About

Rebecca Utz is a professor involved in the Behavioral Medicine Research Group at the University of Utah's Department of Psychology. Her work is part of a dynamic interdisciplinary group that includes core Health Psychology faculty, affiliated faculty from the U of U Medical Center, and health-focused graduate students across the department. The group provides opportunities for research feedback, professional development, and collaboration, with activities such as research presentations, outside speakers, grant development brainstorming, journal clubs, and professional panels. Her contributions include engaging in research that explores health equity, social support in underrepresented communities, and health outcomes, as evidenced by her involvement in practice dissertation defenses and collaborative projects. The group’s activities aim to sharpen thinking, generate new ideas, and support the professional growth of students and early career faculty, ultimately fostering successful careers in behavioral medicine.

Research topics

• Psychology
• Sociology
• Developmental psychology
• Psychiatry
• Gerontology
• Medicine
• Clinical psychology
• Gender studies
• Psychotherapist

Selected publications

• Caregiver burden: changes over time and associations with anxiety and depression symptoms

  Aging & Mental Health · 2026-04-27

  articleSenior author

  OBJECTIVES: Family caregivers commonly report high levels of burden, which is associated with risk for depression and anxiety. However, less is understood about how symptoms respond to changes in caregiver burden. This clinical-trial study assessed the influence of caregiver burden on anxiety and depression among informal caregivers on persons with Alzheimer's disease and related dementias. METHODS: = 139) self-reported caregiver burden, depression, and anxiety symptoms, up to 6 times over a twenty-week period. Multilevel models assessed concurrent and longitudinal effects of changes in caregiver burden on changes in depression and anxiety symptoms. RESULTS: CI [0.08, 0.22]). CONCLUSION: While worsening depression and anxiety symptoms that followed an increase in burden were modest in the context of a single month, reporting higher than typical burden for two or more months was related to clinically relevant shifts in the risk for depression and anxiety. Results indicate that interventions designed to reduce burden would likely benefit caregivers' mental health.

  PublisherDOI

• Engaging in the Life-planning in Early Alzheimer’s and other Dementias advance care planning intervention is associated with perceived advance care planning concordance and interpersonal connectedness

  The Gerontologist · 2025-08-05 · 2 citations

  articleOpen access

  BACKGROUND AND OBJECTIVES: Persons living with dementia often rely upon a care partner as their surrogate medical decision maker, yet little is known about how dementia care dyads achieve advance care planning (ACP) concordance: when a care partner fully understands a care recipient's values and preferences as best they can. Examining data from a pilot study of the online Life-planning in Early Alzheimer's and other Dementias (LEAD) intervention to better understand how dyads achieve perceived ACP concordance, we hypothesized that: (1) engaging in ACP was associated with perceived ACP concordance, (2) perceived ACP concordance was associated with interpersonal connectedness, and (3) engaging in ACP was associated with interpersonal connectedness. RESEARCH DESIGN AND METHODS: Dyads completed the LEAD intervention and answered open-ended survey questions. After aggregating data supporting and or not supporting each hypothesis, process codes and subcodes were used to identify the elements involved in each supported hypothesis (Cohen's Kappa .65-.82). RESULTS: N = 48 community-based dyads completed the LEAD intervention, with N = 43 answering open-ended questions. Care recipients averaged 65.1 years of age (SD =14.8); care partners averaged 54.9 years (SD = 14.6) and were primarily spouses (n = 32, 66.7%) or children (n = 12, 25.0%). Engaging in ACP was associated with higher interpersonal connectedness and with perceived ACP concordance. Perceived ACP concordance was not associated with higher interpersonal connectedness. DISCUSSION AND IMPLICATIONS: These findings suggest that clinicians should focus on facilitating ACP discussions with dyads, as these conversations appear crucial for fostering understanding and agreement between dyad members, ultimately leading to perceived ACP concordance.

