Document text
Principal Investigator: Wendy G. Lichtenthal
Organization: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
Fiscal Year: 2024
Award: $434,596
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY/ABSTRACT
The pain of loss figures prominently for millions of Americans, and while the emotional toll of bereavement is
well-recognized, resulting disruptions to social connection often go unnoticed and unaddressed. The proposed
study examines ruptures to social connection following what is widely acknowledged as the most devastating
form of loss: the death of a child. Bereaved parents face increased risk for numerous adverse health outcomes
including cardiovascular disease, dementia, and early mortality. One likely contributor to these outcomes is
social isolation. For many parents, their child’s death precipitates long-term estrangements. Friends and family
often do not know what to say or do and may avoid contact. Drained by the need to constantly “put on a brave
face,” parents may self-isolate, and even close relationships may deteriorate or collapse. Social isolation itself
is a well-established risk factor for physical and mental illness, and its adverse outcomes mirror those of
parental grief. Healthcare systems are in a unique position to address bereavement-induced social isolation
due to their many touchpoints with families. That said, direct clinical care for every bereaved parent is neither
possible due to finite resources, nor called for depending on individuals’ risk levels and preferences. Both the
public health model and the transitional model of bereavement care call for the majority of bereaved individuals
to be supported over the long term by their surrounding communities. However, bereaved parents often face
breakdowns in social relationships at the very time that they need these informal supports most. It is therefore
critical that healthcare systems have interventions and resources to help bereaved parents build and maintain
community-based social support. As a basis for these interventions, research identifying specific intervention
targets is sorely needed. While qualitative studies have described the numerous social challenges faced by
bereaved parents, existing research stops short of quantifying changes in specific social network
characteristics and their impacts on perceived isolation (i.e., loneliness), or offering adaptive strategies to help
maintain social connection. The proposed mixed methods study seeks to fill this gap by 1) quantifying changes
in social network characteristics (negative interactions, social integration, emotional support, shared sense of
purpose, network size, network composition); 2) determining associations among network characteristics,
perceived isolation, and health; and 3) identifying adaptive strategies that help maintain social connections. We
will conduct a quantitative survey of approximately 300 bereaved parents assessing network characteristics,
perceived isolation, and health, and in-depth, semi-structured interviews with a subset of ~45 parents to
identify strategies that help maintain social connection. The long-term goal of this research is to develop a
multimodal intervention that can be implemented by healthcare systems to help mitigate bereavement-induced
social isolation. The proposed study has the potential to reduce isolation and adverse health outcomes among
the millions of bereaved parents in the U.S., and potentially can be expanded to other bereaved populations.
Terms: <0-11 years old><Address><Amentia><American><Bereavement><Bereavement Care><Cardiovascular Diseases><Cessation of life><Characteristics><Child><Child Youth><Children (0-21)><Cigarette><Communities><Community Education><Community Health Education><Data><Death><Dementia><Deterioration><Emergencies><Emergency Situation><Emotional><Evaluation><Face><Family><Feeling><Friends><Future><Goals><Grief><Grief reaction><Health><Health Care Systems><Healthcare Systems><Individual><Intervention><Intervention Strategies><Interview><Loneliness><Mediating><Mental disorders><Mental health disorders><Methods><Modeling><Outcome><Pain><Painful><Parents><Population><Position><Positioning Attribute><Prevalence><Psychiatric Disease><Psychiatric Disorder><Public Health><Research><Research Resources><Resources><Risk><Risk Factors><Rupture><Smoking><Social Network><Social isolation><Social support><Structure><Survey Instrument><Surveys><Time><adverse consequence><adverse outcome><cardiovascular disorder><clinical care><death risk><demographics><develop therapy><experience><faces><facial><feelings><health care settings><healthcare settings><informal support><intervention delivery><intervention development><interventional strategy><kids><lonely><mental illness><mortality><mortality risk><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><palliative><parent><preference><protective factors><psychiatric illness><psychological disorder><repair><repaired><social><social integration><social relationships><social support network><therapy development><treatment development><youngster>