CONFIDENCE Financial Education for Caregivers

Not Applicable

Completed

Conditions: Dementia
Alzheimer Disease
Caregiver Burden
Financial Stress

Interventions: Behavioral: Confidently Navigating Financial Decisions and Enhancing Financial Wellbeing in Dementia Caregiving

Registration Number: NCT05292248

Lead Sponsor: Case Western Reserve University

Brief Summary: The purpose of this study is to determine how feasible it is to deliver an online course to reduce out-of-pocket costs of caregiving and reduce financial stress among Latino family caregivers to a family member living with dementia. The investigators hope that that the results of this study will help to reduce high these out-of-pocket costs and improve financial wellbeing for Latino family caregivers.

Caregivers will be asked to to participate in 3 online surveys, in addition to participating in 5, 1.5 hour group-based Zoom learning sessions.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 20

Inclusion Criteria

Caregiver to someone diagnosed by a physician with probably Alzheimer's disease or a related dementia at least 6 months ago
Latino or Hispanic ethnicity
At least 50 years of age of older
Able to attend 5, 1.5 hour to 2 hour group-based lessons over 5 weeks
No plans to place family member in a facility within the next 3 months

Exclusion Criteria

Unreliable access to email, a computer and internet access
Does note speak and read English
Previously participated in CONFIDENCE program

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
CONFIDENCE Education Intervention	Confidently Navigating Financial Decisions and Enhancing Financial Wellbeing in Dementia Caregiving	Participants will attend the 5-week CONFIDENCEProgram. This program will include attending 5 group-based sessions delivered by videoconference. Each session will last approximately 1.5 hours each and will cover topics such as how to budget, accessing community resources to displace the out-of-pocket costs of caregiving, asking for help, balancing employment and caregiving, and more.

Primary Outcome Measures

Name	Time	Method
Monthly Out-of-pocket Caregiving Costs	Change in median costs from from baseline to 8 weeks post-intervention	Monthly out-of-pocket costs of caregiving is based on the tool used by the AARP Public Policy Institute in their 2016 report on the out-of-pocket costs of caregiving. This measure combines caregiver recall of care costs in the previous month, collected at baseline, with 5 days of daily spending diaries. Daily surveys will be sent using an email with a survey link, and a text message reminder. Monthly costs include less-frequent, high-cost expenditures (e.g., mortgage payment), while daily costs include lower-cost items caregivers may pay for more frequently (e.g., groceries). Daily self-reports of spending will be averaged and multiplied by 6 to approximate the number of days in a month, and added to estimated monthly costs. Positive scores indicate increased out-of-pocket costs. The researchers advise against relying on this outcome. In this pilot study, we found that this measure has qualitatively different meanings for adult child and spousal caregivers.

Secondary Outcome Measures

Name	Time	Method
Caregiver Self-efficacy	Change from baseline to post-intervention (within 1 week); change from baseline to 8 weeks post-intervention	Self-efficacy is measured using the Caregiver Self-Efficacy Scale. This 8-item scale asks about multiples domains of self-efficacy (e.g., managing behavioral symptoms, accessing respite, and controlling upsetting thoughts). It demonstrates high reliability (alpha=0.89) and good test-retest reliability (0.73). Participants rate the extent to which they are "Not confident at all" (1) to "Totally confident" (10). Scores range from 8 (lowest level of self-efficacy) to 80 (highest level of self-efficacy). The outcome measure will use the average change score from baseline scores. Positive scores indicate an increase in self-efficacy.
Psychological Financial Strain	Change from baseline to post-intervention (within 1 week); change from baseline to 8 weeks post-intervention	The measure for psychological financial strain is from multiple scales. Items 1 to 14 ask about financial anxiety. Lastly, the investigators included the 1-item question that asks about financial worry ("I worry constantly about money". Participants are asked to indicate the extent to which each statement is true (Very true \[3\], Somewhat true\[2\], Somewhat untrue\[1\], and Complete untrue\[0\]). Scores are summed such that scores range from 0 to 45, where higher scores indicate higher levels of financial strain.
Caregiver Resourcefulness	Change from baseline to post-intervention (within 1 week); change from baseline to 8 weeks post-intervention	Resourcefulness is measured using the 28-item Caregiver Resourcefulness Scale (alpha=0.85). This scale has two factors: one focused on help-seeking and another on self-help. Caregivers are asked the frequency at which they use different strategies to manage challenges, and may respond: Not at all like me (0), Pretty much not like me (1), A little bit not like me (2), A little bit like me (3), Pretty much like much like me (4), or Very much like me (5). Items are added together to create a total score. Scores range from 0 to 140, where higher scores indicate higher levels of resourcefulness. The outcome measure will use the average change score from baseline scores