Citation

Chumbler NR, Beverly CJ, Beck CK. Eval. Program Plann. 1997; 20(2): 117-127.

Copyright

(Copyright © 1997, Elsevier Publishing)

DOI

10.1016/S0149-7189(96)00043-2

PMID

unavailable

Abstract

This study examined the relationships between older adults' likelihood of receiving a personal response system (PRS) and (1) predisposing characteristics (gender, race, marital status, age, and education level); (2) enabling characteristics (living alone, living in an extended family), and availability of informal (family/ friend) caregivers; and (3) need characteristics (physical and cognitive function). PRS applies modem communication technology to protect older adults living in the community by sending an automatic telephone call for help if a person at home cannot use normal means for signalling an emergency. The study sample consisted of older adults (N = 553) living in rural areas of Arkansas and enrolled in a Medicaid waiver program for community-based services. Nurse case-managers evaluated the participants in their homes and decided whether PRS should be prescribed. Fifty-two percent of respondents were prescribed PRS free of charge by the nurse case-managers. We entered the three sets of characteristics into an adapted version of Andersen's behavioral model of health services utilization (Andersen, 1968, Andersen, 1995). We used logistic regression to evaluate the effects of predisposing, enabling, and need characteristics' relationships in relation to receipt of PRS. Based upon multivariate analysis, four variables--living alone, cognitive and physical function, and race--had statistically significant direct effects on PRS prescription. In other words, after adjusting for the effects of predisposing, enabling, and need characteristics, cognitive intactness and living alone had the strongest positive effects on receiving PRS, followed by being Caucasian and having difficulties performing activities of daily living (i.e., assistance needed with bathing, dressing, toileting, and moving in/out of bed/chairs). Our results should be of value in designing, planning, and implementing PRS systems in rural areas.