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

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 (R-2 = .32, adj. R (2) = .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.