How Effective Are Interventions With Caregivers? An Updated Meta-Analysis

Sörensen, Silvia; Pinquart, Martin; Duberstein, Paul R.

doi:10.1093/geront/42.3.356

Cited by 968 publications

(862 citation statements)

References 116 publications

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“…A meta-analysis of caregiver support and education-based interventions suggested an average effect size of 0.14-0.41 standard deviation unit decrease in burden and depression associated with a successful intervention. 37 The effect size of HCTD in our study on strain (0.45 standard deviation units) and depression (0.41 standard deviation units) approximates the effect of the most successful caregiver support interventions, suggesting the differences seen in our study are clinically significant.…”

Section: Discussionsupporting

confidence: 55%

Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

et al. 2011

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BACKGROUND: Family caregivers provide assistance with health care tasks for many older adults with chronic illnesses. The difficulty they experience in providing this assistance, and related implications for their well-being, have not been well described. OBJECTIVE: The objectives of this study are: (1) to describe caregiver's health care task difficulty (HCTD), (2) determine the characteristics associated with HCTD, and (3) explore the association between HCTD and caregiver well-being. DESIGN: This is a cross-sectional study. PARTICIPANTS: Baseline sample of caregivers to older (aged 65+years) multimorbid adults enrolled in an ongoing cluster-randomized controlled trial (N=308). MAIN MEASURES:The HCTD scale (0-16) is comprised of questions measuring self-reported difficulty in assisting older adults with eight health care tasks, including taking medication, visiting health care providers, and managing medical bills. Caregivers were categorized using this scale into no, low, medium, and high HCTD groups. We used ordinal logistic regression and multivariate linear regression analyses to examine the relationships between HCTD, caregiver self-efficacy, caregiver strain (Caregiver Strain Index), and depression (Center for Epidemiological Studies Depression Scale), controlling for patient and caregiver socio-demographic and health factors. KEY RESULTS: Caregiver age and number of health care tasks performed were positively associated with increased HCTD. The quality of the caregiver's relationship with the patient, and self-efficacy were inversely associated with increased HCTD. A onepoint increase in self-efficacy was associated with a significant lower odds of reporting high HCTD (OR, 0.64; 95% CI, 0.54, 0.77).Adjusted linear regression models indicated that high HCTD was independently associated with significantly greater caregiver strain (B, 2.7; 95% CI, 1.12, 4.29) and depression (B, 3.01; 95% CI, 1.06, 4.96). CONCLUSIONS: This study demonstrates that greater HCTD is associated with increased strain and depression among caregivers of multimorbid older adults. That caregiver self-efficacy was strongly associated with HCTD suggests health-system-based educational and empowering interventions might improve caregiver well-being.

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Section: Discussionsupporting

confidence: 55%

Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

et al. 2011

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“…Reviews of the caregiving literature indicate a need for interventions directly targeting caregivers and the use of valid and reliable assessments to determine needs and measure outcomes (Brown & Brown, 2014;Pinquart & Sörensen, 2003;Sörensen, Pinquart, & Duberstein, 2002). Previous studies on home modification interventions for caregivers used caregiver report or assessments designed to evaluate functional performance of people with disabilities to assess caregiver support.…”

Section: Discussionmentioning

confidence: 99%

In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers

Keglovits

Somerville

Stark

2015

The American Journal of Occupational Therapy

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Home modification interventions have the potential to provide support to informal caregivers; however, the impact of these interventions on caregivers is understudied, and adequate assessments are lacking. This study describes the development and preliminary psychometric properties of a performance-based assessment that identifies environmental barriers to performance of daily caregiving activities. An existing assessment of person–environment fit was modified using key informant interviews and was administered to 31 informal caregivers. The In–Home Occupational Performance Evaluation for Providing Assistance demonstrated reliability across raters, good internal consistency for all subscales, and convergent validity with existing measures. This assessment has the potential to guide home modification interventions and measure the impact on informal caregiving in the home.

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“…However, as seen in marketing, certain information can have the ability to persuade [47]. In a meta-analysis of intervention studies with family caregivers, those that combined content education with social support and other tactics produced the largest effects [48]. And as mentioned in the discussion of the programs' theoretical structure, knowledge may inform attitudes and could serve as a prerequisite for change.…”

Section: Discussionmentioning

confidence: 99%

Empiric validation of a process for behavior change

Elliot

Goldberg

MacKinnon

et al. 2015

Behav. Med. Pract. Policy Res.

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Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre-and post-intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [p<0.01]). Norms, perceived control abilities, and self-monitoring were confirmed in at least two studies (p<0.01 for each). Replication of findings across studies with a common design but varied populations provides a robust validation of the theory and processes of an effective intervention. Combined findings also demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change. KeywordsBehavior change, Mediation, Peer-led INTRODUCTION Knowledge about how healthy lifestyles can prevent illness has outpaced effective means to assist people in living health lives [1]. That limitation is not due to lack of research, and contributions have come from diverse disciplines, such as health promotion, behavioral economics, psychology, decision analysis, and sociology. However, progress may have been constrained due to a focus on outcomes rather than deconstructing how change occurred [2][3][4]. Our group has studied a series of behavior change interventions that use a shared format and theoretical structure. All had documented efficacy in randomized controlled trials [5][6][7][8][9][10], and for each, specific program components were related to behavioral endpoints [11][12][13]. Comparing their observed patterns of findings presents a means to assess theories of behavior change and validate an effective intervention format.

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How Effective Are Interventions With Caregivers? An Updated Meta-Analysis

Abstract: Caregiver interventions are effective, but some interventions have primarily domain-specific effects rather than global effects. The differences between intervention types and moderators suggest ways of optimizing interventions.

Cited by 968 publications

References 116 publications

Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults

In-Home Occupational Performance Evaluation for Providing Assistance (I–HOPE Assist): An Assessment for Informal Caregivers

Empiric validation of a process for behavior change

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