Patterns of Enrollment and Engagement of Custodial Grandmothers in a Randomized Clinical Trial of Psychoeducational Interventions

Abstract

The authors used Andersen’s (2008) behavior model to investigate patterns of enrollment and treatment engagement among 343 custodial grandmothers who participated in a randomized clinical trial of three psychosocial interventions:(a) a behavioral parenting program, (b) a cognitive behavioral coping program, or (c) an information-only condition. Treatment completion was superior to that typically found with birth parents, even though the grandmothers and their target grandchildren both had high levels of mental and physical health challenges. Compliance did not differ significantly by condition but was higher among grandmothers who self-reported less positive affect, were older, and were using mental health professionals. Treatment satisfaction was highest in grandmothers who attended more treatment sessions, reported lower annual family income, had a health problem, and were using mental health professionals. The practice and policy implications of these findings are discussed, especially in terms of strategies for enhancing the engagement of custodial grandfamilies in future psychoeducational interventions.

A randomized clinical trial of interventions for improving well-being in custodial grandfamilies.

“…Our previously reported finding of virtually no difference between our three RCT conditions on measures of treatment satisfaction suggests that each condition was appraised by CGMs as being equally credible and beneficial (Smith, Strieder, Greenberg, Hayslip, & Montoro-Rodriguez, 2016). This similarity of appraisals is unsurprising given that all three conditions were meaningfully structured, led by professionals, permitted personal expression in a safe group environment, and provided useful information to participants.…”

“…At the same time, however, it is noteworthy that only 20% of CGMS failed to attend at least one session which is superior to the 25 to 50% of birth parents scheduled to begin BPT who never attend a single session (Chaco et al, 2016). Nevertheless, identifying strategies for increasing first time attendance at interventions designed for grandfamilies is critical to insure that those most in need actually attend so that treatment effects can be maximized (see Smith et al, 2016).…”

The Utility of Solution-Oriented Strategies to Support Grandparents Raising Grandchildren

“…While program impact findings here cannot necessarily speak to key change processes explaining treatment effects, the emphasis on feeling personally efficacious in setting and implementing goals as well as in future-oriented, solutionbased thinking, and improved emotional functioning (Kim & Franklin, 2015) are potential explanatory mechanisms. In addition, bonding with group facilitators (Kim, 2007) as well as with fellow grandparent caregivers (Hayslip et al, 2015;Smith et al, 2016) may contribute to the positive program outcomes found here.…”

Behavioural approaches to recruitment and retention in clinical trials: a systematic mapping review

“…A majority of studies (n=23, 74%) were exploratory, looking to apply behavioural approaches to identify issues within recruitment/retention by assessing barriers/facilitators to their targets and predisposing characteristics of participants. They explored these barriers/facilitators through qualitative interviews and/or focus groups,27–39 intervention mapping,40 41 surveys/questionnaires,27 31 32 36 42–48 and secondary data analysis 49. These studies identified potential strategies to address these insights, some only suggesting directions for future research while others developed interventions but did not formally evaluate them.…”