2793-LB: Competing Needs and Barriers to Health Care Seeking among Black Females with Type 2 Diabetes, Obesity, and Multicaregiving Responsibilities

Introduction and Objective: Females with type 2 diabetes and obesity who have multiple caregiving responsibilities, defined as the provision of care (emotional, physical/tangible, financial, spiritual) to parents/grandparents, children/grandchildren, and/or significant others, experience competing demands that create barriers to diabetes management. However, these relationships are less clear among female caregivers in the sandwich (~40-50 years old) and club sandwich (~50-60 years old) generations. Therefore, the objective of this study was to assess the efficacy of a multi-caregiving intervention on competing needs and barriers to healthcare seeking and among older Black/African American females with type 2 diabetes, obesity, and multicaregiving responsibilities. Methods: Sixty participants were randomized to either the multi-caregiving intervention (diabetes education and skills training; multi-caregiving coping and stress management) (n=29) or diabetes enhanced usual care (n=31). The outcome was competing needs and healthcare seeking behavior (defined as at least one of the following: not seeking healthcare due to 1) needing money for food, clothing, housing, etc.; 2) lacking transportation; 3) being sick; 4) working; or 5) paying for medical care). Generalized linear mixed methods effects models were used to conduct the analysis. Results: The mean BMI was 38.4, and the mean age was 53 years (range 40-64 years). Over 6 months, the proportion of self-reported competing needs and barriers to healthcare seeking decreased from 45% to 33% (p=0.056, alpha=0.1), with no significant difference between groups. Conclusion: These findings suggest that social support from addressing multi-caregiving responsibilities and providing health education may reduce perceived barriers to healthcare seeking among older Black/African American females with type 2 diabetes, obesity, and multiple caregiving responsibilities in these generations. Disclosure J.S. Williams: None. A.Z. Dawson: None. Funding National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (R21DK123720)