Grandparents Providing Care to Grandchildren: A Population-Based Study of Continuity and Change

Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Research Review: Grandparental care and child mental health - a systematic review and meta-analysis

BACKGROUND

The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status.

METHODS

We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater.

RESULTS

The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender.

CONCLUSIONS

The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.

Lost support, lost skills: Children's cognitive outcomes following grandparental death

OBJECTIVE

This study examines the implications of grandparental death for cognitive skills in middle childhood.

METHOD

This study uses data from the Future of Families and Child Wellbeing Study (N = 2479) to estimate ordinary least squares regression models of the associations between grandparental death and subsequent cognitive skills among children in middle childhood.

RESULTS

Experiencing a grandparental death between ages 5 and 9 is associated with boys' lower reading, verbal, and math scores at age 9, with associations most notable for Black and Hispanic boys; grandparental death before age 5 has minimal influence on boys' cognitive skills at age 9. There is little indication that grandparental death adversely affects girls' cognitive skills.

CONCLUSION

The numerous and persistent implications of grandparental death for boys' cognitive skills merit greater recognition of grandparental death as a source of family instability, stress, and ultimately inequality in child development.

"I'm Afraid If This Goes Wrong… What Will Become of Me?": The Psychological Experience of Grandparents in Pediatric Palliative Care

Portugal has been identified as the European country with the most rapid evolution of Pediatric Palliative Care provision, where approximately 7800 children have life-limiting conditions. This is a highly complex experience not only for the children and their parental caregivers, but also for their healthy siblings and grandparents. The present descriptive-exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting conditions in grandparents. A total of 19 families, consisting of 15 grandmothers and 4 grandfathers, completed a sociodemographic and clinical data sheet and a semi-structured interview was conducted in which they shared their testimony. The results of the thematic analysis highlighted an integrated view on 10 important dimensions in the grandparental experience and promoted creative responses by means of their own perspective. However, it has some limitations, such as the small sample size and the data collection procedure via telephone. The results contribute to the design of specific intervention methodologies in an ecosystemic approach and suggest further research to explore more protective factors and communication with health professionals. For psychological intervention, it is suggested considering the identification of individual and family resources that contribute to the activation of key processes in resilience and posttraumatic growth.

Intergenerational Support and Second-Child Fertility Intention in the Chinese Sandwich Generation: The Parallel Mediation Model of Double Burnout

In 2013, the Chinese government implemented a two-child policy to increase the country’s fertility rate. However, the persistently low rates necessitated other measures to boost fertility. This study empirically investigated the association between intergenerational support and second-child fertility intention in the Chinese sandwich generation and demonstrated the mediating role of parental burnout and burnout in caring for grandparents. Survey data collected at Time 1, Time 2, and Time 3 included 2939 participants from different regions of China. Before analyzing the data, coarsened exact matching and propensity score matching was conducted to reduce sampling bias. Regression analysis results indicated that intergenerational support has a significant total positive effect on second-child fertility intention. Furthermore, mediation path analysis revealed that parental burnout and burnout in caring for grandparents play significant but opposite directional mediating roles in the association between intergenerational support and second-child fertility intention. Sensitivity analysis using different calipers yielded similar results. These results indicated that second-child fertility intention can be increased among the Chinese sandwich generation with intergenerational support, by mitigating parental burnout. However, intergenerational support did not alleviate burnout in caring for grandparents in the sandwich generation; therefore, formal older adult care policies are required to help the sandwich generation experience lower burnout, while receiving intergenerational support.

Intergenerational support and retirement timing among older men and women by race/ethnicity

Retirement timing is associated with health and economic outcomes for older adults. However, it is unclear how the pressures of supporting older parents and young adult children are associated with retirement. This study uses a life course perspective to consider how the linked lives of working older adults and their support of adult children and parents are associated with retirement. Cox proportional hazard models are estimated using the Health and Retirement Study (1992-2014) to assess the relationship between intergenerational support exchanges and retirement timing by gender and race/ethnicity. Providing most types of intergenerational support and especially providing time support are associated with an increased risk of retirement. Unlike all other respondents, Hispanic women providing intergenerational time support have similar retirement risks as those not providing any intergenerational support. These differing patterns by race/ethnicity suggest that earlier life course trajectories may shape older adults' ability to respond to family needs.

Caregiver Concern About Child Overweight/Obesity in Grandparent Versus Parent-Headed Households in the United States

OBJECTIVE

To examine the association of caregivers' concern about children's overweight and obesity status with family structure (grandparent versus parent-headed households).

METHODS

Caregivers reported their relation to the child aged 10 to 17 years and the child's weight and height (National Survey of Children's Health 2016-20). Overweight/obesity was calculated using Centers for Disease Control and Prevention growth charts. We estimated associations (prevalence odds ratio) of residing in a grandparent-headed household with lack of weight concern (responding "Yes, it's too low" or "No, not concerned" to "Are you concerned about this child's weight?") among propensity score-matched children with overweight and obesity. Covariates included child's sex, race, ethnicity, age, family poverty ratio, primary household language, highest level of education among reported adults, caregiver mental and emotional health, usual source of care and survey year.

RESULTS

The prevalence of child overweight/obesity was higher in grandparent-headed households. Among children with overweight/obesity, 64.65 (SE = 3.27)% of grandparents and 66.55 (SE = 0.81)% of parents did not express concern about the child's weight status. Among children with obesity, it was 52.42 (SE = 4.63)% and 49.04 (SE = 1.28)%, respectively. Family structure was not associated with caregiver lack of weight concern in propensity score-matched samples.

