Mechanisms Through Which a Family Caregiver Coaching Intervention Might Reduce Anxiety Among Children in Military Househ

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Mechanisms Through Which a Family Caregiver Coaching Intervention Might Reduce Anxiety Among Children in Military Households Megan Shepherd‑Banigan1,2   · Kelley A. Jones2 · Ke Wang3 · Nicole DePasquale4 · Courtney Van Houtven1,2,5 · Jennifer M. Olsen3 Published online: 4 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Objectives  Children of injured or disabled veterans and service members may be at risk for mental health and adjustment problems due to household stress. Yet, there are few widely available interventions to address the needs of this population. Reducing distress and improving coping skills of the parent who cares for the injured or disabled adult may improve child outcomes. This paper examines whether changes in caregiver psychosocial outcomes after a caregiver coaching intervention are associated with decreases in child anxiety. Methods  Using programmatic data collected between 2015 and 2019 from participants in a family caregiver coaching intervention (170 caregivers, 294 children), we apply linear mixed models to assess associations between changes in family caregiver well-being, including problem solving, depressive symptoms, burden, health complaints and quality of life, and changes in parent-reported child anxiety. Results  The baseline median Spence Children’s Anxiety Scale—Parent score was 17; children aged 6–11 had slightly higher scores. Child anxiety scores decreased on average 2.8 points (SD 8.4) between baseline and follow-up. In adjusted models, decreases in caregiver depressive symptoms and health complaints were associated with decreases in child anxiety. Caregiver problem-solving skills, quality of life, and subjective burden were not associated with changes in child anxiety. Conclusion  Family caregiver-focused interventions that decrease caregiver stress may positively affect children in the household. Few resources are directed at military children; therefore, practitioners should consider ways to leverage caregiver interventions to address child well-being, such as incorporating information on parenting strategies and addressing issues faced by military children. Keywords  Child anxiety · Family caregiver · Chronically ill or disabled parents · Military household · Intervention effects

Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s1099​5-020-02964​-w) contains supplementary material, which is available to authorized users. * Megan Shepherd‑Banigan megan.shepherd‑[email protected]; [email protected]

1



Durham VA Health Care System, 508 Fulton Street, Durham, NC 27705, USA

Kelley A. Jones [email protected]

2



Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC 27701, USA

Ke Wang [email protected]

3



Rosalynn Carter Institute for Caregiving, Georgia Southwestern State University, 800 GSW State University Drive, Americus, GA 31709, USA

4



Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, 20