Project Healthy Grandparents (PHG)

Scientific Rating:
NR
Not able to be Rated
See scale of 1-5
Child Welfare System Relevance Level:
High
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Project Healthy Grandparents (PHG) has been reviewed by the CEBC in the area of: Kinship Caregiver Support Programs, but lacks the necessary research evidence to be given a Scientific Rating.

Target Population: Grandparent-headed families of children (birth to 16 years old) in which the birth parents are absent

For children/adolescents ages: 0 – 16

For parents/caregivers of children ages: 0 – 16

Brief Description

The goal of PHG is to improve the well-being of families in which grandparents are raising their grandchildren in parent-absent homes. PHG provides comprehensive health and social support services and improved access to community resources. PHG’s comprehensive services include monthly home visitations by registered nurses and social workers, parenting education classes and support groups, legal service referrals, as well as early intervention services for young children. In many cases, referrals are made to other healthcare or community service providers, and transportation services are available, if needed. To be eligible for services, the grandparent(s) must be responsible for at least one grandchild age 16 years or younger and the child’s parents must be absent from the home. Once enrolled, participants have access to all PHG services free of charge for one year.

Program Goals:

The goals of Project Healthy Grandparents (PHG) are:

  • Improved physical and mental health of grandparents
  • Decreased psychological stress of grandparents
  • Improved family resources
  • Improved family social support
  • Improved parenting skills
  • Decreased child behavior problems
  • Improved developmental outcomes for children birth through 5 years

Essential Components

The essential components of Project Healthy Grandparents (PHG) include:

  • Individual monthly home visitation by a social worker: PHG’s social workers provide parenting information, family support, consultations on benefits, such as TANF, and referrals to handle critical housing, food and legal needs. The breadth and depth of PHG’s social work services provide grandparents with the information, referrals, and resources they need to establish a secure and safe environment for their grandchildren.
  • Individual monthly or bimonthly home visitation by a registered nurse (RN): PHG’s RNs provide in-home healthcare support services for grandparents, including blood pressure monitoring, glucose screening, cholesterol screening, mental health screening, vision screening, weight monitoring, and nutrition counseling. Many grandparents raising grandchildren have a significant chronic disease (e.g., hypertension, obesity/overweight, diabetes, etc.). Helping clients learn to manage their chronic diseases effectively is essential if they are to be able to continue as the primary care provider of their grandchildren.
  • Monthly support groups: Support groups are held monthly with the goal of providing peer support and education on various topics of concern to participants.
  • Individual or group parenting education/support: Social workers are trained in the Triple P parenting model and educate the grandparents
  • Individual early intervention (EI) services: All children age 0-5 years are screened for possible developmental delays using the Ages and Stages Questionnaire (ASQ). All children who are determined to be “suspect” in terms of the results of the ASQ or who have a history of alcohol or drug exposure in utero/during pregnancy are referred for a comprehensive developmental evaluation at the Neurodevelopmental Clinic at Emory University School of Medicine. PHG’s EI specialist works closely with the families on any EI service recommendations made by Emory University School of Medicine and assures that the children receive any necessary services. The EI specialist provides developmentally appropriate toys and other materials for the grandchild to use.
  • All children receive health screenings by the RNs and referrals are made to primary care providers and specialists, as needed. RNs also provide health education to the children.
  • School-aged children are eligible for tutoring and homework assistance when there are experiencing educational challenges.
  • Individual or group transportation services: PHG provides transportation for grandparents to attend support group meetings, EI appointments, as well as select health care appointments.

Child/Adolescent Services

Project Healthy Grandparents (PHG) directly provides services to children/adolescents and addresses the following:

  • Children living with their grandparents (parents are absent), possible developmental delays, possible health concerns, child behavior problems

Parent/Caregiver Services

Project Healthy Grandparents (PHG) directly provides services to parents/caregivers and addresses the following:

  • Grandparent caregiver of a child with possible developmental delays, health problems, and behavior problems; possible elevated psychological distress levels; possible health issues
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Clients participate in group support sessions. They also work with their social workers to identify sources of support (e.g. relatives, friends, church members, neighbors, etc.).

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Community Agency
  • Foster/Kinship Care

Homework

This program does not include a homework component.

Languages

Project Healthy Grandparents (PHG) does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

Access to meeting rooms for support groups.

Minimum Provider Qualifications

The minimum qualifications for social workers is a Bachelor’s degree in social work, although a Master’s degree in social work is preferred. For registered nurses, a Bachelor’s of Science degree in nursing is required.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

There are manuals for social work and RN services; however, they need updating.

