Does a one-week health program promote well-being among caregiving parents? A quasiexperimental intervention study in Germany

Background Burden of care and negative health consequences are evident in informal caregiving. Intervention studies, if any, are largely limited to the field of adult or elderly care although there are specific needs for parents of chronically ill and disabled children, for example, lack of acceptance, special life course problems, and supply deficits. Aim The effect of a legally funded, one-week health program offered by the Social Insurance for Agriculture, Forestry, and Horticulture (SVLFG) on the well-being of the participating parents of children with a high level of care is determined. Secondary outcome measures are stress and behavior theory-based characteristics. Subject and methods In a controlled panel study (intervention group n = 23, comparison group n = 33, allocation not randomized) well-being (WHO-5 index) and other measures (subjective burden, acceptance of the care situation, institutional and social support, recreational and care-related behavior) were collected at several measurement points. Statistical methods are fixed effects panel regressions under control of time-varying characteristics (external conditions, period effects). Results At the start of the intervention, 70% of the intervention group (83% mothers, 73% at least 51 years old) are at the threshold of clinically relevant depressiveness. After a very clear initial effect, the level remains above the baseline level for up to 15 weeks after the intervention (under stable conditions). A sinking below the initial level is prevented until at least 26 weeks even with significantly increasing external conditions. The main drivers appear to be sustained increases in acceptance of the care situation, institutional support, and recreational behavior. Conclusion Given the high initial burden of the participants, the sustainability of the prevention-oriented intervention is considerable. Nevertheless low-threshold interventions such as telephone or online counselling could be useful after approximately 25 weeks. The intervention is unique for the social insurance system in Germany. The design allows a causal interpretation of the treatment effects despite the small number of cases. Further studies should particularly address effect heterogeneity.