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Applying Andersen’s Model to Explain Service Use and Quality of Life Among Australian Caregivers of Children with Autism Spectrum Disorder

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Abstract

Access to necessary supports and services is extremely important for the wellbeing and, ultimately, quality of life (QOL) of family caregivers. By understanding patterns of health service utilization, we can better tailor current services to meet caregivers’ needs. Framed by Andersen’s Behavioral Model, predisposing, enabling and need factors associated with service utilization, and their relation to QOL, were examined in a cross-sectional sample of 156 Australian caregivers of children and adolescents with autism spectrum disorder (ASD). Participants completed an online survey to assess services accessed, QOL (Quality of Life in Autism - Part A), health beliefs (Health Opinions Questionnaire), ASD symptom severity (Quality of Life in Autism - Part B), and caregiver distress (Depression Anxiety Stress Scales – 21 item). Multivariate regression analyses confirmed the role of predisposing (i.e. higher education), and enabling (i.e. higher income) variables, although family structure (i.e. having more than one children with ASD; OR = 7.22, CI: 1.77–29.54, p < .01) and caregiver distress (OR = 1.04, CI: 1.0–1.07, p < .05) were identified as the strongest predictors of service access. Both of these variables also helped to explain a sizeable portion of the variance in QOL scores (R2 = .32, adj. R2 = .24, p < .001). Personal barriers to health care utilization exist for parents of children with ASD which impact their decision to access help. There is, however, a need for further research to expand Andersen’s model by examining subjective and objective QOL indicators applicable to the caregiver cohort.

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Acknowledgements

The authors would like to acknowledge the School of Psychology, University of Adelaide, internal funding grant. The authors are also grateful to the organizations that assisted with recruitment and to participants, who dedicated their time to this study.

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  1. University of Adelaide, Adelaide, Australia

    Miranda Willet, Diana Dorstyn, Clemence Due & Wenjing Li

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  1. Miranda Willet
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  2. Diana Dorstyn
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  3. Clemence Due
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  4. Wenjing Li
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Correspondence to Diana Dorstyn.

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All procedures performed were in accordance with the ethical standards of the University of Adelaide Human Research Ethics Committees, the NHMRC National Statement on Ethical Conduct in Human Research, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all study participants.

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Willet, M., Dorstyn, D., Due, C. et al. Applying Andersen’s Model to Explain Service Use and Quality of Life Among Australian Caregivers of Children with Autism Spectrum Disorder. J Dev Phys Disabil 30, 339–354 (2018). https://doi.org/10.1007/s10882-018-9589-x

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