Dementia, Family Caregiver, Peer Support
Conditions
Keywords
African American/Black
Brief summary
The purpose of this study is to test a peer support intervention for caregivers who are caring for a loved one living with dementia.
Detailed description
African Americans are twice as likely to develop Alzheimer's disease or a related form of dementia (ADRD) than their White counterparts. These individuals are, however, more often diagnosed later, creating additional physical, spiritual, psychosocial challenges for both the person living with ADRD and their family caregivers. African American ADRD caregivers are therefore at greater risk for adverse physiological and psychological health effects of caregiving, including significant burden and stress. Evidence suggests that peer to peer support using storytelling may be effective in assisting ADRD caregivers with surrogate healthcare decision making, an important aspect of palliative care. Access to and use of palliative care, a recognized approach to serious illness care symptom management, among African Americans are low. The impact of this healthcare inequity further reduces the quality of life for African American ADRD caregivers and subsequently their care recipients. Prior approaches to serious illness care have failed to address the needs of African Americans living with ADRD from a palliative care perspective. This inability to meet their needs leads to increased unmet caregiver needs. Peer mentorship, a relationship-centered person-to-person approach may reduce healthcare decision making burden within cultural groups such as African Americans through cultural tailoring by promoting oral traditions, personal contact, and storytelling. Our current study includes perspectives of lower socioeconomic status African American ADRD caregivers who have expressed the need for person-centered, non-judgmental, on-demand, culturally congruent caregiving support for advance care planning and healthcare decision making. Simultaneously, former caregivers retrospectively described perceived benefits of peer support while caregiving and their willingness to serve as peer mentors to current caregivers. Additional data from healthcare provider and community stakeholders support the need and potential benefits of peer support for ADRD caregivers. Based on these preliminary findings, there is an urgent need and exciting opportunity to address the unmet palliative care needs of current caregivers through peer support. For this innovative project, investigators will use the experiential expertise of former caregivers to help current caregivers with advance care planning and healthcare decision making. The purpose of this project is to use a stakeholder-informed approach in further developing and pilot testing the co-created Peer Support for Caregivers of African Americans Living with Alzheimer's Disease and Related Dementias (Pair2Care), a culturally sensitive caregiver peer support intervention. Aim: Conduct feasibility and acceptability testing of Pair 2 Care in current and trained former African American ADRD family caregiver peers paired based on congruent identity traits (e.g., relationship to care recipient, gender identity, etc.). Investigators will determine if Pair2Care is feasible and acceptable by evaluating satisfaction and appropriateness of the intervention for broader dissemination.
Interventions
Former caregivers will be paired with a current caregiver based on a similar personal attribute (e.g., relationship to care recipient). Each pair will complete at least five virtual face-to-face (video) interactions and at least 10 other interactions either via phone call, email, or text messaging over the 6-month time period.
Sponsors
Study design
Intervention model description
A model to explain factors impacting advance care planning among African Americans
Eligibility
Inclusion criteria
* African-American * English-speaking * Adult (18+) * Family caregivers of people living with dementia (current or former)
Exclusion criteria
* Non-African-American * Non-English-speaking * Under age 18 * Non-Family caregiver
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Medical Outcomes Study Social Support Survey (MOS SSS) | Baseline and 6 months post baseline | This instrument contains 19 items that comprise 4 subscales: Emotional/Informational Support, Tangible Support, Affectionate Support, and Positive Social Interaction. Each item is scored on a 5 point Likert scale of 1 (none of the time) to 5 (all the time), with higher scores indicating more social support. Total and subscale scores are in a range of 1-5 calculated by taking the mean across items. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Peer Support Former caregivers will be paired with a current caregivers
Peer Support: Former caregivers will be paired with a current caregiver based on a similar personal attribute (e.g., relationship to care recipient). Each pair will complete at least five virtual face-to-face (video) interactions and at least 10 other interactions either via phone call, email, or text messaging over the 6-month time period. | 15 |
| Total | 15 |
Baseline characteristics
| Characteristic | Peer Support |
|---|---|
| Age, Customized | 59.6 years STANDARD_DEVIATION 13.5 |
| Employment Full-time | 7 Participants |
| Employment Homemaker | 1 Participants |
| Employment Not employed, retired | 5 Participants |
| Employment Part-time | 2 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 14 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Marital Status Married | 8 Participants |
| Marital Status Separated/Divorced | 3 Participants |
| Marital Status Single | 3 Participants |
| Marital Status Widowed | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 15 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 0 Participants |
| Region of Enrollment United States | 15 participants |
| Relationship to loved one with dementia Daughter | 10 Participants |
| Relationship to loved one with dementia Friend/Neighbor | 0 Participants |
| Relationship to loved one with dementia Other | 3 Participants |
| Relationship to loved one with dementia Other relative | 0 Participants |
| Relationship to loved one with dementia Son | 0 Participants |
| Relationship to loved one with dementia Spouse | 2 Participants |
| Sex: Female, Male Female | 15 Participants |
| Sex: Female, Male Male | 0 Participants |
| Years as caregiver to the loved one with dementia | 4.4 years STANDARD_DEVIATION 3.4 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 15 |
| other Total, other adverse events | 0 / 15 |
| serious Total, serious adverse events | 0 / 15 |
Outcome results
Medical Outcomes Study Social Support Survey (MOS SSS)
This instrument contains 19 items that comprise 4 subscales: Emotional/Informational Support, Tangible Support, Affectionate Support, and Positive Social Interaction. Each item is scored on a 5 point Likert scale of 1 (none of the time) to 5 (all the time), with higher scores indicating more social support. Total and subscale scores are in a range of 1-5 calculated by taking the mean across items.
Time frame: Baseline and 6 months post baseline
Population: 1 participant was not able to complete the intervention due to the death of their spouse
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Emotional/Informational Support at Baseline | 3.75 score on a scale | Standard Deviation 1.03 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Emotional/Informational Support at 6 Months | 3.79 score on a scale | Standard Deviation 0.99 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Tangible support at Baseline | 3.68 score on a scale | Standard Deviation 1.02 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Tangible support at 6 months | 3.50 score on a scale | Standard Deviation 1.29 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Affectionate support at Baseline | 4.22 score on a scale | Standard Deviation 0.67 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Affectionate support at 6 months | 3.95 score on a scale | Standard Deviation 0.9 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Positive social interaction at Baseline | 4.11 score on a scale | Standard Deviation 0.72 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Positive social interaction at 6 months | 3.98 score on a scale | Standard Deviation 0.83 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Overall social support at Baseline | 3.88 score on a scale | Standard Deviation 0.75 |
| Peer Support | Medical Outcomes Study Social Support Survey (MOS SSS) | Overall social support at 6 months | 3.77 score on a scale | Standard Deviation 0.83 |