Promoting Resourcefulness in Grandmothers Raising Grandchildren

描述(由申请人提供)：这项R21探索性研究基金的目标是试点、测试和改进一种适应的干预措施，向抚养孙子孙女的祖母传授个人和社会应变技能。足智性训练(RT)干预有很强的理论基础，而且开始有经验证据表明，它在减轻压力、将抑郁症状降至最低以及提高抚养孙子的祖母以外的人群的最佳生活质量方面是有效的。这项研究将在100位祖母抚养孙子孙女的小型随机对照试验的背景下，为确定两种创新设计的RT方法的必要性、可接受性、可行性、保真度、安全性和有效性提供数据。在两种RT方法中都教授了相同的个人(自助)和社交(求助)足智性技能；然而，一种方法使用表现性写作(EW)来练习技能，另一种方法使用口头披露(VD)。这两种方法的效果将与无RT和仅注意控制条件下的EW和VD进行比较。根据足智性理论，将对治疗结果进行比较的结果包括感知到的压力、负面情绪和抑郁认知(在四周的干预期之后)，个人和社会的足智性(干预后6周)，以及抑郁症状和生活质量指标(干预后12周)。定量和定性数据将用于RT干预的试点测试和未来的改进。具体目标将如下所述。第一个目的是检查RT-EW和RT-VD与EW、VD的比较，以及控制条件对预期在足智性理论指定的数据点上影响的结果。第二个目的是检验治疗条件(RT-EW、RT-VD、EW、VD和对照)对七项研究结果的影响是否受到相关背景因素的影响，包括祖母、孙子的特征和照顾情况。最后，由于文献表明并不是所有的祖母都不堪重负或压力很大，而且先前的研究表明10%的祖母在基线时可能是高度足智多谋的，不需要RT，第三个目标是分析来自EW或VD的随机选择的高度足智多谋的祖母的定性数据，以提供更多的信息来完善RT并设计替代方法来提高照顾孙子的祖母的生活质量。一旦建立，这种干预措施将有助于促进照顾孙子孙女的祖母人数不断增加，从而使她们能够继续为孙子孙女提供适当的照顾，并避免将儿童安置在机构或寄养家庭。

DESCRIPTION (provided by applicant): The goal of this R21 exploratory research grant is to pilot test and refine an adapted intervention that teaches personal and social resourcefulness skills to grandmothers raising grandchildren. The resourcefulness training (RT) intervention has strong theoretical grounding, and there is beginning empirical evidence for its effectiveness in reducing stress, minimizing depressive symptoms, and promoting optimal quality of life for populations other than grandmothers raising grandchildren. This study will provide data for determining the necessity, acceptability, feasibility, fidelity, safety, and effectiveness of two innovatively designed methods of RT within the context of a small randomized controlled trial with 100 grandmothers raising grandchildren. The same personal (self-help) and social (help-seeking) resourcefulness skills are taught within both RT methods; however, one method uses expressive writing (EW) for practicing the skills and the other uses verbal disclosure (VD). The effects of these two methods will be compared with EW and VD without RT and with an attention only control condition. Based on Resourcefulness Theory, outcomes on which the treatments will be compared include perceived stress, negative emotions, and depressive cognitions (immediately after the four week intervention period), personal and social resourcefulness (6 weeks post-intervention), and depressive symptoms and quality of life indicators (12 weeks post-intervention). Both quantitative and qualitative data will be used for the pilot testing and future refinement of the RT interventions. Three specific aims will be addressed as follows. The first aim is to examine the effects of RT-EW and RT-VD in comparison with EW, VD, and the control condition on outcomes that are expected to be affected at data points specified by Resourcefulness Theory. The second aim is to examine whether the effects of the treatment conditions (RT-EW, RT-VD, EW, VD, and control) on the seven study outcomes are influenced by relevant contextual factors, including characteristics of the grandmother, her grandchild, and the caregiving situation. Finally, because the literature suggests that not all grandmothers are overwhelmed or stressed and previous studies suggest that 10% of the grandmothers may be highly resourceful at baseline and not need RT, the third aim is to analyze qualitative data from EW or VD on randomly selected highly resourceful grandmothers to provide additional information for refining the RT and designing alternative methods for enhancing the quality of life of grandmothers caring for grandchildren. Once established, such interventions will be useful in promoting optimal, healthy functioning among the growing population of grandmothers caring for grandchildren so that they can continue to provide adequate care for their grandchildren and avoid placement of the child in an institution or foster care.