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Belonging as Black women: Black grandmothers pilot program
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1
Belonging as Black Women: Black Grandmothers Pilot Program
Capstone Paper and Final Prototype
NaKaisha Tolbert-Banks
University of Southern California
Suzanne Dworak-Peck School of Social Work
DSW Program
Dr. Jane James
December 2023
2
I. Acknowledgments
Thank you God for allowing me the opportunity to see this journey and supplying me
with ample energy to make it through. To my village, thank you for being thoughtful, giving,
caring, a listening ear, and prayerful with me during this journey. To my husband and my
daughters: Thank you from the bottom of my heart for your sacrifice and allowing me as a wife
and mother to venture into unchartered territory and attain this goal. Without your love, support,
and encouragement this would have been a miserable journey. To my dad who unknowingly
encouraged me daily, I am extremely grateful for you. Thank you.
To my Capstone Committee Chair, Dr. James: Your countless hours of guidance and
encouragement have not gone unnoticed. Thank you for your kindness, support, sacrifice and
dedication to the students you serve daily. Dr. Franklin: I truly thank you for your support,
reminders to laugh and take a break throughout the journey, and most importantly for reminding
me that the sacrifices made were only temporary. Ms. Lewis: Your reminders that I have not
depleted my brain cells (although it felt like), have been a God send. I appreciate you and thank
you for the role that you play in the lives of so many, and for truly being a Black grandmother
who whole-heartedly cares about family and community. Ms. Tonya, you have been an amazing
thought partner, program partner, encourager, turned friend. Without you and every voice of the
Black Grandmothers, my journey would not have been possible. Thank you.
To my professors: what I have learned from each of you throughout this journey has been
invaluable. I am grateful. Finally, to my amazing colleagues and future Doctors of Social Work;
this has been a journey for the books. Thank you for your support, laughs, tears of joy and
frustration, and most importantly your encouragement. We will have stories to share for many
3
years to come. I look forward to the opportunities that lie ahead for us. May we always
remember to serve our fellow humans and communities with the same courage, respect, decency,
heart and determination we put into our studies. We got this!
4
TABLE OF CONTENTS Page Number
II. Executive Summary 5-9
III. Abstract 10
IV. Positionality Statement 11-12
V. Problem of Practice 12-14
• Literature Review 15-18
VI. Conceptual/Theoretical Framework 18-20
VII. Proposed Solution/Project Description 20-23
▪ Theory of Change 23-25
▪ Solution Landscape 25-27
VIII. Methodology 27-28
IX. Implementation Plan/Strategy 28-30
• Financial Plan Summary 30-32
• Method for Assessment 32-33
• Challenges 33-35
• Ethical Considerations and Applying Design Justice Principles 35-36
X. Lessons Learned 36-38
XI. Conclusion and Implications 38-41
Appendices 42-59
References 60-72
5
II. Executive Summary
The Belonging as Black Women: Black Grandmothers Pilot Program is a non-clinical,
evidence-informed, peer-led intervention designed to increase social support and connection and
decrease social isolation among Black grandmothers. Black grandmothers aged 45-65 experience
a diminished sense of belongingness due to social isolation and resultant loneliness. The
diminished sense of belongingness intersects with the Grand Challenges for Social Work to
Eradicate Social Isolation (2018). Belongingness refers to the innate human desire to be a
socially accepted group member, while loneliness is a subjective feeling of being alone,
irrespective of interpersonal interactions (McCallum et al., 2021). The National Academies of
Sciences, Engineering, and Medicine (2020) reported that approximately one-third of adults 45
years of age and older have experienced feelings of loneliness, which can lead to increased rates
of depression, anxiety, and suicide. A systemic review conducted by Williams et al. (2018)
revealed that interventions are necessary as many individuals worldwide risk experiencing social
isolation in some facet, which exacerbates an individual’s mental health issues.
Existing research connects loneliness and social isolation as a unique set of factors that
can negatively impact the health of individuals, specifically highlighting the impact on older
adults (Czaja et al., 2021; Malcom et al., 2019). Veazie et al. (2019) state that social isolation is a
lack of support or social contact. Additionally, Gardiner et al. (2018) define social isolation as
having few contacts within one’s social network. An article by Jiminez (2002) explores the
historical background of African-American grandmothers and the complex nature of their
responsibilities within communities and the family unit, including raising grandchildren. As
such, this pilot program addresses the needs of Black grandmothers by providing them with
6
access to peer-led support circles to address the issues of concern they may encounter, including
social isolation and loneliness, and to garner support regarding everyday life issues they
experience, such as grief (Wynn, 2023).
Both stigma and structural racism have been touted by Richards (2021) as critical barriers
to health-seeking behavior. Additionally, studies (Alcaraz et al., 2019; Brandt et al., 2022; Stangl
et al., 2019) reveal that social isolation significantly impacts individuals’ health and well-being.
The physical and mental health impacts of social exclusion have been subjectively explored,
while evidenced data about the behavioral effects yield further exploration (Dewald-Kaufmann et
al., 2021). Kalinowski et al. (2022) highlighted the expectations of Black women as pillars
within their families and the strength they must portray, denying their internal suffering.
Since human beings are inherently social creatures and belonging and connection can mitigate
the detrimental effects of social isolation (Allen et al., 2022), Black women’s journeys must
include flexible support systems and a felt sense of connection.
In a study that aimed to understand the impact of expectations and increased stress upon
Black women, Rivera et al. (2021) found that mental illness stigma inhibits Black women from
seeking necessary care and support, leading to a downward spiral into social isolation. A similar
study by Lemberger-Truelove (2018) revealed that the social experiences of Black women can
impact their ability to access communities. The traumatic death of JoAnne A. Epps, presented by
Womack (2023), portrays an unfortunate example of Black trauma and the negative impacts of
trauma on Black women and their perceived place in society. As the studies on the trauma of
Black women progress, the issues and concerns brought to light by Black women can be openly
7
expressed and supported within the support circles, further imploring the need for this type of
intervention for Black women.
The pilot program has been designed based on the foundational research on peer-led
support programs. First, the Circle Kubatana Tose (Friendship Bench, online, 2023) is a postintervention support group for individuals who participated in the Friendship Bench, which
psychiatrist, Dr. Dixon Chibanda founded. The Friendship Bench is an intervention that uses
trained grandmothers within the Zimbabwean community to serve individuals with mild to
moderate mental health concerns (Fernando et al., 2021; Kamvura et al., 2021). A similar group
in Okinawa, Japan, is the moai, consisting of five individuals who are either members of the
circle by birth or have been selected later in life to be part of the moai. These groups, in which
members meet regularly to exchange information, experience life, share advice, and even offer
financial support to their members, significantly impacts the behavior of their participants,
promoting healthier lifestyles and alleviating feelings of loneliness (Buettner & Skemp, 2016).
The design thinking elements, including empathizing, defining, ideating, prototyping, and
testing, were all utilized in designing and testing the intervention in this study. The first three
stages of design thinking were the most crucial as they supported the design of the intervention,
defined the problem to be addressed, and imagined the criteria for stakeholders and desired
intervention outcomes. Focus groups began by collecting data, through qualitative and
quantitative surveys, to assess the problem from a stakeholder perspective, further supporting
aspects within the design thinking process while monitoring progress.
Fuss et al.(2021) examined the heightened necessity for older adults to establish a sense
of belonging and identity through social engagement supported by computer-mediated
8
communication. The pilot program, for Black grandmothers, has been designed to conduct
virtual social support circles, and the research by Fuss et al. (2021) adds insight to the need for
this program. Fortuna et al. (2022) also report a significant increase in peer support since 2004,
offered in various capacities, from inpatient services to digital and community-based support
globally.
The pilot program was implemented in five stages. (See Appendix H). The first phase
conducted focus group with Black grandmothers to gather stakeholder information. The second
phase collected applications of interest from Black grandmothers to become Grand Facilitators.
The third phase conducted the facilitator training for Black grandmothers to equip them with
skills to facilitate support circles. The fourth phase supported grandmothers in facilitating
support circles using learned skills. The fifth and final phase is the certification phase for
grandmothers who have completed each of the four phases.
The pilot program originated in the midwest through one grandmother in collaboration
with the Voices of Black Grandmothers. Three additional grandmothers have joined the initiative,
with two residing in the Southeast and one in the Northeast region of the United States (see
Appendix A). By increasing the number of Black grandmothers trained as Grand Facilitators,
peer-led support circles can be increased throughout the United States. The increased virtual
support circles will allow Black grandmothers continual access to social connections, support,
and information from other Black grandmothers.
Through the CDC, the State of Mental Health and Aging America issue brief (2008),
highlights emotional, instrumental, and informational support as three key supports provided by
social support interventions. In the pilot program, the support circles provide Black
9
grandmothers with emotional and informational support. By sharing their lived experiences or
valuable resources within the support circles, peers in the Black grandmother’s support circles
connect and motivate each other, alienating the feelings of loneliness. The exchange of
information is invaluable in conjunction with a grandmother’s ability to offload any emotional
distress they may be experiencing and receive support from others participating within the
support circle.
With limited resources in the United States designed specifically for Black grandmothers,
this intervention offers access to emotional and informational support, which can benefit a firsttime grandmother or a seasoned grandmother with ample grand-parenting experience.
10
III. Abstract
Black grandmothers face significant barriers to accessing social support services within the
United States. Black grandmothers often serve as the pillars of their families and communities,
offering unwavering support. The emotional load of constantly supporting their families and
communities can become unexpressed and burdensome if they do not receive equal support
measures. Additionally, Black women face numerous barriers regarding access to quality
healthcare, mental health care, and aging, which can have an adverse impact on their mental
health and motivation to seek support, thereby opening a gateway to isolation and loneliness.