CONCLUSIONS

Appropriate caregiver concern about child's weight status was low in both grandparent and parent-headed households in the United States.

Mental health and parenting demands among grandparent caregivers of young U.S. children

Substance abuse epidemics and changes in incarceration and foster care policies have recently placed more young children in grandparent custody. Grandmothers bear much of this caregiving responsibility. Our objective was to compare grandparent caregivers of preschool-aged children (grandparent(s) only or in multigenerational households) to parent caregivers, by caregiver sex, in their mental health, available emotional support, and capacity to manage parenting demands. Using U.S. National Survey of Children's Health data (2016-2019), we used survey-weighted logistic regression models adjusted for socio-demographic confounders and conducted sub-group analyses by caregiver sex. Among 30,046 families with a child aged 1-5 years, 776 (4.1%) were grandparent-only, 817 (3.3%) multigenerational, 28,453 (92.7) parent-headed (weighted percentages). Most caregivers (78.7%) were in Excellent/Very Good mental health, but grandfathers in grandparent-only households were less so. Despite being more likely to parent alone, caregivers in grandparent-only households had about twice the odds of having a source of emotional support (adjusted prevalence odds ratio [aPOR] = 2.07; 95% confidence interval [CI] 1.12, 3.83). Grandmothers, in particular, had greater odds of handling day-to-day parenting demands (aPOR = 2.40, 95% CI 1.35, 4.27) and of reporting rarely/never feeling angry with the child in their care (aPOR = 2.77, 95% CI 1.53, 5.01), compared to mothers in parent households. Caregivers in multigenerational households displayed no differences as compared to parents except for grandfathers in multigenerational households who were more likely often bothered by the child. Despite increasing demands on grandparents, they generally reported faring as well as or better than parent caregivers, especially grandmothers. Their prior experience and social support may make them resilient.

Economic Resources Shaping Grandparent Responsibility Within Three-Generation Households

The purpose of this descriptive study was to explore factors associated with perceptions of grandparent responsibility for grandchildren in three-generation households, focusing especially on a comparison of grandparents' and parents' financial contributions to the household and ethnicity of grandparent(s). The analysis used information about three-generation families in the 2011-2015 American Community Survey, retrieved through the Integrated Public Use Microdata Series. In 30% of these families, grandparents said they were "primarily responsible" for the grandchildren, even though the child's parent was also in the household. Logistic regression models showed that grandparents who contributed a larger share of household income and grandparents who were householders were significantly more likely to report being primarily responsible for grandchildren in three-generation households, suggesting that the distribution of financial resources (or resource balance) within the household was associated with perceptions of responsibility. However, grandparents' race and ethnicity moderated this association, indicating that cultural norms may intersect with resources in shaping these reports. The findings suggest that perceived responsibilities of grandparents in three-generation households may be shaped by the balance of financial resources among household members, but also by cultural norms of grandparenting.

A Qualitative Exploration of Facilitators and Barriers to Physical Activity Participation among Chinese Retired Adults in Hong Kong

The purpose of this study was to identify facilitators and barriers associated with physical activity participation among retired Chinese adults in Hong Kong. This study adopts an interview research design in order to generate an in-depth understanding and insights into the participants' thoughts, motivators and experiences of physical activity participation. Independent, semi-structured interviews with 10 retired participants (aged 54-74) were conducted based on an interview protocol with open-ended questions prompting the participants to describe their experiences. Transcribed texts were analysed using thematic analysis, combining both deductive and inductive analysis techniques. Common physical activities reported were walking, stretching exercise and jogging/running. Participants responded that their physical activity level increased since their retirement. We report the interview results according to the themes which emerged from the analysis: (1) physical and mental health, (2) socio-emotional factors, (3) environmental context, (4) family responsibilities. We found that the themes (1), (2) and (3) act either as a facilitator or a barrier for the participants interviewed, while theme (4) family responsibilities act as a barrier. The findings suggested that future physical activity interventions for retired Chinese adults should include more physical activity knowledge, such as the benefits to physical and mental health brought by physical activity and social elements, considering the specific challenges that participants are confronted with (from the family side).

Time, money, and entry into parenthood: The role of (grand)parental support

OBJECTIVE

The study's objective is to understand how parental propensities to provide support, as predicted by parental characteristics, shape adult daughters' and sons' entry into parenthood in the United States.

BACKGROUND

Much research explores the influence of parental support on adult children's fertility, but the evidence is mixed and primarily focuses on European contexts. Theoretical approaches suggest that to best understand how parental support shapes adult children's outcomes, it is important to account for different forms of parental support, that is, time and money, and variation in parental characteristics.

METHOD

This study combined different data from the Panel Study of Income Dynamics: the 2013 Roster and Family Transfers module, main interview data file, and the Childbirth and Adoption History File. We implemented a two-step analysis strategy. In the first, we built two different measures of propensities to receive parental support (PPS) in the form of time and money. In the second, we used discrete-time logistic regression models to analyze the effects of these propensities to receive parental support on adult daughters' and sons' fertility.

RESULTS

We find a positive and consistent effect of all types of PPS measures on adult daughters', but not adult sons', likelihood of entry into parenthood. The fertility decisions of adult daughters are highly responsive to the prospect of receiving parental support in the form of time or money.

