Applying a Family Caregiver Supports Needs Assessment Tool in Home-based Primary Care: An Approach to Elder Mistreatment Risk Reduction and Prevention
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Recruitment Feasibility
研究概览
简要总结
This study will evaluate the feasibility, acceptability, and preliminary effects of the Carer Support Needs Assessment Tool (CSNAT) intervention for family caregivers of older adults receiving home-based primary care. The CSNAT is a structured, caregiver-centered approach designed to identify caregiver support needs and facilitate supportive problem-solving conversations between clinicians and family caregivers.
Family caregivers will be assigned to either the CSNAT intervention or a comparison group receiving usual care. Feasibility will be evaluated through participant recruitment, retention, and intervention adherence. Acceptability will be assessed through qualitative interviews with caregivers who participate in the intervention.
The study will also examine the preliminary effects of the CSNAT intervention on caregiver outcomes, including caregiver strain, physical well-being, mental well-being, and emotional management. In addition, the study will explore whether improvements in caregiver well-being are associated with a reduced risk of situations that may contribute to harm or neglect of the older adult receiving care.
This pilot study will provide information on the practicality of implementing the CSNAT intervention in home-based primary care and will inform the design of future larger-scale studies.
详细描述
Family caregivers play a crucial role in the care of older adults with health and daily living needs at home. At the same time, caregiving in this context can be stressful and demanding, and family members can experience strain, poor health, and unmet support needs. These circumstances can further impact the older adults they care for, including creating unwanted risks to their health and safety. Caregivers of patients receiving home-based primary care may be especially likely to experience these challenges because many patients have multiple health conditions and require extensive support.
The Carer Support Needs Assessment Tool (CSNAT) is a structured approach where caregivers identify and prioritize areas where they need support by responding to the CSNAT questionnaire (i.e., tool). The tool covers 15 areas related to both caregiving responsibilities and caregivers' own well-being. After completing the questionnaire/tool, caregivers use their responses to the CSNAT to shape discussions about their care needs with a healthcare provider. Together, the caregiver and clinician create a plan to address identified support needs and later review progress and any additional needs.
This study will evaluate whether the CSNAT approach can be successfully used with family caregivers of older adults receiving home-based primary care. Eighty caregivers will be randomly assigned to either a CSNAT intervention group or a usual-care control group. Caregivers in the intervention group will complete the CSNAT, participate in a support planning discussion with a nurse practitioner, and take part in a follow-up discussion approximately one month later. Caregivers in the control group will receive usual care, which may include informal conversations with their healthcare provider about caregiving needs.
Researchers will assess the practicality and acceptability of the CSNAT approach by examining recruitment, participation, retention, and completion of study activities. The study will also collect information on caregiver strain, caregiver physical and mental well-being, and factors related to risk of elder mistreatment before and after the study period. In addition, interviews with a subset of caregivers in the intervention group will be conducted to better understand their experiences with the CSNAT approach.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Be 18 years of age or older.
- •Self-report as providing consistent care to an older adult who receives medical home visits by a nurse practitioner as part of the UTMB Home-Based Primary Care (HBPC) Program.
- •Provides consistent care to an older adult which includes one or more of the following: a) Assistance with activities of daily living (ADLs), b) Medication management, c) Medical or nursing-related tasks
- •Provides consistent care to an adult age 65 years or older.
- •Be able to read, speak, and understand English.
排除标准
- •Does not provide consistent home care (including assistance with ADLs, medication management, or medical/nursing tasks)
- •Provides care to a patient who is under 65 years of age
- •Provides care to a patient not enrolled in the UTMB Health HBPC program
- •Provides care to a patient not receiving in-home visits by a nurse practitioner.
- •Is younger than 18 years of age
- •Is unable to read or speak English
- •Has an obvious neurological or psychiatric condition that may affect participation
- •Has communication deficits that may impact ability to participate
研究组 & 干预措施
Behavioral: Carer Support Needs Assessment Tool (CSNAT)
The Carer Support Needs Assessment Tool (CSNAT) is a caregiver-centered intervention designed to identify and address family caregiver support needs. The intervention includes completion of the CSNAT assessment followed by structured support and problem-solving discussions with a clinician to prioritize needs, develop action plans, and connect caregivers with available resources.
干预措施: CSNAT-I (Behavioral)
Usual Care Control Group
Participants in this arm will receive usual home-based primary care services. As part of standard practice, family caregivers may engage in informal, ad hoc conversations with the visiting nurse practitioner regarding caregiving needs and concerns during routine home care visits for the older adult receiving care. Caregivers in this arm will not receive the structured Carer Support Needs Assessment Tool (CSNAT) intervention. Participants will complete study assessments at baseline and post-intervention.
结局指标
主要结局
Recruitment Feasibility
时间窗: During participant recruitment (up to 12 months).
Recruitment feasibility will be assessed by the time from identification of a potential participant to enrollment, participant refusal rate, and average time required to enroll 20 caregivers per study arm.
Participant Acceptability of CSNAT Intervention
时间窗: From posttest to two weeks following completion of the post-intervention assessment
Acceptability of the CSNAT intervention will be assessed through semi-structured qualitative interviews conducted with intervention participants who complete the study intervention. Interviews will explore: (1) caregiver experiences and caregiving-related stressors; (2) caregiver support needs; (3) participant experiences with and perceptions of the CSNAT intervention; and (4) barriers and facilitators to participation in the intervention. Interview data will be analyzed to identify themes related to the acceptability, perceived usefulness, and implementation of the intervention.
Participant Retention
时间窗: From enrollment through completion of post-intervention assessments (approximately 1 month).
Retention will be assessed as the proportion of enrolled participants who complete both baseline and post-intervention assessments.
Intervention Adherence
时间窗: From intervention initiation through completion of the one-month follow-up discussion.
Intervention adherence will be assessed as the proportion of participants in the intervention arm who complete the CSNAT assessment and both planned support discussions with the nurse practitioner.
次要结局
- Change from Baseline in Caregiving Strain at One Month(Baseline and one month)
- Change From Baseline in Caregiver Physical Health at One Month(Baseline and one month)
- Change From Baseline in Caregiver Quality of Life at One Month(Baseline to one month)
- Change from Baseline in Elder Mistreatment and Neglect Scores and Associations with Other Secondary Measures at One Month(Baseline and one month)
- Change From Baseline in Caregiver Mental Health at One Month(Baseline to one month)
- Change From Baseline in Caregiver Depressive Symptoms at One Month(Baseline to one month)