Talk, Listen, Connect: When Families Grieve™

The purpose of this evaluation is to better understand childhood grief and patterns of resource use among bereaved families as well as the impact of multimedia materials on young bereaved children and their caregivers. It studies Talk, Listen, Connect III: When Families Grieve™ (TLC III), which is a bilingual (English and Spanish) set of materials designed to help military and civilian families with young children in the United States (US) better cope with the death of a parent by providing resources, tools, and communication strategies. TLC III is a multimedia kit developed by Sesame Workshop (the non-profit organisation and producer of Sesame Street and other resources for children and their families) that includes a DVD, print materials for caregivers, tips and activities for families, a storybook for children, as well as supporting materials available via the internet. (See Related Summaries, below.) "Sesame Workshop’s goal in producing TLC III was to provide materials uniquely suited to the needs of bereaved civilian and military families with young children. Sesame Workshop was uniquely suited to such a venture, given that Muppet characters are widely recognized and trusted by children, as well as their parents, many of whom grew up watching Sesame Street and other Sesame Workshop programming."

Completed in April 2011, this study examined the impact of the TLC III kit in helping bereaved caregivers and their children (ages 2 to 16 years) cope with grief and loss related to a parental death. This document presents data from caregiver reports using a combination of standardised and developed measures to evaluate: (i) the utilisation and overall satisfaction with the Sesame Workshop TLC III kit, (ii) emotional reactions to the kit materials, (iii) impact on caregivers' and children's coping, (iv) use of suggested activities to sustain positive memories of the deceased parent, (v) impact on emotional health and functioning of the children and caregivers, and (vi) impact on child-caregiver relationships. Study participants were 93 adult caregivers of parentally bereaved children whose parents had died since Sept 11 2001. Caregiver participants included mostly women (92%) over the age of 30 (85%); both civilian and military families were well represented in the sample. The majority of the deceased were fathers (87%) of children in the study. The majority of children in the baseline cohort were between the ages of 2 and 8 years (58.2%), with girls (50%) and boys (44%) equally represented. After completing the baseline questionnaire, participants were randomly assigned to the experimental group that received the TLC III kit or to a control group that received a Sesame Workshop kit about emergency preparedness entitled, Let's Get Ready! Planning Together for Emergencies (hereon referred to as the Ready kit). The Ready kit was similar to the TLC III kit in structure but not in content (see Related Summaries, below) and was selected as a comparable control due to its potentially anxiety-provoking topic and similar structure.

"Results of the evaluation indicate that TLC III was a highly appealing and easy-to-use set of materials that effectively met its goals of providing useful tools to families with young children and helping them better cope with the death of a parent. The kit was highly rated in the areas of utilization, satisfaction, and impact." Specifically, in terms of:

• Utilisation and satisfaction: TLC III materials were used by over 95% of the families who received them. Eighty-six percent of caregivers viewed the DVD, 70% reported use of the storybook/activity book, and 80% viewed the parent/caregiver guide. Ninety-one percent of TLC III group caregivers rated the overall kit materials as good to excellent. Over 85% of these caregivers stated that the materials were easy to extremely easy for their child to understand. More than 75% of the caregivers rated the individual kit components (i.e., DVD, guide for caregivers, storybook, and website) as moderately to extremely appealing, relevant, and helpful. Caregivers cited the kit's "realistic" and "effective" strategies for addressing the various ways in which families experience grief, as well as the kit's appropriate use of "clear" and "honest" language for discussing difficult concepts with children, such as death and suicide.
• Impact:
  • Participants who used the TLC III kit materials were significantly more likely to report that the materials had a positive impact on their child's coping with grief than those study participants who used the Ready Kit, as well as on their own coping with grief than those who used the Ready kit.
  • The majority of caregivers in the TLC III group reported a positive change in their interactions with their children since viewing the kit materials. For example: 83% felt they had "more appropriate language to better discuss the death with my child."; 79% felt "better able to reassure my child that he/she is loved and safe."; 79% felt "better able to comfort my child."; and 79% felt "more comfortable talking with my child about death."

"TLC III caregivers' narrative responses indicated that the activities and topics suggested within the kit materials provided their families with new strategies for coping and communicating about the death. Caregivers also noted that kit materials validated effective coping strategies that their family already had in place. In these ways the kit served its intended purpose as a resource and support for families coping with the death of a parent....[M]ultimedia kits are likely to have the greatest impact when used as targeted programs for populations that view the materials as extremely relevant to their most pressing concerns....The findings of this evaluation suggest that materials similar to TLC III, which demonstrated its capacity to help adults and their young children communicate about difficult topics, can be further used to educate and engage...families and communities about diverse, emotionally challenging issues."

Editor's note: To request a copy of this 40-page report in PDF format, please contact June Lee at June.Lee@sesame.org