical trial. The web-based online intervention, Grandmother Initiatives in Family Transformation (GIFT), tests online resourcefulness training with reinforcement of the resourcefulness skills through 4 weeks of structured journaling, against a 4 week online, unstructured journaling-only group. In this two-group randomized trial, we will randomly assign a national, convenience sample of 334 grandmothers to GIFT resourcefulness training (n=167) or the 4 week unstructured journal-only group (n=167). Specific Aims are to determine 1) whether the 4-week GIFT intervention with structured journal reinforcement versus the 4-week unstructured journal-only group improves grandmothers' mental health and physical health and family well-being over time; 2) if a) problem solving/coping (resourcefulness), b) resources (subjective and instrumental social support), and c) situational appraisals (appraised stress, appraised reward, and depressive cognitions) mediate the relationships between GIFT and individual and family outcomes at 2 weeks, 12 weeks, and 24 weeks post-intervention; and 3) if a) grandmother demographics (age, race, education, marital status, employment status, family income, age and number of grandchildren in the household), b) caregiving status to grandchildren, and c) family demands (intra- family strains) moderate the relationship between the intervention and the outcomes in Aims 1 and 2. Repeated measures and structural equation modeling will be used to analyze these data, with content analysis of the journals to evaluate enactment fidelity and to uncover additional strategies used by grandmother caregivers. Given the limited interventions available to this group of women, an intervention that transcends time and place and is available 24 hours a day is expected to bolster the personal and social resourcefulness of grandmothers living with grandchildren, leading to improvements in grandmother and family well-being.

GIFT：针对祖母照顾者的基于网络的足智多谋培训 过去二十年里，祖父母为户主的家庭数量有所增加，这主要是由于父母的影响 吸毒导致家庭不稳定，由于吸毒的持续影响，多代同堂的家庭数量增加 2008年经济低迷，失业和就业不足持续存在。大多数祖母 与孙子一起生活的人报告压力和压力增加，并面临抑郁和整体贫困的风险 比没有照顾的同龄人更健康。压力和抑郁症状会对身体产生连锁反应 家庭，增加了家庭功能出现问题的风险。积极应对技巧的存在， 例如足智多谋，可以减少或减轻照顾和家庭相关压力的负面影响 关乎祖母及其家人的福祉。我们已经证明，面对面的足智多谋培训 对于老年人，包括祖母，可以改善身心健康。本研究的目的 是将我们之前面对面的足智多谋干预扩展到基于网络的形式，重点关注 祖母们要么抚养孙子，要么住在多代同堂的家庭里，帮助照顾她们的孩子 护理，并在这项随机临床试验中测试其对健康的影响。基于网络的在线干预， 祖母家庭转型倡议 (GIFT)，测试在线足智多谋培训 通过 4 周的结构化日记（相对于 4 周的在线记录）强化足智多谋的技能， 非结构化的仅日记组。在这项两组随机试验中，我们将随机分配一个全国性的、 334 名祖母参加 GIFT 智谋培训（n=167）或 4 周非结构化培训的便利样本 仅期刊组（n=167）。具体目标是确定 1) 4 周 GIFT 干预是否与 结构化日记强化与为期 4 周的非结构化日记强化组相比，提高了祖母的认知能力 随着时间的推移，心理健康、身体健康和家庭福祉； 2) 如果 a) 解决/应对问题 （足智多谋），b）资源（主观和工具性社会支持），c）情况评估 （评估压力、评估奖励和抑郁认知）调节 GIFT 和 干预后 2 周、12 周和 24 周的个人和家庭结果； 3) 如果 a) 祖母人口统计数据（年龄、种族、教育程度、婚姻状况、就业状况、家庭收入、年龄和 家庭中孙子女的数量），b）对孙子女的照顾状况，以及 c）家庭需求（内部） 家庭压力）调节干预与目标 1 和 2 的结果之间的关系。 将使用重复测量和结构方程模型来分析这些数据，并进行内容分析 评估制定保真度并发现祖母使用的其他策略的期刊 照顾者。鉴于该妇女群体可获得的干预措施有限，超越这一群体的干预措施 时间和地点，每天 24 小时待命，有望增强个人和社交的足智多谋 祖母与孙子一起生活，从而改善祖母和家庭的福祉。