The Role of Intergenerational Relationships: Applying the Family Stress Model to Grandfamilies

Abstract The Family Stress Model (FSM) of Economic Hardship (Conger, Rueter, & Conger, 2000) was developed to explain the impact of financial stress on families through links between economic difficulties, parental emotional distress, marital conflict, disrupted parenting behaviors, and child maladjustment. The FSM has been cross validated in samples of custodial grandparents (i.e., grandparents who provide substantial care for their grandchildren; Smith et al., 2017). The current study modified the FSM by replacing inter-parent relationship difficulties with inter-generational relationship problems between the custodial grandparents and their children to ultimately examine the adjustment of the grandchildren. This change to the model is supported by prior research conducted on intergenerational stress impacting the parenting and subsequent development of children in grandfamilies (Barnett, Mills-Koonce, Gustafsson, & Cox, 2012). Using a nationwide sample of 317 custodial grandparents aged 40 and older (M = 61 yr) the fit of the modified model was tested using AMOS 26. Latent variables in the model included Economic Pressure, Caregiver Distress, Disrupted Parenting, Intergenerational Relationship, and Child Adjustment. Moderate fit was achieved (χ2(308) = 574.88; CFI = .896; RMSEA = .052). All pathways were significant with the exception of Disrupted Parenting to Child Adjustment. These results indicate that intergenerational relationships are an important predictor of child adjustment, and an applicable substitute for inter-partner relationships when modeling family stress in custodial grandfamilies. Details and clinical implications will be discussed.

of taking care of grandchildren. The three groups are 'no care, providing care occasionally, providing care frequently'. The mediating and moderating effects of social networks between grandchild care and depressive symptoms are tested. Results show that older adults who provide grandchild care report superior social networks and better mental health than those who don't provide grandchild (reference group). After controlling the related variables, the older adults who provide grandchild occasionally benefit more than those who take care of grandchild frequently. Grandchild care is related to larger social networks, and the social networks are fully mediating the association between grandchild care and depressive symptoms. Taking care of grandchildren may provide health benefits to older adults due to keeping their social roles and feeling more generative; however, we have scarce knowledge of the relationships in Asian countries. This study addressed this question in older Japanese. The data was obtained from a two-year follow-up mail survey conducted in 2016 on 3,116 randomly selected older Japanese, aged 65-84 years, living in a metropolitan area. The main outcome was deterioration of health assessed by the Self-Rated Health (SRH), WHO-5, and Instrumental Activities of Daily Living (IADLs), defined as decline in 1 or more points obtained after 2 years of follow-up. The frequency of taking care of grandchildren was assessed as every day, 4-6 days per week, 1-3 days per week, 1-3 days per month, several days per year, and none. A multiple linear regression examined the impact of taking care of grandchildren as a predictor of protection of decline in SRH, WHO-5 and IADLs. The models were adjusted for confounding factors. Of 1,561 who responded to the follow-up survey, 959 people had grandchildren at baseline. The subjects had a mean age of 73.2±5.3 years, and mean scores of SRH:2.1±0.6; WHO-5;16.1±5.3, IADLs; 4.9±0.6 (higher scores represent higher evaluation). The higher frequency of taking care of grandchildren were longitudinally associated with less decline in SRH, WHO-5, and IADLs (standardized partial regression coefficient, β=-0.090, p=0.013; β =-0.023, p=0.547; β =-0.107, p=0.008, respectively). In conclusion, taking care of grandchildren might be a protective factor of comprehensive and functional health deterioration.

THE IMPACT OF TAKING CARE OF GRANDCHILDREN ON HEALTH OUTCOMES IN JAPANESE COMMUNITY-DWELLING ELDERLY
Hawai 'i,Honolulu,Hawaii,United States,4

