McGinnis, Kathleen
(2014)
Concordance of race/ethnicity of interventionists and caregivers of dementia patients: relationship to study outcomes.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Purpose: To assess the effects of racial/ethnic concordance between caregivers and interventionists on several study outcomes in a multisite randomized clinical trial with racially/ethnically diverse caregivers and interventionists.
Design and Methods: Family caregivers of patients with Alzheimer’s disease were randomized to intervention or control groups at 5 sites from 2002 to 2004. Interventionists provided tailored multicomponent interventions aimed at improving quality of life in 3 racial/ethnic caregiver groups. This analysis included the 323 caregivers assigned to the intervention group and a subgroup of those who received at least one face-to-face intervention. To examine the relationship of concordance with outcomes, the following outcomes were modeled using random effects logistic and linear mixed models, as appropriate: loss to follow-up, mean changes in burden, problems, depression, and social support, number of sessions attended, and satisfaction with the study. The main models included the covariates concordance, caregiver gender/ race/ethnicity, and interventionist race/ethnicity and interventionist was specified as the random effect.
Results: White caregivers were more likely to have at least one face-to-face intervention than African-American or Hispanic caregivers. Of those who received a face-to-face intervention, concordance was not statistically significantly associated with any of the outcomes examined. There were some differences in outcomes by caregiver gender/race/ethnicity. Based on the main multivariate model, mean change in problems was statistically significantly greater (worse) for African-American men than for white women (p=.010), African-American women (p=.03), white men (p=.004), Latina women (p=.002), and Latino men (p=.004). African-American men and Latino/a men and women were more likely to report higher satisfaction with the study compared to white men and women and African-American women.
Conclusions: No overall differences were found in outcomes by racial/ethnic concordance between caregivers and interventionists. Out of the seven outcomes, we found a difference by race/ethnicity for only two outcomes. Problems became worse for African-American males compared to African-American females and white males and females and satisfaction was higher for African-American males compared to African-American women and white men and women. Research studies need to continue to address the disparity in outcomes by participant race/ethnicity.
Public Health Significance: To eliminate racial/ethnic disparities in health, these disparities also need to be evaluated and eliminated in health research settings.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
27 June 2014 |
| Date Type: |
Publication |
| Defense Date: |
20 March 2014 |
| Approval Date: |
27 June 2014 |
| Submission Date: |
6 April 2014 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
101 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
DrPH - Doctor of Public Health |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
racial disparities |
| Date Deposited: |
27 Jun 2014 20:37 |
| Last Modified: |
15 Nov 2016 14:17 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/20725 |
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