Evaluating Practices That Foster Care Partnerships and Wellbeing Among Informal Carers and Long-term Care Workers (WELLCARE)

WELL CARE - Implementation and Evaluation Phase

WELL CARE aims to strengthen the supports available to informal carers and long-term care (LTC) workers for improving their resilience and mental wellbeing through care partnerships. The project consortium, lead by prof. Elizabeth Hanson (Linnaeus University) and consisting of six research organizations and nine national and European advocacy organizations, identifies good practices able to prevent or mitigate both occupational and non-occupational risks for informal carers' and LTC workers' resilience and mental wellbeing. On this basis, and under its Grant Agreement with the European Commission, the project team develops innovative solution prototypes, which will be transferable across different countries and contexts and guide stakeholders into the actual implementation in 5 European Union (EU) countries (Germany, Italy, Netherlands, Slovenia, Sweden), where the LTC sector presents dissimilar characteristics. Finally, the investigators will exploit the data and evidence collected and generated by WELL CARE to analyze related EU and national policies, and to formulate action-oriented recommendations for policy makers and stakeholders.

The current study protocol concerns the research activities within Work Package 3 of the project, particularly the activities during the Implementation and Evaluation Phase that runs from September 2026 until the end of 2027. During this phase the project team studies the results of local implementation partners' efforts who - building on the solution prototypes developed earlier in the WELL CARE project - develop and implement new supportive work and care practices. The investigators study the effects that implementing these practices brings about among participating caregivers in terms of mental wellbeing, resilience and care partnership dynamics, while also studying the implementation process itself to capture the processes, conditions and (organizational) contexts favorable to fostering care partnerships.

Study Overview

• Status: Not yet recruiting
• Conditions: Mental Wellbeing
• Intervention / Treatment: Other: Solution Prototype in Germany; Other: Solution Prototype in Italy; Other: Solution Prototype in Slovenia; Other: Solution Prototype in Sweden; Other: Solution Prototype in the Netherlands

• Study Type: Interventional
• Enrollment (Estimated): 450
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ludo M Glimmerveen, PhD; Phone Number: +31616824480; Email: l.m.glimmerveen@vu.nl

Study Locations

• Germany
  • Zittau, Germany
    • Hochschule Zittau/Görlitz
    • Contact: Andreas Hoff; Phone Number: +49 3583 612-0; Email: A.Hoff@hszg.de
• Italy
  • Ancona, Italy
    • INRCA
    • Contact: Marco Socci; Phone Number: +39 071 8004786; Email: M.Socci@inrca.it
• Netherlands
  • Amsterdam, Netherlands
    • Vrije Universiteit Amsterdam
    • Contact: Ludo Glimmerveen; Phone Number: +31616824480; Email: l.m.glimmerveen@vu.nl
• Slovenia
  • Ljubljana, Slovenia
    • University of Ljubljana
    • Contact: Valentina Hlebec; Phone Number: +386 1 58 05 248; Email: Valentina.Hlebec@fdv.uni-lj.si
• Sweden
  • Kalmar, Sweden
    • Linneaus University
    • Contact: Elizabeth Hanson; Phone Number: +46 703614846; Email: elizabeth.hanson@lnu.se

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion criteria for recruiting participants will be...

For informal caregivers:

o currently providing - or having provided within the last 6 months - unpaid care or support to a family member, partner, or friend receiving long-term care services;

For long-term care workers:

• employed in a long-term care setting at one of the participating research sites;
• directly involved in care provision or implementation of the new practices under study;

For care recipients:

• currently receiving care from long-term care workers and/or informal caregivers;
• requiring support with everyday personal care and/or more complex daily tasks due to ageing, chronic illness, disability or frailty;

• living in the community or in a long-term care setting included in the study;

  - for other stakeholders:

• involved directly or indirectly in the planning, management, or implementation of the newly adopted practices at the research site;

For all participants:

• aged 18 years or older;
• able to provide informed consent;
• sufficient proficiency in the local language to complete the questionnaire and/or participate in an interview;

The exclusion criteria for recruiting participants will be...

• having a (permanent or temporary) psychiatric disorder or mental illness which makes the person unable to understand instructions and participate in the study activities;
• experiencing circumstances that would make participation unduly burdensome (e.g., acute stress or illness);
• providing care for fewer than the minimum number of hours required for inclusion; the threshold will be defined per country in a context-sensitive way, reflecting national differences and the characteristics of the implemented practices and their target populations;
• only being involved in the provision or receiving of short-term or acute care (i.e., not long-term care);

