Impact of support groups on kinship care providers : a project based on an investigation at Community Coalition, Los Angeles, California

The purpose of this study was to explore how peer support groups influence kinship care providers’ (KCPs’) sense of self-worth and empowerment, and how they impact KCPs’ ability to advocate on behalf of the children in their care. Few studies to date have examined self-worth in the realm of KCPs’ parenting issues of guilt and regret, nor have they explored whether support group participation encourages relearning parenting skills and therefore instills a sense of empowerment. Although the majority of KCPs in the United States are informal care providers, most prior research on this population focused on formal kinship care providers; this study included both formal and informal caregivers. Thirteen KCPs who belong to a support group formed under the auspices of a community agency in South Los Angeles were interviewed for this study; participants were female and predominantly African American, with a median age of 64 years. Agency staff who worked with these caregivers were guided by a mission statement engendering community activism and advocacy. Major findings indicated that KCPs gained a sense of empowerment through increased knowledge from invited speakers and through emotional support from their group counterparts, thus improving their navigation of the child welfare system and increasing their connections to others. This study confirmed the value of peer support groups for KCPs. Further, it underscored the need for social workers to be sensitive to issues of racism within the child welfare system and to encourage KCPs to bring these issues to the support group

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049