Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers.

Abstract

The goal of this study was to evaluate the practice-oriented model of service use (Yeatts, Crow, & Folts, 1992) relative to the more widely used behavioral model ( Andersen, 1968) in its ability to explain the use of respite services by caregivers of Alzheimer's patients. Unlike the behavioral model, which focuses primarily on characteristics of the service user, the practice-oriented model focuses primarily on characteristics of the service. Interview data from 1,158 caregivers participating in the Alzheimer's Disease Demonstration Grants to States program ( Montgomery, Kosloski, Karner, & Schaefer, 2002) were analyzed. Separate regression models were estimated for adult day care and in-home respite, using the full information maximum likelihood procedure described by Arbuckle (1996), and ordinary least squares regression with listwise deletion of missing data. The findings indicate that the factors related to respite use tapped by the practice-oriented model add significantly to explanatory models of service use over models that use only the factors typically represented by the behavioral model. Additional analyses, including a set of interactions with ethnicity, indicated that this improvement occurs primarily for White and Hispanic caregivers, and less so for African Americans. The findings are discussed in terms of their implications for enhancing the timely use of respite services and directions for future research.