Grandparents as Parents: Investigating the Health and Well-Being of Trauma-Exposed Families

An excerpt from the introduction: Over the past two decades, the number of grandparents serving as primary caregivers for their grandchildren has steadily increased. Nationally, 42% of all grandparents living with grandchildren function as the primary caregivers (U.S. Census, 2006). In the southern region of the country, this phenomenon is particularly salient, and expected to continue, with estimates that range from 7% to 15% higher than in 2000 (U.S. Census, 2004). Kentucky is no exception, with 67,394 children living with their grandparents, 58.8% of those grandchildren fall under the responsibility of their grandparents (American Community Survey, 2005). In fact, Region IV – which includes the state of Kentucky – has the greatest density of grandparents as head of household, many of whom are poor and of advancing age (U.S. Census, 2004). Projected demographic trajectories predict this trend will continue, necessitating the development of programs and services to address the unique needs of these modern day families

Evidence-Informed Guidelines for Pediatric Pandemic Planning and Response

From the executive summary: Pandemic events are unpredictable and inevitable. When they occur, the impact is both all-encompassing and asymmetrical; each pandemic targets specific, vulnerable populations, but ultimately impacts individuals, families and communities throughout the world. Regardless of origin or circumstances, the next pandemic will certainly count infants, children, and adolescents among its most vulnerable targets. As evidenced by the 2009 H1N1 influenza pandemic, children may be at higher risk than populations more typically seen as susceptible to pandemic illness (the elderly, those with weakened immune systems, etc.). Children also can function as disease vectors, spreading the virus through their ubiquitous presence in settings where they live, attend school, and play. This document is the result of a two-year international, mixed-methods study of the physical, social, and mental health effects of pandemic on children and families – particularly the impact of quarantine and hospital isolation during these events. This project also examined the psychosocial effects of pandemic disaster on professionals who care for children before, during, and after pandemic. Based on the empirical findings of this study, researchers developed a set of evidence-informed, child-focused, best practice guidelines for use by stakeholders during future pandemics across a variety of relevant fields. In addition, data gathered and analyzed for the project have been used to create a set of Kentucky-specific recommendations that respond to the state’s unique geographic and population needs

A Parent-Led Intervention to Promote Recovery Following Pediatric Injury: Study Protocol for a Randomized Controlled Trial

Background: Injury is one of the most prevalent potentially emotionally traumatic events that children experience and can lead to persistent impaired physical and emotional health. There is a need for interventions that promote full physical and emotional recovery and that can be easily accessed by all injured children. Based on research evidence regarding post-injury recovery, we created the Cellie Coping Kit for Children with Injury intervention to target key mechanisms of action and refined the intervention based on feedback from children, families, and experts in the field. The Cellie Coping Kit intervention is parent-guided and includes a toy (for engagement), coping cards for children, and a book for parents with evidence-based strategies to promote injury recovery. This pilot research trial aims to provide an initial evaluation of the impact of the Cellie Coping Kit for Children with Injury on proximal targets (coping, appraisals) and later child health outcomes (physical recovery, emotional health, health-related quality of life). Method / Design: Eighty children (aged 8–12 years) and their parents will complete a baseline assessment (T1) and then will be randomly assigned to an immediate intervention group or waitlist group. The Cellie Coping Kit for Injury Intervention will be introduced to the immediate intervention group after the T1 assessment and to the waitlist group following the T3 assessment. Follow-up assessments of physical and emotional health will be completed at 6 weeks (T2), 12 weeks (T3), and 18 weeks (T4). Discussion: This will be one of the first randomized controlled trials to examine an intervention tool intended to promote full recovery after pediatric injury and be primarily implemented by children and parents. Results will provide data on the feasibility of the implementation of the Cellie Coping Intervention for Injury as well as estimations of efficacy. Potential strengths and limitations of this design are discussed. Trial Registration: Clinicaltrials.gov, NCT03153696. Registered on 15 May 2017

Trauma-Informed Care in Child Welfare: An Imperative for Residential Childcare Workers

Context: Rates of traumatization among residential child welfare professionals are alarmingly high. The well-being of these professionals is associated both with their intention to stay in their jobs and outcomes of children in their care. Several risk factors threaten the well-being of child welfare professionals, including primary and secondary exposure to experiences with the potential to provoke posttraumatic stress reactions.Objectives: This manuscript details experiences empirically shown to have potential negative impacts on professional well-being, discusses why these impacts are of particular concern for residential childcare workers, and describes the types of organizational cultures and climates that appear to mitigate these negative impacts.Implications: Trauma-informed care at the organizational level is proposed both as a means to reduce harm to child-welfare professionals and promote the rehabilitation of children within the child welfare system

The role of secondary traumatic stress breakthrough champions in reducing worker trauma and improving organizational health using a configurational analysis approach

Background Emerging research has demonstrated that organizational efforts at becoming secondary traumatic stress (STS)-informed can improve the overall well-being of the workforce, especially when implementation activity by a champion team is high. Questions remain, however, regarding the mechanisms that enable these improvements. Method This study uses configurational analysis to determine necessary and sufficient conditions to produce reductions in STS symptoms in workers as well as organizational improvements toward being more STS-informed in a cohort survey of 6,033 professionals working with individuals exposed to trauma representing 52 organizations. The Secondary Traumatic Stress Informed Organizational Assessment (STSI-OA) was used to measure professional's perceptions of how well the unit addressed secondary trauma in the workplace, and the Secondary Traumatic Stress Scale (STSS) assessed traumatic stress symptoms in respondents. Champions' activity was scored using the categories suggested by Shea. Results For the STSS outcome, either a STSI-OA positive increase of 10 or more points or high levels of champion problem-solving were independently sufficient for an improvement in the outcome. The STSI-OA model had two pathways: high levels of peer engagement via the scaling up of innovations using PDSAs or the combination of facilitation of peer knowledge and skills together with working in a child welfare organization. Either pathway was sufficient by itself to yield the STSI-OA outcome. Conclusions Identifying and cultivating the champions' use of problem-solving and peer engagement strategies can transform the threat posed by indirect trauma exposure into an opportunity for shared experience and healing. Plain Language Summary Organizational champions are individuals or teams that strive to promote change within their workplace. These champions are integral to spreading innovative ideas and strategies and creating organization-wide changes ( Powell et al., 2015 ). However, little is known about the processes or specific strategies that make champions successful. One area in which champions are needed is in improving organizations' response to and understanding of secondary traumatic stress (STS), among those in helping professions that are indirectly exposed to trauma through the traumatic stories of those they work with. In fact, research has shown that organizational efforts to address STS improve the well-being of individual professionals within that organization ( Sprang et al., 2021 ). The present study sought to better understand what champion-related processes or conditions led to organizational change in addressing the effects of indirect exposure and improving symptoms related to STS. Results showed that organizational change in addressing STS and champions' problem-solving strategies resulted in reductions in individual professionals' STS symptoms. Furthermore, champions' use of peer engagement or sharing of knowledge among peers in child welfare settings led to improvements at an organizational level. These results show that organization-level change can have a direct impact on individual well-being and there are specific champion activities that can promote this change. Specifically, results demonstrate a need to identify and support champions' use of problem-solving and peer engagement strategies to turn the individual and organizational threat posed by indirect trauma into an opportunity for shared healing