Training Contact:
Training is obtained:

Onsite a possiblity, if travel expenses for the trainer are covered

Number of days/hours:

1.5-2 days at Georgia State University, or elsewhere

Relevant Published, Peer-Reviewed Research

This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.

Child Welfare Outcomes: Not Specified

Show relevant research...

Kelley, S. J., Yorker, B. C., Whitley, D. M., & Sipe, T. A. (2001). A multimodal intervention for grandparents raising grandchildren: Results of an exploratory study. Child Welfare, 80(1), 27-50.

Type of Study: One-group pretest-posttest study
Number of Participants: 24

Population:

  • Age — Children: Mean=6.8 years, Adults: 39-78 years (Mean=55.7 years)
  • Race/Ethnicity — Children: Not specified, Adults: 100% African American
  • Gender — Children: Not specified, Adults: 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study was to examine the efficacy of Project Healthy Grandparents (PHG) to improve reduce psychological stress, improve physical and mental health, and strengthen the social support and resources of grandparents raising grandchildren. Measures utilized include the Grandparent Interview Form, the Brief Symptom Inventory (BSI), the Family Resource Scale (FRS), the Family Support Scale (FSS), the Short Form 36 (SF-36) General Health Survey, and the Family Crisis Oriented Personal Evaluation Scales (F-COPES). Results indicated improved mental health scores, decreased psychological distress scores, and increased social support scores. Participants also experienced improvement in the level of public benefits received and in their legal relationships with their grandchildren. Limitations include lack of randomization, lack of control group, small sample size, lack of follow-up, and lack generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: None.

Kelley, S. J., Whitley, D., & Sipe, T. (2007). Results of an interdisciplinary intervention to improve the well-being and physical functioning of African American grandmothers raising grandchildren. Journal of Intergenerational Relations, 5(3), 45-64. doi:10.1300/J194v05n03_04

Type of Study: One-group pretest-posttest study
Number of Participants: 120

Population:

  • Age — 38-83 years (Mean=56.2 years)
  • Race/Ethnicity — 100% African American
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study was to examine the efficacy of Project Healthy Grandparents (PHG) to improve the psychosocial well-being and physical functioning of grandmothers raising grandchildren. Measures utilized include the Grandparent Demographic Form, the Brief Symptom Inventory (BSI), the Family Resource Scale (FRS), the Family Support Scale (FSS), the Short Form 36 (SF-36) General Health Survey and the Family Crisis Oriented Personal Evaluation Scales (F-COPES). Results indicated that there were statistically significant differences in the direction predicted for psychological distress, family resources, social support, and family coping, but not physical health. Limitations include lack of randomization, lack of control group, lack of follow-up, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: None.

Kelley, S. J., Whitley, D. M., & Campos, P. E. (2010). Grandmothers raising grandchildren: Results of an intervention to improve health outcomes. Journal of Nursing Scholarship, 42, 379-386. doi:10.1111/j.1547-5069.2010.01371.x

Type of Study: One-group pretest-posttest study
Number of Participants: 529

Population:

  • Age — 38-83 years (Mean=56.7 years)
  • Race/Ethnicity — 98.5% African American and 1.5% White or Hispanic
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article explored the impact of Project Healthy Grandparents (PHG) to improve the health of grandmothers raising grandchildren in parent-absent homes. Measures utilized include the Short Form-36 General Health Survey (SF-36). Results indicated that comparison of pretest and posttest mean scores on the SF-36 indicated significantly improved mean scores for vitality, physical effects on role functioning, emotional effects on role functioning, and mental health. No significant differences were found for other attributes. Limitations include lack of randomization, lack of control group, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: 12 months.

Whitley, D. M., Kelley, S. J., & Campos, P. E. (2011). Perceptions of family empowerment among African American custodial grandmothers raising grandchildren: Thoughts for research and practice. Families in Society: Journal of Contemporary Social Services, 383-389. doi:10.1606/1044-3894.4148

Type of Study: One-group pretest-posttest study
Number of Participants: 311

Population:

  • Age — 36-83 years (Mean=56.8 years)
  • Race/Ethnicity — 98.5% African American and 1.5% Other
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article explored the impact of Project Healthy Grandparents (PHG) in regards to empowerment practice on grandmothers raising grandchildren. Measures utilized include the Family Empowerment Scale (FES), the Family Support Scale (FSS), and the Short Form-36 General Health Survey (SF-36). Results indicated that the service model appears to have enhanced perceptions of empowerment with the sample of African American grandmothers. Additionally, the service intervention supports the empowerment dimensions and three subscales (knowledge, advocacy, and self-efficacy); the results did not support the competency subscale. Although all age groups experienced an increase in empowerment, older grandmothers had significant differences in perceptions regarding social systems, as well as a sense of competency as compared with younger grandmothers. Limitations include lack of randomization, lack of control group, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: None.