  PublisherOA PDFDOI

• “Quality of life matters to me more than life, itself”: A qualitative exploration of older adults’ values and preferences on controlling the time of death

  Death Studies · 2025-08-01

  article

  This study explored healthy older adults' values and preferences for controlling time of death and if these preferences change with hypothetical future disease. We used an interpretive descriptive approach to analyze open text responses (N = 121) from a national study on end-of-life values and preferences (age ≥ 50, N = 517). Codes/categories were developed deductively by three coders who engaged in ongoing conversation about discrepancies and refined the codes iteratively. Controlling time of death and having a natural death were both desirable care preferences and varied with hypothetical future disease. We identified three values that shaped preferences: A Good Death, Burden to Others, and Relationship with Family. We also identified two contextual factors that modified preferences: Disease Trajectory and Legal Concerns. We found that a hypothetical future diagnosis of dementia and anticipation of financial burden to family motivated preferences to control time of death.

  PublisherDOI

• Redefining respite for family caregivers: lessons learned from the COVID-19 pandemic

  Frontiers in Health Services · 2025-07-25 · 1 citations

  articleOpen access1st authorCorresponding

  Introduction: Respite care is provided to caregivers through in-home respite providers, drop-off day centers, and institutional or overnight facilities, where the caregiver can take a break or get time-away, while the care-recipient is provided with personal care, companionship, and/or supervision. During the global COVID-19 pandemic (2020+), these types of formal respite services were disrupted, leaving caregivers with little to no access to respite. This study aimed to understand how caregivers accessed and achieved respite when respite services were not readily available, and how their experiences during and following the unprecedented global public health crisis have influenced and informed the way that caregivers achieve the needed and desired respite. Methods: This study integrates several sources of qualitative and descriptive data collected via electronic surveys and semi-structured interviews with family caregivers and respite providers over the past several years (from 2019 to 2024). Results: The following themes were identified: (a) disruption and loss of formal respite services resulted in caregiver isolation, as well as acute and protracted stress, (b) personal networks and shared caregiving arrangements provide opportunities for informal respite, (c) respite is associated improved caregiver wellbeing, but caregivers often are hesitant to use respite (d) daily activities and routines can provide a form of respite for caregivers, (e) family caregivers showed resilience and adaptability in the face of COVID-19 challenges, revealing the potential benefit of taking "short breaks" throughout the day to achieve a feeling of respite. Discussion and conclusions: These qualitative, descriptive insights provide a blueprint for a reimagined definition of caregiver respite, where respite is conceptualized as an outcome or benefit that caregivers seek and can create on their own, rather than only defining respite as a formal service provided to caregivers by outside organizations. In the face of significant workforce shortages that threaten the widespread availability and access to formal respite services, a re-imagined model of respite has the potential to better meet the respite needs and wishes of family caregivers, and maximize the benefit of short-breaks when formal respite services may not be available.

  PublisherOA PDFDOI

• “It seems to have drawn us closer”: Participant Reflections on Digital Advance Care Planning

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Persons living with dementia (PLWD) and their care partners (CP) experience improved outcomes when engaging in advance care planning (ACP). We explored participant reflections on a web-based intervention for ACP in dementia. A thematic analysis was conducted on open-text feedback data from N = 47 dyads (PLWD and CP). Two coders analyzed data independently, resolved discrepancies, and collaborated with the research team to determine themes. The sample was mostly female (54%), white (86%), and aged 26 to 93. Among care recipients, 67% had mild cognitive impairment or dementia; the remainder reported early warning signs of Alzheimer’s disease. Three themes included: (1) Dynamic nature of ACP in dementia, (2) Cognitive issues, and (3) Emotional issues. Findings revealed that dyads (PLWD and CP) used the web-based intervention for ongoing, dynamic ACP despite cognitive issues and emotional issues. For example, despite PLWD “needing questions clarified” and having “frustration” and “overwhelm,” CPs stated, “It seems to have drawn us closer,” “These are important and necessary plans to make, but it is sad to go through this process,” and “Even though (we) have already completed our directives…this…helped to have additional considerations for our end-of-life plan…” These findings support a Delphi expert panel definition of ACP in dementia as a continued process with family over time that is adapted to the PLWD’s capacity. We add that ACP remains beneficial even in the face of cognitive and emotional challenges. Researchers and clinicians should acknowledge cognitive and emotional issues for persons engaging in dynamic ACP in dementia.

