Rural Dementia Caregiver Project

Not Applicable

Completed

• Conditions: Depression; Stress, Psychological; Dementia Frontotemporal; Loneliness; Dementia; Self Efficacy; Social Isolation; Health Care Utilization; Dementia, Multi-Infarct; Dementia, Lewy Body
• Interventions: Behavioral: Attention Control; Behavioral: Building Better Caregivers Workshop

• Registration Number: NCT04428112
• Lead Sponsor: University of California, San Francisco

Brief Summary

These caregivers are a vulnerable group due to their physical isolation and well-documented rural disparities in health care access and quality. Many rural dementia caregivers experience serious health consequences due to caregiving responsibilities that can limit their ability to maintain their caregiving role. Thus, there is a pressing need for effective, scalable, and accessible programs to support rural dementia caregivers.

Online programs offer a convenient and readily translatable option for program delivery because they can be accessed by caregivers in the home and at the convenience of the user. Building Better Caregivers is an online 6-week, interactive, small-group self-management, social support, and skills-building workshop developed for caregivers of individuals with Alzheimer's disease or related dementia.

The investigators will conduct a hybrid effectiveness-implementation randomized controlled trial that will enroll and randomize 640 rural dementia caregivers into two groups: the intervention (workshop) group and the attention control group. Caregivers will be recruited throughout the United States. Primary outcomes will be caregiver stress and depression symptoms. The investigators hypothesize that stress scores and depression symptoms will be significantly improved at 12 months in the intervention group versus control group. The investigators will also identify key strengths (facilitators) and weaknesses (barriers) of workshop implementation. The investigators will use the RE-AIM implementation framework and a mixed methods approach to identify implementation characteristics pertinent to both caregivers and rural community organizations.

If the Building Better Caregivers workshop is proven to be effective, this research has the potential to open new research horizons, particularly on how to reach and effectively support isolated dementia caregivers in rural areas with an intervention that is scalable, even in low-resourced settings. If the workshop can achieve its goals with rural dementia caregivers, some of those most isolated, it would also be expected to be scalable in other low-resourced settings (e.g., in urban or suburban environments).

Detailed Description

Not available

Study Timeline

• Study Start: 2020-06-05
• Study First Submitted: 2020-06-09
• Study First Submitted QC: 2020-06-09
• Study First Posted: 2020-06-11
• Primary Completion: 2023-10-16
• Study Completion: 2023-10-16
• Status Verified: 2023-11
• Last Update Submitted: 2023-11-14
• Last Update Posted: 2023-11-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 418

Inclusion Criteria

• Aged 18 years or older
• Caring for person with dementia
• Able to read and write in English
• Able to access the internet
• Providing care for ≥ 10 hours per week
• Reporting a minimum stress level of 4 or more on a 10-point scale
• Living in rural area of United States (self-identify or zip code is a Rural Urban Commuting Area Codes (RUCA) defined rural area)

Read More

Exclusion Criteria

• Have an anticipated inability to complete the 12-month follow-up (e.g., planned travel)

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Attention Control Group	Attention Control	Participants will be offered the online workshop after the 12 month trial is completed if they so desire.
Building Better Caregivers Workshop Group	Building Better Caregivers Workshop	Building Better Caregivers Workshop is a 6-week online self-management and skills building workshop. Participants receive the online workshop as soon as possible after randomization.

Primary Outcome Measures

Name	Time	Method
Change in visual numeric stress scale score from baseline to 12 months	Baseline and 12 months	A visual numeric stress scale. The scale score ranges from 0 to 10, with higher score indicating worse outcome.
Change in Personal Health Questionnaire Depression (PHQ-8) scale score from baseline to 12 months	Baseline and 12 months	Personal Health Questionnaire Depression (PHQ-8) scale. The scale score is calculated by summing each item to produce a total score between 0 and 24, with higher scores indicating worse outcome.

Secondary Outcome Measures

Name	Time	Method
Change in Short Caregiver Self-Efficacy scale score from baseline to 12 months	Baseline and 12 months	Short Caregiver Self-Efficacy scale (8-items). The scale scores is calculated by taking the mean of the items to produce a total score between 1 and 10, with higher scores indicating better outcome.
Change in caregiver health care utilization from baseline to 12 months	Baseline and 12 months	3-items measuring overnight hospitalizations, nursing home or other long-term care facility use, and hospital emergency room visits from the Health and Retirement Study, modified time frame from self-report for past 12 months to self-report for past 6 months; scored as single items; with higher scores indicating worse outcome.
Change in Zarit Burden Interview-12 (ZBI-12) scale score from baseline to 12 months	Baseline and 12 months	Short form of the Zarit Burden Interview-12 (ZBI-12) scale (12-items). The scale score is calculated by summing each item to produce a total score between 0 and 24, with higher scores indicating worse outcome.
Change in Lubben Social isolation scale score from baseline to 12 months	Baseline and 12 months	Lubben Social isolation scale (6-items). The scale score is calculated by summing each item to produce a total score between 0 and 30, with lower scores indicating worse outcome.
Change in person with dementia general health score as reported by caregiver from baseline to 12 months	Baseline and 12 months	Patient-Reported Outcomes Measurement Information System (PROMIS) measure SF-1 caregiver-reported general health single item. The scale score ranges from 1 to 5, with higher scores indicating worse outcome.
Change in caregiver self-rated general health score from baseline to 12 months	Baseline and 12 months	Patient-Reported Outcomes Measurement Information System (PROMIS) measure SF-1 self-rated general health single item. The scale score ranges from 1 to 5, with higher scores indicating worse outcome.
Change in person with dementia health care utilization as reported by caregiver from baseline to 12 months	Baseline and 12 months	3-items measuring overnight hospitalizations, nursing home or other long-term care facility use, and hospital emergency room visits from the Health and Retirement Study, modified time frame from caregiver report for past 12 months to caregiver report for past 6 months; scored as single items; with higher scores indicating worse outcome.
Change in UCLA loneliness scale score from baseline to 12 months	Baseline and 12 months	UCLA loneliness scale (3-items). The scale score is calculated by summing each item to produce a total score between 3 and 9, with higher scores indicating worse outcome.

Trial Locations

Locations (1)

University of California, San Francisco; 🇺🇸 San Francisco, California, United States