CONCLUSIONS

Our results reflect the importance of informal support for women's entry into parenthood and highlight gender differences in the perceived and actual costs of becoming parents.

Household transitions between ages 5 and 15 and educational outcomes: Fathers and grandparents in Peru

BACKGROUND

Latin America has high rates of single motherhood and intergenerational coresidence, resulting in children experiencing changes in household composition - particularly with respect to fathers and grandparents. In other contexts, such changes have been shown to influence educational outcomes.

OBJECTIVE

To test if the presence of grandparents and fathers in the household are differentially associated with educational outcomes during schooling years in Peru.

METHODS

Young Lives longitudinal data consist of around 2,000 children who were followed from age 1 to age 15 between 2002 and 2017. Using value-added and child fixed effects models, I examine if the number of changes in household structure involving fathers and grandparents, the type of change (exit or entrance), and the identity of the household members are associated with cognitive outcomes. Persistence was tested as well as heterogeneous associations by child's age at transition and disadvantage.

RESULTS

More than half the children experienced a change in household composition between ages 5 and 15. Father separation was associated with worse cognitive scores and lower likelihood of being on-grade. This was strongest if separation occurred when children were older. Grandparent presence in the household was not as strongly correlated with child outcomes, but results suggest that children have better cognitive performance after grandparent separation from the household. Associations between household composition and child outcomes were stronger if children were disadvantaged.

CONTRIBUTION

This research provides evidence that fathers and grandparents are both important contributors to child educational outcomes in a context where three-generational households are common.

Grandparenting activities and mental health in Northern Sri Lanka

Grandparenting activities are of increasing interest to researchers seeking to understand reduced social engagement and depression among aging adults. Heterogeneity in the population and caretaking roles complicate its measurement. We piloted a measure of grandparenting activities among 79 grandparents (aged 55+) in Sri Lanka and correlated those activity levels with psychological distress. Second, we explored whether the aforementioned correlation varied by grandparent functional limitations. We found that greater engagement in generative grandparenting activities was correlated with lower distress, and that association was stronger among grandparents with more functional limitations. We discuss possible explanations and implications of these findings.

Grandchild Care and Well-Being: Gender Differences in Mental Health Effects of Caregiving Grandparents

OBJECTIVE

The literature on the gendered differences of mental health as a result of grandchild care has shown mixed results. Research on grandchild care further suggests that nonresidential grandchild care improves mental health outcomes, while residential grandchild care arrangements decrease mental health outcomes in grandparents. The moderating or buffering role of social engagement remains understudied in the grandchild care-mental health relationship. The present study examines mental health effect differences between caregiving grandmothers and grandfathers, and the moderating effects of social engagement.

METHOD

Using 2002-2012 data from the HRS (Health and Retirement Study), a nationally representative sample of U.S. adults aged 50 and over, I examine the mental health effects of grandchild care and the moderating effect of social engagement in fixed effects models.

RESULTS

Grandfathers experience particularly worsened mental health outcomes when providing grandchild care in a skipped-generation household. Both grandmothers and grandfathers experience mental health improvements from increased social engagement. Social engagement, particularly for grandmothers, serves as a buffer or produces role enhancement for grandmothers in skipped-generation care arrangements.

DISCUSSION

Nonresidential and residential grandchild care affect mental health outcomes differently for grandmothers and grandfathers. However, social engagement consistently serves as a buffer or mental health improvement for all grandparents. Findings further encourage the continued study of social engagement and gender differences in older adults more broadly.

Grieving a Grandparent: The Importance of Gender and Multigenerational Relationships

Objective

This study examined adult grandchildren's experience of losing a grandparent in the context of a multigenerational family.

Background

Although the death of a grandparent in adulthood is often an expected life event, this loss may still result in grief for adult grandchildren. Furthermore, bereavement is not merely an individual experience, but a family one. Characteristics of the relationship between bereaved adult grandchildren and their bereaved middle-generation parents may influence adult grandchildren's grief responses. This includes both structural (e.g., gender of parent; coresidence with parent) and emotional (e.g., relationship quality; worry about parent) aspects of this tie.

Method

Young adult grandchildren from Wave 2 of the Family Exchanges Study (2013, N = 204) reported on their recent grandparent loss experiences (N = 216) and relationships with their middle-generation parents (N= 142).

Results

Three-level multilevel models revealed that (a) grandsons who lost a grandmother reported significantly fewer grief symptoms than all other gender combinations; (b) worry about a middle-generation parent was associated with higher grief symptoms, but; (c) this effect was significantly stronger when the middle-generation parent was a mother, and when adult grandchildren were coresident with that bereaved parent. Finally, relationship quality with the middle-generation parent was not associated with grief symptoms, irrespective of context.

Conclusion

Results highlight the intersection of emotional and structural aspects of multigenerational relationships following the death of a family member.

Oral health knowledge and oral health related quality of life of older adults

OBJECTIVE

To assess the relationship between oral health knowledge and oral health related quality of life among older adults with different ethnicities living in San Bernardino County, California. There is a gap in oral health knowledge (OHK) and how it relates to perceived oral health related quality of life. Thus, there is a need to assess OHK as a component of oral health literacy and identify areas in which knowledge gaps exit to develop educational strategies that address the need of the elderly population.

