Providing Family Education for Grandparent Caregivers: Lessons from the GRandS Program

Introduction

Over 2.7 million grandparents in the United States report being primary caretakers for their grandchildren (U.S. Census Bureau, 2015b). Most grandparents raising grandchildren (also known as GRGs) are still in the workforce, representing 57% of grandfamilies, and it is estimated that about 20% live below the poverty line (Generations United, 2017). In addition, recent data have shown that over 1 million GRGs (39%) have been responsible for their grandchildren for 5 years or more (U.S. Census Bureau, 2015a). It is estimated that only one in 20 children raised by grandparents or other relatives are in the foster care system, limiting GRGs' access to the financial, health, and social service resources offered to licensed foster parents (Generations United, 2017).

Grandparents take on the responsibility of raising grandchildren for a number of reasons, including stressful family situations and parental incarceration, physical and mental illness, substance abuse, and military deployment. Regardless of whether they have just started caring for a grandchild or have been raising a grandchild or grandchildren for years, grandparents are likely to find this role difficult and need proper resources to assist them as they parent for a second time. Cooperative Extension, as it provides parent and family education in family and consumer sciences (FCS), is in a prime position to serve GRGs in local communities (Bjelde, 2004).

Description of GRandS Program

The state of Florida has one of the highest proportions of grandparents serving as primary caregivers for grandchildren, with approximately 157,353 children living in households with their grandparents as caregivers (U.S. Census Bureau, 2015c). In response to the increasing need across the state for Extension services for GRGs, we developed and conducted the GRandS (Grandfamily Resilience and Sustainability) Program as part of Palm Beach County Cooperative Extension's FCS programming. Palm Beach County is the largest county in Florida (approximately 2,400 square mi), and recent data have shown that approximately 9,800 grandparents in the county have primary care of and responsibility for grandchildren (U.S. Census Bureau, 2015a). The GRandS Program was funded in 2010, with renewable support through 2015, by the National Institute of Food and Agriculture's Children, Youth, and Families at Risk (CYFAR) Sustainable Communities Project. The grant supported the employment of a full-time program coordinator (an FCS agent) and a full-time program assistant (both members of our author team) who worked closely with legal and social services in the community.

The GRandS Program was designed to meet the following objectives:

• Increase participants' knowledge of and skills in parenting and understanding of child development.
• Fortify family relationships among caregivers, their spouses, and other family members.
• Inform grandparent caregivers about, and connect them to, available community resources for addressing their own as well as their grandchildren's normative and special needs.

Although the GRandS Program involved a number of different events (e.g., presentations by guest speakers, resource fairs, Grandparents Day celebrations), the program was primarily focused on the delivery of an educational curriculum. We offered courses at four regional sites (three urban, one rural) across the county to facilitate grandparent participation. The GRandS Program used the following research-based curricula:

• Parenting a Second Time Around, a Cornell Cooperative Extension program designed specifically to address issues important to GRGs (see http://www.human.cornell.edu/pam/outreach/parenting/academic/parentingasecondtimearound.cfm);
• Family Treasures, a strengths-based Extension program that promotes healthful family communication and strong family connections (Family Treasures: Creating Strong Families, by J. DeFrain, 2006, Board of Regents of the University of Nebraska, Lincoln, Nebraska);
• Parenting Wisely, a DVD-based program that promotes positive parenting and reduces child behavior risk (see http://www.familyworksinc.com/); and
• Nurturing Parenting, a curriculum that teaches nurturing parent skills based on child needs and ability (see http://www.nurturingparenting.com/).

We separated the educational program into three units, consistent with the program objectives: (a) parenting and child development, (b) family strengths, and (c) community resources and legal issues. Each unit included two or more sessions offered once or twice a month, depending on the availability of the grandparent caregivers.

Evaluation Method

We conducted a quantitative evaluation of the GRandS Program using a retrospective pretest-then-posttest design and received approval from the University of Florida Institutional Review Board. We collected data via questionnaire, doing so separately by curricular unit.

To assess the first program objective (Unit 1), we used the Alabama Parenting Questionnaire–Short Form (Elgar, Waschbusch, Dadds, & Sigvaldason, 2007), which comprises nine items addressing three dimensions of parenting: poor parental monitoring, inconsistent discipline, and positive parenting behaviors. Although not a CYFAR common measure, it is a recommended evaluation instrument for measuring parenting behaviors (University of Minnesota, 2017). Participants responded using a 5-point scale ranging from 1 (never) to 5 (always) to statements such as "You threaten to punish your child and then do not actually punish him/her." We computed mean scores for each subscale and calculated internal consistency using Cronbach's alpha (Cortina, 1993). Similar to a correlation, Cronbach's alpha evaluates whether the items in a scale are correlated with one another (α ranging from 0.0 to 1.0). Alphas larger than .70 are generally considered acceptable to good. Cronbach's alphas for the subscales of the Alabama Parenting Questionnaire ranged from .71 to .93 for both pretest and posttest subscales.

We measured the second program objective (Unit 2) using subscales from the American Family Strengths Inventory (DeFrain & Stinett, 2008): positive communication (5-item subscale), global family strengths (10-item subscale). Participants responded using a 4-point scale ranging from 1 (definitely disagree) to 4 (definitely agree) to statements such as "I am committed to developing even stronger communication among family members." We computed mean scores for each subscale, and internal consistency (Cronbach's alpha) ranged from .77 to .93 for pretest and posttest subscales. The posttest alpha estimate for positive communication was below expectations (α = .53); however, given the strong pretest internal consistency estimate (α = .77), we used both pretest and posttest mean scores in our analysis.

