Application of the Modified Socio-Cultural Framework for Health Service Disparities: Family Burden Among Latino Families of Children with Autism Spectrum Disorder

Background and Purpose: The experiences raising a child with autism have not been explored in families from a variety of racial/ethnic backgrounds. It has been suggested that the experience of raising a child with autism may vary by race, ethnicity, and culture. The purpose of this study is to enhance the understanding of family burden among Latinos raising children with autism by utilizing the modified Socio-cultural Framework for Health Service Disparities (Lopez, 2014). The specific aims include exploring whether or not there are differences in family burden among Latina and non-Latina mothers, investigating the separate dimensions of family well-being and functioning as well as burden, and disentangling sociodemographic and sociocultural factors that affect family experience.

Methods: Latina and non-Latina White families were recruited through service agencies, support groups and organizations that provide services for children with developmental disabilities. Child age at the time of the study ranged from 2 to 21 years of age. Forty-five Latina mothers who completed an interview about treatment and services, parental stress and coping, and child autism symptoms are included in the study. Fifty-six White mothers completed the questionnaire as a mail survey. White mothers reported more child behavior problems, higher levels of education, and higher incomes compared to Latina mothers.

Results: Latina mothers reported lower levels of family burden (M=5.35) compared to White mothers (M=8.16), t(100)=-3.77,p<.001. Latina and White mothers differed significantly on family well-being and functioning, with Latina mothers averaging 4.30 and White mothers having a mean of 2.98,  t(100) = 4.25, p = .000. In addition, higher levels of negative family impact were reported by White mothers 5.31compared to Latina mothers 3.65, t(100)=-3.05, p<.01.

Two hierarchical regression models were developed for each of the dependent variables. Model 1 for family burden included ethnicity, behavior problems, maternal age, and maternal education, explained 23.7% of the variance (adjusted R²) and was statistically significant, F_{(4, 97)}=8.84, p<.001. The number of child behavior problems, β = .183, p<.05, maternal age, β = .220, p<.05, and maternal education, β = .280, p<.05, were positively related to family burden. After including family cohesion in Model 2 39.1% of the variance (adjusted R²) in the model was accounted for, F_{(5, 96)}=13.98,  p<.001.  The number of behavior problems, β = 0.183, p<.05, maternal age, β = 0.191, p<.05, maternal education, β = 0.272, p<.05, and family cohesion, β = -.398, p<.001 significantly predicted family burden.  Similar patterns of findings were found for family well-being and functioning as well as negative family impact.

Conclusions & Implications: Analyses indicate Latino families experience less family burden than non-Latino White families. Child, caregiver, and family factors contributed to the relation between being Latino and family burden. This study is a first step to disentangling the modified Socio-Cultural Framework-Health Service Disparities to isolate relevant factors that contribute to family well-being, functioning, and burden. Understanding the perceived impact of autism on Latino families may aid in the development of culturally informed services that enhance service utilization among families, reduces burden, and enhances family strengths.