Modeling Pathways by Which the Caregiver TLC Psychoeducational Program Affects Psychological Health of Caregivers

The study seeks to elucidate the pathways by which the Caregiver Thrive, Learn & Connect (TLC) psychoeducational program affects the psychological health of caregivers by examining the degree to which changes in self-efficacy, personal gains, and emotional support mediate the changes in perceived depression, anxiety, and burden.

Using pre-post data from the Caregiver TLC randomized controlled trial (n = 81) for each outcome and mediator pair, a series of multiple regression models were executed to test the degree to which the program's total effects on changes in depression, burden, and anxiety from baseline to post-intervention are due to changes in each mediator variable from pre- and post-intervention assessments. Caregivers were primarily female (85%), White (62%), and Black (38%), with a median age of 62 and household income of $75,000+. Caregivers reported caring for a person with dementia (69%) or chronic health conditions (31%).

Mediation path modeling indicated that changes in self-efficacy were affected by participation in the Caregiver TLC program, mediating between 32% and 63% of the total treatment effect on the outcome variables. Change in personal gains and change in emotional support also demonstrated meaningful mediation effects, albeit smaller in magnitude.

Results confirm that the observed positive impact of the Caregiver TLC program is due to changes in self-efficacy (in particular) and to a lesser degree to changes in personal gains and emotional support. These results confirm that strengthening caregivers' perceived self-efficacy to manage stress plays a significant role in improving psychosocial functioning.