The impact of a Spanish online and telephone intervention for caregivers of Veterans post-stroke: Findings on caregiver burden

Abstract: Background/Objectives: Hispanic caregivers report higher levels of burden and poorer mental health compared to non-Hispanic caregivers. While problem-solving interventions have shown promise in improving stroke caregiver and patient well-being, they have not been specifically tailored or tested with Hispanic stroke caregivers. This study aimed to evaluate the effectiveness of a telephone- and online-based problem-solving intervention that was culturally adapted for Spanish-speaking Hispanics on caregiver burden. Methods: A two-arm parallel randomized clinical trial (NCT03142841) with repeated measures was conducted with 210 Hispanic caregivers of veterans who had experienced a stroke within the past year. Participants were recruited from three VA medical centers. The intervention consisted of 8-telephone sessions using online materials conducted by a trained interventionist. Participants in the standard group received usual VA resources they would have received as part of routine care such as stroke-related information. Chi-square tests and regression analyses were used to assess outcomes at 9 and 21 weeks. Results: Most participants were female (88%), college-educated (49%), and spouses or partners of a veteran (46%). Caregivers in the intervention group showed significantly greater reductions in caregiver burden (p = 0.011; p < 0.001) compared to the standard care group. Conclusions: Similarly to others reporting positive findings with non-Hispanic caregivers, these findings suggest that the problem-solving intervention can potentially alleviate Hispanic Spanish-speaking stroke caregivers' burden by improving coping skills, problem-solving, and social support. Further research is needed to address gaps in effective interventions and promote equitable care for this population.

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