Mobile Web-based Behavioral Intervention for Improving Caregiver Well-being
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Over 15 million men and women provide informal caregiving services to family members who have dementia. The literature is replete with evidence that caregiving results in high rates of depression and distress, and potentially high rates of physical morbidity. For example, 40% of caregivers are at risk for depression compared to just 5% of non-caregiving older adults. Further, increased symptoms of depression and distress in caregivers are associated with accelerated risk for developing cardiovascular disease. Thus, efficacious interventions for reducing caregiver distress appear potentially valuable for both mental and physical well-being.
Given the distress experienced by caregivers, it is no surprise that over 80 intervention studies for reducing caregiver distress have been published. The message from these studies is that caregiver interventions, in general, are effective for reducing distress. Yet, the implementation of Evidence Based Treatments (EBTs) continues to be a challenge. Despite identification of EBTs, their use at the community-level has been absent. In 2007, NIH sponsored a workshop on the use of EBTs for caregivers. The conclusion was that "The majority of effective interventions for caregivers were not being implemented through the aging network." Ten years later, this lack of implementation remains. It is critical that scientists develop interventions for caregivers with maximal reach and minimal cost. Currently, most caregiver intervention frameworks require caregivers to meet with a therapist in one of four formats: a) face-to-face meetings with a therapist outside the caregiver's home, b) face-to-face meetings with a therapist in the caregiver's home, c) in-person, group-based meetings, or d) phone-based interventions in which caregivers call a therapist or support group. While possibly efficacious, these therapeutic formats are limited because: a) community agencies serving caregivers do not offer EBTs, b) the interventions are often not accessible to caregivers who reside outside the care network, c) they require caregivers to attend therapy sessions on specific days and times that may not be convenient for them, or d) they may require caregivers to find alternate care for their care recipients while they attend the therapy. To address these limitations, the investigators have adapted an evidence-based, brief Behavioral Activation (BA) program to be delivered to caregivers via mobile phones with internet-based capabilities, thereby increasing caregivers' access to quality care. This mobile intervention is now being tested in this full-scale trial. The investigators will test mechanisms of action, namely that increased behavioral activation promotes well-being in caregivers. To do so, the investigators will recruit and randomize 200 caregivers to receive either a mobile BA intervention (N = 100) known as the mobile pleasant events program (mPEP), or a web-based bibliotherapy condition (N = 100) teaching skills on coping with caregiving. Participants will be assessed for depressive symptoms, positive and negative affect, well-being, and blood pressure at baseline, 3-months, 9-months, and 15-months follow-up time points.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Brent T Mausbach, PhD
- Phone Number: 8588227529
- Email: bmausbach@ucsd.edu
Study Contact Backup
- Name: Igor Grant, MD
- Phone Number: 8585436222
- Email: igrant@ucsd.edu
Study Locations
-
-
California
-
La Jolla, California, United States, 92093
- University of California San Diego
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria -
- English-speaking
- Spouse or Child Caregiver of a loved-one with Alzheimer's Disease or Related Dementia (ADRD)
- Aged 40 years or older at the time of enrollment
- Providing at least 20 hours of in-home care per week
- Screening positive for mild depressive symptoms (CESD-R≥16).
Exclusion Criteria -
- Diagnosed with a terminal illness
- Demonstrates cognitive impairment (MMSE<27)
- Severe hypertension (>200/120 mm Hg)
- Participating in another active caregiver intervention (other than support groups)
- Receiving psychiatric care for serious mental illnesses such as schizophrenia or bipolar disorder
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: mPEP
Behavioral Activation Therapy - Increase engagement in pleasant activities as a mechanism for reducing distress and improving overall well-being.
Participants will use an online web tool to select and schedule activities they deem will be rewarding and fulfilling.
They will then track their engagement in these activities on a weekly basis.
|
Behavioral Activation Therapy
|
|
Active Comparator: Bibliotherapy
Bibliotherapy - Develop improved coping and problem-solving skills.
Participants will receive bibliotherapy handouts describing various means of managing their distress and solving caregiving-related problems.
|
Provide educational material on coping strategies pertinent to caregivers
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Center for Epidemiologic Studies Depression Scale--Revised (CESD-R)
Time Frame: 15-months
|
20 item scale measuring Depressive Symptoms.
Each item rated on a range of 0-4 and items are summed to create a total score (Range = 0-80).
Higher scores denote greater depressive symptoms.
|
15-months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Blood Pressure
Time Frame: 15-months
|
Systolic and Diastolic Blood Pressure
|
15-months
|
|
Positive and Negative Affect Scale (PANAS)
Time Frame: 15-months
|
Positive and Negative Affect Scale (PANAS).
There are 10 items asking about Positive Affect, each item is rated on a range of 1-5.
All 10 items are summed to create a total score (Range = 10-50) There are 10 items asking about Negative Affect, each item is rated from 1-5, and items are summed to create an overall score (Range = 10-50).
Higher scores denote greater positive and negative affect, respectively.
|
15-months
|
|
Dementia Quality of Life Scale for Older Family Carers (DQoLOC)
Time Frame: 15-months
|
Dementia Quality of Life Scale for Older Family Carers (DQoLOC).
Scale consists of 22 items, each item is rated from 1-5.
The total range for the scale is 22-110, with higher score indicating greater quality of life.
|
15-months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Brent T Mausbach, PhD, University of California, San Diego
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 180454
- R01AG061941 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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