Social isolation, derived from one of the Grand Challenges of Social Work (2018), is a
ramification of Black women’s negative experiences. The impact of systemic and societal
barriers, such as economic insecurities, racism, lack of social support, and healthcare inequities,
necessitate accessible interventions to mitigate the barriers they face. Access to social support
and connection to other Black grandmothers is a limited resource. Therefore, the Belonging as
Black Women: Black Grandmothers Pilot Program offers a peer-led program for Black
grandmothers aged 45-65. Black grandmothers convene within virtual peer-led support circles to
socially connect through discussions that highlight relevant topics impacting Black
grandmothers, their livelihood, families, and overall well-being. Black grandmothers (n=3)
trained through evidence-informed, manual-based training were equipped with the necessary
skills to facilitate virtual social support circles. The facilitator training provides Black
grandmothers with needed skills to lead social support circles, increasing access to social support
within the United States.
11
IV. Positionality Statement
I am a professional social worker for 25 years from the Midwest, United States. Most
recently, I served as a Licensed Clinical Social Worker in private practice. My passion for
empowering and building communities comes from my experiences of volunteering in the
community as a teenager. As a young girl, I learned the power of human connection through the
many family and community gatherings I attended. Lessons from my elders and various
volunteer experiences taught me the importance of being myself, honoring my elders, and
deriving pleasure from serving others. Unknowingly, volunteering as a teenager grew my passion
for social work. I subsequently decided to pursue a career in social work, where I have worked
with families and children, as an educator in higher education, and as an advocate for mental
health.
As a child, I embraced my relationship with my Black grandmother. The life lessons I
gained from our connection, such as acknowledging every person regardless of the color of their
skin, where they were born, how they were raised, and despite their treatment towards me,
instilled in me crucial, long-lasting life skills. My grandmother taught me the importance of
family and community and that helping others is an act of kindness that goes a long way.
Moreover, the insights gained from these life lessons strengthened my resolve to pursue a career
in social work. The positive and not-so-positive life experiences I have encountered as a Black
woman in America give rise to the need for empathy as a critical component within the humancentered design process (Thomas & McDonagh, 2013).
In remembering the lessons I learned from my grandmother, I strive to ensure that I
understand the environmental backgrounds of the stakeholders, whose voices are an integral
12
component of the work I engage in daily. I endeavor to be conscientious of the privileges granted
to me, to refrain from making presumptions in my professional endeavors, and to actively listen
when participating in and observing the communities to which I am generously granted access.
V. Problem of Practice and Literature Review
Black grandmothers aged 45-65 experience a diminished sense of belongingness due to
social isolation and resultant loneliness. The diminished sense of belongingness intersects with
the grand challenges for social work to eradicate social isolation (2018). Belongingness refers to
the innate human desire to be a socially accepted group member, while loneliness is a subjective
feeling of being alone, irrespective of interpersonal interactions (McCallum et al., 2021). The
National Academies of Sciences, Engineering, and Medicine (2020) reported that approximately
one-third of adults who are 45 years of age and older have experienced feelings of loneliness,
which can lead to increased rates of depression, anxiety, and suicide.
Richards (2021) identified both stigma and structural racism as critical barriers to healthseeking behavior. Other studies (Alcaraz et al., 2019; Brandt et al., 2022; Stangl et al., 2019)
reveal that social isolation significantly impacts individuals’ health and well-being. The physical
and mental health impacts of social exclusion have been subjectively explored, while evidenced
data about the behavioral effects yield further exploration (Dewald-Kaufmann et al., 2021).
Therefore, engaging various stakeholders from researchers to policymakers and community
members can provide support in better understanding the impact of social isolation amongst
Black grandmothers.
As human beings are inherently social creatures, belonging and connection to other
humans can mitigate the detrimental effects of social isolation (Allen et al., 2022). Therefore,
13
Black women’s journeys must include a flexible support system and a felt sense of connection.
Kalinowski et al. (2022) highlighted the expectations of Black women as pillars within their
families and the strength they must portray, denying their internal suffering.
In a study aimed to understand the impact of expectations and increased stress on Black
women, Rivera et al. (2021) found that mental illness stigma inhibits Black women from seeking
necessary care and support, leading to a downward spiral into social isolation. A similar study by
Lemberger-Truelove (2018) revealed that the social experiences of Black women can impact
their ability to access support communities. As such, Fuss et al. (2021) examined the increased
need for older adults to gain a sense of belonging and identity through social engagement
supported by computer-mediated communication.
The Belonging as Black Women: Black Grandmothers pilot program offers non-clinical
support circles for Black grandmothers similar to support groups offered by Project Healthy
Grandparents (2023). The support circles will offer Black grandmothers social interaction within
peer-led social environments with discussions based on individual’s lived experiences as offered
by Peer Support Space, Inc. (2019). The unique design of the pilot program, which differs from
Project Healthy Grandparents and Peer Support Space, Inc., is that support circles are to be peerled versus led by a degree-level professional to meet the specific needs of Black grandmothers
and address life issues experienced by Black women to include grand-parenting.
The pilot program has been designed based on the foundational research on peer-led
support programs. First, the Circle Kubatana Tose (Friendship Bench, 2023) is a postintervention support group for individuals who participated in the Friendship Bench, which
psychiatrist Dr. Dixon Chibanda founded. The Friendship Bench is an intervention that uses
14
trained grandmothers within the Zimbabwean community to serve individuals with mild to
moderate mental health concerns (Fernando et al., 2021; Kamvura et al., 2021). A similar group
in Okinawa, Japan, is the moai, consisting of individuals who become members of the circle in
childhood. These groups, in which members meet regularly to exchange information, experience
life, and share advice and even financial support, significantly impact the behavior of their
participants, promoting healthier lifestyles and alleviating feelings of loneliness (Buettner &
Skemp, 2016). The Circle Kubatana Tose and moai were designed to meet the mental and
physical health needs of the individuals within their communities while offering social support
for members of the communities. The difference with the pilot program model is that it is offered
within the United States and is more social connection-focused than physical or mental healthspecific.
The State of Mental Health and Aging in America issue brief (2008) reported
7.24%-8.52% of individuals aged 50 years and older in Illinois and 8.53%-9.82% of adults in
Indiana experienced mental distress within the past 30 days. Although dated, the results provide
evidence of a need to support distressed individuals within two states that are a part of the pilot
program. In addition, the urgency for peer-led, non-clinical support circles for Black women who
have experienced discrimination, racism, and sexism (Chinn et al., 2021) is supported by
evidence that individuals aged 50 and older experienced exacerbated social isolation and
loneliness (National Academies of Sciences, Engineering, and Medicine, 2020). Additionally, it
is critical to gain insight into the benefits that social support circles offer Black grandmothers,
who are a tremendous support for their families, as presented by Sumo et al. (2015).
15
Literature Review
Social isolation is a product of the stigma attached to mental illness. Social isolation
refers to a state in which there is minimal social contact with other people (Campbell, 2020).
Addressing stigma, as it relates to mental illness, will uncover the ability of individuals, families,
and communities to observe better how social isolation impacts those who live with a mental
illness. Unfortunately, within the Black community, barriers can hinder individuals from
accessing and receiving the help they desire and require regarding mental health treatment.
Studies reveal a positive correlation between stigmas and mental health problems. According to
Keller et al. (2019), stigma leads to mental health issues, which affect an individual’s motivation
to seek assistance, consequently leading to suicide.
The Grand Challenges for Social Work (2018) highlights the Eradication of Social
Isolation as a grand challenge under the stronger social fabric category. Improving social
connections is necessary as social isolation disconnects individuals from social support. Social
isolation, which leads to mental illness in older adults, poses a significant problem as it can limit
individuals physically and mentally from connecting with others, including medical doctors,
friends, family members, or co-workers, due to their inability to connect socially (Brandt, 2022;
Noone et al., 2020). The limitations experienced by individuals who isolate should be addressed,
as they can lead to adverse mental conditions. Cook et al. (2019) identify that within the United
States, minority individuals of a specific racial or minority background exhibit more severe and
persistent mental health disorders than their White counterparts. The study by Cook et al. (2019)
also reveals that minority individuals are less likely to access the mental health care they require
compared to their White counterparts.
16
Stigma and discrimination impact and hinder individuals from seeking mental health
treatment and needed services. A study by Henderson et al. (2013) revealed that seventy percent
of individuals with a mental illness do not receive the required treatment. The study further
revealed that 55 percent of Black individuals with mental health issues intended to seek
professional help, while 12 percent had no intention of seeking any help. In a statistic provided
by the National Alliance on Mental Illness (NAMI), 63% of Black people believe that mental
illness is a sign of weakness (NAMI, 2021, online), and only one in three African American
individuals receive the mental health care they need (American Psychiatric Association, 2017).
The prevailing belief within the Black community that mental illness indicates weakness poses a
notable challenge, as it compels individuals to exert great effort in hiding their mental health
issues, potentially resulting in detrimental outcomes like suicide. The stigma attached to mental
illness creates barriers for individuals who ultimately should address their mental health concerns
and receive mental health care when necessary.
The social stigma associated with mental illness has significant implications for
individuals experiencing isolation, giving rise to various notable concerns. Systemic issues, such
as racism, can impact an individual's desire and ability to seek mental health treatment. This can
manifest as heightened stress levels and interconnections with other aspects of the individual’s
life (Williams, 2018), as seen in Figure 1 (see Appendix B). Lack of support, whether through
their medical provider, treatment team, or within their social circle, can impact an individual’s
ability to seek treatment due to judgment, discrimination, shame, or the stigma attached to
mental illness.
