Assessing the Reliability of the Zarit Caregiver Burden Interview: A Comprehensive Reliability Generalization Meta-Analysis

Caregiving is a common role, and assessing caregiver burden requires culturally appropriate tools. The Zarit Caregiver Burden Interview (ZBI) is widely used and adapted across cultures. This study aimed to perform a reliability generalization meta-analysis of Cronbach's alpha for the ZBI. A systematic search was conducted in Elton Bryson Stephens Company, PubMed, Scopus, and Web of Science databases up to September 2023. Studies reporting Cronbach's alpha for the ZBI were included. A Random Effects Model with a Restricted Maximum Likelihood approach was used to estimate pooled Cronbach's alpha values. Heterogeneity was assessed using Tau2 , I2 , and Cochran's Q statistics. Publication bias was evaluated through Rosenthal's safe N, Egger regression test, Kendall's Tau, and a funnel plot. Moderator analysis was conducted using a mixed-effects model. A total of 41 studies with 7,818 participants were analyzed. The pooled Cronbach's alpha was 0.89 (95% confidence interval: 0.88-0.91), with high heterogeneity (I2 =94.52%). Moderator analysis showed that study location and sample type significantly influenced alpha values. Higher caregiver age and greater variability in ZBI scores were associated with higher alpha values. No publication bias was detected. The ZBI is a reliable tool across various cultures and caregiver groups. It can be effectively used in clinical and research settings to assess caregiver burden.