Self-Efficacy Change among Diverse Family Caregivers in Dementia Care

Objectives To determine whether changes in caregiver self-efficacy (beliefs about one’s ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care. Methods In the Dementia Care Study (D-CARE), community-dwelling older adults with dementia and their unpaid family caregivers were randomized to receive usual care, community-based, or health system-based comprehensive dementia care. Caregiver self-efficacy was assessed at baseline, 6 months, and 18 months using a 4-item scale (range 4-20, higher scores indicate greater self-efficacy). Among all caregivers, we compared least squares means for overall change in self-efficacy from baseline across racial and ethnic groups (Latino, non-Latino Black, and non-Latino White). Results Among 2,126 dementia caregivers, 205 self-identified as Latino, 247 as non-Latino Black, and 1,674 as non-Latino White. Mean baseline caregiver self-efficacy scores were between 13.1 and 13.6 for all racial and ethnic groups. The least squares mean for self-efficacy change was between +1.53 and +1.66 from the baseline for all racial and ethnic groups. Caregiver self-efficacy change did not differ significantly by caregiver race and ethnicity. Discussion Black, Latino, and White dementia caregivers reported similar improvements in caregiver self-efficacy after participating in a comprehensive dementia care trial. Personalized aspects of comprehensive dementia care appear to address the needs of diverse caregiver populations. Clinical Trial Registration NCT03786471