. The University of Arizona, Tucson, Arizona, United States
The Family Stress Model (FSM) of Economic Hardship (Conger, Rueter, & Conger, 2000) was developed to explain the impact of financial stress on families through links between economic difficulties, parental emotional distress, marital conflict, disrupted parenting behaviors, and child maladjustment. The FSM has been cross validated in samples of custodial grandparents (i.e., grandparents who provide substantial care for their grandchildren; Smith et al., 2017). The current study modified the FSM by replacing inter-parent relationship difficulties with inter-generational relationship problems between the custodial grandparents and their children to ultimately examine the adjustment of the grandchildren. This change to the model is supported by prior research conducted on intergenerational stress impacting the parenting and subsequent development of children in grandfamilies (Barnett, Mills-Koonce, Gustafsson, & Cox, 2012). Using a nationwide sample of 317 custodial grandparents aged 40 and older (M = 61 yr) the fit of the modified model was tested using AMOS 26. Latent variables in the model included Economic Pressure, Caregiver Distress, Disrupted Parenting, Intergenerational Relationship, and Child Adjustment. Moderate fit was achieved (χ2(308) = 574.88; CFI = .896; RMSEA = .052). All pathways were significant with the exception of Disrupted Parenting to Child Adjustment. These results indicate that intergenerational relationships are an important predictor of child adjustment, and an applicable substitute for interpartner relationships when modeling family stress in custodial grandfamilies. Details and clinical implications will be discussed.

TOO MANY TREATS OR NOT ENOUGH TO EAT? THE IMPACT OF CUSTODIAL GRANDPARENTS ON FOOD SECURITY AND NUTRITION Danielle Nadorff, and Rahel Mathews, Mississippi State University, Mississippi State, Mississippi, United States
In the US, 28.5% of seniors are obese, with a BMI of 30 plus. The prevalence of obesity for children is also an alarming 17%, making it one of the primary public health burdens. According to the socio-ecological model, a child's weight status can be influenced by factors related to parenting style, family, and the community. The literature reflects a significant emphasis focusing on children and their parents. However, according to the US Census, 7.5 million grandchildren are living with their grandparents, with about 1/3 of these residing in skipped-generation households. There are essential age-related differences in food preparation and eating behaviors between middle-aged and older grandparents and younger adult parents that may influence their children's eating behaviors. Grandparents may provide a positive feeding environment, including role-modeling healthy food intake, teaching children about nutrition, and involving them in mealtimes and cooking, monitoring and encouraging children to eat nutritious foods, especially vegetables and regularly serving vegetables. However, grandparents have also reported providing energy-dense and nutrient-poor food and drinks and used food as a reward or gift. The current study aims to investigate the influence of caregiver type (grandparents only, parents only, or multigenerational households) on children's nutrition, food security, and BMI. One-way ANCOVAs controlling for SES found that grandparent-headed households had children with more deficient diet and higher BMIs, but also less food insecurity. These results indicate that age-related changes in caregiver type are an important predictor of children's nutritional health. Details and clinical implications will be discussed.

A SYSTEMATIC REVIEW OF INTERVENTIONS THAT REDUCE FAMILY AND FRIEND CAREGIVING TIME
Zachary Baker, 1 Eric Jutkowitz, 2 and Joseph Gaugler, 1 1. University of Minnesota,Minneapolis,Minnesota,United States,2. Brown University,Providence,Rhode Island,United States The decreasing number of family/friend caregivers available to help the rising number of older adults is creating a critical family care gap. For this reason, there is a growing need for interventions that reduce family/friend caregiving time. We systematically reviewed five electronic databases to identify randomized trials, case control, quasi-experimental, and cross-sectional studies that evaluated a modifiable element that could be targeted for interventions with care recipients 65+ and/or their family/friend caregivers and reported on an outcome of time spent caregiving. We excluded studies without a comparison, broadly defined. The initial search included 1,812 unique records. Following abstract and title screening 311 full-texts were reviewed. Fifty-five studies published between the years of 1990 and 2019 met inclusion criteria. Studies predominantly focused on care recipients with dementia (58%) and were largely conducted in western countries (91%). The categories of interventions reviewed included pharmaceuticals (25%), public long-term care financing (7%), case management (7%), care setting (16%), technology (7%), multi-component interventions (9%), skills building (15%), additional formal expertise/care (9%), and other (5%), with one study falling into multiple categories. Pharmaceuticals, case management, care setting, and multi-component interventions demonstrated promising evidence to reduce family/ friend caregiving time. Methodologically, studies were inconsistent in measurement and ascertainment of caregiving time. Given the public health concerns of reduced availability of family/friend caregivers for older persons in the upcoming decades, caregiving interventions should consider measurements of caregiving time as key outcomes.