Kelley, S. J., Whitley, D. M. & Campos, P. E. (2013). African American caregiving grandmothers: Results of an intervention to improve health indicators and health promotion behaviors. Journal of Family Nursing, 19(1), 53-73. doi:10.1177/1074840712462135

Type of Study: One-group pretest-posttest study
Number of Participants: 504

Population:

  • Age — 38-83 years (Mean=56.7 years)
  • Race/Ethnicity — 100% African American
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study was to examine the efficacy of Project Healthy Grandparents (PHG) to improve the health of grandmothers raising grandchildren. Measures utilized include the Healthier People Health Risk Appraisal (HRA). Results indicated that a comparison of pretest and posttest scores indicated significant changes in the desired direction for a number of health indicators and health promotion behaviors, including blood pressure, annual routine cancer screenings, frequency of weekly exercise, and improved dietary intake, as well as participants’ perception of their health and life satisfaction. No improvements were observed in the proportion of participants who were obese or overweight. Limitations include lack of randomization, lack of control group, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: 12 months.

Whitley, D. M., Lamis, D. & Kelley, S. J. (2016). Mental health stress, family resources and psychological distress: A longitudinal mediation analysis in African American Grandmothers Raising Grandchildren. Journal of Clinical Psychology, 72, 563–579. doi:10.1002/jclp.22272

Type of Study: One-group pretest-posttest study
Number of Participants: 679

Population:

  • Age — Adults: 33-83 years (Mean=55.76 years)
  • Race/Ethnicity — Adults: 98.5% African American
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examines the effectiveness of Project Healthy Grandparents (PHG) for African American grandmothers raising grandchildren on the relationship between dichotomized levels of mental health stress (low vs. high) and elevated levels of psychological distress, mediated by perceptions of family resources. Measures utilized include the Short Form-36 General Health Survey (SF-36), the Family Resource Scale (FRS), and the Brief Symptom Inventory (BSI). Results indicated that perception of family resources contributes to lower psychological distress among custodial grandmothers exhibiting low and high levels of mental health stress. There was no significant difference in the strength of the mediated effects between grandmothers experiencing low levels of mental health and those experiencing high levels of mental health stress. Limitations include lack of randomization, lack of control group, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: 12 months.

Whitley, D. M., Kelley, S. J., & Lamis, D. A. (2016). Depression, social support, and mental health: A longitudinal mediation analysis in African American custodial grandmothers. The International Journal of Aging and Human Development, 82(2-3), 166-187. doi:10.1177/0091415015626550

Type of Study: Two-group pretest-posttest study without control group
Number of Participants: 667

Population:

  • Age — Adults: 33-83 years (Mean=55.90 years)
  • Race/Ethnicity — Adults: 98.5% African American, 1.5% Other
  • Gender — 100% Female
  • Status — Participants were recruited via community agencies serving children and families.

Location/Institution: Southeastern United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article explored the impact of Project Healthy Grandparents (PHG) in regards to the relationship between depression and mental health quality of life mediated by social support, among younger (55 or younger) versus older (55+) African American grandmothers raising grandchildren. Measures utilized include the Brief Symptom Inventory (BSI), the Family Support Scale (FSS), and the Short Form-36 General Health Survey (SF-36). Results indicated that social support was a mediator in the association between depressive symptoms and mental health quality of life for older African American grandmothers; however, this same relationship did not hold for their younger counterparts. Additionally, there was a positive correlation between perceived helpfulness of support sources and mental health quality of life at 12-month follow-up in younger and older grandmother parenting groups. Results also indicate younger grandmothers experienced higher levels of depressive symptoms at baseline and lower levels of mental health quality of life when compared with older grandmother. Limitations include lack of randomization, lack of control group, and lack of generalizability due to ethnic composition of the participants.

Length of postintervention follow-up: 12 months.

References

Kelley, S. J., Whitley, D. M. & Campos, P. E. (2011). Behavior problems in children raised by grandmothers: The role of caregiver distress, family resources, and the home environment. Children and Youth Services Review, 33, 2138-2145.

Whitley, D. M., White, K. R., Kelley, S. J., & Yorker, B. C. (1999). Strengths-based case management: The application to grandparents raising grandchildren. Families in Society, 80, 110-119.

Contact Information

Name: Susan Kelley, RN, PhD
Agency/Affiliation: Georgia State University
Website: phg.snhp.gsu.edu
Email:
Phone: (404) 413-1091

Date Research Evidence Last Reviewed by CEBC: February 2017

Date Program Content Last Reviewed by Program Staff: January 2017

Date Program Originally Loaded onto CEBC: March 2017