Co-Creating and Evaluating Community-Based Kinship Navigator Programs for Our Use: Partnering with Lived Experience Experts of Informal Kinship Caregivers and Navigators to Profile Caregiving Challenges, Address Program Implementation, and Identify Mechanisms of Change in Caregiver Well-Being in Washington State

Abstract

Informal kinship caregivers comprise the majority of caregivers of maltreated children who cannot stay safely with their biological parents, especially grandparent-headed households (U.S. Census Bureau, 2023). Despite sharing similar challenges and service needs, informal kinship caregivers receive significantly less support and services compared to their formal counterparts (Denby, 2015; Lin, 2014; Pittman, 2023). The disparity persists in benefits and service opportunities between these two groups (Smith, 2018). However, kinship navigator programs can address this imbalance by catering to both formal, licensed kinship caregivers and informal, unlicensed caregivers. Kinship navigators help families negotiate complicated eligibility criteria, service gaps, and access barriers that exacerbate racial and class inequities (Gleeson, 2020). Consequently, kinship navigator programs possess the potential not only to support formal caregivers but also to reach informal caregivers who might not traditionally seek services. This approach aims to enhance community engagement and promote increased access to services, irrespective of the circumstances surrounding kinship care (Rushovich et al., 2021). To address the lack of research evidence concerning informal kinship care (Berrick & Hernandez, 2016) and the significance of prevention-related needs within informal kinship care as a strategy for preventing formal foster care placements (Brown et al., 2024), this mixed-methods dissertation study aims to provide a comprehensive understanding of the service needs and utilization patterns of informal kinship caregivers. Additionally, it seeks to examine the service delivery and program implementation of the kinship navigator program in Washington State through a secondary analysis of quantitative survey data, linked administrative data, and qualitative focus group data. These data were originally collected as part of a university-service agency partnership between the University of Washington and local service agencies using a community-engaged research (CEnR) approach. Specifically, this dissertation will 1) identify the distinct patterns of caregiving challenges in informal kinship placement, as well as significant sociodemographic variations in such patterns, and the role of KNP engagement in the association between these distinct groups and sociodemographic determinants; 2) explore the street-level program implementation of KNP from perspectives of informal kinship caregivers and navigators with lived experience expertise (LEE) within a RE-AIM framework (i.e. Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance); and finally, 3) examine the mechanism of change in caregiver well-being of informal kinship caregivers attending the enhanced Kinship Navigator Program intervention in Washington States with a focus on the roles of service utilization, and caregiver stress reduction. Collectively, research findings will inform policy change and tailor intervention to advance kinship first culture and future kinship-centered program implementation.