Evaluating the effects of the World Health Organisation’s online intervention ‘iSupport lite’ to reduce burden in multilingual dementia carers: results from the Australian Draw-Care randomised clinical trial

Background The World Health Organisation’s (WHO) iSupport Lite program contains six short practical public health support messages for carers of people with dementia to reduce stress and improve their mental health. We culturally adapted WHO’s iSupport Lite into a digital intervention—‘Draw-Care’—comprising six animated films and tipsheets hosted on a website and available in 10 languages. Aim To assess the effectiveness of ‘Draw-Care’ on multilingual family carers’ burden, mood and quality of life. Methods A single-blind, parallel-group randomised clinical trial conducted with multilingual adult carers with internet access. The trial was community-based, conducted online, between 1 August 2023 and 8 November 2024, with follow-up at 6- and 12-weeks. The target was 194 participants (156 needed with 25% attrition). The primary outcome was reduction in carer burden, as measured by the Zarit Burden Interview (ZBI). Secondary outcomes were improvement in carer mood and quality of life, as measured by the Centre for Epidemiological Studies Depression (CES-D), the World Health Organisation Quality of Life Scale (WHOQOL-Bref), Care-related Quality of Life instrument (CarerQoL-7D), and productivity and activity impairment as measured by the Work Productivity and Activity Impairment Questionnaire as adapted for caregiving (WPAI:CG). Findings One hundred sixteen participants consented and 93 (46 waitlist control, 47 intervention) were included in the analyses. Participants mean age was 54.80 (SD 13.33), 72 (77.4%) were women, and 29 (31.5%), 27 (29.4%) and 22 (23.9%) were from European, Vietnamese and Chinese backgrounds, respectively. No statistically significant differences were observed between the intervention and control groups on the ZBI, CES-D, WHOQOL-Bref and WPAI:CG. Null effects for some outcomes may be due to ceiling effects or insufficient power. A statistically significantly higher mean CarerQoL-VAS score was found for the intervention group (mean difference=0.75, 95% CL: 0.25 to 1.24, P=.003) over 6- and 12-weeks, compared to the control. Interpretation ‘Draw-Care’ showed no significant effect on carers’ burden and mood but did show significant improvements in some carers’ quality of life measures.