Unmet Support Service Needs Among Rural Family Caregivers: A Population-Based U.S. Study a population-based U.S. study

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Published Dec 26, 2023
DOI: https://doi.org/10.18103/mra.v11i12.4854

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Main Article Content

Erin Kent, PhD, MS
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Cecil G. Sheps Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Elizabeth Aimone, MS
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Maija Reblin, PhD
Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, VT
Shakira J. Grant, MBBS, MSCR
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, Division of Hematology and Division of Geriatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
Lixin Song, PhD, RN, FAAN
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX
Madeline Sterling, MD, MPH, MS
Department of Medicine, Weill Cornell Medicine, New York, NY
Yiqing Qian, PhD, MPH
8. Center for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, MDDepartment of Psychiatry and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
Eliza M. Park, MD, MSc
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC

Abstract

Background:  In rural communities around the world, individuals with serious health problems and their family caregivers often experience greater barriers to healthcare access. Identifying unmet support service needs of rural-dwelling caregivers can reveal intervention and policy targets. We examined unmet needs reported by rural caregivers in the U.S.


Methods: We used data from the 2015-2018 U.S. Behavioral Risk Factor Surveillance System that included the optional caregiving module (32 U.S. states, D.C. and Puerto Rico). We identified rural caregivers using metropolitan statistical area (rural) and the item, "During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability?" Logistic regression models incorporating sampling weights provided adjusted odds ratios (adjusted ORs) of factors associated with having any unmet support service needs, and specific need types: classes about giving care, help with service access, support groups, individual counseling, respite. Factors included sociodemographic (gender, race/ethnicity, age, education, income, employment, marital status) and caregiving-related (intensity [±20 hours/week and ±2-year duration], caregiver-care recipient relationship, and main health problem) variables.


Results: Of the 8,651 rural caregivers (representing 2.3 million) included, 16% endorsed unmet needs. Help accessing services was the most common need, followed by support groups and individual counseling. Factors associated with higher odds of any unmet need included Black vs. White race (adjusted OR: 1.74 [95%CI: 1.21-2.50]), college vs. high school graduate (adjusted OR: 1.85 [1.37-2.52]), and higher vs. lower intensity caregiving (adjusted OR: 2.18 [1.27-3.73]).


Conclusions: Many U.S. rural caregivers report unmet support service needs. Future interventions to benefit rural caregivers should target individuals and communities with the highest unmet needs.

Article Details

How to Cite
KENT, Erin et al. Unmet Support Service Needs Among Rural Family Caregivers: A Population-Based U.S. Study. Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4854>. Date accessed: 16 may 2024. doi: https://doi.org/10.18103/mra.v11i12.4854.
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Issue
Vol 11 No 12 (2023): December Issue, Vol.11, Issue 12
Section
Research Articles

