Community Health Worker Assisted Task Specific and Cognitive Therapy at Home With Exposure After Stroke (CATCHES)
CATCHES is a novel intervention for preliminary testing, integrating Task Specific Therapy at home guided by Community Health Workers (CHW) under supervision of a licensed Physical Therapist (PT) guided by telehealth based Cognitive Behavioral Therapy (CBT) to reduce task specific fears through repetitive exposure and adaptive behavioral activation strategies and facilitate engagement in physical activity.
- To integrate and establish feasibility of CATCHES intervention. Hypothesis: A multidisciplinary team providing home based TST with exposure therapy tailored to an underserved urban setting will inform a patient-centered behavioral intervention to reduce fear of falling (FOF) among post-acute stroke patients returning home. Feasibility outcomes will include recruitment, retention, and fidelity of implementation.
- Test effects of the intervention on hypothesized treatment mechanism of fear of falling. Hypothesis: Therapy will reduce task specific fear of falling Primary outcome will be change in Activities-specific Balance Confidence Scale.
- Explore physical activity measures subjectively and objectively. Exploratory outcomes include pre and post Timed Up and Go test, patient reported outcome surveys and activity as measured by wearable devices.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Carmen E Castillo
- Phone Number: 212-305-7755
- Email: cec34@cumc.columbia.edu
Study Contact Backup
- Name: Imama A Naqvi, MD, MS
- Phone Number: 212-305-8389
- Email: ian2108@cumc.columbia.edu
Study Locations
-
-
New York
-
New York, New York, United States, 10032
- The Neurological Institute of New York, Columbia University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Aged over 18 years
- Plan for discharge home after stroke and ability to provide consent
- Low balance confidence (Activities-specific Balance Confidence < 80)
Exclusion criteria:
- Modified Rankin Scale > 2 at time of enrollment
- Severe Stroke (NIH Stroke Scale > 14 and/or significant aphasia, dysarthria, or cognitive impairment precluding ability to complete study questionnaires as determined by interviewer)
- Legal blindness precluding ability to view infographic or education materials
- Terminal non-cardiovascular illness (life expectancy < 1 year)
- Co-morbid mental illness requiring hospitalization
- Unavailable for follow-up
- Non-English and non-Spanish speaking
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention
Task Specific Training Task-Specific Training (TST) which is the repeated, active practice of a motor skill or activity that is meaningful to an individual with the goal of skill acquisition and retention will be provided over 5 sessions after initial an initial assessment by a physical therapist.
Cognitive Behavioral Therapy (CBT) with exposure is a psychotherapeutic intervention that focuses on modifying individuals' thoughts and behavior guided through graded exposure will be guided by a psychologist.
|
At the baseline visit (T0), informed consent will be obtained, and baseline questionnaires and measurements completed.
A physical activity monitor will be provided.
After discharge, Task Specific Training guided by Cognitive Behavioral Therapy with Exposure delivered over 7 one-hour sessions including two intake sessions by specialists and five follow up sessions delivered by CHWs individually at home over 3 months.
After the final session at 12 weeks (about 3 months), participants will complete a study end visit (T1) which will include follow up questionnaires and measurements.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of Intervention Completers to Demonstrate Feasibility
Time Frame: 3 months
|
This outcome is designed to measure intervention feasibility, which will take recruitment, retention, and fidelity of implementation into account.
The participants who complete 100% of the study required procedures will be tallied.
|
3 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Activities-specific Balance Confidence Scale Score
Time Frame: Baseline and 3 months
|
This outcome is designed to measure the change in fear of falling.
This is a 16-item self-reported questionnaire with a score range of 1-100. 1 = no confidence and 100 = completely confident.
The higher the score, the lesser the fear.
Total scores are calculated by summing items (16-1600 range) and dividing by 16.
|
Baseline and 3 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Timed Up and Go Test Score
Time Frame: Baseline and 3 months
|
This exploratory outcome is to measure change in physical function.
The Timed Up and Go Test (TUG) assesses mobility, balance, walking ability, and fall risk in older adults.
The test involves recording the length of time it takes a participant to stand from a chair, walk 3 meters, turn around, walk back to the chair, and sit down.
Change in time to perform the test will be assessed.
Measured in number of second taken to complete the test.
When the number is negative, it means that the participant took less time to complete the test at 3 months compared to baseline.
|
Baseline and 3 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Imama A Naqvi, MD, MS, Columbia University
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 (Actual)
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
- AAAU8161
- 5P30AG064198-05 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.