The preliminary efficacy of Caring of Caregivers Organically (CoCO) health education program on the health of Latina caregivers of persons with Alzheimer’s disease and related dementias

Abstract

Background By 2060, the prevalence of Alzheimer’s disease and related dementias (ADRD) in Latinos is projected to increase by 832%,1 representing an increased demand of caregivers. Caregiving has been shown to increase risk for depression and anxiety,2 poorer quality of life (QoL)3 and health behaviors.4 There is a critical need to create linguistically and culturally responsive interventions to promote caregiver health as they often forgo their own health to help the person with ADRD. CoCO is a health education program centered on caregiver’s physical and mental health. The purpose of this study was to assess the preliminary efficacy of CoCO on health‐related QoL, health behaviors, and symptoms of depression among Latina ADRD family caregivers. Methods Fourteen Latina ADRD family caregivers were randomized to the 8‐week, 2‐hours per week CoCO health education program delivered by health companions (n=8, mage=59.41±11.1) or a wait‐list control group who received the CoCO manual (n=6, mage=43.3±18.2). Health‐related QoL was assessed through the RAND 36‐item Health Survey (SF‐36).5 The Positive Health Behaviors scale6 was used to assess engagement in healthy activities. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.7‐8 T‐tests were used to assess change in the measures per group pre‐post intervention. Cohen’s d was used to calculate effect sizes. Results There were statistically significant increases in depressive symptoms pre‐post in both the intervention group (PreM=14.1±13.3, PostM=22.5±14.9, p=.007, d=1.32) and the control (PreM=5.5±3.6, PostM=14.0±10.0, p=.046, d=1.08). There were statically significant decreases in the emotional well‐being domain of the SF‐36 questionnaire in the control group only (PreM=79.3±18.5, PostM=67.3±15.5, p=.030, d=1.23). Cohen’s d values showed medium effect sizes showing a positive directionality in the physical activity domain of the health behavior scale for the intervention group only (PreM=5.50±4.90, PostM=7.75±4.03, p=.152, d=0.57). Conclusion Participants in the intervention demonstrated medium effects for the physical activity domain, suggesting an increase in physical activity. However, findings also indicate increased depressive symptoms and poorer health‐related quality of life. Health education interventions promoting health behavior changes in Latina ADRD family caregivers might benefit from including more extensive problem solving and coping strategies to improve depressive symptoms and QoL.