Corresponding Author

Brittany L. Smalls

2195 Harrodsburg Road, Suite 125

Lexington, KY 40504

Author Affiliations

Brittany Smalls

Department of Family and Community Medicine, University of Kentucky, Lexington, KY

Center for Health Equity Transformation, University of Kentucky, Lexington, KY

ORCID: https://orcid.org/0000-0003-3727-346X

Adebola Adegboyega

College of Nursing, University of Kentucky, Lexington, KY

Kelly N.B. Palmer

Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ

Jennifer Hatcher

Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ

University of Arizona Cancer Center

Author Area of Expertise

Brittany L. Smalls: health services research, health inequities, rural health, social determinants of health

Adebola Adegboyega: health inequities, social determinants of health, qualitative research

Kelly N.B. Palmer: Community-based research, social determinants of health

Jennifer Hatcher: rural health research, community-based research


Purpose: This study examines the associations of social support and type 2 diabetes (T2D) risk factors among members of rural-dwelling, grandparent-headed households (GHH).

Methods: Prospective data were collected from rural-dwelling members of GHH with no known diagnosis of T2D. Data collected on family characteristics, T2D clinical risk factors, and social support were assessed.

Results: Sixty-six grandparents and 72 grandchildren participated in the study. The average age and HbA1Cs were 59.4 years and 6.2% ± 1.4 for grandparents and 11.8 years and 4.9% ± 0.6 for grandchildren. Most grandparents were found to have prediabetes or undiagnosed diabetes. The number of people living in GHHs was associated with grandparents’ triglycerides, HDL, and BMI. Average social support scores among grandparents suggested moderately high perceived social support (79 ± 3.4). For grandchildren, social support from grandparents was associated with diastolic blood pressure and HbA1C, whereas support from teachers, classmates, and close friends was associated with HbA1C and BMI in grandchildren.

Implications: This study shows that grandparent caregivers are at an increased risk for T2D. Perceived social support between grandparents and grandchildren influences T2D risk factors. However, social support provided by peers, teachers, and close friends is also associated with T2D risk factors in grandchildren. These findings support the use of family-based diabetes prevention programming, peer support, and school settings as mechanisms for interventions to reduce T2D in adolescents, particularly those within GHHs.



Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Smalls BL, Adegboyega A, Palmer KNB, Hatcher J. Evaluating social support and T2D risk factors among members of rural-dwelling grandparent-headed households. J Appalach Health 2022;4(2):65–82. DOI: https://doi.org/10.13023/jah.0402.06.