17
Wong et al. (2017) authored an article highlighting how self-stigma and discrimination
impacted by racial and ethnic issues influence whether or not an individual seeks mental health
care. The article also identifies self-stigma related to alienation and individuals feeling isolated
or disconnected within society (Wong et al., 2017). Identifying when individuals feel like they
lack support regarding seeking mental health services can be a positive step toward eliminating
social isolation and empowering individuals to connect socially. Harandi et al. (2017) believe
that having a social support system is imperative, as it is an integral component that can impact
one's mental health.
It is essential to have interventions that will benefit the consumer and policies within
systems that can benefit both the consumer and the system serving the consumer. Malcolm et al.
(2019) presented meta-analyses stating that interventions and the effectiveness of interventions
can be impacted by the inability to determine the causal relationship and nature between health,
loneliness, and social isolation. Gronholm et al. (2017) investigated the identification of
appropriate levels of interventions in relation to stigma, as well as the specific populations that
should be targeted when devising strategies to address individuals involved in anti-stigma
interventions. Although mass media campaigns and specific targeted interventions have
demonstrated some effectiveness (Gronholm, 2017), further study and research are necessary to
assess the impact of shorter-term interventions and the benefits.
Martinez and Hinshaw (2016) authored a study presenting information regarding mental
health stigma and findings regarding the reach of the strategies to address mental health stigma.
The study provides two perspective lenses: the person stigmatizing those with mental illness and
those experiencing stigma. The study reveals that stigma is observed in all cultures. Therefore, it
18
is necessary to implement interventions at multiple levels that are consistent in order to address
the various factors that need to be modified for positive outcomes and to reduce stigma.
Mental health literacy can provide opportunities for improvements and understanding of
mental health interventions that can help recognize and address various mental health problems
(Furnham & Swami, 2018; Jorm, 2012). Jorm (2012) posits that societies may achieve mental
health literacy through community campaigns, training, or websites containing mental healthrelated information. Furnham and Swami (2018) argue that prioritizing mental health literacy
should be a central objective of national policy to empower and educate the entire community,
which can help deal with the vice. Despite the crucial role of mental health literacy in addressing
mental health problems, this intervention is not as widely adopted in most states and countries.
The stigma surrounding mental health problems, aging, and access to quality care issues
are barriers that significantly impact older adults within the Black community, hence increasing
rates of isolation. With increased mortality rates among African Americans aged 18-49 (Aaron et
al., 2021), a community that is better educated about the barriers impacting the Black
community, how to address them, and how to access supportive services is critical. According to
Schwei et al. (2021), peer-to-peer support programs can help older adults who are socially
isolated to connect with other older adults, improving their physical and social well-being.
VI. Conceptual/Theoretical Framework
Domenech-Rodriguez and Wieling (2005) found that due to a lack of theoretical and
methodological frameworks focusing specifically on communities of color, disparities were more
prevalent within mental health services, ultimately impacting beliefs in the design of programs
for these communities. As such, Domenech-Rodriguez and Wieling (2005) propose to utilize a
19
framework to address behavior, attitudes or beliefs, and social interactions of the individuals the
Belonging as Black Women: Black Grandmothers pilot program will serve. The intersectionality
theory (Carbado et al., 2013), as a critical transformational construct within research and
practice, can be utilized to examine further the impact of constructs such as race, gender, and
oppression upon Black women. As Kelly et al. (2021) posits, the intersectionality theory, as
introduced by Black feminists and activists, can help transform public health practices,
particularly pertaining to mental health programs.
The structural symbolic interaction and identity theory helps one understand the
relationship between oneself and society and how interactions with other individuals can impact
one’s social behavior (Serpe et al., 2020). This theory relates to the pilot program in that Black
grandmothers participating in the program will engage in introspection or self-observation
throughout their program. The grandmothers will also be afforded the space to understand how
society and those they interact with in their grand facilitator training and peer-led support circles
may influence their behaviors, positively or negatively, within and outside the social setting.
Their involvement aims to assess whether a sense of belonging is attainable by engaging socially
with other Black grandmothers and, through behavior change, increase their ability to engage
with other Black grandmothers.
The person-in-environment (PIE) theory is a noteworthy theory to consider when
analyzing the experiences of Black grandmothers, social isolation, and the detrimental effects of
systems, such as systemic racism. According to Kondrat (2013), person-in-environment theory
examines how individuals behave in their surroundings, providing insight into the significance of
20
their lives by observing them, regardless of the circumstance in their environment. As we
observe Black grandmothers within their environments, we may gain a better perspective of the
impact of the systemic barriers they face.
Regrettably, failing to address the complex and challenging issues faced by Black women
perpetuates the harmful and degenerative systems in existence. Therefore, the Black
grandmother's peer-led support circles are critical to the support and sustainment of Black
women as they are designed to: 1) engage Black grandmothers in supportive, culturally-centered,
trauma-aware social environments, 2) provide alternative ways to ponder life situations and
circumstances by engaging in peer-led and peer-supported open dialogue which is derived from a
person-centered model (Chmielowska et al., 2022; Razzaque & Stockmann, 2016), and 3) offer
alternative ways of thinking which can ultimately change the behaviors of support circle
participants. The logic model (see Appendix C) provides additional insight into the intervention.
VII. Proposed Solution
The Belonging as Black Women: Black Grandmothers Pilot Program enables Black
grandmothers to access empowered environments through social connections with other Black
grandmothers. In the program, Black grandmothers engage in virtual, peer-led facilitated
discussions on various topics impacting Black grandmothers. The peer-facilitated support circles
aim to eradicate social isolation, a prominent issue within the Grand Challenges for Social Work.
Black grandmothers aged 45-65 can reduce social isolation and improve their social
connections by participating in a monthly, one-hour, non-clinical, virtual support circle. The
facilitators of the peer-led support circles are also Black grandmothers who attend a three-hour
21
manual-based training to enhance their facilitation skills and ability to demonstrate learned skills
as they facilitate support circles. The availability and accessibility of support circles led by Black
grandmothers will be enhanced by augmenting the number of Black grandmothers trained as
peer facilitators.
The prototype is an evidence-informed training manual to educate and equip Black
grandmothers with skills to facilitate non-clinical support circles for other Black grandmothers.
The training manual used in a three-hour facilitator training session is divided into four modules,
which encompass the following:
Module 1: Introductions, Icebreakers, and Program History
Module 2: Mental Health Education
Module 3: Facilitation Skills Education
Module 4: Facilitation Skills Practice
The training manual is a comprehensive guide that aims to improve the skills of
grandmothers who will lead the support circles. The manual can be referenced anytime by
grandmothers, while the designer can incorporate new information into the manual as needed.
The training manual also includes references to bodies of research that support various
facilitation skills, which can help the facilitators sharpen their skills and gain vast knowledge.
The objectives for each module are as follows:
Module 1: Introductions, Icebreakers, and Program History
Objective 1: Build social connection among group members
Objective 2: Increase awareness of the program's mission
Module 2: Mental Health Education
22
Objective 1: Increase awareness about mental health issues
Objective 2: Increase awareness about personal self-care
Module 3: Facilitation Skills Education
Objective: Enhance facilitation skills
Module 4: Facilitation Skills Practice
Objective: Enhance leadership and communication skills
Black grandmothers (n=3) attended a two-hour facilitator training in June 2023 to test the
manual prototype. Tolbert-Banks (2023) conducted a post-training feedback survey to collect
quantitative and qualitative data. Participants (n=3) reported that the handouts and supplemental
material included in the manual were helpful and would support them in their role as a facilitator.
Additionally, according to the survey, two of the three grandmothers expressed that virtual
instruction on conducting a Zoom session would be advantageous. Additionally, the participants
recommended to include additional training time to complete the manual's content.
Jones et al. (2013) highlight the importance of understanding the information one aims to
collect using a well-formatted survey. The post-training survey results provided information that
has been utilized to update the facilitator training manual and the skills training portion of the
facilitator training. Due et al. (2018) highlight the importance of practice facilitation and being
attuned to individuals' needs, abilities, and desires to address any expectations or changes
necessary within the practice setting. As the facilitator manual is updated to include feedback
from the participants’ post-survey results, the design will be tested with the next cohort of
grandmothers in training, tentatively scheduled for November 2023.
23
An essential element of the program resides within the third module. The third module,
which focuses on mental health, presents a lengthy discussion regarding the need for an open
space to speak freely regarding mental health challenges the grandmothers may be facing. Due to
the social stigma, which is a significant barrier for Black Americans attempting to access mental
health services, the program needs to offer a safe space for grandmothers to speak openly about
their lived experiences. Module 3 is crucial in promoting the discussion of mental health issues
within support groups, fostering comfort, and facilitating the process. Conner et al. (2010)
presented research regarding barriers to mental health treatment and ways to improve coping
strategies for older adults within the African-American community.
Lastly, for potential and current participants to access information regarding the pilot
program, an online website was developed that provides general information regarding the
Belonging as Black Women: Black Grandmothers Pilot Program (2023) (see Appendix D). The
link to the grand facilitator training manual flip book can be found at this link:
https://online.fliphtml5.com/yiqam/rjah/#p=1
Theory of Change
Having initially met with the pilot program partner, Voices of Black Grandmothers, it was
decided that conducting a community needs assessment via survey would be the most beneficial
approach to determining the next steps for the pilot program. The needs assessment, conducted in
2022 by Tolbert-Banks, addressed areas of impact due to the lack of resources and stigma that
hindered Black grandmothers from seeking mental health services or other necessary support. It
also provided a roadmap, which is now being utilized to design the pilot program.
