Impact of two psychosocial interventions on white and African American family caregivers of individuals with dementia

Abstract

Purpose: We developed manual-guided, replicable interventions based on common needs and cultural preferences of White and African American family caregivers (CGs) of individuals with dementia, and we evaluated these interventions after a 6-month follow-up.

Design and methods: We randomly assigned White (n = 70) and African American (n = 48) CGs of individuals with dementia to either a skills training condition or a minimal support control condition.

Results: The degree of treatment implementation was methodically assessed, and findings demonstrated that both interventions were delivered according to protocol and were well received by CGs. CGs in both groups reported decreasing levels of problem behaviors and appraisals of behavioral bother, and increased satisfaction with leisure activities over time. On a measure of appraisal of distress related to behavior problems, White CGs showed more improvement in the minimal support control condition, and African American CGs showed the greatest improvements in the skills training condition. Spouse and nonspouse CGs also showed differential responses to intervention.

Implications: Brief manual-guided interventions can be effective with White and African American CGs, and greater attention should be paid to possible differential responses to interventions by race and relationship to care recipient.

Figure 1

Revised Memory and Behavior Problem Checklist behavioral bother scores: caregiver race by group interaction effect. (MSC and STC = minimal support control and skills training conditions, respectively.) —●— MSC Black; —○— MSC White; —▼— STC Black; —▽— STC White.

Figure 2

Revised Memory and Behavior Problem Checklist mean number of behavior problems by caregiver race, relationship, and group interaction effect. (MSC and STC = minimal support control and skills training conditions, respectively.) —○— MSC White Spouse; —△— STC White Spouse; —●— MSC Black Spouse; —▲— STC Black Spouse; —□— MSC White Nonspouse; —⋄— STC White Nonspouse; —■— MSC Black Nonspouse; —◆— STC Black Nonspouse.

Figure 3

Mean social network scores on the Lubben Social Network Index: caregiver race by relationship interaction effect. —○— White Spouse; —●— Black Spouse; —▽— White Non-Spouse; —▼— Black Nonspouse.