The modifying effect of work-care role conflict on the effectiveness of carer support: results from the Australian Draw Care randomized clinical trial.

Abstract

Background: People who care for a family member with dementia alongside paid work often experience role conflict. This study explores whether work-care role conflict (WCRC) modifies the effectiveness of Draw Care, an online and culturally adapted carer support intervention.

Methods: Secondary exploratory analysis of a single-blind, parallel-group trial (August 2023-November 2024) that compared Draw Care against waitlist control in adult carers from diverse linguistic backgrounds. To formally test whether WCRC moderated the effect of the Draw Care intervention, we ran a full-sample linear mixed model that included a 3-way interaction between time-point, treatment group, and an indicator of WCRC. Work-care role conflict was operationalized as self-report of missed work or reduced productivity due to competing care and employment demands. Outcomes included carer burden, mood, quality of life, and productivity/activity impairment at 6 and 12 weeks.

Results: Forty-two of 93 carers reported WCRC. Reductions in caregiver burden due to treatment at 6 weeks (-10.00; 95% CI, -19.70 to -0.31, p = .043) and 12 weeks (-9.56; 95% CI, -18.83 to -0.29, p = .043) were significantly larger in participants with WCRC than without. This moderating effect of WCRC was driven by a robust, absolute reduction in caregiver burden in intervention group participants with WCRC over the initial 6 weeks (-7.19, 95% CI, -12.72 to -1.67, p = .011), with much of this improvement preserved at 12 weeks (-6.85, 95% CI, -12.17 to -1.53, p = .012).

Conclusions: WCRC appears to modify the effectiveness of Draw Care, suggesting that the intervention may be particularly helpful for carers navigating role conflict.

Clinical trial registration number: ACTRN12622000382774 and ACTRN12622000358741.