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.
Brijnath B, Dang T, et al. • Age and ageing • 2026
'Draw-Care' showed no significant effect on carers' burden and mood but did show significant improvements in some carers' quality of life measures.
Key Findings
Results
The Draw-Care intervention showed no statistically significant effect on the primary outcome of carer burden as measured by the Zarit Burden Interview (ZBI).
The trial was a single-blind, parallel-group randomised clinical trial conducted online between 1 August 2023 and 8 November 2024
93 participants were included in analyses (46 waitlist control, 47 intervention)
No statistically significant differences were observed between the intervention and control groups on the ZBI
The authors note that null effects may be due to ceiling effects or insufficient power
The target sample was 194 participants (156 needed with 25% attrition), but only 116 consented and 93 were analysed, suggesting the trial was underpowered
Results
The Draw-Care intervention produced a statistically significant improvement in carers' quality of life as measured by the CarerQoL-VAS score.
The intervention group had a statistically significantly higher mean CarerQoL-VAS score compared to the control group
Mean difference = 0.75 (95% CL: 0.25 to 1.24, P = .003)
This effect was observed over both 6- and 12-week follow-up periods
The CarerQoL-7D is described as the Care-related Quality of Life instrument
Results
The Draw-Care intervention showed no statistically significant effects on carer mood as measured by the Centre for Epidemiological Studies Depression (CES-D) scale.
No statistically significant differences were observed between the intervention and control groups on the CES-D
Follow-up assessments were conducted at 6 and 12 weeks
The null effect may be attributable to ceiling effects or insufficient statistical power
Results
The Draw-Care intervention showed no statistically significant effects on carer quality of life as measured by the WHOQOL-Bref, nor on work productivity and activity impairment as measured by the WPAI:CG.
No statistically significant differences were observed between the intervention and control groups on the WHOQOL-Bref
No statistically significant differences were observed on the Work Productivity and Activity Impairment Questionnaire as adapted for caregiving (WPAI:CG)
These null findings were noted alongside the possibility of ceiling effects or insufficient power
Results
The trial enrolled a multilingual sample of family carers with diverse cultural backgrounds, with women comprising the large majority of participants.
93 participants were included in final analyses out of 116 who consented
Mean participant age was 54.80 years (SD 13.33)
72 participants (77.4%) were women
29 (31.5%) were from European backgrounds, 27 (29.4%) from Vietnamese backgrounds, and 22 (23.9%) from Chinese backgrounds
The intervention was available in 10 languages
Background
Draw-Care was developed as a culturally adapted digital version of the WHO's iSupport Lite program, consisting of six animated films and tipsheets hosted on a multilingual website.
The WHO iSupport Lite program contains six short practical public health support messages for carers of people with dementia
The adaptation comprised six animated films and tipsheets hosted on a website
The intervention was available in 10 languages
The trial was community-based and conducted entirely online
Results
The trial failed to reach its pre-specified target sample size, potentially limiting the statistical power to detect effects on most outcomes.
The target was 194 participants (156 needed with 25% attrition)
Only 116 participants consented and 93 were included in the analyses
The authors acknowledged that 'null effects for some outcomes may be due to ceiling effects or insufficient power'
What This Means
This research tested a digital tool called 'Draw-Care,' which is an adapted version of a World Health Organization program designed to support family members who care for people with dementia. Draw-Care consists of six short animated videos and information sheets available in 10 languages, aimed at reducing stress and improving the wellbeing of carers from diverse cultural backgrounds. The study was conducted as a randomised trial in Australia, with carers assigned either to access Draw-Care immediately or to a waitlist control group, and outcomes were measured at 6 and 12 weeks.
The study found that Draw-Care did not significantly reduce carer burden, depression symptoms, or most quality-of-life measures compared to the control group. However, carers who used Draw-Care did report a small but statistically significant improvement in one specific quality-of-life measure — the CarerQoL-VAS — suggesting the intervention may have had some positive effect on how carers felt about their overall wellbeing. The authors noted that the study enrolled fewer participants than originally planned (93 instead of a target of 194), which may have made it harder to detect meaningful differences between groups.
This research suggests that a brief, freely available, multilingual digital tool based on WHO guidance may offer modest benefits for the quality of life of diverse family dementia carers, but may not be sufficient on its own to reduce the broader burden and emotional difficulties associated with caregiving. Future larger studies would be needed to determine whether the intervention's effects are real or whether the lack of significant findings reflects the study's limited size.
Brijnath B, Dang T, Enticott J, Tian Y, Markusevska S, Antoniades J, et al.. (2026). 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.. Age and ageing. https://doi.org/10.1093/ageing/afag030