Subjective stressors moderate effectiveness of a multi‐component, multi‐site intervention on caregiver depression and burden

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Abstract
Objectives: The present study assessed whether caregiving contextual factors moderated outcomes of a caregiver intervention.Methods: Extant data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II study, a randomized‐control trial of a multi‐component, multi‐site intervention for dementia caregivers was utilized. 498 caregivers {83.1% women; mean [standard deviation (SD)] age = 60.3 (13.1)}, and their care recipients [58.6% women, mean (SD) age = 78.5 (9.6)] were randomly assigned to intervention or control group. Multiple regression was used to regress Center for Epidemiological Studies of Depression Scale (CES‐D) and Zarit burden scores on the interaction between group membership and various factors reflecting the caregiving context.Results: Lower follow‐up CES‐D scores in the intervention group were found only for those: in the fourth quartile of baseline CES‐D (β = −0.13, p = 0.05; overall interaction p = 0.009), with high Revised Memory and Behavior Problems Checklist (RMBPC) stress (β = −0.16, p = 0.03) and with a home health aide (β = −0.29, p = 0.009). Diminished burden was found in the intervention group only for the following: those in the fourth quartile of baseline burden (β = −0.16, p = 0.01), and in the fourth quartile (β = −0.16, p = 0.05) of Mini Mental State Examination, and with high RMBPC stress (β = −0.18, p = 0.008), with a trend for diminished burden among those with a paid homemaker (β = −0.19, p = 0.075).Conclusion: Results suggest greater intervention efficacy among caregivers experiencing subjective stress. Copyright © 2013 John Wiley & Sons, Ltd.

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