MATERIALS AND METHODS

The study was a cross-sectional study that included adults 65 years and older using a validated "Comprehensive Measure of Oral Health Knowledge" (CMOHK) and an "Oral Health Profile Index" (OHIP-14). Odds ratios were conducted to determine the factors associated with OHK.

RESULTS

Mean OHK score were 16.8, 14.6, and 8.9 for Caucasian, Asian, and Hispanics, respectively. "Poor" OHK was significantly associated with participants over the age of 75 years (OR = 1.9; 95% CI: 1.15-3.16), high school education or less (OR = 10.8; 95% CI: 5.92-19.84), minority ethnicity (OR = 7.3; 95% CI: 4.27-12.61), income less than $25,000 (OR = 10.7; 95% CI: 5.92-19.26), and reading ability less than "Excellent" (OR = 7.27; 95% CI: 4.35-12.14). Mean OHIP-Severity scores were 7.4, 12.5, and 24.4 for Caucasian, Asian, and Hispanics, respectively. Respondents with Poor OHK were 5.17 times more likely to be identified with high levels of severity (Severity >10).

CONCLUSION

It is imperative to develop communication strategies to inform older adults on oral health knowledge that provide equal opportunities for all ethnicities.

Grandparental partnership status and its effects on caring for grandchildren in Europe

Grandparents are important childcare providers, but grandparental relationship status matters. According to several studies, caregiving is reduced after grandparental divorce, but differential responses by grandmothers versus grandfathers have often been glossed over. To explore the effects of relationship status on grandparental care, we analysed data from the Survey of Health, Ageing and Retirement in Europe (SHARE) comparing four grandparental relationship statuses (original couple, widowed, divorced, and repartnered) with respect to grandmothers' and grandfathers' provision of care to their birth children's children. When proximity, kinship laterality, and grandparents' age, health, employment, and financial status were controlled, divorced grandmothers without current partners provided significantly more childcare than grandmothers who were still residing with the grandfather, those who had new partners unrelated to the grandchildren, and widows without current partners. Grandfathers exhibited a very different pattern, providing substantially less grandchild care after divorce. Grandfathers in their original partnerships provided the most grandchild care, followed by widowers, those with new partners and finally those who were divorced. Seemingly contradictory findings in prior research, including studies using SHARE data, can be explained partly by failures to distinguish divorce's effects on grandmothers versus grandfathers, and partly by insufficient controls for the grandmother's financial and employment statuses.

Uptake of Childcare Arrangements—Grandparental Availability and Availability of Formal Childcare

Grandparents constitute an important source of childcare to many parents. Focusing on the Belgian context, this paper improves our understanding of childcare decision-making by investigating how formal childcare availability and availability of grandparents affect childcare arrangements. By means of multinomial regression models we simultaneously model uptake of formal and informal childcare by parents. Combining linked microdata from the Belgian censuses with contextual data on childcare at the level of municipalities, we consider formal childcare availability at a local level, while including a wide array of characteristics which may affect grandparental availability. Results indicate that increasing formal care crowds-out informal care as the sole care arrangement, whereas combined use of formal and informal care becomes more prevalent. Characteristics indicating a lack of grandmaternal availability increase uptake of formal care and inhibit to a lesser extent the uptake of combined formal and informal care. While increasing formal care substitutes informal care use, the lack of availability of informal care by grandparents may be problematic, particularly for those families most prone to use informal care.

Experiences of intergenerational co-parenting during the postpartum period in modern China: A qualitative exploratory study

Most studies conducted in the West on the role played by intergenerational families in co-parenting have focused mostly on families with a single mother or those in difficult circumstances, while little is known about the experiences of members of intergenerational intact families during the early postpartum period. This study aimed to explore the intergenerational co-parenting experiences of young parents and grandmothers in China, focusing on how they shared the responsibility of caring for the new mother and infant during the postpartum period. A total of 16 eligible intergenerational intact families, including 16 mothers, 15 fathers and 12 grandmothers, were interviewed. The data set was analysed using the approach of directed content analysis guided by Feinberg's Ecological Model of Co-parenting. The data were categorized into four themes: 'division of labour', 'postpartum and infant care agreement', 'support-undermining' and 'joint family management'. An additional theme, 'expressed a need for family support', emerged from the data on these intergenerational families. The findings emphasize the importance of intergenerational co-parenting relationships in families where two generations co-parent the newborn together.

Intergenerational Relationships, Family Caregiving Policy, and COVID-19 in the United States

Families and intergenerational relationships are important sources of risk for COVID-19 infection, especially for older adults who are at high risk of complications from the disease. If one family member is exposed to the virus they could serve as a source of transmission or, if they fall ill, the resources they provide to others could be severed. These risks may be especially heightened for family members who work outside the home and provide care, or for those family members who care for multiple generations. Policies have the potential to help families bear the burden of these decisions. This essay argues that policies that address health, employment, and other social issues have implications for families, and that policies aimed at families and caregivers can affect the health, employment, and the general well-being of the nation.

Grandparenting and Mortality: How Does Race-Ethnicity Matter?