24
To understand causal factors from a mental health perspective, Ward et al. (2013)
illuminated how identified cultural problems can impact the mental health of Black women and
the larger Black unit they support. The Strong Black Woman (SBW) concept encompasses layers
of history as to the impact incurred by Black women attempting to operate solely by themselves.
Green (2019) understands the Strong Black Woman concept as a coping mechanism acquired
culturally from other Black woman figures, which filters in social learning theory and how it can
be utilized to support this pilot program. Due to the weight the SBW concept carries, the level of
depression experienced by women within this role and the risk of suicidality they may
experience due to this role may not be uncommon. Ward et al. (2013) and Green (2019) created
gateways to understanding the potentially deadly impact the strong Black woman can experience
due to a cultural mindset passed through generations.
The pilot program creates non-clinical, supportive, nurturing, and socially connecting
environments for Black grandmothers to engage. Due to shifts in family dynamics and parental
requirements for aid, they may depend on the extended family, such as grandparents, to help with
their children (Baker et al., 2008). Partnering with Voices of Black Grandmothers will allow an
expert organization to advocate for and advance the importance of Black grandmothers uniting in
nurturing environments to break down barriers that lead to social isolation and diminish their
overall mental health and well-being.
The program will be effective through peer support of those with lived experience and the
use of evidence-based tools for educational purposes, such as the UCLA Loneliness scale
(Russell et al., 1978; Steptoe et al., 2013), the Toronto Empathy Questionnaire (Spreng et al.,
2009), the GAD-2 which measures levels of anxiety (Sapra et al., 2020), and the PHQ-2 which
25
measures levels of depression, grandmothers can receive educational support increasing their
awareness of mental health and wellness tools (see Appendix E). Ward and Heidrich (2009)
presented results from their study highlighting Black women’s beliefs about mental illness, to
include family-related stress and social stressors as causes of mental health issues. As such, it
was pertinent to incorporate a component of mental health education by presenting various
screens into the design of the program for Black grandmothers to understand their mental health
better. The pilot program will support Black grandmothers in environments that have shown to
be successful when led by peers. In addition, as studies reveal, peer-led interventions can
significantly help to reduce stigma, as Sun et al. (2022) reported. A logic model of the program
has been included to further expound upon the program’s design (see Appendix C).
Solution Landscape
Belonging as Black Women: Black Grandmothers pilot program will seek to answer the
following: 1. Is an evidence-informed training manual beneficial to the education of Black
grandmothers in becoming a peer-facilitator, and 2. Can non-clinical, peer-led social support
circles for Black grandmothers, ages 45 to 65, increase a sense of belongingness, support, and
social connection when led by a peer Black grandmother?
The pilot program collaborates with the Voices of Black Grandmothers, an organization
located in the Midwest, in Illinois. The Voices of Black Grandmothers are professional women
who identify as Black grandmothers and seek to establish connections with other Black
grandmothers in empowering and supportive environments (Voices of Black Grandmothers,
online, 2023).
26
The proposed solution is to offer monthly, virtual, non-clinical, peer-led support circles.
Wade et al. (2022) describe the term peer-led as an interchangeable term with terms such as peersupport, peer-mentor, or peer-advocate. Additionally, Wade et al. (2022) define peer-led as a
voluntary action in which an individual steps up and leads a group of peers to work towards a
specific outcome. The uniqueness of the program is that the peer-led circles will be facilitated by
“Grands” (Black grandmothers) who have gone through a three-hour peer facilitator training,
which will include evidence-informed components of primary mental health education, self-care
and wellness education, communication, and peer support education, and a one-to-one individual
coaching session that will specifically support each Grand in their co-facilitation process to
become a grand facilitator for the peer-led sessions.
The pilot program aims to provide access to virtual, peer-led connection circles for Black
grandmothers beginning in the Midwest region. Following will be the scaling of the program to
have at least one trained Black grandmother as a grand facilitator, leading a support circle in
every region within the United States, by December of 2024 while being empathetic to the
expressed needs of support and connection for all Black Grandmothers.
The pilot program focused on the Midwest region and is housed within the Midwest
region of the United States as of 2023. Indiana and Illinois are the two states within the Midwest
region that supported the pilot launch. The objective is for the program to extend its reach to
additional regions, with the aim of having each region within the United States take ownership of
the program’s operations of support circles. Incorporating region-specific resources and
addressing the specific needs of the Black grandmothers in each region is vital to the program’s
existence.
27
In December 2022, a landscape analysis was conducted through a virtual session with
seven Black grandmothers. The survey gathered data regarding social connections, receiving
support from, or providing assistance to other Black grandmothers. The feedback received from
the survey was utilized to begin the ideation process in crafting the structure of the pilot
program. Tolbert-Banks (2022) conducted a survey in which seven Black grandmothers (n=7)
reported that connecting with other Black women in a group session is helpful. Additionally, all
seven participants (n=7) stated that the connection session held was helpful for them (See
Appendix F).
VIII. Methodology
The five stages of the design thinking process were used to develop the capstone project.
The five stages were an intricate component to the design of the program’s final product. An
evidence-informed training manual was designed to train Black grandmothers on facilitation
skills necessary for leading support circles for Black grandmothers. In designing a quality
product, it was helpful to use each step of the five stages of the design thinking process:
empathize, define, ideate, prototype, and test.
Initially, research was conducted through interviews and a quantitative and qualitative
survey to obtain information from and better understand Black women’s needs regarding social
connectivity. Next, from the collected responses, the needs and problems identified were used to
design a grand facilitator training for Black grandmothers, which would be designed as a peerled model. A prototype of the training manual was designed and used to conduct the facilitator
training with three Black grandmothers. Finally, to test the prototype, one Black grandmother
28
successfully facilitated a virtual support circle of Black grandmothers by using the skills learned
in the facilitator training.
The support circles for Black grandmothers are peer-led by a grandmother who has
attended and completed a three-hour facilitator training program. The criteria for acceptance into
the facilitator training program are as follows:
1. Identify as a Black grandmother
2. Age 45+
3. A current member of Voices of Black Grandmothers
4. A member for at least one year with Voices of Black Grandmothers
5. Agree to attend and complete one three-hour virtual facilitator training and co-facilitate two
support circles
Each individual accepted into the facilitator training program needed to identify as a
Black grandmother and be at least 45 years old. Additionally, the program partner considered
being a Voices of Black Grandmothers member for at least one year as critical, as it would add
substance to the program and demonstrate dedication to Black grandmothers. Appendix G
presents a visual detailing the five design thinking steps related to the intervention and criteria
design.
IX. Implementation Plan/Strategy
The pilot program was implemented in five stages (see Appendix H). The first phase
involved conducting focus groups with Black grandmothers to determine stakeholder interest in
attending monthly support circles and their interest in becoming peer facilitators of the support
circles. In the second phase, grandmothers who participated in support circles were required to
29
complete an application expressing their interest in becoming grand facilitators. The third phase
involved completing the facilitator training, organized for the grandmothers invited to participate
in the facilitator skills training. The fourth stage consisted of grandmothers who had completed
the facilitator skills training, using their learned skills by co-facilitating in a live support circle.
The fifth and final phase is certification, occurring after grandmothers have completed the four
stages required to become a grand facilitator.
During the third phase, the facilitator training for grandmothers, the prototype of the
training manual was utilized in a two-hour training session. The qualitative and quantitative
feedback from participant surveys (n=3) was used to update and add content to the training
manual after the initial training session in preparation for its second iteration. The training
manual (see Appendix B) was critical in training grandmothers on using facilitation skills to
facilitate virtual support circles. After receiving feedback from stakeholders, it was determined
that the facilitator training would be increased to a three-hour session.
EPIS Implementation Framework
Barriers and Facilitators: Inner Context
The barriers and facilitators within the inner and outer context of the EPIS
implementation framework are divided into four stages: exploration, preparation,
implementation, and sustainment. George et al. (2014) provide insight into 44 articles
highlighting various barriers and facilitators affecting the participation of racial and ethnic
minorities in research; their work highlights the significance of including diverse racial and
ethnic groups in research studies. As the pilot program is specifically designed to serve Black
women, it is critical to have stakeholders’ active participation and valuable feedback to ensure
30
effective program development. The grid shown in Appendix I details the four stages of the EPIS
Framework’s inner context.
Barriers and Facilitators: Outer Context
The table presented in Appendix I provides the four constructs of the EPIS Framework
and the potential barriers to funding in the outer context. Within the exploration stage, exploring
various partnerships and funding avenues, such as community grants, will allow leadership to
identify existing funding that can be utilized to implement the pilot program, beginning with
local, state, and community-specific grants. During the implementation phase, grant dollars may
be acquired and contracts signed, providing funds to cover training the grand facilitators
(grandmothers). Ensuring the pilot program lead and program partner can oversee the program's
success and monitor the funding/budgets through the secured grant is essential to the
implementation phase. Additionally, the grand facilitators (grandmothers) will ensure that they
attend and complete the facilitation skills training and can provide appropriate information
detailing their experience as needed to report to the funder as an outcome.
Financial Plan Summary
The financial plan for the pilot program is presented in two components. Firstly, the
startup costs for the program will be provided, followed by the overall operating expenses
(Appendix J). Secondly, a budget summary will be outlined to discuss the costs of training
grandmothers to become trained facilitators.
31
The program will seek an initial startup grant of $10K. Additional funds will come from
private donations, an annual campaign, and in-kind contributions estimated for year one. The
startup costs include a virtual office (Zoom), which will be utilized to support the monthly
support circle meetings as well as any additional programmatic or community meetings that may
be required, the costs of a computer and printer used for running meetings and conducting
program administrative work, and costs for the cloud-based survey management program which
will be used to collect and track qualitative and quantitative data from stakeholders and other
programmatic data needs. All program and funding meetings will be held virtually, except for
one in-person meeting that will be held annually to bring the program founder, program partner,
and any volunteers together to discuss the startup year and plan for the next fiscal year.
