Low‐Intensity Social Care for Dementia Caregivers: A Randomized Trial

Background Resource needs increase strain among dementia caregivers. We tested the impact of CommunityRx‐Dementia, a low‐intensity resource referral intervention that provides education about common resource needs, a personalized list of nearby resources, and navigation support via a navigator and online resource finder. Methods We conducted a single‐blind RCT comparing usual care (control) versus usual care plus CommunityRx‐Dementia (intervention). We enrolled (12/2020–2/2024) English‐speaking dementia caregivers agreeing to receive text messages who lived in a 62 ZIP code geography around an urban academic medical center. We assessed caregiver self‐efficacy (primary, 12 months), loneliness, need for help and self‐reported hospitalizations and emergency department (ED) visits (other pre‐specified outcomes). Pre‐planned, main analyses included participants with ≥ 1 baseline health‐related social risk (HRSRs); post hoc analyses included caregivers without baseline HRSRs. Results Caregivers with HRSRs ( n = 133) were predominantly female (84%) and Black (79%); 52% had household income < $50 K/year; 94% texted a navigator and 31% requested additional resource information. Caregiver self‐efficacy (range 1–5, intervention = 3.5; control = 3.5, odds ratio [OR]: 0.80, 95% CI: 0.30, 2.09) and rates of loneliness (intervention = 41%; control = 50%; OR: 0.62, 95% CI: 0.24, 1.59), needing help (23% = intervention, 34% = control; OR: 0.80, 95% CI: 0.30, 2.11) and hospitalization (intervention = 0.1, control = 0.2; IRR: 0.42, 95% CI: 0.14, 1.30) were similar at 12 months, but ED utilization was lower in the intervention group (0.3 vs. 0.7, IRR: 0.41, 95% CI: 0.19, 0.90). Caregivers without HRSRs ( n = 210) were mainly female (75%) and Black (82%); 25% had household income < $50 K/year; 95% texted a navigator and 39% requested additional resource information. Self‐efficacy, loneliness, hospitalizations, and ED utilization were similar between arms at 12 months, but odds of needing help were 0.31 (95% CI: 0.12, 0.83) for the intervention group. Conclusions A low‐intensity social care intervention aimed at dementia caregivers did not improve self‐efficacy at 12 months but reduced emergency care utilization among those with HRSRs. Trial Registration ClinicalTrials.gov , Registered 10/29/19, Identifier: NCT04146545