4. Discussion
ADRD, dementia, Alzheimer’s Disease Knowledge Scale
Guided by the sociocultural stress and coping model, this study examined the preliminary evidence of the benefit from the SCP Plus program that aimed at reducing caregiving burden of African American family caregivers who cared for a person with ADRD. Results indicated that SCP Plus is a promising program as it helped the senior companions gain knowledge of dementia and improved their preparedness for caregiving. SCP Plus also appeared to be associated with increases in caregiver participants’ knowledge of dementia, decreasing their caregiving burden/stress, as well as increasing satisfaction with social support and positive aspects of caregiving.For volunteer lay providers, findings from the training component of the SCP Plus offer promise as the senior companions were able to gain knowledge and skills as part of the program. The training focused on improving the senior companions’ knowledge of dementia, sense of competence, and preparedness for caregiving. The qualitative interviews also underscored that caregivers perceived that senior companions benefitted from SCP Plus. Similar to findings from a dementia-focused adaption of a Minnesota-based SCP [Both the quantitative and qualitative findings suggest that caregivers reported increased knowledge of dementia after participating SCP Plus. These findings are promising, as research suggests that there is a continued need for interventions that promote knowledge of ADRD among racial and ethnic minority groups [Findings also suggested that the SCP Plus program significantly decreased their caregiving burden/stress. These results are consistent with a meta-analysis that reported a small significant effect of psychoeducational interventions on caregiver burden [The study findings highlight the role of social support as part of the SCP Plus. One aspect of social support is the intentional linkage between the senior companions and the caregivers as part of the program. Senior companions are typically focused on providing care to the CR, versus the caregiver. For some participants, the lay provider, peer-led model may have provided the opportunity to build a stronger relationship between the caregiver and the senior companion. This is consistent with other research suggesting that peer support relationships have positive social impacts [Finally, the results from the SCP Plus related to the positive aspects of caregiving (PAC) are promising, as Cheng and colleagues [The results of this study must be interpreted with caution, as there are several limitations that provide lessons for future studies. First, the final sample size was very small, due in part to the negative impact of COVID-19. Therefore, we could not control for any confounding variables when examining the preliminary effectiveness of the SCP Plus program. However, it should be noted that the post-hoc power analyses yielded higher than anticipated effect sizes, which yielded statistical significance in spite of the low sample size. Nevertheless, a larger sample is needed to better examine the effectiveness of the SCP Plus. Moreover, because the intervention and data collection were suspended due to COVID-19 in Louisiana, we could not compare the differences in the three sites as planned. The main difference of participants in the Louisiana site might be that its SCP is connected to large hospital systems compared to the other two completed sites, which are more a part of community agencies. This may potentially influence some of the outcomes for caregivers in Louisiana. Second, the sample included African American ADRD caregivers from three sites in one southern region of the U.S. It is thus limited to represent SCP in other States or regions. A larger and more representative sample would shed light on how the SCP Plus could be implemented in other regions. Third, only the post-test for senior companions were designed at the end of the training, which may limit the comparisons of the main outcomes for senior companions. Because there might be no or few changes in the 2 days before and after the training, we did not survey the senior companions in the control group. Future study can modify the design, as post-testing senior companions at the end of the program, as well as 6 months after the program ended, should be similar to the parts of caregivers. Though the focus of the project was caregivers, collecting more information on senior companions may help the Senior Corps in developing other ADRD-related services. Moreover, the measurement of knowledge of dementia can be updated to include more recent information on dementia. The Alzheimer’s Disease Knowledge Scale (ADKS) with 30 items is recommended to measure participants’ knowledge of ADRD for future studies. Lastly, telephone-based interventions can be considered in the future to accommodate the spatial and geographical limitations of face-to-face interventions and other restrictions (e.g., COVID-19).