Abstract 4147913: Factors Associated with Activation to Perform Self-care among Rural Caregivers of Patients with Chronic Diseases and the Association of Activation to Perform Self-care with Adherence to Cardiovascular Disease Risk Reduction Measures

Introduction: Caregivers are at high risk of cardiovascular disease (CVD), depression, and mortality compared to non- caregivers. Patient activation- one's knowledge, skills and confidence to manage their own health-is associated with improved self-management behaviors for several chronic conditions. Studies exploring patient activation among rural caregivers of patients with chronic diseases are lacking. Aims: To determine 1) demographic, socio-economic, and psychological characteristics associated with activation in rural caregivers, and 2) association between activation and reported adherence to recommended CVD risk reduction measures and affective symptoms in rural caregivers of patients with chronic diseases. Method: In this cross-sectional study, 277 rural caregivers were included (mean age 54 ± 14 years; 76% were female; and 70% were married). We measured sociodemographic factors using a standardized survey, activation using patient activation measure (PAM), caregiver burden using the Zarit Burden Interview, social support using the Medical Outcomes Study Social Support Survey, depression using the Patient Health Questionnaire-9, anxiety using the Brief Symptom Inventory– Anxiety subscale, and adherence to recommended CVD risk reduction measures using the Medical Outcomes Study (MOS) Specific Adherence Scale. Hierarchical regression analysis was performed. Results: In this study, patient activation was high (mean PAM 69 ± 26). Caregivers who reported low activation had significantly poorer social support, more depressive symptoms, higher anxiety level, and scored higher on food insecurity ( p <.05). High patient activation was associated with better adherence to recommended CVD risk reduction measures ( β = 0.17; p <.01), less depressive symptoms ( β = -0.2; p <.001), lower anxiety level ( β = -0.23; p <.001), and lower caregiver burden ( β = -0.15; p <.01) compared to those with the lowest scores. Conclusion: In rural caregivers, higher activation was associated with better adherence to health behavior recommendations and favorable self-reported outcomes. Greater attention should be given to patient activation and psychosocial factors to reduce CVD risk in this population.