Caregiver Burnout
Conditions
Keywords
Male, Black or African American, Hispanic or Latino, Feasibility Studies
Brief summary
Two arm study, experimental and control, to explore the impact of an online training program to prepare community health workers (CHWs) conduct effective outreach to support African American and Latino male caregivers of older adults.
Detailed description
The investigators used a randomized, two-group, pretest/posttest design to test the efficacy of the IN-HOME prototype and explore the following research question: To what extent did exposure to the IN-HOME prototype relate to positive changes in Community Health Workers' (CHWs') knowledge, skills, and perceived self-efficacy to conduct outreach to African American and Latino male caregivers of older adults? The community-focused and community-based approach of the intervention included an evaluation that required strategies to address gender preferences for resources and providing care and cultural awareness to understand the communities of focus. The evaluation recognized additional barriers such as racial/ethnic group historical experiences and racism that effects the groups health outcomes and health care interactions. To ensure that the approach was culturally appropriate and the materials were culturally relevant, the investigators worked with caregiver and health disparities researchers and CHW practitioners to create an advisory committee of experts that provided input into the development of the intervention to empower CHWs to conduct outreach to African American and Latino male caregivers. The PI, with input from the advisory committee, developed necessary research materials, including the recruitment protocols, evaluation instrumentation, and human subjects consent materials. The PI also outlined the appropriate statistical analysis methods. All procedure documents were reviewed by the Institutional Review Board before the evaluation launch. The investigators recruited participants through evaluation partners who disseminated the study information to CHWs via electronic notifications and flyers. Evaluation partners included sites with CHW-related programs and CHW organizations such as, the Virginia CHW Association, the Dallas-Fort Worth CHW Organization, Connection Health, and the Hispanic Health Initiative Incorporated. The notification provided information about the goal of the study, participant eligibility, and a link to an interest and eligibility form. After a potential participant completed the interest and eligibility form and determined as eligible for the project, they received a link to a consent form that was located on a secure online platform. CHWs were randomly assigned to the intervention or control group after consent and enrollment in the study. All participants completed an online pretest survey. The intervention group was exposed to IN-HOME and completed an online posttest survey two weeks after completing the IN-HOME modules. The control group participants were not exposed to the IN-HOME program but were asked to review the AARP's English Care at Home resource webpage. The control group participants completed a posttest two weeks after completing the pretest. Participant responses to pretest and posttest survey measures were linked using non-personal identifiers. The investigators downloaded and exported the data from the online data collection system into an encrypted Excel file and imported the raw data into STATA. The investigators matched the pretest and posttest responses using the random assigned identifiers and conduct analyses to test for the effect of IN-HOME exposure on changes in CHWs' knowledge, skills, and self-efficacy to conduct outreach to African American and Latino male caregivers. Effectiveness measure for intervention feasibility was statistically significant differences between pretest and posttest for knowledge and self-efficacy measures among the intervention group participants.
Interventions
A multi module online training
OTHERAARP's English Care at Home resource webpage
Caregiver information from the American Association of Retired Persons
Sponsors
KDH Research & Communication
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
Yes
Inclusion criteria
* Must self-identify as working as a community health worker * Must be actively employed conducting community-based outreach at an organization (paid or volunteer) * Must be 18 years of age or older * Must live in the United States
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Preparedness Pretest | Baseline | We asked participants six identically worded questions relating to their perceived preparedness to deliver male caregiver outreach at pretest and posttest. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not at all prepared) to 10 (very much prepared), with higher scores indicating better outcomes. We averaged scores from each preparedness question for each participant, then averaged these scores across all participants for group comparisons. |
| Knowledge Pretest | Baseline | We asked participants 16 identically worded knowledge-based multiple-choice questions during the pretest and posttest. For each participant, we averaged their correct scores from these knowledge questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average knowledge score for group comparisons, also ranging from 0 to 100. |
| Skills Pretest | Baseline | We asked participants eight identically worded skills-based multiple-choice questions at pretest and posttest. For each participant, we averaged their correct scores from these skills questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average skills score for group comparisons, also ranging from 0 to 100. |
| Self-efficacy Pretest | Baseline | We asked participants 15 identically worded questions relating to their perceived self-efficacy/confidence in providing outreach to male caregivers. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not very confident) to 10 (very confident), with higher scores indicating better outcomes. We averaged self-efficacy scores across all self-efficacy questions for each participant, then averaged these scores across all participants for group comparisons. |