In addition to the questionnaires, posttest-only items were developed for the assessment of Units 1 and 2 and included statements that measured the extent to which the specific objectives were met for the unit. Participants responded using a 5-point scale to statements such as "After participation in [Unit 2], I am willing to practice positive communication with all my family members."

We used the GRandS Community Resources Questionnaire, a posttest-only scale developed for the project, to measure the third program objective (Unit 3). Participants responded using a 5-point scale to items such as "After participation in GRandS [Unit 3], I am more comfortable asking service providers for help." Because the questionnaire was composed of individual items, we did not calculate internal consistency.

Approximately 200 GRGs participated in GRandS outreach activities, including fairs, conferences, celebration events, and educational sessions. Among the 150 grandparents who attended at least one of the educational sessions, only 53 completed a unit evaluation. Likewise, grandparents who completed a unit evaluation did not necessarily attend sessions for all three units; hence, there were differences in the sample sizes across the unit evaluations. Demographic data for the 53 participants showed that they primarily were females (77%), were over the age of 55 (78%), and lived in low-income households (50% reported earning less than $25,000/year). In fact, about half of participants reported that they "sometimes" or "never" had enough resources for rent, food, clothing, or health care. Fifty-seven percent of participants identified themselves as White, 31% as Black, and 11% as Hispanic/Latino.

Evaluation Results

The outcome we expected related to the first program objective was that GRGs would improve their knowledge of parenting and child development. Based on a sample of 28 participants, results from the paired-samples t-tests on pretest and posttest mean scores from the Alabama Parenting Questionnaire were not significant. Mean scores, however, changed in the expected directions. Pretest-to-posttest mean scores related to inconsistent discipline and poor parental monitoring decreased, whereas mean scores related to positive parenting increased. Mean scores on the items assessing unit objectives showed that a majority of respondents indicated strong agreement that after participating in the program, they had improved knowledge and skills in parenting and child development (Table 1).

For the second program objective, the expected outcome was that GRGs would improve their understanding and application of qualities of strong families. Based on a sample of 24 participants, results from the paired-samples t-tests on pretest and posttest mean scores showed statistically significant improvements in both positive communication and global family strengths (Table 2). Effect sizes (Cohen's d) showed that the size of the difference between pretest and posttest mean scores was moderate to large (Lakens, 2013). In addition, participants responded favorably on items assessing specific unit objectives (Table 3), with over 58% of participants expressing strong agreement with the statements indicating that the program improved interpersonal communication and increased family strengths.

With regard to the third program objective, the expectation was that GRGs would become more aware of informal and formal community support services. Thirty-five GRGs completed the posttest-only GRandS Community Resources Questionnaire. These GRGs most often identified health services and legal aid as resources they had become familiar with because of program participation. They also reported that program participation helped them understand the importance of connecting with local GRG programs and support groups. The GRGs indicated strong agreement that the program had helped them be more comfortable asking service providers for help (67.6%) and more confident in expressing their needs to service providers (62.9%). Also, the GRGs reported that they better understood their legal options (60%) and legal terms (66.7%) and planned to contact a legal aid attorney to receive assistance or information (50%).

Challenges in Offering Extension Programs for Grandfamilies

The GRandS Program coordinator FCS agent and the program assistant felt that addressing the grandparents' needs took them beyond the scope of their capacities and responsibilities as Extension educators. Sometimes grandparents would listen to, offer advice to, and/or console one another during meetings—notable features of group therapy, not parent education. What is more, in many cases, Extension staff found themselves engaging in crisis management and referral to community support organizations. Program staff found that such efforts often interfered with the delivery of program sessions. In addition, efforts to promote program sustainability met with resistance from grandparents who were overwhelmed by their parenting responsibilities, lack of necessary resources, and high levels of need.

From these experiences, we learned that the variety of needs experienced by grandfamilies cannot be met by family life education alone. This realization is something to consider when working with grandparents with limited resources. As a result, we offer two suggestions to Extension professionals who deliver programming to GRGs with low resources or high levels of need. First, it may be helpful to partner with a social worker or counselor who can address the human service and mental health needs of GRGs before, during, or after sessions. Second, Extension professionals may benefit from advanced training in crisis management and helping skills (e.g., Shulman, 2016).

Conclusion

The GRandS Program demonstrated successes in meeting program objectives. However, the program's implementation was not without challenges. The program was designed to provide family life education to clients as a preventative effort toward helping them avoid or lessen crisis in their lives. However, the grandparents who participated were in varying levels of crisis, with needs that were beyond the scope of the GRandS Program. For Extension programs to successfully serve grandfamilies and evaluate their progress, several factors deserve emphasis:

• a long-term sustainability plan that addresses, among other things, diversification and continuation of funding sources and support from community partners and trained volunteers;
• needs assessments of grandfamily clientele to target their specific educational needs;
• short educational units with brief evaluation measures given immediately after delivery;
• advanced training for FCS educators; and
• time for debriefing and celebrating successes, as GRandS events celebrating grandfamilies with meals provided were highly attended.

A great example of a low-cost sustainable Extension program (Doggett, Marken, & Caldwell, 2014) is a 1-day event in which grandfamilies are celebrated while being connected with relevant community partners who can assist them with garnering appropriate resources.

Acknowledgments

We would like to thank all the community partners who assisted in the implementation of the GRandS Program. The study was supported by the CYFAR program's Sustainable Community Projects with funding from the U.S. Department of Agriculture National Institute of Food and Agriculture.

References

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