Assessments

GiveCare uses a progressive measurement system built to answer one question: what do we need to understand now in order to support this person well, without overwhelming them?

Why caregivers get short, staged measures

National caregiver data shows heavy time, stress, work, and financial demands: caregivers spend 27 hours a week on average providing care⁶, and nearly two-thirds report moderate or high emotional stress. Half of working caregivers experience work impacts, and nearly half report a negative financial impact. A measurement system that assumes long, uninterrupted attention would miss many of these caregivers, so GiveCare stages its questions.

Entry screen: BSFC-s

Before SMS, GiveCare may begin with the BSFC-s, a 10-item short version of the Burden Scale for Family Caregivers developed as an economical measure of subjective caregiver burden¹. Its score runs from 0 to 30, and higher scores indicate greater burden. A supplied assessment handoff imports its reading at signup only when it is unused, unexpired, and bound to the signup email. If there is no handoff, enrollment proceeds without it.

Ongoing SMS battery

Once a caregiver is in the SMS system, the runtime uses these measures:

ID	Name	Role
gc_sdoh6	GC-SDOH-6 six-domain snapshot	Baseline at SMS entry
gc_sdoh30	GC-SDOH-30 targeted deep dive	Four additional questions in one flagged GC domain
ema3	EMA-3 reading	Short-interval stress, mood, and coping between structural checks

Mira offers an assessment only when code finds a gap: a missing baseline, one older than the instrument's 30-day cadence, or an eligible targeted area, outside the offer cooldown.¹⁹ A current need interrupts an assessment without losing the question, and completing an assessment does not schedule another invitation.¹⁹

How the runtime works is defined in the SMS runtime contract.

Where GC-SDOH comes from

Standard social-determinants frameworks were built for patients, so GiveCare adapts that tradition to the caregiver as the primary subject. It draws on these published sources:

• The National Academy of Medicine report notes that health is shaped by community-wide factors such as poverty, unemployment, and inadequate housing¹⁸.
• PRAPARE is a national effort to help providers collect data on their patients' social determinants of health⁴.
• The AHC screening tool requires awardees to screen for five core domains: living situation, food, transportation, utilities, and safety⁵.

See SDOH Framework and SDOH in Caregiving.

Why GiveCare does not stop at one existing instrument

Burden-oriented tools such as the MCSI (13 questions on strain related to care provision) and the Zarit Burden Interview (caregiver perceptions of burden) are established quick screens⁸⁹. GiveCare also looks at other kinds of signal.

The shortened Caregiver Well-Being Scale is designed to help identify areas of caregiver strength and areas in which additional support is needed³. The University of Connecticut lists 14 items for it, while its record for the 2013 Tebb short-form paper describes a 6-item version². The scale is not part of the active SMS assessment loop. See Assessment Instrument Evidence and Boundaries for source lineage and public claim limits.

REACH II tested a multi-component psychosocial intervention to reduce burden and depression among family caregivers of people with Alzheimer's disease or related disorders¹⁰.

PROMIS measures separate constructs rather than folding them into one score:

• Social isolation covers perceptions of being avoided, excluded, or disconnected¹¹, while companionship covers perceived availability of someone to share enjoyable activities with¹².
• Depression covers negative mood, views of self, and social cognition¹³.
• Meaning and purpose covers a sense that life has purpose¹⁴, and general life satisfaction covers a cognitive evaluation of life experiences¹⁵.

Alignment with the field-level research agenda

The 2019 UC Davis caregiving research priorities include risk/needs assessment of changing caregiver needs over the trajectory of caregiving, and outcome measures relevant to caregivers from diverse social and cultural groups¹⁶.

The UC Davis Interprofessional Family Caregiving Competencies ask health professionals to identify family caregivers in routine assessments, use valid and reliable tools to assess the consequences of caregiving, and monitor and respond to changes over time¹⁷. The National Strategy to Support Family Caregivers was created to support caregivers of all ages⁷.

What assessment results are for

Assessments are there to make the caregiver's situation easier to understand, surface which domains need attention, route benefits, resources, and follow-up, and track change over time. They are not a substitute for diagnosis, treatment planning, or licensed clinical assessment.

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1. Graessel E et al. "Burden Scale for Family Caregivers (BSFC-s)." University of Erlangen. Source → ↩

2. Tebb SC, Berg-Weger M, Rubio DM. "The Caregiver Well-Being Scale: Developing a Short-Form Rapid Assessment Instrument." Health & Social Work 38(4), 2013. Source → ↩

3. University of Connecticut M3EWB. "Caregiver Well-Being Scale – Shortened Version." Source → ↩

4. NACHC. "PRAPARE Implementation and Action Toolkit." 2019. Source → ↩

5. CMS. "Accountable Health Communities Health-Related Social Needs Screening Tool." Source → ↩

6. AARP/NAC. "Caregiving in the United States 2025." Source → ↩

7. U.S. Department of Health and Human Services. "National Strategy to Support Family Caregivers." 2022. Source → ↩

8. Modified Caregiver Strain Index (MCSI). Source → ↩

9. Zarit Burden Interview. Source → ↩

10. REACH II. Source → ↩

11. PROMIS. "Social Isolation." Source → ↩

12. PROMIS. "Companionship." Source → ↩

13. PROMIS. "Depression." Source → ↩

14. PROMIS. "Meaning and Purpose." Source → ↩

15. PROMIS. "General Life Satisfaction." Source → ↩

16. UC Davis Family Caregiving Institute. "Research Priorities in Caregiving." 2019. Source → ↩

17. Sexson KE et al. "Interprofessional Family Caregiving Competencies." UC Davis Family Caregiving Institute, 2021. Source → ↩

18. NAM. "Communities in Action: Pathways to Health Equity." 2017. Source → ↩

19. GiveCare. "GiveCare SMS Runtime Contract." Source → ↩↩