Friday, December 28, 2007

Grandparents raising grandchildren: a response to a nutrition and physical movement intervention

The number of grandparents in the United States raising their grandchildren have increased over the past 2 decades. Nationally, nearby are 2.4 million co-resident grandparents who are the primary caregivers for their grandchildren; of all African American grandparents residing near their grandchildren, 51.7% are primary caregivers. Of all grandchildren living in grandparent households, 35.1% are African American, next to no parents present. Grandparent caregivers are at increased risk for physical and mental health problems, including diabetes, hypertension, cardiovascular disease, insomnia, and depression. These grandparents may abandon their own health while focusing on the requirements of their grandchildren. Grandparents may also deal next to the added stress of their caregiver roles by overeating, drinking alcohol, and smoking. According to a study in Atlanta, GA, among 100 African American grandparents raising their grandchildren, 54% have high blood pressure, 80% be overweight, and 48% consumed high-fat foods. African Americans, as a group, are at increased risk for obesity, cardiovascular disease, cancer, and other lifestyle-related diseases. However, increased consumption of fruits, vegetables, grain, and low-fat dairy products may decrease chubbiness, blood pressure, and stroke in the African American population. This pilot study explored the impact of an college program on the nutrition and physical activity awareness of African American grandparents raising their grandchildren. Grandparents' opinion about the program be solicited, along with ways to promote future interventions.


The nutrition and physical hum intervention was implement with urban, African American grandparents raise their grandchildren who were participating in a community-based intervention, Project Healthy Grandparents. Serving primarily low-income, African-American grandparent" head families surrounded by the Atlanta, GA, area, Project Healthy Grandparents strives to promote the health and well-being of family through home-based nursing and social work case-management services, parenting classes, grandparent support groups, and referrals for legalized assistance. Annually, 12 support groups and 10 parenting classes are open to adjectives current and previous Project Healthy Grandparents participants.


The program consisted of 10 min to 15 min} nutrition and physical flurry lessons, base on the National Heart, Lung, and Blood Institute's "Ways to Enhance Children's Activity and Nutrition" (We Can!). We Can! is a behaviorally oriented program for caregivers and their children ages 8 to 13 years. The program be targeted specifically to the grandparents and was modified to be culturally appropriate. Each of the 10 grandparent-caregiver module, developed by two of the researchers, included a key message, PowerPoint presentation, and movement. A pretest, posttest one-group design was used to check grandparents' nutrition and physical activity practice. The principal investigator wrote one true-false item for the first and last programme and two items for each of the other eight curriculum, resulting in an 18-item test. Items be written at a third-grade level and be reviewed by two of the other investigators for appropriateness. They were read to participant because of the lower-level reading skills of some of the grandparents. The pretest and posttest were similar and administered at the first session and 3 weeks after the last session, respectively. Two weeks after the posttest, a trained facilitator conducted a 1-hour focus group next to 18 grandparents who attended at least six sessions. The focus group elicit participants' perception of factors influencing what they intellectual, their motivational levels, reported behavior change, satisfaction near the program, and suggested improvements. The intervention was implement from January through May of 2006, during the first 15 minutes of 10 grandparent support groups and parenting classes. A nutrition graduate student facilitated the sessions. The average attendance be 26, with a catalogue of 24 to 27 participants.


Three through themes emerge from the focus group, including influences related to cost, presence of grandchildren in the home, and cultural considerations. Cost was a foremost theme identified as grandparents responded to question about the most earth-shattering things learned give or take a few diet and physical activity, change made in diet or physical movement, and materials used most frequently. Participants indicated they liked study inexpensive ways to exercise around the house and neighborhood and found it helpful to swot up the benefits of walking. They reported using the 1-1b rice sock weights and handout on inexpensive community nutrition and fitness resources provided as part of the program. One of the participant reported buying more fresh vegetables, but noted their higher cost as a screen to a healthful diet.


The influence of having grandchildren surrounded by the home was the second key theme that emerge as participants answered question about their motivation and barrier to make diet and lifestyle change. Participants noted that they were motivated to craft changes, but they have to consider their grandchildren's tastes and food preferences. One grandparent stated that she tries to put away nutritiously, but her grandchild is 12 and she "doesn't want to make her [grandchild] devour like that." The grandparents concluded that their motivation to spawn lifestyle changes stemmed from concerns roughly speaking their own health and anyone able to precision for their grandchildren and desires to prevent future strength problems in their grandchildren.


Cultural influences on diet and preferences for traditional foods emerge as the third major matter regarding making lifestyle change as a result of the program. The importance of culture and ethnic influences be evident as participant identified major barrier to their motivation, what they found most and least of use about the program, and the program resources they utilized most frequently. One participant stated that it be difficult to stay motivated because there is to be "no brackish, no fried chicken, no this, and no that. They have taken everything away." Another participant like learning how to use breadcrumbs to boil a healthier performance of "fried" chicken. The most frequently used materials included the "Do the Hand Jive!" handout, which featured using one's hand to judge portion sizes, and the Heart Healthy Home Cooking--African American Style booklet.


Findings indicate that urban African American grandparents raise their grandchildren were conversant about nutrition and physical buzz and were reactive to learning more. Perceived barrier to more-healthful eating and physical buzz were financial costs, family unit's food preferences, and cultural influences. Future interventions should utilize a family-based approach to address these barriers and target behavior change in both grandparents and their grandchildren.

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