Little is known about whether and how intergenerational relationships influence older adult mortality. This study examines the association between caring for grandchildren (i.e., grandparenting) and mortality and how the link differs by race-ethnicity. Drawing from the Health and Retirement Study (1998-2014, N = 13,705), I found different racial-ethnic patterns in the effects of grandparenting on mortality risk. White grandparents who provide intensive noncoresident grandparenting (i.e., over 500 hours of babysitting per two years) and multigenerational household grandparenting have a lower risk of mortality compared to noncaregiving grandparents. In contrast, black grandparents have a higher mortality risk than their noncaregiving counterparts when providing intensive noncoresident, multigenerational household, and skipped-generation household (i.e., grandparent-headed family) grandparenting. Caregiving Hispanic grandparents are not significantly different from their noncaregiving counterparts in mortality risk. These findings suggest that important variations in social and cultural contexts for racial-ethnic groups shape the consequences of grandparenting for older adult mortality.

Adolescent Physical Activity Disparities by Parent Nativity Status: the Role of Social Support, Family Structure, and Economic Hardship

In this cross-sectional study, we examine disparities in physical activity (PA) rates, a determinant of obesity risk, by exploring the impact of household economic hardship, social support, and family structure on adolescent physical activity levels. We assess whether these factors have a different impact on PA stratified by parental nativity status (Hispanic adolescents of foreign- and native-born caregivers compared with whites). The sample included 1927 white and Hispanic 15-year-olds of foreign-born (outside of USA) and native US-born caregivers from the Fragile Families and Child Wellbeing Study. We assessed whether economic hardship, family/friend encouragement for PA, married/cohabiting caregivers, and having a resident grandparent was associated with frequency of PA in the past week, while controlling for age, education, and child's sex. We examined the interaction effects of parent nativity on economic hardship and family support. Results indicate disproportionately higher PA levels for white adolescents compared with Hispanic adolescents of foreign-born caregivers (B = -0.41, SE = 0.19, p = 0.03), for adolescents with more family/friend encouragement (B = 0.81, SE = 0.10, p < 0.001), and for adolescents in cohabiting households (B = 0.28, SE = 0.14, p = 0.04); support and hardship factors did not vary by nativity status. Researchers and practitioners should address differences among ethnic/generational subgroups and family/friend supports that may improve adolescent PA levels, particularly among Hispanic adolescent subgroups. Physical activity levels continue to be dismal especially for racial/ethnic minority groups, which puts them at further risk of consequences of physical inactivity, including life-long complications associated with being an obese adolescent.

Family Change and Changing Family Demography

Increases in life expectancy, high rates of movement into and out of couple relationships, and increasing exposure to stepfamilies raise new questions about who is in a family, the distinction between who lives together and who is a family member, and the extent to which family members are expected to meet the long-term obligations that define kinship. These questions are important because families have traditionally served as a vital private safety net for family members. Demographic changes increase family members' uncertainty about their relationships. Family ties are less stable and more uncertain among the economically disadvantaged, and uncertainty may exacerbate these disadvantages by weakening individuals' ability to rely on family members' support to alleviate hardship. I argue that demographers should focus on individuals' family relationships to gain insight into living arrangements and family dynamics. I also outline the development of family concepts and improvements in study design to identify principles that demographers should incorporate in new research to shed light on families' support for their members.

Stepfamily Structure and Transfers Between Generations in U.S. Families

Unstable couple relationships and high rates of repartnering have increased the share of U.S. families with stepkin. Yet data on stepfamily structure are from earlier periods, include only coresident stepkin, or cover only older adults. In this study, we use new data on family structure and transfers in the Panel Study of Income Dynamics (PSID) to describe the prevalence and numbers of stepparents and stepchildren for adults of all ages and to characterize the relationship between having stepkin and transfers of time and money between generations, regardless of whether the kin live together. We find that having stepparents and stepchildren is very common among U.S. households, especially younger households. Furthermore, stepkin substantially increase the typical household's family size; stepparents and stepchildren increase a household's number of parents and adult children by nearly 40 % for married/cohabiting couples with living parents and children. However, having stepkin is associated with fewer transfers, particularly time transfers between married women and their stepparents and stepchildren. The increase in the number of family members due to stepkin is insufficient to compensate for the lower likelihood of transfers in stepfamilies. Our findings suggest that recent cohorts with more stepkin may give less time assistance to adult children and receive less time assistance from children in old age than prior generations.

What do we know about grandparents? Insights from current quantitative data and identification of future data needs

Against the background of a 'new wave' of empirical studies investigating various aspects of grandparenthood across a broad range of regional contexts, this article aims to take stock of what has been achieved so far and which lessons we can learn from this for the future. Our focus is on the measurement of grandparenthood and grandparenting in quantitative social surveys and the implications this has for the substantive questions we can ask and the answers we can get out of such data. For several broader questions-who is a grandparent and when does this transition happen; what does it mean to be a grandparent; and what are the implications of grandparenthood for families?-we review previous questionnaire items from a variety of surveys as well as studies in which they were used. We identify relevant issues related to these questions which cannot be adequately addressed with currently available data, but should be considered in new or ongoing survey projects. The answers provided by recent studies as well as the many still open questions identified here indicate excellent prospects for scholarship on grandparents in the years to come.