Two facilitator trainings will host eight (8) grandmothers to become grand facilitators and
run the monthly support circle meetings. Additionally, grand facilitators will be able to attend
one educational skills training session each quarter, which will last one hour. Once grandmothers
have completed the 3-hour facilitator training, they will be scheduled to complete two (2) cofacilitation sessions in which they will lead a support circle. They will be eligible to receive a
$100 stipend for each of the two support circle sessions they lead. Grandmothers will receive a
packet via postal mail, including their training manual, any relevant handouts and fliers
supporting the Belonging as Black Women: Black Grandmothers program, and instructions on
the training, facilitation, and final application process to become a trained grand facilitator.
In preparation for the next fiscal year, 2025, a plan will be discussed to design a train-thetrainer program that will allow organizations to identify an individual to be trained who can
32
utilize the curriculum to train other individuals within their organization, ministry, or community.
The train-the-trainer program will be at a cost, meaning each individual who attends will become
certified after completing the training and purchasing a license to use the curriculum-designed
program. Additionally, the program founder will conduct a needs assessment of local and
nationwide senior centers that may need trained grand facilitators to host support circles for their
older adults.
Operating expenses include the costs for the corporate trainer who will train the
grandmothers using the facilitator curriculum in two separate facilitator trainings, one offered in
the spring and the other offered in the fall of 2024. Since it will be essential to remain educated
on older adults and any new research that may be prevalent in the program’s operation, training
and professional development funds have been allocated to cover continuing education costs.
Methods for Assessment
Several individuals assisted in ensuring that program goals and updates regarding the
pilot program were accomplished. The program’s future success will depend on a robust
communication plan outlining the tasks of the involved parties (see Appendix K). Germaine et al.
(2020) highlight the key benefits of a solid communication plan that incorporates clear
messaging, an understanding of what is being communicated on both sides, and the ability for
individuals to provide feedback.
Additionally, quantitative and qualitative surveys have been used throughout the pilot
program to obtain data and assess program outcomes from stakeholders regarding critical
components of the program. To gather initial information from grandmothers who would enroll
33
in the grand facilitator training, each grandmother (n=4) completed an electronic application.
Data was captured from the grandmothers, including quantitive and qualitative responses. (see
Appendix F).
Data has been obtained from stakeholders and the program partner regarding aspects of
the program, including the development of the focus groups, application process, notification of
successful application and acceptance into the grand facilitator training, grand facilitator training,
and finally, the co-facilitation of support circles. Lorentzen and Hedvall (2018) discuss the
importance of empathic modeling in the design process to bridge design with building empathy
for human diversity, which was a significant focus in the design of the pilot program.
Regularly connecting with grandmothers to disseminate information about the facilitator
training schedule, peer-led support circles, or other program needs will be conducted through
disseminating fliers or communicating updates through the program partner. Additionally, an
informational website will house basic information about the program and will be available for
grandmothers to access (see Appendix D).
Challenges
There were two identified challenges within the pilot program. The stakeholders were
vital to the design and evaluation of the program. The quantitative and qualitative data collected
from surveys and the verbal feedback from grandmothers in training and the program partner
provided insight into areas of the program design that could be improved.
The first identified challenge was determining a time to train interested Black
grandmothers to become Grand Facilitators. The challenge was that grandmothers were available
at different times, on various days of the week, lived in different time zones within the United
34
States, or were only available on weekends due to other commitments throughout the week. It
was decided that within each cohort, two dates and timeframes would be offered to
grandmothers, and the date and time that most grandmothers could attend would be chosen. An
example is the first cohort of grandmothers trained (n=3), which was conducted on a Sunday, and
an alternative option given was to have a second training for grandmothers, in which the date and
time would be set based upon the next set of qualifying data received. For example, if
grandmothers chose Wednesday evenings at 6:30 pm EST as the second best option, this would
be the time for a second facilitator training.
The second challenge identified was determining how many grandmothers the program
would train within the pilot program. During an initial pilot program design meeting to include
the pilot program partner, Voices of Black Grandmothers, it was initially decided to train a
minimum of six grandmothers and a maximum of eight grandmothers. After the first facilitator
training in June 2023, three grandmothers were trained as facilitators; it was decided that each
facilitator training could train a maximum of six grandmothers. The benefit of smaller training
groups is that each grandmother can have an in-depth and engaged experience with the trainer
the training content provided, and socialize with other grandmothers in training.
Regarding leadership, it is crucial to have solid leadership to direct, support, and identify
problems and solutions within the design and running of a program. Azad et al. (2017) discuss
various components of leadership and management, stating that leading and managing are vital
components to the success of a team. As a leader for the pilot program, being able to delegate
was a critical component in asking for support when necessary and entrusting others to complete
tasks toward the identified goal. Also, a positive attitude sets a positive tone for the team and
35
stakeholders. The team who collaborated on this pilot program came with positive attitudes and
could set short and long-term goals, engage in crucial conversations, and create solutions for
problems that occurred.
Another leadership strategy beneficial in designing and implementing the program was
being open to suggestions. This leadership strategy creates an open-door policy for welcoming
suggestions and utilizing the feedback received from stakeholders and design partners. This
strategy builds trust and transparency in that those involved know their opinions will be heard
and that their voice matters, which aligns with the design justice principles. As the pilot program
has been successfully implemented, receiving feedback from participants through quantitative
and qualitative surveys provides insight into the stakeholders’ use of the program and specific
feedback regarding how it impacted them and met their needs (see Appendix F).
Ethical Consideration and Applying Design Justice Principles
Costanza-Chock (2018) highlights the importance of design justice as a social movement
that should challenge the dominant systems that may oppress the intent of a design to ensure
equitable distribution and fairness within the design. One key element of the design of the
support circles is to ensure participant confidentiality. Malhotra and Baker (2022) discuss the
importance of having a set of guidelines to discuss confidentiality. Confidentiality was addressed
in training module three of the grand facilitator training, which educates participants on
facilitation skills. This section addresses the ethics of confidentiality and ensures that each
participant, including the facilitator, adheres to the group agreements and honors confidentiality
as required within each support circle due to the nature of personal information shared amongst
group members.
36
Additionally, designing the training manual for Black grandmothers was detrimental to its
validity in utilizing evidence-informed research to support the content presented. For example,
understanding that using only the editor’s perspective in designing and writing the manual could
bring about negative consequences, such as distributing outdated or incorrect information, which
could potentially impact the trust that the community of grandmothers has in the pilot program or
the designer of the manual. Due to the content being driven by a personal perspective rather than
reliable research, grandmothers may be less apt to participate, damaging the desired outcome of
having Black grandmothers as trained facilitators. The third design justice principle addresses
designing for those served within the community rather than designing based on the editor’s
intentions (Designjustice.org, 2018). It, therefore, aligns with designing the intervention with the
grandmothers as the focal point.
Lastly, in understanding the importance of the design justice principles, they were
strongly considered in the design process and layout for the training manual and how they could
be incorporated into the training for Black grandmothers. The design justice principles were also
utilized within the support circle environment to ensure the inclusivity of all members and that
each grandmother entered and left the space empowered by the environment. The first design
justice principle speaks to an awareness of the exploitative and oppressive systems that have
impacted communities and design in a way that brings healing and empowers the community as
a system (Designjustice.org, online, 2018).
X. Lessons Learned
Design thinking is critical in co-creating a program from the ground up. Torkildsby
(2018) highlights the importance of considering all aspects of design thinking, including the dark
37
aspects of the process. It is a unique process that bridges the thought processes of individuals
into a chaotically organized formula used to build something tangible. The pilot program utilized
design thinking to create a prototype incorporating the stakeholders' input as a vital design
component. Without the element of design thinking, a critical component of the pilot program’s
build would have been missed, and the opportunity to design an authentic program for Black
grandmothers would have been prosaic.
Community partnerships, stakeholder engagement, networking, and research were critical
to the design and success of the prototype and pilot program. Designing the prototype and pilot
program as an isolated task could not be possible, and they could only be scaled and taken to the
next level with continued partnerships and design thinking, which is a critical part of the success
of the expanded program (see Appendix C).
Having multiple hands at the table, ready to engage and do the work, is an extreme
benefit. Implementing a program and providing positive outcomes for communities in need, who
can access necessary programs or services, such as the pilot program, is even more
advantageous. Although the work may be difficult, and the laborers may be scarce, the positive
outcomes far exceed the scarcity. In the vital concept of empathizing, the user’s needs remain the
central focus of the design throughout the design thinking process, which is vital to the success
and implementation of the design (THI-HUYEN et al., 2021).
This model has a moderate to high likelihood of success as it has been piloted and data
collected discussing the benefits from the perspectives of stakeholders who have firsthand
involvement with the facilitator training component of the pilot program. The program can be
scaled within the Black community and utilized with grandmothers from other ethnic and racial
38
backgrounds in various communities, such as assisted living communities or rural communities.
Alterations made to the delivery of the model would be to ensure the program is delivered to
meet the needs of the program participants. For example, within a rural community, the program
may be delivered by phone instead of through a virtual, computer-based setting due to the
potential lack of inadequate broadband connections seen within rural communities (ValentínSívico et al., 2023).
XI. Conclusion and Implications
In multiple ways, grandparents' role is critical within families, as they have a supportive
role in their families' functioning and stability, as Michel et al. (2023) described. Although the
mixed-method study by Michel et al. (2023) discusses how grandparents are affected
psychosocially when their grandchildren are diagnosed with cancer, a critical component of the
article highlights that literature often negates research surrounding grandparents.
