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Exploring Family Caregiver Services: Variations in Utilization Patterns and Barriers to Access among Diverse Ethnic Groups. Julian Chow 1 , Erica Auh 1 , Nancy Giunta 1 , and Andrew Scharlach 1. Annual Meeting of the Society for Social Work and Research Miami, FL, January 14, 2005. - PowerPoint PPT Presentation
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Exploring Family Caregiver Services: Variations in Utilization Patterns and
Barriers to Access among Diverse Ethnic Groups
Julian Chow1, Erica Auh1, Nancy Giunta1, and Andrew Scharlach1
1 Center for the Advanced Study of Aging Services - University of California, Berkeley
Annual Meeting of the
Society for Social Work and Research
Miami, FL, January 14, 2005
Center for the Advanced Study of Aging Services
Mission: Improving services for the elderly through
research, collaboration and education
Current projects include: Strategic Plan for an Aging CA (SB910) Family Caregiver Support Program LTC Insurance and Quality Assurance LTC Integration and Case Management Consortium for Social Work Training in Aging
Overview
Literature Review
Research Questions
Method
Results
Discussion & Implication
Literature Review
Lower level of formal service use among minority CGs compared with White CGs (yet, inconclusive)
Disparities in types of formal service use between minority and White CGs
Comparison between White and non-White CGs in most studies
Research Questions
Do racial/ethnic CGs use services differently from White?
Do racial/ethnic groups rely on different sources of service?
Do they use different types of services? How do they see barriers to service use?
Method
Random Digit Dialing
Respondent caring for someone over age 50
Surveys conducted in English and Spanish
Interview lasted approx. 30 minutes
N = 1,643
Demographic
ANHPI Hispanic African American White
Female 73% 76% 80% 74%
Gender (n=1,559)
Age** (n=1, 529)
Under 35 18% 27% 19% 8%
35 - 49 46% 41% 34% 28%
50 - 64 34% 24% 39% 40%
65 + 3% 8% 21% 25%
* p<0.05; ** p<0.01
Demographics (cont’d)Marital Status** (n=1,435)
ANHPI Hispanic African American White
Married 65% 58% 33% 64%
Living w/ partner 0% 4% 2% 2%
Separated 0% 3% 7% 2%
Divorced 6% 12% 22% 12%
Widowed 1% 3% 8% 9%
Never Married 28% 22% 28% 12%
Children < 18 Living in Household** (n=1,555)
Yes 41% 47% 36% 24%
Demographics (cont’d)Education** (n=1,552)
ANHPI Hispanic African American White
< High school 0% 15% 1% 2%
Some high school 3% 10% 9% 4%
High school graduate 16% 23% 23% 20%
Post high school education 19% 29% 40% 36%
College graduate 43% 18% 21% 25%
Post graduate degree 19% 5% 6% 14%
2001 Household Income** (n=1,359)< $30,000 32% 53% 52% 35%
$30,000 + 68% 47% 48% 65%
Demographics (cont’d)Country of Origin** (n=1,323)
ANHPI Hispanic African American White
USA 34% 67% 96% 96%
Canada 0% 0% 0% 1%
Mexico 0% 25% 0% 0%
Europe 0% 0% 0% 2%
South America 0% 2% 0% 0%
Middle East 0% 0% 1% 0%
Asia/Pacific Island 49% 0% 0% 0%
Indian Subcontinent 14% 0% 0% 0%
Central America 0% 6% 2% 0%
Other 3% 0% 0% 0%
Total Number of Service Use
ANHPI Hispanic African American
White Total
Used no service 21% 20% 13% 17% 18%
Used at least one service 79% 80% 87% 83% 82%
Mean number of total service use**
2.0933 2.0927 2.8969 2.5137 2.4096
Range (min:max) 8(0:8) 9(0:9) 8(0:8) 10(0:10) 10(0:10)
* p<0.05; ** p<0.01
Result of Post Hoc Test (Tukey HSD)
ANHPI Hispanic
African American White
ANHPI -0.8036*
Hispanic -0.8042** -0.4209**
African American
* p<0.05; ** p<0.01
Formal & Informal Service Use
ANHPI Hispanic
African American White Total
Used at least one FORMAL service** 57% 65% 77% 72% 70%
Used at least one INFORMAL service* 66% 59% 58% 52% 55%
* p<0.05; ** p<0.01
Ratio of Formal and Informal within One’s Service Use**
ANHPI Hispanic
African American White Total
FORMAL only 26% 36% 34% 45% 41%
INFORMAL only 34% 22% 14% 15% 18%
Both 40% 42% 51% 40% 41%
* p<0.05; ** p<0.01
Service Use by Type
ANHPI Hispanic
African American White Total
Information** 28% 19% 34% 29% 27%
Access 17% 10% 6% 11% 11%
Education* 20% 28% 42% 28% 29%
Counseling 11% 11% 12% 14% 13%
Counseling from clergy 4% 18% 21% 18% 17%
Support group** 19% 20% 18% 23% 22%
* p<0.05; ** p<0.01
Service Use by Type (cont’d)
ANHPI Hispanic
African American White Total
In-home respite* 42% 39% 41% 32% 35%
Day respite 7% 7% 16% 11% 10%
Night respite* 10% 9% 15% 12% 11%
Legal information** 15% 16% 29% 27% 23%
Financial information* 23% 13% 20% 20% 18%
* p<0.05; ** p<0.01
Service Use by Source
ANHPI Hispanic
African American White Total
In-home respite**
formal
informal
30%
70%
19%
81%
18%
82%
37%
63%
30%
70%
Night respite**
formal
informal
0%
100%
31%
69%
43%
57%
54%
46%
47%
53%
* p<0.05; ** p<0.01
Barriers to Service Use
ANHPI Hispanic
African American White Total
Already have all the help needed**
69% 63% 63% 75% 70%
Help not wanted by CR 44% 42% 37% 41% 41%
Service not available** 26% 42% 34% 28% 33%
Poor quality** 17% 37% 40% 21% 27%
Language** 35% 25% 11% 9% 15%
No one to stay with CR while CG gets help*
17% 30% 23% 25% 26%
* p<0.05; ** p<0.01
Barriers to Service Use (cont’d)
* p<0.05; ** p<0.01
ANHPI Hispanic
African American White Total
No time to get help 39% 23% 17% 25% 25%
Not available the times they need**
22% 38% 34% 20% 26%
Transportation not available**
30% 24% 14% 23% 23%
High cost** 30% 53% 49% 46% 47%
Service not offered by people like them*
17% 24% 29% 19% 21%
Discussion
Ethnic differences in total number of service use
Differences in sources
Some groups are more likely to rely on one source
Discussion (cont’d)
Different ethnic groups use different types of services
In-home respite, education, and information are most widely used across group
But sources of help seem to matter
Ethnic groups identify different barriers
Implication
Provide culturally specific services
Outreach to minority, especially immigrant, communities
Provide resources for the informal support network
Thank You!
Center for the Advanced Study of Aging Services
University of California, Berkeley
http://cssr.berkeley.edu/aging