Abstract Body (Do not enter title and authors here): Introduction: Given the substantial evidence that adults who provide informal care for their chronically ill families are at high risk of poor health, including the development of cardiovascular disease (CVD), engagement in and maintenance of healthy behaviors are critical. Furthermore, rural caregivers living in socioeconomically austere healthcare environments face additional challenges in engaging in self-care. We conducted a CVD risk reduction intervention program for rural caregivers to promote self-care in the context of caregiving burden.
Aims: The aim was to determine whether caregiving burden moderated the intervention effect on engagement in healthy behaviors.
Method: In this randomized controlled trial (RCT), rural caregivers with at least two or more CVD risk factors (N=311, 76% female, 96% white, mean age=54.8 years) were randomly assigned to either intervention or control groups. The 12-week education and counseling intervention designed to promote self-care was delivered by telehealth. Outcomes were assessed at 4 and 12-month follow-ups. Caregiving experience was assessed using the Zarit Burden Interview (ZBI) and the Osbert Caregiving Burden Scale (time spent and difficulty in caregiving subscales). Engagement in healthy behaviors was assessed using the modified version of the Medical Outcome Scale-Specific Adherence Scale. ANOVA and three-way repeated measures ANOVA were used.
Results: Most caregivers reported a little or no burden (n=123, 39.5%) or mild-moderate caregiving burden (n=120, 38.5%), but one-fifth reported moderate to severe burden (n=68, 21.8%) as categorized by baseline ZBI scores. Caregivers with moderate to severe burden had more time spent on caregiving (p<.001) and higher levels of caregiving difficulty (P <.001) at baseline. The intervention group significantly improved engagement in self-care at 4 and 12 months compared to the control group (Time X RCT Group, P < 0.001), but the effect was not moderated by their caregiver burden groups (Time X RCT Group X Caregiving Burden groups, P = 0.843, Figure 1).
Conclusion: The CVD risk reduction program designed for rural caregivers effectively improved engagement in heart-healthy behaviors regardless of their caregiving burden levels.