Research regarding grandparents has been found during the nine-month research period
for the pilot program, from January to September 2023. However, research about Black
grandmothers, social support, and access is limited, particularly regarding resources that offer a
more robust perspective on how Black grandmothers can gain access to available support.
The Belonging as Black Women: Black Grandmothers pilot program has afforded Black
grandmothers access to research to understand better the benefits of social support circles
(networks), which are sacred spaces in which they can divulge topics that are impacting them,
their grandchild(ren), or families, and engage in ways that allow them the ability to maintain
support by attending support circles with other Black grandmothers.
39
The pilot program has given Black grandmothers (n=3) the opportunity to be educated
and trained as grand peer facilitators using evidence-informed training, and additional
grandmothers (n=2) will be trained in quarter one of 2024. Grandmothers (n=3) who have
attended and completed the grand facilitator training have begun to share their experience and
knowledge about the grand facilitator training with other Black grandmothers. The results of this
shared knowledge from their peers and feedback from qualitative and quantitative surveys have
provided other Black grandmothers with insight, leading to an interest in becoming trained as
grand facilitators.
Wisniewski et al. (2020) discussed the results from a meta-analysis on the use and impact
of feedback and how it could be used to interpret data received. Feedback from the quantitative
and qualitative surveys used throughout the pilot program has been instrumental in the program’s
design and iterative processes. Likewise, the survey feedback has also been utilized to educate
Black grandmothers on an opportunity to be trained through an evidence-informed curriculum
that will allow them to serve and support other Black grandmothers in communities throughout
the United States.
The implications of the pilot program concluded that social connection is vital to the
mental health and wellness of Black grandmothers, dissipating social isolation and increasing
social connection. It is critical to understand stakeholder engagement as a vital component of the
pilot program’s outcomes (Goodman & Thompson, 2017). Additionally, peer-led social
environments enable Black grandmothers to support and engage in systems that are not easily
accessible or available for Black women within the United States. The pilot program allowed
Black grandmothers to support group participants and the grand facilitator, demonstrating the
40
importance of support circles for all participants. Magnani et al. (2017) corroborate the
correlation between support group participation, decreased feelings of isolation, and improved
perception of an individual’s condition.
As Black grandmothers reported in quantitative and qualitative surveys collected by
Tolbert-Banks (2023) throughout the pilot program, there is a need for peer-led facilitated
support circles for Black grandmothers (see Appendix F). Identifying communities that would
benefit from piloting peer-led support circles with trained Black grandmothers can create access
to environments that benefit from culturally diverse services. For example, using the framework
constructed for the Belonging as Black Women: Black Grandmothers pilot program could afford
access to grandmothers in other communities who may be isolated or lack access to social
connections, such as within rural communities within the United States. Beginning the first
quarter (January to March) of 2024, it is critical to conduct a needs assessment in communities
that require a specialized program that provides access to grandmothers who are isolated.
Social support circles led by Black grandmothers, a population that has been socially
isolated, subjected to systemic racism, and largely forgotten in an inequitable American culture,
may be beneficial in breaking down barriers through collaborative partnerships within
communities that are unaware of the experiences, wealth of knowledge, and cultural richness that
this community of women possesses.
Creating avenues, such as the Belonging as Black Women: Black Grandmothers pilot
program, can significantly alter the service accessibility landscape, particularly in fostering
social connection and decreasing isolation amongst underserved populations. In 2024, the goal is
to increase the number of Black grandmothers trained in the United States who will offer
41
facilitated peer-led virtual support circles. Four grandmothers will be trained within the first six
months of 2024, and an additional four will be trained in the remaining six months of 2024.
As the population of older adults continues to grow annually, it is critical to increase access to
services that benefit their mental health, well-being, and positive social impact (Bergman &
Segel-Karpas, 2021; Kang & Kim, 2022). Ultimately, instilling hope and empathy and
empowering communities to be less socially isolated and more socially engaged positively
impact individuals, their families, and the communities in which they reside. The positive or
negative impact is a systemic issue that affects us all.
42
APPE
NDICES
Appendix A
43
Appendix B
44
Appendix C
45
Appendix D
The link to the Belonging as Black Women: Black Grandmothers Pilot Program website:
https://belongingasblackwomen.carrd.co/#work
Sample pilot program flier
46
Appendix E
47
Appendix E (con’t)
48
Appendix E (con’t)
49
Appendix E (con’t)
50
Appendix F
51
Appendix F (con’t)
52
Appendix F (con’t)
53
Appendix G
54
Appendix H
55
Appendix I
INNER CONTEXT EXPLORATION PREPARATION IMPLEMENTATION SUSTAINMENT
Leadership of
organization(s) may not
initially trust pilot
program lead without
established relationship;
Organization(s) may not
buy-in to the pilot
program intervention to
serve indicated
population
Identifying key
stakeholders within
partner organization, with
volunteers and
community leaders
What might the attitudes
of the leadership be
towards pilot program?
Barrier: If leadership has
a negative attitude
toward the pilot program
or program lead, this can
transferred to any key
staff or organizational
volunteers who may be
involved within the
program and become a
barrier within the inner
context.
In preparing to
implement the
Belonging as Black
Women: Black
Grandmothers Pilot
Program it is important
to understand the roles
of those within
leadership who will be
involved, how many
individuals will be
incorporated into the
planning and
preparation of
implementing the
program.
What is the skill set of
the leadership and their
knowledge of support
circles and facilitation
skills and whether or
not it would require a
pre-educational
course/training to
educate the leadership
prior to implementation
of training within the
identified population
Barrier: Lack of
preparation by
leadership to move into
the implementation
stage; lack of time
management in
accomplishing required
tasks in preparation
stage.
Identifying the skill set of
the leadership involved
with the pilot program.
Identifying the level of
motivation of leadership
to work towards
implementation of the
pilot program.
Identifying who amongst
leadership will implement
pilot program and who
will monitor progress of
goals in program
implementation within
the community.
Barrier: Lack motivation
to engage in tasks to be
completed to implement
the pilot program; lack of
leadership may impact
the efficacy of the pilot
program being
implemented within
identified community.
Leadership lacks
required skill set to aid in
implementation of the
pilot program
Sustaining the pilot
program and its
offerings within the
community/amongst
the identified
population
Barrier: Leadership
may not continue to
engage stakeholders
to continue offering
the pilot program.
Leadership may not
meet guidelines of
the contract in which
funding is received
to pilot the program,
therefore, funding
could be affected/
eliminated which can
impact the outer
context.
FACILITATORS
(People;
stakeholders;
strengths)
Program Founder,
Program Partner,
Community leaders,
Volunteers
Program Founder,
Program Partner,
Volunteers
Program Founder,
Program Partner,
volunteers
Utilize a leadership style
questionnaire to assess
leadership style/skills
Program Founder,
Program Partner,
Volunteers,
Community leaders
56
Appendix I (con’t)
57
Appendix J
58
Appendix K
59
Appendix L
The link to the grand facilitator training manual flip book is below:
https://online.fliphtml5.com/yiqam/rjah/#p=1
60
References
Aaron, S., Gazaway, S., Harrell, E., & Elk, R. (2021). Disparities and Racism
Experienced Among Older African Americans Nearing End of Life. Current geriatrics
reports, 10(4), 157–166. https://doi.org/10.1007/s13670-021-00366-6
Alcaraz, K., Eddens, K., Blase, J., Diver, W., Patel, A., Teras, L., Stevens, V.,
Jacobs, E., & Gapstur, S. (2019). Social Isolation and Mortality in US Black and
White Men and Women. American journal of epidemiology, 188(1), 102–109.
doi.org/10.1093/aje/kwy231
Allen, K., Gray, D., Baumeister, R., & Leary, M. (2022). The Need to Belong: a Deep Dive into
the Origins, Implications, and Future of a Foundational Construct. Educational
psychology review, 34(2), 1133–1156. https://doi.org/10.1007/s10648-021-09633-6
Altman, M., Huang, T. T. K., & Breland, J. (2018). Design Thinking in Health Care. Preventing
chronic disease, 15, E117. https://doi.org/10.5888/pcd15.180128
America Brief Issue. (2008). The state of mental health and aging in America. Online. https://
www.cdc.gov/aging/pdf/mental_health.pdf
American Psychiatric Association. 2017. Mental health facts for African Americans. 1-4.
https:// www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/MentalHealth-Disparities/Mental-Health-Facts-for-African-Americans.pdf
Azad, N., Anderson, H. G., Jr, Brooks, A., Garza, O., O'Neil, C., Stutz, M. M., & Sobotka, J. L.
(2017). Leadership and Management Are One and the Same. American journal of
pharmaceutical education, 81(6), 102. https://doi.org/10.5688/ajpe816102
61
Baker, L., Silverstein, M., & Putney, N. (2008). Grandparents Raising Grandchildren in the
United States: Changing Family Forms, Stagnant Social Policies. Journal of societal &
social policy, 7, 53–69.
Belonging As Black Women: Black Grandmothers Pilot Program. (2023). Homepage. Online.
https://belongingasblackwomen.carrd.co/#work
Bergman, Y. S., & Segel-Karpas, D. (2021). Aging anxiety, loneliness, and depressive symptoms
among middle-aged adults: The moderating role of ageism. Journal of affective
disorders, 290, 89–92. https://doi.org/10.1016/j.jad.2021.04.077
Brandt, L., Liu, S., Heim, C., & Heinz, A. (2022). The effects of social isolation stress and
discrimination on mental health. Translational psychiatry, 12(1), 398. https://doi.org/
10.1038/s41398-022-02178-4
Buettner, D., & Skemp, S. (2016). Blue Zones: Lessons From the World's Longest Lived.
