(see Poster Gallery) Self-Care Practices of African American Informal Kinship Caregivers: A Mixed Methods Pilot Study

Background: Research has revealed persons who take on the primary responsibility of caring for related children (e.g., grandparents raising grandchildren) often experience high levels of stress. Chronic stress places individuals at increased risk of many health problems, including cardiovascular disease, Alzheimer’s disease, and depression. Subsequently, kinship caregivers incur a host of negative outcomes related to high stress including physical health and mental health problems. These negative outcomes suggest a need for research focused on factors to improve kinship caregivers’ physical and mental health. With the goal of improving the overall health of African Americans providing informal kinship care, this study sought to explore the self-care behaviors of this unique population because self-care practices have been associated with positively coping with stress.

Methods: This pilot study employed a fully mixed sequential equal status design. Specifically, we used quantitative and qualitative methods to examine (a) the prevalence of stress (b) caregivers’ health; and (c) how caregivers understand and describe their self-care practices. We recruited African American informal kinship caregivers from child welfare agencies, one Head Start program, and the community (N=12; children ages 5 to 12). Data was collected from the caregivers using several measures including the Parenting Stress Index, Family Resource Scale, and a demographic form to obtain their self-ratings of health. Univariate analysis was conducted to determine the distribution of the dependent, independent, and control variables, as well as demographic variables. Semi-structured qualitative interviews were conducted, transcribed verbatim, and analyzed using the phenomenological methods suggested by Moustakas and Creswell.

Results: The quantitative analysis revealed that 33% of caregivers reported high or clinically significant levels of stress. Additionally, most kinship caregivers faced resource challenges, with only 1 participant reporting their family resources were almost always adequate, but 50% of the caregivers reported their family resources were seldom or sometimes adequate and 25% of caregivers reported they were somewhat unhealthy. From the qualitative analysis, three themes emerged that illuminated African American informal kinship caregivers’ lived experiences with stress and their self-care practices: (a) maladaptive coping; (b) questions surrounding care for the children if something happened to the caregiver [who will take care of the children if something happens to me]; and (c) positive self-care practice

Implications: The finding of high stress levels among caregivers is consistent with prior research; however, the utilization of qualitative methods allows us to not only explore specific factors that contribute to their stress, but importantly to gain knowledge from caregivers about the self-care practices that may possibly reduce their stress and improve their health. In this study to continue positive self-care practices, the caregivers had to give priority to their own needs. Specifically, several kinship caregivers noted making positive self-care practices (e.g., spending time alone; spiritual practices) a consistent part of their lives helped to renew their energy to provide care for their children. Future research should consider using biomarkers of stress and interventions that include self-care practices to determine the most effective self-care practices to improve caregivers’ overall health.