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Evaluating a Practice-Oriented Service Model to Increase the Use of Respite Services Among Minorities and Rural Caregivers

Correspondence: Address correspondence to Julian Montoro-Rodriguez, Kent State University, School of Family and Consumer Studies, 142 Nixson Hall, Kent, OH 44242-0001. E-mail: jmontoro{at}kent.edu

Purpose: 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.Design and Methods: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.Results: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.Implications:The findings are discussed in terms of their implications for enhancing the timely use of respite services and directions for future research.

Key Words: Service use • Respite • Ethnicity • Community-based services • Caregiving