American journal of lifestyle medicine, 10(5), 318–321. https://doi.org/
10.1177/1559827616637066
Campbell, T. 2020. Social isolation, loneliness and health in the time of COVID. Arch
Community Med Public Health, 6(1), 102-103. doi: 10.17352/2455-5479.000087
Carbado, D.., Crenshaw, K., Mays, V., & Tomlinson, B. (2013). INTERSECTIONALITY:
Mapping the Movements of a Theory. Du Bois review : social science research on
race, 10(2), 303–312. https://doi.org/10.1017/S1742058X13000349
Chinn, J. J., Martin, I. K., & Redmond, N. (2021). Health Equity Among Black Women in the
United States. Journal of women's health (2002), 30(2), 212–219. https://doi.org/
10.1089/jwh.2020.8868
62
Chmielowska, M., Mannocci, N., Tansel, A., & Zisman-Ilani, Y. (2022). Peer support and shared
decision making in Open Dialogue: Opportunities and recommendations. Frontiers in
psychology, 13, 1059412. https://doi.org/10.3389/fpsyg.2022.1059412
Conner, K., Copeland, V., Grote, N., Rosen, D., Albert, S., McMurray, M., Reynolds,
C., Brown, C., & Koeske, G. (2010). Barriers to treatment and culturally endorsed
coping strategies among depressed African-American older adults. Aging & mental
health, 14(8), 971–983. https://doi.org/10.1080/13607863.2010.501061
Cook, B., Hou, S., Lee-Tauler, S., Progovac, A., Samson, F., & Sanchez, M. 2019. A Review
of Mental Health and Mental Health Care Disparities Research: 2011-2014. Medical
Care Research and Review, 76(6), 683–710. https://doi.org/10.1177/1077558718780592
Costanza-Chock, S. (2018) Design Justice: towards an intersectional feminist framework for
design theory and practice, in Storni, C., Leahy, K., McMahon, M., Lloyd, P. and
Bohemia, E. (eds.), Design as a catalyst for change - DRS International Conference
2018, 25-28 June, Limerick, Ireland. https://doi.org/ 10.21606/drs.2018.679
Czaja, S., Moxley, J., & Rogers, W. (2021). Social Support, Isolation, Loneliness, and Health
Among Older Adults in the PRISM Randomized Controlled Trial. Frontiers in
psychology, 12, 728658. https://doi.org/10.3389/fpsyg.2021.728658
Design Justice Network. (2018). Design Justice Network Principles. Online. https://
designjustice.org/read-the-principles
Dewald-Kaufmann, J., Wüstenberg, T., Barton, B., Goerigk, S., Reinhard, M., Musil, R., Werle,
J., Falkai, P., Jobst, A., & Padberg, F. (2021). Dynamics of the immediate behavioral
63
response to partial social exclusion. Scientific reports, 11(1), 1853. https://doi.org/
10.1038/s41598-020-80039-0
Domenech-Rodríguez, M., & Wieling, E. (Eds.) (2005). Developing culturally appropriate,
evidence-based treatments for interventions with ethnic minority populations. SAGE
Publications, Inc. https://doi.org/10.4135/9781452231662
Due, T., Kousgaard, M., Waldorff, F., & Thorsen, T. (2018). Influences of peer facilitation in
general practice - a qualitative study. BMC family practice, 19(1), 75. https://doi.org/
10.1186/s12875-018-0762-1
Fernando, S., Brown, T., Datta, K., Chidhanguro, D., Tavengwa, N., Chandna, J., Munetsi, E.,
Dzapasi, L., Nyachowe, C., Mutasa, B., Chasekwa, B., Ntozini, R., Chibanda, D., &
Prendergast, A. (2021). The Friendship Bench as a brief psychological intervention
with peer support in rural Zimbabwean women: a mixed methods pilot evaluation.
Fortuna, K. L., Solomon, P., & Rivera, J. (2022). An Update of Peer Support/Peer Provided
Services Underlying Processes, Benefits, and Critical Ingredients. The Psychiatric
quarterly, 93(2), 571–586. https://doi.org/10.1007/s11126-022-09971-w
Friendship Bench. (2023). Circle Kubatana Tose. Online. https://
www.friendshipbenchzimbabwe.org/ckt
Fuss, B., Dorstyn, D., & Ward, L. (2021). Belonging in the Online World: Older Adults' Use of
Internet for Community. Journal of Social Inclusion, 12(2), 2-29. https://
digital.library.adelaide.edu.au/dspace/bitstream/2440/134842/2/hdl_134842.pdf
64
Gardiner, C., Geldenhuys, G., & Gott, M. (2018). Interventions to reduce social isolation and
loneliness among older people: an integrative review. Health & social care in the
community, 26(2), 147–157. https://doi.org/10.1111/hsc.12367
George, S., Duran, N., & Norris, K. (2014). A systematic review of barriers and facilitators to
minority research participation among African Americans, Latinos, Asian Americans,
and Pacific Islanders. American journal of public health, 104(2), e16–e31. https://
doi.org/10.2105/AJPH.2013.301706
Germaine, P., Catanzano, T., Patel, A., Mohan, A., Patel, K., Pryluck, D., & Cooke, E. (2021).
Communication Strategies and Our Learners. Current problems in diagnostic radiology,
50(3), 297–300. https://doi.org/10.1067/j.cpradiol.2020.10.009
Global mental health (Cambridge, England), 8, e31. https://doi.org/10.1017/gmh.2021.32
Goodman, M., & Sanders Thompson, V. (2017). The science of stakeholder engagement in
research: classification, implementation, and evaluation. Translational behavioral
medicine, 7(3), 486–491. https://doi.org/10.1007/s13142-017-0495-z
Grand Challenges for Social Work. (2018). Eradicate Social Isolation. GC Fact Sheet No. 5.
Online. https://grandchallengesforsocialwork.org/wp-content/uploads/2015/12/180604-
GC-social-isolation.pdf
Green, B. (2019). Strong Like My Mama: The Legacy of “Strength,” Depression, and Suicidality
in African American Women. Women & Therapy, 42. 1-24. https://doi.org/
10.1080/02703149.2019.1622909
65
Gronholm, P., Henderson, C., Deb, T., & Thornicroft, G. 2017. Interventions to reduce
discrimination and stigma: the state of the art. Social psychiatry and psychiatric
epidemiology, 52(3), 249–258. https://doi.org/10.1007/s00127-017-1341-9
Harandi, T., Taghinasab, M., & Nayeri, T. 2017. The correlation of social support with
mental health: A meta-analysis. Electronic physician, 9(9), 5212–5222. https://doi.org/
10.19082/5212
Henderson, C., Evans-Lacko, S., & Thornicroft, G. 2013. Mental illness stigma, help seeking,
and public health programs. American journal of public health, 103(5), 777–780. doi.org/
10.2105/AJPH.2012.301056
Jimenez, J. (2002). The History of Grandmothers in the African-American Community. Social
Service Review, 76(4), 523–551. https://doi.org/10.1086/342994
Jones, T., Baxter, M., & Khanduja, V. (2013). A quick guide to survey research. Annals of the
Royal College of Surgeons of England, 95(1), 5–7. https://doi.org/
10.1308/003588413X13511609956372
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better
mental health. American Psychologist, 67(3), 231–243. https://doi.org/10.1037/
a0025957
Kalinowski, J., Wurtz, H., Baird, M., & Willen, S. (2022). Shouldering the load yet again: Black
women's experiences of stress during COVID-19. SSM. Mental health, 2, 100140.
https:// doi.org/10.1016/j.ssmmh.2022.100140
Kamvura, T., Turner, J., Chiriseri, E., Dambi, J., Verhey, R., & Chibanda, D. (2021). Using a
theory of change to develop an integrated intervention for depression, diabetes and
66
hypertension in Zimbabwe: lessons from the Friendship Bench project. BMC health
services research, 21(1), 928. https://doi.org/10.1186/s12913-021-06957-5
Kang, H., & Kim, H. (2022). Ageism and Psychological Well-Being Among Older Adults: A
Systematic Review. Gerontology & geriatric medicine, 8, 23337214221087023. https://
doi.org/10.1177/23337214221087023
Keller, S., McNeill, V., Honea, J., & Paulson Miller, L. 2019. A Look at Culture and Stigma of
Suicide: Textual Analysis of Community Theatre Performances. International journal of
environmental research and public health, 16(3), 352. doi.org/10.3390/
ijerph16030352
Kelly, C., Kasperavicius, D., Duncan, D., Etherington, C., Giangregorio, L., Presseau, J., Sibley,
K. M., & Straus, S. (2021). 'Doing' or 'using' intersectionality? Opportunities and
challenges in incorporating intersectionality into knowledge translation theory and
practice. International journal for equity in health, 20(1), 187. https://doi.org/10.1186/
s12939-021-01509-z
Kondrat, M. (2013). Person-in-environment. Encyclopedia of social work. https://doi.org/
10.1093/acrefore/9780199975839.013.285
Kroenke, K., Spitzer, R., & Williams, J. (2003). The Patient Health Questionnaire-2: validity of a
two-item depression screener. Medical care, 41(11), 1284–1292. https://doi.org/
10.1097/01.MLR.0000093487.78664.3C
Lemberger-Truelove, T. (2018). Belonging, Striving, and Style of Life Among Black Women in
the Southwestern United States. The Journal of Individual Psychology, 74(1), 75-95.
