Exploring sex differences in immersive safety training for home-based care among informal caregivers: A randomized comparative study

BACKGROUND: Informal caregivers are key to home-based care safety. OBJECTIVE: To evaluate whether the effectiveness of immersive training aimed at reducing home-based care errors differs according to caregiver sex. METHODS: A randomized comparative study with pre-post assessment involving 141 informal caregivers compared virtual reality (VR; n=70) and 360° video training (360VT; n=71). Data were collected at baseline and three months after the intervention. The primary outcome was the number of self-reported home-based care errors. Data were analysed using a mixed-effects Poisson regression model. RESULTS: The mean number of self-reported errors decreased from 0.91 to 0.46 per caregiver after training. Exploratory subgroup analyses suggested that pre-post changes may have differed according to training modality and caregiver sex, with larger estimated reductions among women in the VR group (IRR=0.29, 95%CI: 0.14-0.59; p=0.0005) and among men in the 360VT group (IRR=0.19, 95%CI: 0.06-0.60; p=0.0048). The phase×modality×sex interaction was statistically significant (IRR=13.88, 95%CI: 1.95-98.75; p=0.0087). Satisfaction was high overall, although women in the VR group reported lower ease of participation (adjusted p=0.0373). CONCLUSIONS: Immersive training may contribute to improving home-based care safety among informal caregivers. These findings also highlight the importance of appropriate onboarding, usability adaptations, and further evaluation in larger and more diverse caregiver populations.