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References

1. American Association for Retired Persons, National Alliance for Caregiving. Caregiving in the United States 2020. Washington, DC: AARP; May 2020.
2. Cohen SA, Ahmed N, Brown MJ, Meucci MR, Greaney ML. Rural-urban differences in informal caregiving and health-related quality of life. J. Rural Health. Mar 2022;38(2):442-456. https://www.ncbi.nlm.nih.gov/pubmed/33956360.
3. Bouldin ED, Shaull L, Andresen EM, Edwards VJ, McGuire LC. Financial and Health Barriers and Caregiving-Related Difficulties Among Rural and Urban Caregivers. J. Rural Health. Jun 2018;34(3):263-274. https://www.ncbi.nlm.nih.gov/pubmed/28940539 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866208/pdf/nihms937313.pdf.
4. Owsley KM, Hamer MK, Mays GP. The Growing Divide in the Composition of Public Health Delivery Systems in US Rural and Urban Communities, 2014-2018. Am. J. Public Health. Jul 2020;110(S2):S204-S210. https://www.ncbi.nlm.nih.gov/pubmed/32663081.
5. Coughlin SS, Clary C, Johnson JA, et al. Continuing Challenges in Rural Health in the United States. J Environ Health Sci. 2019;5(2):90-92. https://www.ncbi.nlm.nih.gov/pubmed/32104722.
6. Kaufman BG, Thomas SR, Randolph RK, et al. The Rising Rate of Rural Hospital Closures. J. Rural Health. Winter 2016;32(1):35-43. https://www.ncbi.nlm.nih.gov/pubmed/26171848.
7. Sterling MR, Cene CW, Ringel JB, Avgar AC, Kent EE. Rural-urban differences in family and paid caregiving utilization in the United States: Findings from the Cornell National Social Survey. J. Rural Health. Mar 30 2022. https://www.ncbi.nlm.nih.gov/pubmed/35355330.
8. L'Heureux T, Parmar J, Dobbs B, et al. Rural Family Caregiving: A Closer Look at the Impacts of Health, Care Work, Financial Distress, and Social Loneliness on Anxiety. Healthcare (Basel). Jun 21 2022;10(7). https://www.ncbi.nlm.nih.gov/pubmed/35885682.
9. Young HM, Bell JF, Whitney RL, Ridberg RA, Reed SC, Vitaliano PP. Social Determinants of Health: Underreported Heterogeneity in Systematic Reviews of Caregiver Interventions. Gerontologist. Feb 14 2020;60(Suppl 1):S14-S28. https://www.ncbi.nlm.nih.gov/pubmed/32057083.
10. Services CfMM. CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities. 2022.
11. Innes A, Morgan D, Kosteniuk J. Dementia care in rural and remote settings: a systematic review of informal/family caregiving. Maturitas. Jan 2011;68(1):34-46. https://www.ncbi.nlm.nih.gov/pubmed/21093996.
12. Bakitas MA, Elk R, Astin M, et al. Systematic Review of Palliative Care in the Rural Setting. Cancer control : journal of the Moffitt Cancer Center. Oct 2015;22(4):450-464. https://www.ncbi.nlm.nih.gov/pubmed/26678972.
13. Centers for Disease Control and Prevention (CDC). BRFSS Stastical Brief: Caregiver Optional Module. 2021.
14. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System, Years 2015-2018. 2018.
15. Centers for Disease Control and Prevention (CDC). Metropolitan statistica area (MSA). 2022; https://www.cdc.gov/nchs/hus/sources-definitions/msa.htm. Accessed November 1, 2023, 2023.
16. Beach SR, Schulz R. Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults. J. Am. Geriatr. Soc. Mar 2017;65(3):560-566. https://www.ncbi.nlm.nih.gov/pubmed/27935019.
17. Kent EE, Lee S, Asad S, Dobbins EE, Aimone EV, Park EM. "If I wasn't in a rural area, I would definitely have more support": social needs identified by rural cancer caregivers and hospital staff. Journal of psychosocial oncology. Oct 10 2022:1-18. https://www.ncbi.nlm.nih.gov/pubmed/36214743.
18. Ugalde A, Blaschke S, Boltong A, et al. Understanding rural caregivers' experiences of cancer care when accessing metropolitan cancer services: a qualitative study. BMJ Open. Jul 11 2019;9(7):e028315. https://www.ncbi.nlm.nih.gov/pubmed/31300501 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629412/pdf/bmjopen-2018-028315.pdf.
19. Carroll L, Chippior J, Karmali S, Sriram D, Ysseldyk R. We Are Caregivers: Social Identity Is Associated with Lower Perceived Stress among Rural Informal Caregivers. Can J Aging. Mar 2019;38(1):59-75. https://www.ncbi.nlm.nih.gov/pubmed/30404674.
20. Cohen SA, Kunicki ZJ, Nash CC, Drohan MM, Greaney ML. Rural-Urban Differences in Caregiver Burden Due to the COVID-19 Pandemic among a National Sample of Informal Caregivers. Gerontol Geriatr Med. Jan-Dec 2021;7:23337214211025124. https://www.ncbi.nlm.nih.gov/pubmed/34212069.
21. James CV, Moonesinghe R, Wilson-Frederick SM, Hall JE, Penman-Aguilar A, Bouye K. Racial/Ethnic Health Disparities Among Rural Adults - United States, 2012-2015. MMWR. Surveill. Summ. Nov 17 2017;66(23):1-9. https://www.ncbi.nlm.nih.gov/pubmed/29145359.
22. Richman L, Pearson J, Beasley C, Stanifer J. Addressing health inequalities in diverse, rural communities: An unmet need. SSM Popul Health. Apr 2019;7:100398. https://www.ncbi.nlm.nih.gov/pubmed/31011618.
23. Henning-Smith C, Moscovice I, Kozhimannil K. Differences in Social Isolation and Its Relationship to Health by Rurality. J. Rural Health. Sep 2019;35(4):540-549. https://www.ncbi.nlm.nih.gov/pubmed/30609155.
24. Campione JR, Zebrak KA. Predictors of Unmet Need Among Informal Caregivers. J. Gerontol. B. Psychol. Sci. Soc. Sci. Nov 13 2020;75(10):2181-2192. https://www.ncbi.nlm.nih.gov/pubmed/31907540.
25. Caldwell JT, Ford CL, Wallace SP, Wang MC, Takahashi LM. Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States. Am. J. Public Health. Aug 2016;106(8):1463-1469. https://www.ncbi.nlm.nih.gov/pubmed/27310341.
26. Xu H, Kadambi S, Mohile SG, et al. Caregiving burden of informal caregivers of older adults with advanced cancer: The effects of rurality and education. Journal of geriatric oncology. Apr 12 2021. https://www.ncbi.nlm.nih.gov/pubmed/33858803.
27. Siconolfi D, Shih RA, Friedman EM, et al. Rural-Urban Disparities in Access to Home- and Community-Based Services and Supports: Stakeholder Perspectives From 14 States. J Am Med Dir Assoc. Apr 2019;20(4):503-508 e501. https://www.ncbi.nlm.nih.gov/pubmed/30827892.
28. Miller KEM, Stearns SC, CH VANH, Gilleskie D, Holmes GM, Kent EE. The Landscape of State Policies Supporting Family Caregivers as Aligned With the National Academy of Medicine Recommendations. Milbank Q. May 17 2022.