Using mixed methods to evaluate the use of a caregiver strain measure to assess outcomes of a caregiver support program for caregivers of older adults Margaret Hellie Huyck 1 * , Liat Ayalon 2 and Judy Yoder 3 1 Illinois Institute of Technology, IL, USA 2 School of Social Work, Bar Ilan University, Israel 3 Metropolitan Family Services, Chicago, IL, USA SUMMARY Purpose Many assessment tools have been developed for evaluating caregiving programs, but the majority are too cumbersome for ongoing use. This study reports on a brief assessment tool used to monitor strain among family members caring for an impaired elder. Design and methods Participants were enrolled in the SeniorCare program, a program funded by the Administration on Aging to provide care to family caregivers. The Caregiver Risk Screen (CRS) is a 12-item measure of strain, initially developed as part of an in-home assessment procedure. Its utility for use in practice settings over time was assessed using both quantitative and qualitative methodology. Results Chronbach alpha levels for the CRS were 0.85 at intake and 0.84 at first follow-up. At the first follow-up, the overall index score and five of the 12 items showed statistically significant lessened strain. In subsequent follow-up evaluations, the average improvements were maintained but there was no additional decrease in strain. Individual variations in changes over time were identified by combining quantitative and qualitative information. Themes that emerged in qualitative data served to modify the measure for future use. Implications The brief Caregiver Risk Screen tool appears to be a reliable and valid tool for use in practice settings. It is acceptable to clients and professional staff. Modifications have been made that may further enhance the suitability of this measure for other settings. Copyright # 2006 John Wiley & Sons, Ltd. key words — outcome evaluation; family caregiving; ethnicity; measurement; burden INTRODUCTION It is well established that providing care for an impaired older family member is a common experi- ence, involving 25% of American families (Kaiser Family Foundation, 2002). Recognizing and support- ing family caregiving is a central component of a comprehensive long-term care system. While there is yet no common protocol for family caregiver support services, there are emerging guidelines (Feinberg, 2001). The common challenge for all programs is to identify tools for assessing impact that are user friendly and psychometrically sound. Many tools have been developed and used to assess care recipients, caregivers, situations, and responses (Family Caregiver Alliance, 2002; Feinberg, 2002; Schulz et al., 2003). However, most are overly cumbersome for ongoing use in a practice setting. Thus, in this study, we evaluated the ability of a brief caregiving screen, the Caregiver Risk Screen (CRS; Guberman et al. 2001), to track the caregiver experience overtime. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int J Geriatr Psychiatry 2007; 22: 160–165. Published online 18 December 2006 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/gps.1707 *Correspondence to: Dr M. H. Huyck, Institute of Psychology, Illinois Institute of Technology, Chicago, IL 60616, USA. E-mail: mhhuyck@sbcglobal.net Copyright # 2006 John Wiley & Sons, Ltd. Received 1 September 2005 Accepted 14 February 2006