| Knowledge Posttest | 2 weeks | We asked participants 16 identically worded knowledge-based multiple-choice questions during the pretest and posttest. For each participant, we averaged their correct scores from these knowledge questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average knowledge score for group comparisons, also ranging from 0 to 100. |
| Skills Posttest | 2 weeks | We asked participants eight identically worded skills-based multiple-choice questions at pretest and posttest. For each participant, we averaged their correct scores from these skills questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average skills score for group comparisons, also ranging from 0 to 100. |
| Self-efficacy Posttest | 2 weeks | We asked participants 15 identically worded questions relating to their perceived self-efficacy/confidence in providing outreach to male caregivers. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not very confident) to 10 (very confident), with higher scores indicating better outcomes. We averaged self-efficacy scores across all self-efficacy questions for each participant, then averaged these scores across all participants for group comparisons. |
| Preparedness Posttest | 2 weeks | We asked participants six identically worded questions relating to their perceived preparedness to deliver male caregiver outreach at pretest and posttest. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not at all prepared) to 10 (very much prepared), with higher scores indicating better outcomes. We averaged scores from each preparedness question for each participant, then averaged these scores across all participants for group comparisons. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction Composite Scores at Posttest | 2/3 weeks | We asked intervention group participants five questions about their satisfaction with IN-HOME at posttest. All five satisfaction questions were ratings assessing the participants' perceptions of ease, relevance, engagement, usefulness, and likeliness to tell others about IN-HOME. Each answer choice ranged from 1 to 10, with 10 representing the highest and 1 representing the lowest rating. We averaged satisfaction ratings across all five questions for each intervention participant and averaged these scores across all intervention participants to create a single composite score ranging from 1 to 10, with higher scores indicating higher satisfaction. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) Professional development training for CHWs on African American and Latino male caregiver needs
Intervention to Help Orient Men to Excel (IN-HOME): A multi module online training | 44 |
| Control AARP's English Care at Home resource webpage
AARP's English Care at Home resource webpage: Caregiver information from the American Association of Retired Persons | 43 |
| Total | 87 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 11 | 9 |
Baseline characteristics
| Characteristic | Total | Intervention to Help Orient Men to Excel (IN-HOME) | Control |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 4 Participants | 3 Participants | 1 Participants |
| Age, Categorical Between 18 and 65 years | 83 Participants | 41 Participants | 42 Participants |
| Education level College degree | 37 Participants | 20 Participants | 17 Participants |
| Education level High school diploma/GED | 10 Participants | 6 Participants | 4 Participants |
| Education level Master's degree | 23 Participants | 10 Participants | 13 Participants |
| Education level Professional degree | 2 Participants | 1 Participants | 1 Participants |
| Education level Some college | 15 Participants | 7 Participants | 8 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 17 Participants | 8 Participants | 9 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 69 Participants | 35 Participants | 34 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants | 1 Participants | 0 Participants |
| Hours training 11 to 15 hours | 5 Participants | 0 Participants | 5 Participants |
| Hours training 16+ hours | 62 Participants | 32 Participants | 30 Participants |
| Hours training 1 to 5 hours | 6 Participants | 3 Participants | 3 Participants |
| Hours training 6 to 10 hours | 12 Participants | 7 Participants | 5 Participants |
| Hours training None | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 65 Participants | 34 Participants | 31 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 8 Participants | 2 Participants | 6 Participants |
| Race (NIH/OMB) White | 12 Participants | 7 Participants | 5 Participants |
| Sex/Gender, Customized Sex Female | 63 Participants | 34 Participants | 29 Participants |
| Sex/Gender, Customized Sex Male | 23 Participants | 10 Participants | 13 Participants |
| Sex/Gender, Customized Sex Prefer not answer | 1 Participants | 0 Participants | 1 Participants |
| Trained in caregiving for older adults I don't know | 4 Participants | 1 Participants | 3 Participants |
| Trained in caregiving for older adults No | 39 Participants | 18 Participants | 21 Participants |
| Trained in caregiving for older adults Yes | 44 Participants | 25 Participants | 19 Participants |
| Type of CHW Both | 21 Participants | 8 Participants | 13 Participants |
| Type of CHW Paid | 49 Participants | 25 Participants | 24 Participants |
| Type of CHW Prefer not answer | 5 Participants | 4 Participants | 1 Participants |
| Type of CHW Volunteer | 12 Participants | 7 Participants | 5 Participants |
| Years of CHW experience 1 to 2 years | 31 Participants | 18 Participants | 13 Participants |
| Years of CHW experience 3 to 4 years | 14 Participants | 3 Participants | 11 Participants |
| Years of CHW experience 5 or more years | 30 Participants | 17 Participants | 13 Participants |
| Years of CHW experience 6 to 11 months | 10 Participants | 4 Participants | 6 Participants |
| Years of CHW experience Prefer not to answer | 2 Participants | 2 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Knowledge Posttest
We asked participants 16 identically worded knowledge-based multiple-choice questions during the pretest and posttest. For each participant, we averaged their correct scores from these knowledge questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average knowledge score for group comparisons, also ranging from 0 to 100.
