Residential attitudes and knowledge, use, and future use of home support agencies

Critical review of the health and social service use literature reveals a need to elaborate on the dynamics of factors identified in the behavioral models applied to this field. In particular, research has tended to omit direct measures of attitudes and awareness of social services, including their interrelationships. This study examines determinants of knowledge, use, and future use of local home support agencies among a sample of community-dwelling elderly over the age of 74 living in Kitchener-Waterloo, Ontario. Measures of domestic self-reliance, independent living and perceptions of futurity are incorporated into the analysis. Logistic regression is used to test the models. The results show that attitudes regarding domestic self-reliance and independent living influence use of home support agencies largely through their impact on service awareness. Interestingly, these relationships are opposite to those hypothesized. Education is also found to be a predictor of knowledge of home support, and living arrangement, health status measures, and knowledge arise as important predictors of use and future use. The findings are discussed in terms of their implications for the underlying behavioral models, and for service providers and policymakers.