Care-resistant Behavior, Dementia
Conditions
Keywords
dementia, care-resistant behavior, caregiver coping
Brief summary
266 family caregivers will be randomly assigned to either immediate intervention or delayed intervention groups. All caregivers will complete baseline surveys and 3 weeks of daily diaries. The immediate intervention group will receive 12 weeks of CuRB-IT. They will complete 3 rounds of 3-week daily diaries followed by an intermittent survey at 12 week intervals for the next 33 weeks. The delayed intervention group will receive 12 weeks of attention, complete 1 round of 3-week daily diaries followed by an intermittent survey, then complete 12 weeks of CuRB-IT, and complete 2 rounds of 3--week daily diaries followed by an intermittent survey at 12-week intervals for the next 18 weeks.
Detailed description
The purposes of the delayed-intervention randomized clinical trial (N=266) are to: Care-Resistant Behavior Internet Training (CuRB-IT). 1. examine the efficacy of CuRB-IT in increasing the self-efficacy of family caregivers of persons living with dementia to handle care-resistant behaviors (CRB); 2. further test the efficacy of CuRB-IT in improving caregivers coping strategies (a) among the experimental (immediate-intervention group) as compared to the control (delayed-intervention group) (between groups) and (b) within-person from pre- to post- intervention; 3. examine intervention decay at 3- and 6-months post intervention to determine performance of intervention and inform scheduling of booster sessions; 4. assess the efficacy of the CuRB-IT intervention in preventing onset of poor coping strategies by family caregivers; 5. test the hypothesized mechanism of action that increased CRB self-efficacy and use of CuRB-IT problem-focused coping strategies mediate the relationship between CRB stress appraisal and caregiving activities.
Interventions
BEHAVIORALCuRB-IT
9 1-hour coaching sessions delivered over a videoconferencing platform (Zoom); 6 delivered weekly, 3 delivered biweekly
Sponsors
University of Alabama at Birmingham
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
Yes
Inclusion criteria
* 1)Caregiver of any race or gender who is aged \>18 years * 2\) provides unpaid care, * 3\) cares for a spouse/common-law, sibling, parent or grandparent (or in-law, aged 60+ years), * 4\) lives with or shares cooking facilities with the care recipient, * 5\) Care recipient has mild cognitive impairment or dementia as identified using the Quick Dementia Rating System instrument, * 6\) the care provided consists of help with at least 2 Instrumental Activities of Daily Living or one Activity of Daily Living, * 7\) the care recipient is resistant to receiving assistance with, or refuses to do, at least one instrumental or activity of daily living
Exclusion criteria
* 1\) persons who cannot speak/read English * 2\) who do not have reliable access to a smart phone or internet
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in frequency of care-resistant behaviors and other dementia-related behaviors measured by a 19-item self-report scale (yes/no) for dementia family caregivers | Daily during weeks 1, 2, and 3 | Experimental and control |
| Change in caregiver responses to dementia-related behaviors | Immediately after enrollment | Experimental (immediate) and control (delayed intervention). Measured using yes/no responses to 8 items (2 from the Conflicts Tactics Scale Revised, 2 from the Conflicts Tactics Scale modified for Older Adults, and 4 from the Conflict Tactics Scale for Child Mistreatment). |
| Change in caregiver self-efficacy coping skills | Immediately after enrollment | Experimental (immediate) and control (delayed intervention). Measured using 14 items from the Brief Coping Scale. |
| Change in caregiver self-efficacy measured by selection of items from 10-item CurB-CuRB-IT Strategy checklist | Once at week 15 | Experimental (immediate) |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORRita A Jablonski, PhD
University of Alabama at Birmingham
Outcome results
None listed