African-American women caregivers are vulnerable to poor mental health and social functioning due to their minority status and the high levels of care they provide to disabled elders. Moreover, African-American women provide such care in the context of less formal service. Research and theory suggest that rural and urban African-American women caregivers differ in their mental health, social functioning, and service use; however, virtually no systematic research has addressed these issues. This study will assess the mental health and social functioning of rural and urban African-American women who provide unpaid care to an elder (65 years and older) and will identify factors related to their service use. Using a cross-sectional research design and random sample of elders, this study will yield data on 300 rural and 300 urban African-American women caregivers living in the St. Louis metropolitan and southeastern Missouri Bootheel area. Three years of funding are requested to address four specific aims: (1) To assess and compare caregivers' mental health and functioning; (2) To identify type and quality of caregivers' formal and informal service use; (3) To determine caregiver and care recipient factors associated with caregivers' mental health and social functioning; and (4) To determine caregiver and care recipient factors associated with caregivers' service use. Data will be obtained through personal interviews. Trained African-American female interviewers will screen elders by telephone for caregiver referrals and conduct face-to-face interviews through a structured questionnaire in their home. Data analysis and interpretation will be guided by a stress and coping framework with elements of a life course perspective model. Study results will guide development of policy, programs and services promoting African-American women caregivers' mental health, social functioning, and service use.
