{"doi":"10.3389/fpubh.2025.1688161","title":"Utilization of home- and community-based services among rural family caregivers of persons with dementia: the role of the area deprivation index","abstract":"Background: Dementia significantly impacts rural communities in the U.S., presenting unique challenges for family caregivers due to limited access to essential support services. This study examines the influence of area-level factors on the utilization of home- and community-based services among rural caregivers. Methods: workshop were analyzed. Participants completed an online survey assessing home- and community-based support services and caregiving aspects. Area-level factors were measured using the Area Deprivation Index (ADI) and U.S. Census region, linked to respondents ZIP+4 code and state. Multivariable logistic regression analyses assessed the relationship between area-level factors and support service utilization. Results: About 65% of caregivers used at least one support service, with 52% utilizing home-based services and 52% community-based services. Caregivers in the most deprived rural areas were significantly less likely to use any support services (OR = 0.45; 95% CI [0.23, 0.89]) and community-based services (OR = 0.26; 95% CI [0.26, 0.86]) compared to those in the least deprived rural areas. No significant associations were found between Census region and any type of support service utilization. Conclusion: Service utilization differences within rural areas highlight the need for nuanced, area-specific interventions to enhance support service accessibility for caregivers in deprived rural areas, improving caregiving outcomes. Future research should further investigate area-level variations and their interactions with individual factors to better understand barriers faced by rural caregivers. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04428112, identifier NCT04428112.","journal":"Frontiers in Public Health","year":2025,"id":554356,"datarank":0.12472364253661165,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.020751565452619847,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.020751565452619847,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8479,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT04428112"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":306162,"name":"Kenneth E. Covinsky","orcid":null,"position":1,"is_corresponding":false},{"id":1266856,"name":"Jing Cheng","orcid":"0000-0001-7100-1180","position":2,"is_corresponding":false},{"id":675715,"name":"Dolores Gallagher‐Thompson","orcid":"0000-0001-5321-3403","position":3,"is_corresponding":false},{"id":91631,"name":"Veronica Yank","orcid":"0000-0002-8420-3897","position":4,"is_corresponding":false},{"id":588029,"name":"Jasmine Santoyo‐Olsson","orcid":"0000-0002-5602-1148","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:54:50.112989Z","pmid":"41164840","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}