Time frame: 2 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Knowledge Posttest | 89.83 score on a scale | Standard Deviation 20.37 |
| Control | Knowledge Posttest | 83.48 score on a scale | Standard Deviation 20.61 |
p-value: 0.1695% CI: [-2.5, 15.18]t-test, 2 sided
p-value: 0.2895% CI: [-0.13, 0.04]Regression, Linear
Primary
Knowledge Pretest
We asked participants 16 identically worded knowledge-based multiple-choice questions during the pretest and posttest. For each participant, we averaged their correct scores from these knowledge questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average knowledge score for group comparisons, also ranging from 0 to 100.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Knowledge Pretest | 79.84 score on a scale | Standard Deviation 23.02 |
| Control | Knowledge Pretest | 84.94 score on a scale | Standard Deviation 16.14 |
p-value: 0.2695% CI: [-14.02, 3.84]t-test, 2 sided
Primary
Preparedness Posttest
We asked participants six identically worded questions relating to their perceived preparedness to deliver male caregiver outreach at pretest and posttest. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not at all prepared) to 10 (very much prepared), with higher scores indicating better outcomes. We averaged scores from each preparedness question for each participant, then averaged these scores across all participants for group comparisons.
Time frame: 2 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Preparedness Posttest | 8.61 score on a scale | Standard Deviation 1.28 |
| Control | Preparedness Posttest | 8.02 score on a scale | Standard Deviation 1.74 |
p-value: 0.0895% CI: [-0.07, 1.27]t-test, 2 sided
p-value: 0.3995% CI: [-1.21, 0.48]Regression, Linear
Primary
Preparedness Pretest
We asked participants six identically worded questions relating to their perceived preparedness to deliver male caregiver outreach at pretest and posttest. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not at all prepared) to 10 (very much prepared), with higher scores indicating better outcomes. We averaged scores from each preparedness question for each participant, then averaged these scores across all participants for group comparisons.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Preparedness Pretest | 7.05 score on a scale | Standard Deviation 1.98 |
| Control | Preparedness Pretest | 7.12 score on a scale | Standard Deviation 2.07 |
p-value: 0.8995% CI: [-0.95, 0.82]t-test, 2 sided
Primary
Self-efficacy Posttest
We asked participants 15 identically worded questions relating to their perceived self-efficacy/confidence in providing outreach to male caregivers. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not very confident) to 10 (very confident), with higher scores indicating better outcomes. We averaged self-efficacy scores across all self-efficacy questions for each participant, then averaged these scores across all participants for group comparisons.
Time frame: 2 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Self-efficacy Posttest | 8.55 score on a scale | Standard Deviation 1.17 |
| Control | Self-efficacy Posttest | 8.01 score on a scale | Standard Deviation 1.63 |
p-value: 0.0995% CI: [-0.09, 1.18]t-test, 2 sided
p-value: 0.7195% CI: [-0.86, 0.59]Regression, Linear
Primary
Self-efficacy Pretest
We asked participants 15 identically worded questions relating to their perceived self-efficacy/confidence in providing outreach to male caregivers. Each answer choice was a 10-point confidence rating scale, ranging from 1 (not very confident) to 10 (very confident), with higher scores indicating better outcomes. We averaged self-efficacy scores across all self-efficacy questions for each participant, then averaged these scores across all participants for group comparisons.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Self-efficacy Pretest | 7.25 score on a scale | Standard Deviation 2 |
| Control | Self-efficacy Pretest | 7.03 score on a scale | Standard Deviation 1.93 |
p-value: 0.6295% CI: [-0.66, 1.1]t-test, 2 sided
Primary
Skills Posttest
We asked participants eight identically worded skills-based multiple-choice questions at pretest and posttest. For each participant, we averaged their correct scores from these skills questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average skills score for group comparisons, also ranging from 0 to 100.
Time frame: 2 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Skills Posttest | 83.24 score on a scale | Standard Deviation 21.89 |
| Control | Skills Posttest | 81.25 score on a scale | Standard Deviation 21.43 |
p-value: 0.6795% CI: [-7.31, 11.28]t-test, 2 sided
p-value: 0.6995% CI: [-0.12, 0.08]Regression, Linear
Primary
Skills Pretest
We asked participants eight identically worded skills-based multiple-choice questions at pretest and posttest. For each participant, we averaged their correct scores from these skills questions, resulting in a score that ranged from 0 to 100, with 0 as the minimum score and 100 as the maximum score. Higher scores indicate better outcomes. We then averaged these individual scores across all participants to create a composite average skills score for group comparisons, also ranging from 0 to 100.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Skills Pretest | 80.36 score on a scale | Standard Deviation 23.29 |
| Control | Skills Pretest | 84.15 score on a scale | Standard Deviation 20.73 |
p-value: 0.4495% CI: [-13.43, 5.85]t-test, 2 sided
Secondary
Satisfaction Composite Scores at Posttest
We asked intervention group participants five questions about their satisfaction with IN-HOME at posttest. All five satisfaction questions were ratings assessing the participants' perceptions of ease, relevance, engagement, usefulness, and likeliness to tell others about IN-HOME. Each answer choice ranged from 1 to 10, with 10 representing the highest and 1 representing the lowest rating. We averaged satisfaction ratings across all five questions for each intervention participant and averaged these scores across all intervention participants to create a single composite score ranging from 1 to 10, with higher scores indicating higher satisfaction.
Time frame: 2/3 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention to Help Orient Men to Excel (IN-HOME) | Satisfaction Composite Scores at Posttest | 8.91 score on a scale | Standard Deviation 1.33 |