  PublisherOA PDFDOI

• Assessing feasibility of an online caregiver intervention to improve respite: the Time for Living and Caring (TLC) Study (Preprint)

  2025-01-26

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> Interventions that are self-administered and delivered online are increasingly being seen as a flexible way to support family caregivers. Respite, defined as a planned break or time away from caregiving, is among the most needed and requested forms of caregiver support; yet, few caregiver interventions address caregivers’ use of respite. </sec> <sec> <title>OBJECTIVE</title> We describe the methodology and data used to assess the feasibility, usability, and acceptability of the Time for Living and Caring (TLC) intervention; a technology delivered intervention (app) for dementia caregivers to improve respite time use. </sec> <sec> <title>METHODS</title> This study’s evaluation effort is theoretically guided by a multidimensional definition of feasibility and employs a mixed-methods approach for feasibility analysis. Stakeholder feedback collected via focus groups during the intervention development (n=15), self-reported surveys from participants enrolled in the pilot trial of the intervention (n=163), surveys of a nationwide sample of respite providers (n=57), and end-user statistics, captured passively by Google Analytics from those using the app, were used in the analysis of the TLC intervention feasibility. </sec> <sec> <title>RESULTS</title> Data and metrics, overall, show high rates of feasibility for the TLC online intervention. Favorable ratings of intervention features ranged from 83-99%, which, when combined with open-ended recommendations for improvements, indicate a high degree of usability. Acceptability was measured through appraisal of the intervention experience (85% positive), potential future use (78%), willingness to recommend (91%), and perceived benefit (&gt; 80%). </sec> <sec> <title>CONCLUSIONS</title> Taken together, these data suggest that TLC is a promising intervention that could be implemented as an on-demand resource for respite-using caregivers irrespective of where they are located or when they choose to access it. Additionally, this paper provides a blueprint for systematically evaluating multiple dimensions of feasibility, using various forms of mixed-methods data collected during intervention development and pilot-testing of an intervention, which should help streamline the eventual implementation of effective interventions in real-world settings. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT03689179 </sec>

  PublisherDOI

• Leveraging Existing Datasets to Advance Family Caregiving Research: Opportunities to Measure What Matters

  2025-09-15

  book-chapter

  More than 17.7 million people in the U.S. care for older adults. Analyzing population datasets can increase our understanding of the needs of family caregivers of older adults. We reviewed 14 U.S. population-based datasets (2003–2023) including older adults’ and caregivers’ data to assess inclusion and measurement of 8 caregiving science domains, with a focus on whether measures were validated and/or unique variables were used. Challenges exist related to survey design, sampling, and measurement. Findings highlight the need for consistent data collection by researchers, state, tribal, local, and federal programs, for improved utility of population-based datasets for caregiving and aging research.

  PublisherDOI

• Co-Creating Carer-Centric Service Model: Assessing Carer Needs and Developing Needs-Stratified Interventions

