Evaluating Predictors of Family Caregiver's Self-Efficacy Managing Their Children's Health Care

Family caregivers of children and youth with special health care needs (CYSHCN) are often tasked with managing their children's health care. This study aims to evaluate what factors, if any, contribute to CYSHCN caregivers' self-efficacy managing their children's health care.

We conducted a national cross-sectional survey of English- and Spanish-speaking CYSHCN family caregivers (September 2023-December 2023). Caregiver self-efficacy was measured using a validated 30-item survey of pediatric health care tasks assessed with a 5-point confidence scale. Mean and median item responses were examined. Item-specific responses were dichotomized into those with "lower self-efficacy" ("not" [1] to "somewhat" [3] confident) and "higher" self-efficacy ("quite" [4] to "very" [5] confident). Analysis of variance and regression were used to evaluate differences in self-efficacy across demographic variables.

A total of 1132 respondents participated. Median IQR scores were 5 (4, 5) and mean of 4.39, SD ± 0.68. Responses ranged from 1 to 5; between 10% to 24% of respondents had "lower" self-efficacy across individual items. In adjusted analyses, caregivers with ≥ college education, married status, or widowed/divorced status had higher composite self-efficacy than their reference groups (β = 0.11-0.21, σM = 0.05-0.07). Lack of/unknown child insurance status was associated with lower caregiver composite self-efficacy (β = -0.25, σM = 0.1). Longer duration of caregiving was associated with higher composite self-efficacy (3-5 years [β = 0.28, σM = 0.08], 5-10 years [β = 0.41, σM = 0.09], >10 years [β = 0.36, σM = 0.09]) in comparison with <6 months.

While median item-specific self-efficacy scores were high, we identified respondents with lower self-efficacy across all items. Composite self-efficacy scores were associated with caregiver characteristics.