Sunday, 16 January 2005 - 8:45 AM

This presentation is part of: Community Health Care of Older Adults

An Evaluation of the Development of Community Caregiving Coalitions

With a greater number of older adults in our population, communities may struggle with ways to provide comprehensive support to caregivers and families who provide care to older members. Coalitions provide an alliance of disparate systems to address community needs and tasks, and provide a power base for political advocacy (Armbruster, et al., 1999; Dluhy, 1999). This research is a formative evaluation of six caregiving coalitions that were developed to enhance community caregiving competence within a southern state. The goal was to bring together disparate stakeholders including family caregivers, local businesses, formal service providers, and healthcare personnel. Data were collected 18 months after the initial construction of the six coalitions.

In an effort to analyze the structure, process, and outcome of the coalitions, several methodologies were included within the evaluation. A document analysis was conducted of all coalition meetings (N = 52 sets of minutes). In addition, a focus group and phone interviews were conducted for a sample of coalitions participations (N=18). Lastly, a survey of coalition effectiveness was constructed based upon a conceptual framework for coalition building (Mizrahi & Rosenthal, 2001). The survey was distributed to all coalition members within the state (N=91, 54% response rate).

The findings from this mixed method evaluation reveal several structural and procedural trends in developing the coalitions. Structurally, coalitions in rural areas (n=4) proceeded differently than urban/suburban in constructing coalitions. Rural areas took more time in developing an infrastructure (3 membership meetings in the first year for urban coalitions, and 1 or 0 for rural). Once established, however, rural coalitions contained a higher number of members (M=19.75 individuals per meeting) than the urban/suburban coalitions (M=7.3 members per meeting). Other structural issues that were examined included coalitions meeting schedules, and development of a leadership infrastructure. In analyzing membership composition, no differences were determined by participant role (e.g. family member, formal service provider) in coalitions by location (rural/urban).

Procedural issues were also addressed within the analysis. In determining reasons for participating in a coalition, differences did exist by participant role. Health and human service professionals were more likely than others to be part of the coalition because of a commitment to caregiving (Chi sq., p.=000). Participants also reported high levels of satisfaction about the impact that coalitions were having on caregiving in the communities. However, family caregiviers reported the lowest level of satisfaction compared to other members of the coalition (F-2.39, p.=05).

Lastly, interview data provided information about sustainability of the coalitions. A content analysis was completed of the various interviews, and emerging themes were identified. From the interviews, a major concern was the need for a statewide infrastructure to provide coordination across the six coalitions. In addition, coalition members voiced concerns about ways to publicize and raise awareness of caregiving issues through local media and services. Finally, respondents from more remote counties reported that managing vast geographic areas attenuated the ability of the coalition to impact caregiving in more rural locations.

Implications for coalition development, support, and sustainability are presented.

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