Health Status, Health Promoting Behaviors, and Facilitators and Barriers to Health Promoting Behaviors of Urban versus Rural Primary Caregivers of Children with Disabilities

Abstract

Background: Primary caregivers of children with disabilities are at risk for poor health; rural caregivers may be especially at risk. Engagement in health promoting behaviors can improve the health of these caregivers but few studies have described these behaviors or outlined the facilitators and barriers to health promoting behaviors that they experience. The Integrated Social Ecology Model guided this study. Purpose: To describe and compare the health status, health promoting behaviors, and facilitators and barriers to health promoting behaviors of urban versus rural primary caregivers of children with disabilities living in Central Alberta. Method: A sequential explanatory mixed methods design was used. Phase 1 was a quantitative study using mailed surveys to measure health status and health promoting behaviors. Phase 2 was a qualitative study using telephone interviews to assess facilitators and barriers to health promoting behaviors. Participants: Eighty-nine urban and 105 rural primary caregivers of children with disabilities responded to the survey. Ten urban and ten rural caregivers participated in the telephone interviews. Findings: Quantitative findings revealed many similarities and few differences between the urban and rural samples. Most caregivers reported their health as good to excellent. More urban than rural caregivers had given up paid employment because of their child’s care needs. Rural caregivers traveled further to access their physicians and were more likely to be overweight or obese. For both groups, the most common facilitator of health promoting behaviors was the need for caregivers to stay healthy so that they could continue to meet the long-term care needs of their child. The most common barrier was lack of time due to the numerous appointments, therapies, programs, and care needs of their children with disabilities. The availability of health promoting services and programs was a facilitator unique to urban caregivers and a barrier unique to some rural caregivers. Implications: Urban and rural primary caregivers of children with disabilities experience complex and multifaceted facilitators and barriers to health promoting behaviors that need to be considered when planning programs to improve their health.