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Informal carers; adults (≥18 years), providing- usually- unpaid care to someone (relatives or friends) with a chronic illness, disability and/or other long lasting health and/or care need, outside a professional or formal framework	Other: Solution Prototype in Germany; Project partners are developing a digital educational program for informal carers, covering different phases of caregiving. In addition, a peer-to-peer support program will be developed following a train-the-trainer format. Activities also focus on securing structural funding and enabling broader rollout across the country.; Other: Solution Prototype in Italy; Project partners are collaborating with a large long-term care provider to develop a process for the co-creation of care plans with informal carers. In addition, a mindfulness-based stress reduction intervention is being developed in which informal carers and long-term care workers can participate jointly. These activities aim to improve communication and foster trusting relationships between these groups.; Other: Solution Prototype in Slovenia; Project partners will work with the management of formal care institutions to provide leadership training focused on supporting informal carers' well-being and strengthening collaboration with them. In addition, workshops will be organized to enhance carers' skills, knowledge and self-care practices, alongside joint events to promote mutual understanding and collaboration between formal and informal carers. Community-level activities will also be implemented to increase recognition of carers and the value of care.; Other: Solution Prototype in Sweden; Project partners are working across three sites with distinct areas of focus: (1) within respite care homes, fostering mutual support between informal carers and long-term care workers during the palliative phase and post-bereavement period; (2) within group homes for people living with disabilities, developing a person-centered model to strengthen mutual support and communication between informal carers and long-term care workers; and (3) strengthening support for informal carers during the waiting period for nursing home admission to reduce frustration, anxiety and stress.; Other: Solution Prototype in the Netherlands; Project partners will work across two sites with distinct areas of focus: (1) in collaboration with a disability care provider, improving relationships, communication and coordination between informal carers and long-term care workers in group home settings; and (2) in collaboration with a long-term care provider and an umbrella organization of local citizen-led initiatives, exploring ways to improve coordination and mutual support around initiatives that support ageing in place and strengthen the supportive capacity of local communities for care recipients and their informal carers.
Other: Long-term care workers; adults (≥18 years), working in home and/or residential care settings with people with LTC needs	Other: Solution Prototype in Italy; Project partners are collaborating with a large long-term care provider to develop a process for the co-creation of care plans with informal carers. In addition, a mindfulness-based stress reduction intervention is being developed in which informal carers and long-term care workers can participate jointly. These activities aim to improve communication and foster trusting relationships between these groups.; Other: Solution Prototype in Slovenia; Project partners will work with the management of formal care institutions to provide leadership training focused on supporting informal carers' well-being and strengthening collaboration with them. In addition, workshops will be organized to enhance carers' skills, knowledge and self-care practices, alongside joint events to promote mutual understanding and collaboration between formal and informal carers. Community-level activities will also be implemented to increase recognition of carers and the value of care.; Other: Solution Prototype in Sweden; Project partners are working across three sites with distinct areas of focus: (1) within respite care homes, fostering mutual support between informal carers and long-term care workers during the palliative phase and post-bereavement period; (2) within group homes for people living with disabilities, developing a person-centered model to strengthen mutual support and communication between informal carers and long-term care workers; and (3) strengthening support for informal carers during the waiting period for nursing home admission to reduce frustration, anxiety and stress.; Other: Solution Prototype in the Netherlands; Project partners will work across two sites with distinct areas of focus: (1) in collaboration with a disability care provider, improving relationships, communication and coordination between informal carers and long-term care workers in group home settings; and (2) in collaboration with a long-term care provider and an umbrella organization of local citizen-led initiatives, exploring ways to improve coordination and mutual support around initiatives that support ageing in place and strengthen the supportive capacity of local communities for care recipients and their informal carers.
Other: Care recipients; will be included in the study if their participation is not unduly burdensome. Care recipients in this study are individuals who require support with everyday personal care and/or more complex daily tasks due to ageing, chronic illness, disability or frailty. These needs are increasingly complex, frequently involving multimorbidity and requiring coordinated input from both formal long-term care services and informal carers. The characteristics and needs of care recipients are closely linked to caregiver burden, wellbeing and care intensity, and are therefore an important contextual factor in this study. Moreover, care partnerships dynamics may improve the quality of care that care recipients experience.	Other: Solution Prototype in Italy; Project partners are collaborating with a large long-term care provider to develop a process for the co-creation of care plans with informal carers. In addition, a mindfulness-based stress reduction intervention is being developed in which informal carers and long-term care workers can participate jointly. These activities aim to improve communication and foster trusting relationships between these groups.; Other: Solution Prototype in Slovenia; Project partners will work with the management of formal care institutions to provide leadership training focused on supporting informal carers' well-being and strengthening collaboration with them. In addition, workshops will be organized to enhance carers' skills, knowledge and self-care practices, alongside joint events to promote mutual understanding and collaboration between formal and informal carers. Community-level activities will also be implemented to increase recognition of carers and the value of care.; Other: Solution Prototype in Sweden; Project partners are working across three sites with distinct areas of focus: (1) within respite care homes, fostering mutual support between informal carers and long-term care workers during the palliative phase and post-bereavement period; (2) within group homes for people living with disabilities, developing a person-centered model to strengthen mutual support and communication between informal carers and long-term care workers; and (3) strengthening support for informal carers during the waiting period for nursing home admission to reduce frustration, anxiety and stress.; Other: Solution Prototype in the Netherlands; Project partners will work across two sites with distinct areas of focus: (1) in collaboration with a disability care provider, improving relationships, communication and coordination between informal carers and long-term care workers in group home settings; and (2) in collaboration with a long-term care provider and an umbrella organization of local citizen-led initiatives, exploring ways to improve coordination and mutual support around initiatives that support ageing in place and strengthen the supportive capacity of local communities for care recipients and their informal carers.
Other: Other stakeholders; The characteristics of other stakeholders included in the study may differ per research site, depending on the characteristics of the implemented practices and the context in which implementation is done. This group of respondents will include managers, planners, policy makers, organizational officials or care professionals who are not engaged in the caregiving process itself, but whose work is directly affected by the implemented practices at the research site, and/or whose work may either promote or hamper successful and sustainable implementation.	Other: Solution Prototype in Germany; Project partners are developing a digital educational program for informal carers, covering different phases of caregiving. In addition, a peer-to-peer support program will be developed following a train-the-trainer format. Activities also focus on securing structural funding and enabling broader rollout across the country.; Other: Solution Prototype in Italy; Project partners are collaborating with a large long-term care provider to develop a process for the co-creation of care plans with informal carers. In addition, a mindfulness-based stress reduction intervention is being developed in which informal carers and long-term care workers can participate jointly. These activities aim to improve communication and foster trusting relationships between these groups.; Other: Solution Prototype in Slovenia; Project partners will work with the management of formal care institutions to provide leadership training focused on supporting informal carers' well-being and strengthening collaboration with them. In addition, workshops will be organized to enhance carers' skills, knowledge and self-care practices, alongside joint events to promote mutual understanding and collaboration between formal and informal carers. Community-level activities will also be implemented to increase recognition of carers and the value of care.; Other: Solution Prototype in Sweden; Project partners are working across three sites with distinct areas of focus: (1) within respite care homes, fostering mutual support between informal carers and long-term care workers during the palliative phase and post-bereavement period; (2) within group homes for people living with disabilities, developing a person-centered model to strengthen mutual support and communication between informal carers and long-term care workers; and (3) strengthening support for informal carers during the waiting period for nursing home admission to reduce frustration, anxiety and stress.; Other: Solution Prototype in the Netherlands; Project partners will work across two sites with distinct areas of focus: (1) in collaboration with a disability care provider, improving relationships, communication and coordination between informal carers and long-term care workers in group home settings; and (2) in collaboration with a long-term care provider and an umbrella organization of local citizen-led initiatives, exploring ways to improve coordination and mutual support around initiatives that support ageing in place and strengthen the supportive capacity of local communities for care recipients and their informal carers.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Resilience	Measured using the 2-item Connor-Davidson Resilience Scale (CD-RISC-2). Items are scored on a 5-point Likert scale (0 = "not true at all" to 4 = "true nearly all of the time"). Scoring: sum of items (range 0-8); higher scores indicate greater resilience.	Baseline (within 1 month before the intervention) and follow-up (within 1 month after completion of the intervention).
Mental wellbeing	Measured using the 7-item Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Items are scored on a 5-point Likert scale (1 = "none of the time" to 5 = "all of the time", looking at the past two weeks). Scoring: sum items (range 7-35); higher scores indicate better mental wellbeing.	Baseline (within 1 month before the intervention) and follow-up (within 1 month after completion of the intervention).