Trends in the prevalence of grandparents living with grandchild(ren) in selected European countries and the United States

Research from the United States has shown significant increases in the prevalence of three-generation households and in households consisting solely of grandparents and grandchildren. Such shifts in household composition, which are associated with socio-economic disadvantage, may reflect the activation of grandparents as a latent network of support in response to social and demographic changes such as rising partnership disruption. However, to date, little is known in Europe about trends in grandparent households or whether these households are also likely to be disadvantaged. Moreover, we know little about how the familistic and defamilised policy environments in Europe may affect the activation of such latent kin networks. Employing the Integrated Public Use Microdata Series-International and the Office for National Statistics' Longitudinal Study for England and Wales, we used multivariate techniques to investigate changes in prevalence over time in co-residence with a grandchild across Austria, England and Wales, France, Greece, Portugal, Romania, and the United States. We expected increases in grandparent households in Portugal and Greece, familistic societies with few public alternatives to family support. However, only Romania (like the US) showed an increase in the percentage of people aged 40 and over co-residing with their grandchildren in three-generation households between the late 1970s and 2002. Given rises in poverty and limited support for low-income families in Romania, rises in grandparent coresidence may reflect a coping strategy among poorer families to increasing financial hardship. Regardless of the trends, grandparent households in all the countries studied remained associated with socio-economic disadvantage.

Grandparents providing childcare in Italy

Research on the choices of childcare arrangements in Italy shows the fundamental role of grandparents in providing informal childcare. Therefore, it is important to understand how grandparents provide different types of childcare, especially in terms of differences in their socio-economic, demographic and physical status, jointly with the characteristics of their grandchildren. Grandparents aged 50 and over with at least one non-co-resident grandchild aged 13 years or less were selected from the 2009 Italian household survey. Multilevel multinomial logistic regression models for grandmothers and grandfathers were used to identify the determinants of the probability of providing childcare intensively, occasionally or during school holidays rather than never. The probability of a grandparent providing intensive childcare is significantly reduced by being: male, unmarried, in bad health and with inadequate economic resources. Nevertheless, when analysing the probability of providing childcare occasionally or during holidays, the individual characteristics of grandparents and grandchildren are less significant compared to intensive childcare, meaning that grandparents provide non-intensive care regardless of their individual characteristics, and this is particularly true for grandmothers. Results confirm the fundamental importance of grandparents in providing informal childcare in Italy, and they offer useful information to understand the individual characteristics associated with different types of grandparental childcare.

Support Grandparents Give to Their Adult Grandchildren

Objectives

Many grandparents are involved in young grandchildren's lives, but we know little about grandparents' support of adult grandchildren. This study assessed frequency of different types of support that grandparents provided to adult grandchildren and examined potential explanations for such support (e.g., affection, grandchildren's needs, parents' support).

Method

Grandparents in The Family Exchanges Study Wave 2 (N = 198; Mage = 80.19) reported how often they provided six types of support to a focal adult grandchild.

Results

Multiple regressions revealed that grandparents' affective ties with an adult grandchild were associated with more frequent listening, emotional support, and companionship. Grandparents also provided more frequent emotional support to adult grandchildren when parents incurred life problems, and more frequent companionship and financial support when parents were not employed. Moreover, grandparents' listening, advice, and companionship with adult grandchildren were positively associated with the parents providing these types of support to grandchildren.

Discussion

Consistent with solidarity theory, grandparents experiencing greater affective ties with their grandchildren are invested in these ties regardless of family needs. Findings also offer limited evidence for the family watchdog model in that grandparents provide more support to grandchildren when parents incur problems, even though those parents may still provide support.

Step-grandparenthood in the United States

Objectives

This study provides new information about the demography of step-grandparenthood in the United States. Specifically, we examine the prevalence of step-grandparenthood across birth cohorts and for socioeconomic and racial/ethnic groups. We also examine lifetime exposure to the step-grandparent role.

Methods

Using data from the Panel Study of Income Dynamics and the Health and Retirement Study, we use percentages to provide first estimates of step-grandparenthood and to describe demographic and socioeconomic variation in who is a step-grandparent. We use life tables to estimate the exposure to step-grandparenthood.

Results

The share of step-grandparents is increasing across birth cohorts. However, individuals without a college education and non-Whites are more likely to become step-grandparents. Exposure to the step-grandparent role accounts for approximately 15% of total grandparent years at age 65 for women and men.

Discussion

A growing body of research finds that grandparents are increasingly instrumental in the lives of younger generations. However, the majority of this work assumes that these ties are biological, with little attention paid to the role of family complexity across three generations. Understanding the demographics of step-grandparenthood sheds light on the family experiences of an overlooked, but growing segment of the older adult population in the United States.

Childhood obesity in China: Does grandparents' coresidence matter?

Childhood obesity in China has been increasingly cited as a major public health issue in recent decades. The effect of grandparents on grandchildren's weight outcome is under-analyzed. Using data from the China Health and Nutrition Survey, we examine the effect of grandparents' coresidence on childhood weight outcome with a sample of 2-13-year-old children in China. We use instrumental variables to address the potential endogeneity of grandparents' coresidence. We show that the effect of grandparents' coresidence on childhood weight outcome is significantly positive. Grandparents' coresidence affects a grandchild's weight outcome through changes in dietary patterns and physical activity. The effects on dietary patterns exist in urban areas and significantly lower in rural areas. Grandparents' coresidence decreases physical activity more in rural areas than in urban areas. Furthermore, the effects of coresidence on protein intake and physical activities of children above 6 are significantly higher for males than females. A robustness check, including an ordered logit model with a body mass index category and estimation with additional data, validates our findings.

