Urban versus rural differences in the effects of providing care to children with cerebral palsy on family member's employment

focuses on personal and family unmet needs and support preferences. Results: Several themes emerged from the focus groups, and needs differed by phase of care (initial vs ongoing). Isolation and coping with trauma were themes of both care phases, with some unique features. Immediately after injury, caregivers spoke of isolation from close family members and friends and an overwhelming gulf of emotions coping with the trauma of the injury. After this initial phase, caregivers spoke of experiencing isolation from others living with SCI, for both themselves and their child. They also reported persistent emotional challenges for themselves and their family that peak and wane. Further, they described challenges balancing caregiving with other family roles and maintaining their physical and emotional stamina. Caregivers desired more support from professionals during both the initial and ongoing phases of care. Early on, they reported needing help finding appropriate pediatric SCI rehabilitation centers and processing the large amount of information and emotions. They also wanted more orientation and preparation for specialty care needs and secondary conditions. Care coordination and help navigating benefits and insurance were reported as ongoing needs. Caregivers were unanimous in the need for more peer support as soon as possible and over the “long haul.” They spoke of the power of hearing and receiving support from others who have “been there and done that.” Having formal and informal opportunities to connect with others living with SCI was highly desired. Conclusions/Significance: Results indicate that additional peer and professional social support is needed in order to help caregivers navigate the different phases of caring for their child with SCI. Support: The Craig H. Neilsen Foundation, Grant #288993. SP 48 Urban versus rural differences in the effects of providing care to children with cerebral palsy on family member’s employment B SCHAIBLE, G COLQUITT, L LI, N MOREAU, M CACIULA Georgia Southern University, Statesboro, GA, USA; ACSM, NAK, ISB, Statesboro, GA, USA; Louisiana State University Health Sciences Center – New Orleans, New Orleans, LA, USA; Georgia Southern University, New York, NY, USA Background and Objective(s): Context (urban vs rural) can mediate the impact on the family among other childhood populations with special healthcare needs. To date, few studies have examined the role of context in caring for a child with CP; therefore, we analyzed data from the National Survey of Children with Special Health Care Needs (NS-CSHCN). Study Design: Cross-sectional. Study Participants & Setting: Participants were parents of children (< 18y old) with CP. Children’s mean age of rural respondents was 10.17 (SD=4.69), while 73% were white, 13.5% Hispanic, 11% black, and 2.5% other (non-Hispanic). Among rural families, 33.05% were living in households with incomes below the Federal Poverty Level (FPL). For those respondents living in urban areas, children’s mean age was 9.74 (SD=4.50) and 63% were white, 13% Hispanic, 16% black, and 8% other (non-Hispanic). Overall 21.1% of urban families lived in households with incomes below the FPL. Materials/Methods: The NS-CSHCN was designed to examine stateand national-level estimates of CSHCN. A national random-digit-dial sample of US households were screened for children with special healthcare needs aged 0–17 years. Households reporting a CSHCN participated in an interview for one randomly selected child with a special healthcare need. Of 40 242 completed interviews from 2009 to 2011, 744 reported as having a child with a diagnosis of CP and were included in the sample. We performed logistic regression analyses, in the context of multiply imputed data to address missing data concerns, modeling the probability that family member’s employments were unaffected by the child’s health. Results: Our analysis indicated significant differences between families with children with CP living in an urban environment and those living in a rural setting concerning the impact that the child’s health had on family member’s work lives. There were six significant variables impacting the employment of family members for families living in an urban setting categories relating to missed school days, financial burden, and