Collaborators and Investigators

• Sponsor: VU University of Amsterdam
• Collaborators: Linnaeus University; European Commission; University of Ljubljana; Istituto Nazionale di Ricovero e Cura per Anziani; Hochschule Zittau/Görlitz
• Investigators: Principal Investigator: Elizabeth J Hanson, PhD, Linnaeus University

Publications and helpful links

Helpful Links

• WELL CARE project website

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2027
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): September 30, 2027

Study Registration Dates

• First Submitted: June 25, 2026
• First Submitted That Met QC Criteria: July 13, 2026
• First Posted (Actual): July 16, 2026

Study Record Updates

• Last Update Posted (Actual): July 16, 2026
• Last Update Submitted That Met QC Criteria: July 13, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: caregivers; mental wellbeing; partnership; collaboration; professional; informal carer; long-term care worker; resilence
• Other Study ID Numbers: WELLCARE-WP3-Study

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data underlying the results reported in publications arising from this study (including questionnaire data collected at baseline and follow-up) will be made available under controlled access. Direct identifiers will not be shared. Qualitative interview and focus group data will generally not be shared because complete de-identification cannot be guaranteed and disclosure may compromise participant confidentiality.
• IPD Sharing Time Frame: De-identified individual participant data and supporting documentation will become available following publication of the primary study results. Data will remain available for at least 10 years, subject to the policies of the hosting repository and applicable legal and ethical requirements.
• IPD Sharing Access Criteria: De-identified individual participant data and supporting documentation will be available to qualified researchers for scientifically sound research purposes. Data will be deposited in Zenodo. Access to individual participant data will be provided under controlled access following review of a data access request and, where applicable, a data sharing agreement, in accordance with participants' informed consent, the EU General Data Protection Regulation (GDPR), and applicable national data protection legislation.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No