The Impact of a Health Education Program on Older Latina Mothers of Adults with Intellectual and Developmental Disabilities (IDD)
Research shows that mothers caring for adults with IDD face many health challenges themselves as they get older. When comparing midlife and older Latina caregivers of adolescent and adult children with IDD, to Latina parents who did not have children with IDD, we found that the caregivers had more chronic health conditions and higher rates of depression than non caregivers. Subsequently, we developed and tested an intervention aimed at improving health behaviors of mothers of children with IDD. While we know that caregivers are more susceptible to chronic health conditions as they age; we do not know whether an intervention aimed at changing health behaviors would be more effective among younger versus older caregivers. In this paper, we examine specifically whether the intervention we developed is more effective with older versus younger Latina caregivers in our study. Our research questions are: do older caregivers 1) show greater increases in self-efficacy, 2) greater improvements in health behaviors; and 3) greater reductions in depressive symptoms between pre and post test compared to younger caregivers?
Methods:
The intervention we developed engaged promotoras de salud to deliver an 8 week health education program to 100 Latina mothers of adolescents and adults with IDD. The original study used a randomized trial with a pre and post-test comparing 50 mothers of youth or adults with IDD who received the intervention to 50 who did not. In the present analysis we created a dummy variable of mothers who were 50 and older (n=29) and mothers who were under 50 (n=71). We used a repeated measures analysis of covariance using the older versus younger variable as an interaction term. Outcome measures included health related self-efficacy, nutrition, exercise and self-care behaviors, and depressive symptoms.
Results:
We found that both the older and younger groups of caregivers showed significant improvements in self-efficacy and health behaviors at equal levels between pre and post-test. However, we found that the older Latina caregivers showed greater reductions in depressive symptoms than the younger caregivers compared to their respective control groups.
Implications:
The promotora health intervention shows promising results for both older and younger caregivers in improving health behaviors. While it is beneficial to provide this type of caregiver intervention when the caregiver is younger; we found that older caregivers also benefit and may especially be responsive to the aspects of the intervention that focus on social support and reducing stress and depression. It may be that older caregivers are more isolated and value the social interaction provided by the promotoras; thus leading to greater changes in depressive symptoms. Future research should examine the relationship between social support, age and intervention outcomes. Overall, our study suggests that this intervention using promotoras de salud leads to positive health behaviors among Latina caregivers of children with IDD. Service programs should consider providing health education to parental caregivers as a way of supporting this important form of long-term care of adults with IDD.