Disseminating a psycho-educational caregiver intervention in minority communities: Challenges and lessons learned

Background: In part due to higher disease incidence and lower SES, minorities are more likely to be caregiving than whites. Methods: We evaluated efforts to disseminate Powerful Tools for Caregivers, an evidence-based psycho-educational program to increase caregiver self-efficacy and decision-making skills to Hispanic, African American, and Native American caregivers of older adults in a Northeastern county. Semi-structured interviews (N=28) were conducted with grant coordinators, program facilitators, advisory council members, and program participants to examine the need for, and cultural acceptability of the program, and dissemination barriers and facilitators. Transcribed interviews were coded with a codebook derived from the interview guide. Results: Interviewees perceived that the program met significant need, reduced caregiver stress, and was culturally appropriate, despite few opportunities for cultural tailoring. However, program participation was limited by dissemination challenges stemming from low community engagement, including difficulty involving church and secular community leaders in program promotion, recruiting experienced volunteer facilitators, and scheduling classes at community locations, as well as lack of self-identification as caregivers by target audiences. Discussion: Caregiver support programs may need to market themselves differently to African American, Hispanic, and Native American caregivers who may not see themselves as such, but as engaging in normative family activities. Research is needed to identify concepts that resonate. More generally, dissemination success depends on leveraging existing community partnerships or devoting sufficient time and resources to building new community partnerships. Grants supporting program dissemination should include sufficient time and resources for building community partnerships through networking, participation, and service in target communities.