Impacts of Cultural Factors on Care Burden Among Racial and Ethnic Minority Family Caregivers of Older Adults: The Mediating Effect of Health and Social Service Use

Background and Purpose: Literature on caregiving and service use has shown that use of community-based services are helpful to reduce care burden among family caregivers generally. When research has targeted racial and ethnic minority family caregivers, cultural factors such as receiving informal support by family and friends, and familism play pivotal roles to prevent care burden among minority family caregivers. However, little is known about the interplay relationships between cultural factors, service use, and care burden among racial and ethnic minority family caregivers of older adults. The purpose of this study is 1) to examine the effects of cultural factors (i.e. informal support and familism) on care burden amongst racial and ethnic minority family caregivers of older adults with chronic illnesses, and 2) to explore whether health and social service use might function as a mediator between caregivers’ cultural factors and care burden among minority family caregivers of older adults.

Methods: A cross-sectional survey design was used. A convenience sample of 102 racial and ethnic minority family caregivers of older adults with chronic illnesses was recruited from community, and religious organizations, informal referrals, social service agencies-based service providers. By using SPSS 24, bivariate and hierarchical multiple regression were conducted. Using PROCESS in SPSS, two mediation model analyses with covariates and bootstrapping techniques were also conducted.

Results: Among 102 participants, the majority of minority family caregivers were female (71%), and spouses, had a mean age of 60. Caregiver participants reported using health and social services (M = 5.83, SD = 2.48; range 1-11). Results of the hierarchical regression analysis show that caregivers’ poor health status (b = -1.63, p = .01), caregivers’ higher level of health and social service use (b = .57, p = .02), caregivers with a lower level of connection to a religious community (b = -83, p = .02), and caregivers with a lower level of English proficiency (b = -2.11, p = .02) impacted higher levels of care burden among minority family caregivers. After controlling for caregivers’ socio-demographic factors, familism and informal support were not statistically associated with care burden. In addition, results from the mediation analysis revealed that the association between cultural factors and care burden were not significantly medicated by health and social service use.

Conclusion and Implications: The findings suggest that health and social service agencies should develop culturally tailored intervention which might reduce racial and ethnic minority family caregiver burden. By conducting the intervention, service providers could not only offer specific knowledge about caregiving to all family, but also help other families to increase awareness of the needs of the primary family caregivers in the caregiving process.