https://doi:10.1353/jip.2018.0005
67
Lorentzen, L., & Hedvall, P. (2018). Bringing Human Diversity into Design Processes
Through Empathic Modelling. Studies in health technology and informatics, 256, 128–
136. https://pubmed.ncbi.nlm.nih.gov/30371467/
Magnani, D., Lenoci, G., Balduzzi, S., Artioli, G., & Ferri, P. (2017). Effectiveness of support
groups to improve the quality of life of people with idiopathic pulmonary fibrosis a prepost test pilot study. Acta bio-medica : Atenei Parmensis, 88(5S), 5–12. https://doi.org/
10.23750/abm.v88i5-S.6870
Malcolm, M., Frost, H., & Cowie, J. 2019. Loneliness and social isolation causal association
with health-related lifestyle risk in order adults: a systematic review and meta-analysis
protocol. Syst Rev 8, 48. doi.org/10.1186/s13643-019-0968-x
Malhotra, A., & Baker, J. (2022). Group Therapy. In StatPearls. StatPearls Publishing. https://
www.ncbi.nlm.nih.gov/books/NBK549812/
Martinez, A., & Hinshaw, S. 2016. Mental health stigma: Theory, developmental issues, and
research priorities. In D. Cicchetti (Ed.), Developmental psychopathology: Risk,
resilience, and intervention, 997–1039. https://doi.org/
10.1002/9781119125556.devpsy420
McCallum, S., Calear, A., Cherbuin, N., Farrer, L., Gulliver, A., Shou, Y., Dawel, A., &
Batterham, P. (2021). Associations of loneliness, belongingness and health behaviors
with psychological distress and wellbeing during COVID-19. Journal of affective
disorders reports, 6, 100214. https://doi.org/10.1016/j.jadr.2021.100214
Michel, G., Raguindin, P. F., Priboi, C., Ilic, A., Holmer, P., Scheinemann, K., & GROKids
Project (2023). Acute and long-term psychosocial consequences in grandparents when
68
a grandchild is diagnosed with cancer - the GROKids Project: a population-based
mixed- methods study protocol. BMC psychology, 11(1), 280. https://doi.org/10.1186/
s40359-023-01309-w
National Academies of Sciences, Engineering, and Medicine. (2020). Social Isolation and
Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC:
The National Academies Press.
National Alliance on Mental Illness. 2021. Online. Black/African American - Stigma. https://
www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American
Noone, C., McSharry, J., Smalle, M., Burns, A., Dwan, K., Devane, D., & Morrissey, E. C.
(2020). Video calls for reducing social isolation and loneliness in older people: a rapid
review. The Cochrane database of systematic reviews, 5(5), CD013632. https://doi.org/
10.1002/14651858.CD013632
Peer Support Space, Inc. (2019). About peer support space. Online. https://
peersupportspace.org/
Project Healthy Grandparents. (2023). About us. Online. https://phg.lewis.gsu.edu/
Razzaque, R., & Stockmann, T. (2016). An introduction to peer-supported open dialogue in
mental healthcare. BJPsych Advances, 22(5), 348-356. doi:10.1192/apt.bp.115.015230
Richards, E. (2021). The state of mental health of Black women: clinical considerations.
Psychiatric Times, 38(9), 1. https://www.psychiatrictimes.com/view/the-state-of-mentalhealth-of-black-women-clinical-considerations
Rivera, K., Zhang, J., Mohr, D., Wescott, A., & Pederson, A. (2021). A Narrative Review of
Mental Illness Stigma Reduction Interventions Among African Americans in The United
69
States. Journal of mental health & clinical psychology, 5(2), 20–31. https://doi.org/
10.29245/2578-2959/2021/2.1235
Russell, D., Peplau, L., & Ferguson, M. (1978). Developing a measure of loneliness. Journal of
personality assessment, 42(3), 290–294. https://doi.org/10.1207/s15327752jpa4203_11
Sapra, A., Bhandari, P., Sharma, S., Chanpura, T., & Lopp, L. (2020). Using Generalized Anxiety
Disorder-2 (GAD-2) and GAD-7 in a Primary Care Setting. Cureus, 12(5), e8224. https://
doi.org/10.7759/cureus.8224
Schwei, R., Hetzel, S., Kim, K., Mahoney, J., DeYoung, K., Frumer, J., Lanzafame, R.,
Madlof, J., Simpson, A., Zambrano-Morales, E., & Jacobs, E. (2021). Peer-to-Peer
Serpe, R., Stryker, R., Powell, B. (2020). Structural symbolic interaction and identity theory: the
Indiana school and beyond. In: Serve, R., Stryker, R., Powell, B. (eds) Identity and
Symbolic Interaction. Springer, Cham. https://doi.org/10.1007/978-3-030-41231-9_1
Sharma, N. P., & Gupta, V. (2022). Human Behavior in a Social Environment. In StatPearls.
StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/34662015/
Spreng, R. N., McKinnon, M. C., Mar, R. A., & Levine, B. (2009). The Toronto Empathy
Questionnaire: scale development and initial validation of a factor-analytic solution to
multiple empathy measures. Journal of personality assessment, 91(1), 62–71. https://
doi.org/10.1080/00223890802484381
Stangl, A., Earnshaw, V., Logie, C., van Brakel, W., C Simbayi, L., Barré, I., & Dovidio, J.
(2019). The Health Stigma and Discrimination Framework: a global, crosscutting
framework to inform research, intervention development, and policy on health-related
stigmas. BMC medicine, 17(1), 31. https://doi.org/10.1186/s12916-019-1271-3
70
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and
all-cause mortality in older men and women. Proceedings of the National Academy of
Sciences of the United States of America, 110(15), 5797–5801. https://doi.org/10.1073/
pnas.1219686110
Sumo, J., Dancy, B., Julion, W., & Wilbur, J. (2015). Rationales for Support That African
American Grandmothers Provide to Their Children Who Are Parenting Adolescents. The
Journal of school nursing : the official publication of the National Association of School
Nurses, 31(6), 441–449. https://doi.org/10.1177/1059840515572026
Support and Changes in Health and Well-being in Older Adults Over Time. JAMA
network open, 4(6), e2112441. https://doi.org/10.1001/jamanetworkopen.2021.12441
THI-HUYEN, N., XUAN-LAM, P., & THANH TU, N.T. (2021). The Impact of Design Thinking
on Problem Solving and Teamwork Mindset in A Flipped Classroom. Eurasian Journal of
Educational Research. Online. https://files.eric.ed.gov/fulltext/EJ1326262.pdf
Thomas, J., & McDonagh, D. (2013). Empathic design: Research strategies. The Australasian
medical journal, 6(1), 1–6. https://doi.org/10.4066/AMJ.2013.1575
Tolbert-Banks, N. (2022). Belonging as Black women survey.
Tolbert-Banks, N. (2023). Grand Facilitator post-training feedback survey.
Tolbert-Banks, N. (2022). My knowledge of Black women/culture feedback survey.
Torkildsby A. B. (2018). Empathy Enabled by Critical Design - A New Tool in the Universal
Design Toolbox. Studies in health technology and informatics, 256, 760–770.
Valentín-Sívico, J., Canfield, C., Low, S., & Gollnick, C. (2023). Evaluating the impact of
broadband access and internet use in a small underserved rural
71
community. Telecommunications policy, 47(4), 102499. https://doi.org/10.1016/
j.telpol.2023.102499
Veazie, S., Gilbert, J., Winchell, K., Paynter, R., & Guise, J. (2019). Addressing Social Isolation
To Improve the Health of Older Adults: A Rapid Review. Agency for Healthcare
Research and Quality (US).
Voices of Black Grandmothers. (2023). Who we are. Online. https://
www.voicesofblackgrandmothers.com/about
Wade, L., Leahy, A. A., Babic, M. J., Beauchamp, M. R., Smith, J. J., Kennedy, S. G., Boyer, J.,
Nathan, N., Robinson, K., & Lubans, D. R. (2022). A systematic review and metaanalysis of the benefits of school-based, peer-led interventions for leaders. Scientific
reports, 12(1), 21222. https://doi.org/10.1038/s41598-022-25662-9
Ward, E., Clark, leO., & Heidrich, S. (2009). African American Women's beliefs, coping
behaviors, and barriers to seeking mental health services. Qualitative health research,
19(11), 1589–1601. https://doi.org/10.1177/1049732309350686
Ward, E., & Heidrich, S. (2009). African American women's beliefs about mental illness,
stigma, and preferred coping behaviors. Research in nursing & health, 32(5), 480–492.
https://doi.org/10.1002/nur.20344
Williams D. R. (2018). Stress and the Mental Health of Populations of Color: Advancing Our
Understanding of Race-related Stressors. Journal of health and social behavior, 59(4),
466–485. https://doi.org/10.1177/0022146518814251
72
Wisniewski, B., Zierer, K., & Hattie, J. (2020). The Power of Feedback Revisited: A MetaAnalysis of Educational Feedback Research. Frontiers in psychology, 10, 3087. https://
doi.org/10.3389/fpsyg.2019.03087
Wong, E., Collins, R., Cerully, J., Seelam, R., & Roth, B. 2017. Racial and Ethnic Differences
in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental
Health Challenges. Rand health quarterly, 6(2), 6. https://www.ncbi.nlm.nih.gov/pmc/
articles/PMC5568160/
Womack, K. (2023). Plight of the working Black woman: work, cry, die. The Root. Online.
https://www.yahoo.com/lifestyle/plight-working-black-woman-cry-205000150.html
Wynn, P. (2023). How caregivers deal with anticipatory grief. Brain and Life. Online. https://
www.brainandlife.org/articles/how-caregivers-deal-with-anticipatory-grief?
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Tolbert-Banks, NaKaisha
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Belonging as Black women: Black grandmothers pilot program
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Suzanne Dworak-Peck School of Social Work
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Social Work
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belonging
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