"Maybe This Generation Here Could Help the Next Generation": Older African American Women's Perceptions on Information Sharing to Improve Health in Younger Generations

The prevalence of hypertension is highest among African American women, who often occupy caregiving roles. The purpose of the current study is to describe intergenerational caregiving and communication themes that emerged during focus groups with African American older adult women (mean age = 73 years) on information sharing and self-management of hypertension. Thematic analysis revealed two overarching themes: Caregiving Responsibilities and Improving the Health of Younger Generations. Women wanted to help younger generations better manage their blood pressures. These findings suggest that intergenerational relationships may have an important role in managing health conditions, such as hypertension. Further examination of intergenerational relationships as targets for blood pressure self-management intervention is warranted to: (a) address the need for women to share their wisdom, and (b) help improve blood pressure management among African American individuals across the lifespan. [Res Gerontol Nurs. 2018; 11(1):39-47.].

Continuity and changes in three types of caregiving and the risk of depression in later life: a 2-year prospective study

Objective

previous studies have well documented the psychological consequences of family caregiving but less is known about the heterogeneity of older carers being affected during different temporal phases of caregiving over time. This study aimed to prospectively examine the impact of continuity and changes in grandchild care, parent care and spouse care on older carers' depressive symptoms 2 years later.

Methods

the analytic sample contained 2,398 urban seniors who completed interviews for both the 2011 and 2013 waves of the China Health and Retirement Longitudinal Study. The generalized estimating equations approach estimated the longitudinal associations of caring transitions with depressive symptoms.

Results

in comparison with non-carers, elders who continuously provided grandchild care, and those who stopped providing parent care reported significantly fewer depressive symptoms; those who entered into or exited from providing spousal care reported significantly more depressive symptoms.

Conclusions

by separating the impact of caring transitions on subsequent depressive symptoms, our findings added evidence of the great diversity of caring experiences among older adults who provided care to grandchildren, parents or spouses. Our findings have implications for carer support programmes in targeting those older carers at higher risk of depression.

Understanding Latino Grandparents Raising Grandchildren Through a Bioecological Lens

The purpose of this article is to provide a summary of the published research addressing the challenges and strengths of Latino grandparents raising grandchildren in the United States. Using the bioecological framework as a guide to organize and understand the published literature addressing Latino grandparent caregivers, we examined refereed articles published over the past 19 years. This framework provides a lens for understanding and situating research on Latino grandparents raising grandchildren to discover Latino grandparents' strengths and challenges. The areas of foci include financial challenges, intergenerational relationships, reasons for caregiving, health status, language barriers, and culture. This article concludes with future research opportunities and a call to action for more research on Latino grandparents raising grandchildren.

A Model for School Professionals Working with Grandparent-Headed Families

Grandparent-headed families have multifaceted needs and complicated family contexts. These nontraditional families frequently have strained relationships with their grandchildren's school systems, but there are scarce models providing effective strategies for working with them. The author used multidisciplinary theoretical literature and research outcomes to propose a model for working with grandparent-headed families in schools. First, unique needs, risk factors, and school barriers these grandparent-headed families experience are put forward. In addition, school professionals' needs for practice guidelines for their work with grandparent-headed families are described. A model for working with grandparent-headed families is proposed, built on four theories: symbolic interactionism, attachment theory, role theory, and the strengths-based approach. Implications for teaching, practice, and programming for grandparent-headed families in schools are presented.

Impact of Grandchild Caregiving on African American Grandparents

The aim of this study was to describe the context and impact of caregiving for grandchildren with health concerns on grandparents. The study sample comprised 391 African American grandparents aged 55 or older. Logistic regression analysis indicated that grandparent caregivers of grandchildren with psychiatric or behavioral problems were more likely to experience a negative impact on their health (AOR = 7.86, p =.008) and leisure (AOR = 14.31, p =.024) than grandparent caregivers of grandchildren with no or other types of health problems. The findings underscore the need to support African American grandparent caregivers, particularly those raising grandchildren with mental health problems.

Care-giving to grandchildren and elderly parents: role conflict or family solidarity?

Intergenerational help and care among members of the family belong to the most important dimensions of contemporary welfare regimes. Recent research has indicated that a major part of caring responsibilities is placed on the middle-aged generation. The ‘pivot generation’ is expected to provide help to their adult children and grandchildren as well as to their ageing parents. It has been hypothesised that people helping their parents are discouraged from looking after their grandchildren because they experience lack of energy and time. Using data from the four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), this paper analyses the effect of providing help to ageing parents on the likelihood and intensity of looking after grandchildren. It takes a four-generation perspective: grandchildren, children, parents and grandparents. The results show that the support of parents is not associated with less-frequent and less-intense care of grandchildren. On the contrary, a positive association between caring responsibilities has been observed. The highest tendency to care for grandchildren has been found for people regularly helping their parents. This effect holds after controlling for grandparents’ characteristics and country effects. It is suggested that caring responsibilities tend to accumulate rather than compete with one another and therefore could represent a potential risk of overburden for those who have a general tendency to care.

Do Young Mothers and Fathers Differ in the Likelihood of Returning Home?

Building on research examining "boomerang" adult children, I examine multigenerational living among young parents. Returning home likely differs between young mothers and fathers given variation in socioeconomic characteristics, health and risk-taking, their own children's coresidence, and union stability. Using the National Longitudinal Survey of Youth 1997 (NLSY97), I find that more than 40% of young parents (N = 2,721) live with their own parents at first birth or subsequently. Mothers are generally less likely to move home than fathers but only when not controlling for child coresidence and union stability. Individuals who live with all their children are less likely to return home, and controlling for child coresidence reverses gender differences, though this association disappears in the full model. Young parents who are stably single and those who experience dissolution are highly likely to return home compared to the stably partnered, with the association significantly stronger for fathers than mothers.