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract This symposium aims to explore innovative approaches to enhance the well-being of family carers in Hong Kong through collaborative research and tailored interventions. Utilizing participatory co-creation methods, Jockey Club Carer Space Project underscores the importance of needs-stratified service provision and carer-centric design, illustrating how collaborative research can lead to sustainable, community-driven solutions. Two interventions were developed to support carers of older adults with different levels of need. A randomized controlled trial was conducted to examine effectiveness of a low-intensity cognitive behavioral therapy (CBT)-guided group intervention. Preliminary findings suggest that the intervention may significantly improve mental health outcomes and overall quality of life for family carers of older adults. A two-phase usability evaluation was conducted to collect participants’ feedback on the functionality and user experience of an eCoaching platform, leading to refinements before its launch for evaluating its effectiveness in helping family carers of older adults manage their mental health in a three-arm randomized controlled trial. Quantifying economic burden of family caregiving in Hong Kong, particularly in light of the aging population, highlights the significant monetary value of caregiving time and related out-of-pocket expenses, reiterating the urgent need for policy measures to support family carers in their critical roles. This symposium will provide a platform for discussing innovative, evidence-based interventions that address the complex needs of family carers. By fostering collaboration among researchers, practitioners, and policymakers, this symposium aims to pave the way for more effective carer-centric service model that enhance the quality of life for both carers and care recipients.

  PublisherOA PDFDOI

• Review of “At Home in the City: Growing Old in Urban America”

  Social Forces · 2025-07-09

  article1st authorCorresponding
  PublisherDOI

• Using Active Engagement to Support Dementia Caregivers: Results from the Enhancing Active Caregiver Training (EnACT) Study

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  BACKGROUND: Actively engaging caregivers in applying knowledge and skills through training and support groups improves caregiver outcomes. However, the optimization and systematic testing of active engagement in these settings are lacking. The Enhancing Active Caregiver Training (EnACT) intervention aims to foster active engagement through arts-based, multisensory experiences, helping caregivers manage common dementia-related behavioral symptoms. EnACT uses caregiver-informed vignettes and imagination exercises that enhance active engagement by practicing caregiving skills and reactions in settings that allow for trial and error, better preparing caregivers for challenging situations. We examined the effects of EnACT on two proximal outcomes (capacity to adapt and appraisal of caregiving demands), the distal outcomes of perceived stress and caregiver well-being (positive aspects of caregiving and caregiver burden), and three proposed mechanisms of action (increased preparation, increased multisensory detail, and decreased discrepancy). METHODS: Thirty caregivers of persons living with dementia were randomly assigned to the EnACT intervention (n = 15) or waitlist control (WLC) (n = 15) groups. All participants completed baseline, pretreatment (2 weeks), 3 sessions of ENACT over 6 weeks, and a post-treatment. Data was gathered at six timepoints to assess proximal and distal outcomes, and mechanisms of action. We used linear models conditioning on baseline values to examine the impact of the intervention on our outcomes. Furthermore, we included data of the intervention effect on the WLC group to leverage their exposure when estimating our parameters. RESULTS: Participants in both groups had high retention rates with 97% completing all 6 questionnaires. Exploratory analysis found that the EnACT intervention led to small effect size (Cohen's d 0.2 to 0.3) improvements in both the intervention and WLC groups in perceived stress, two appraisal of caregiving demand subscales (burden, satisfaction), positive aspects of caregiving, and preparation. Additional variables did not show change. CONCLUSIONS: Initial results demonstrate that EnACT has the potential of reducing perceived stress, improving preparation and positive aspects of caregiving, while steadying burden across time. Time in session and number of sessions may influence outcomes, suggesting a need for refinement in intervention dose. Data from this pilot is being used to prepare a fully powered randomized controlled study.

  PublisherOA PDFDOI

Frequent coauthors

• Michael S. Caserta

  University of Utah

  33 shared

• Eli Iacob

  University of Utah

  30 shared

• Kara Dassel

  University of Utah

  24 shared

• Ken R. Smith

  23 shared

• Katherine Supiano

  University of Utah

  23 shared

• Dale A. Lund

  Cornell University

  21 shared

• Amber Thompson

  University of Houston

  18 shared

• Katherine Ornstein

  Johns Hopkins University

  14 shared

Labs

• Behavioral Medicine Research GroupPI

  Engage with a dynamic interdisciplinary group of researchers including core Health Psychology faculty, affiliated faculty in the U of U Medical Center, and health-focused graduate students across all areas of the department.