The experience of grandmothers of children with cancer

OBJECTIVE

to understand, from grandmothers' perspectives, the experience of having a grandchild with cancer.

METHOD

qualitative study, guided by philosophical hermeneutics. Eight grandmothers of children who had finished an oncology treatment participated in this study. Data were collected through interviews, which were recorded, transcribed, and analyzed according to the principles of hermeneutics.

RESULTS

the grandmothers underwent an experience of multiplied, silent, transformative, and permanent suffering. They believe it is their role to be present, but they recognize their adult children's independence and self-determination. Grandmothers highlighted that their experience has been very little accessed and considered by health care professionals.

CONCLUSION

we recommend including grandparents in the context of care and in additional research.

Smoking Cessation and Changes in Body Mass Index Among Middle Aged and Older Adults

Objective: This study contributes to the body of literature examining smoking cessation and body mass index (BMI) for adults aged 50 and older. Method: Utilizing the 2004 and 2010 waves of the RAND Health and Retirement Study, this analysis utilized Fixed Effects (FE) regression on a sample of 1,316 adults aged 50 and older. Results: Older adults undergo a small change in BMI after a transition from smoking to nonsmoking during a 6-year period, and this occurs after accounting for individual-level unobserved heterogeneity. More specifically, men experience a BMI gain of 1.24 ( p< .01) and women experience a BMI gain of 1.58 ( p< .01). Discussion: Gerontologists/health professionals can use these results to inform older adults about the potential for a small increase in BMI and, in the process, assuage any apprehensions about excessive weight gain. This insight may encourage a greater number of older adults to cease smoking.

Dental knowledge and awareness among grandparents

AIM

To investigate grandparent's knowledge and awareness about the oral health of their grandchildren.

METHODS

Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents (59 males, 141 females). χ(2) analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education.

RESULTS

Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children's oral health. Level of awareness was not related to their gender.

CONCLUSION

Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.

Grandparenting Roles and Volunteer Activity

OBJECTIVES

We examine whether grandparenting roles are related to formal volunteering among older adults.

METHOD

Logistic regression is used to examine the likelihood of volunteering based on grandchild care using data from the 2004 wave of the Health and Retirement Study (n = 13,785). Longitudinal analyses utilize treatment effects models to examine changes in volunteering for grandparents who begin nonresidential grandchild care between the 2004 and 2008 waves (n = 10,811).

RESULTS

Results show that grandparents raising coresidential grandchildren have lower odds of volunteering than grandparents providing no regular grandchild care. However, grandparents who provide nonresidential grandchild care are more likely to volunteer than grandparents not providing grandchild care and those raising a coresidential grandchild. Grandparents who provide nonresidential care for grandchildren engage in more volunteering before assuming grandchild care, and their volunteerism increases after becoming a caregiver for a grandchild.

DISCUSSION

Consistent with resource theory and the accumulation of roles, providing nonresidential grandchild care may draw grandparents into formal volunteer activity. The lower human capital resources evidenced by grandparents raising coresidential grandchildren may play a role in their lower likelihood of formal volunteering.

Grandparents' resources and grandchildren's schooling: Does grandparental involvement moderate the grandparent effect?

Recent studies have argued that grandparents have a direct effect on grandchildren's achievements, net of parental resources. However, little is known about the underlying mechanisms. One explanation is that grandchildren can benefit from the cultural resources that grandparents transmit to their grandchildren. If this is the case, one would expect strong effects in families where grandparents are highly involved in the lives of their grandchildren and weak or no effects in other families. Using new nationally representative survey data on three generations in the Netherlands, we examine if and how grandchildren's educational attainment is affected by three grandparental resources: education, occupational status, and cultural resources. We explore how these effects vary by the strength of the tie between grandparent and grandchild. We find no evidence for a main direct grandparental effect, nor do we find interactions with the strength of the tie between grandparent and grandchild. These null-findings are discussed in light of the mixed body of evidence that has been accumulated in the literature and contemporary theorizing on grandparenting.

Full-time versus part-time employment: Does it influence frequency of grandparental childcare?

The impact of grandparents' employment on grandparental childcare has been examined repeatedly, but the findings have so far been inconsistent. We contend that these inconsistencies may have resulted from variations in model specification and crude measurement of employment status. Furthermore, we assert that earlier research overlooked gender differences in the ability to combine paid employment and caregiving as well as variations between maternal and paternal grandparents. We also question the causal interpretation of earlier findings that were based on cross-sectional data. We revisit the issue of the impact of the intensity of employment and analyze SHARE data from 19 countries. We find a significant positive association between part-time employment (as compared to full-time employment) and the frequency of grandparental childcare in a cross-sectional sample, but only among paternal grandmothers. Capitalizing on the panel component of SHARE, we use a within-person estimator to show that this association is unlikely to reflect a causal effect of the intensity of labor market attachment on the frequency of the care of grandchildren, but more probably results from omitted variable bias. We argue that grandparents most likely to provide (intensive) childcare are also most likely to adjust their employment in anticipation of caregiving. The paper documents the usefulness of role strain theory among grandparents and highlights that part-time jobs may reduce role conflict and may thus make grandparenting a more easily manageable experience.

Developing a Culturally Sensitive Lifestyle Behavior Change Program for Older Latinas

Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change.