Video-Based Coping Skills Training for Caregivers

Phase II Trial of a Video That Presents Training in Stress Coping Skills for Caregivers of a Relative With Alzheimer's Disease or Other Dementia

The purpose of this Phase II SBIR study is a) to complete the adaptation begun in Phase I of the ten skill modules of the Williams LifeSkills Video (WLV) for use by persons who are caregivers for a relative with Alzheimer's Disease (AD) or other dementia, b) to script and produce the complete Caregiver LifeSkills Video (CLV) and c) to conduct a randomized clinical trial of the completed CLV to document benefits in terms of reduced psychosocial distress, reduced biomarkers of stress and improved well being.

Study Overview

• Status: Completed
• Conditions: Caregivers
• Intervention / Treatment: Behavioral: Video-based coping skills training with telephone coaching

Detailed Description

An extensive body of research documents adverse effects of being a caregiver for a relative with AD on a broad range of psychosocial and biological indicators of stress, including increased hassles and depression (Russo & Vitaliano, Experimental Aging Research 1995; 21:273-294 ) and the metabolic syndrome (Vitaliano et al, Journal of Gerontology: Psychological Sciences 1996; 51:290-299). Interventions to reduce psychological distress in caregivers have not produced clinically meaningful results thus far (Shulz et al. Gerontologist 2002; 42:589-602) and no intervention trials have included assessment of biomarkers of stress. Logistic obstacles make it hard for caregivers to participate in treatments that require them to come to a treatment site outside the home; thus, interventions with caregivers are hard to deliver. The Williams LifeSkills Video (WLV) is based on the LifeSkills Workshop, which has been shown in randomized clinical trials to reduce hostility and blood pressure in post-MI patients (Gidron et al. Health Psychology 1999; 18:416-420) and to reduce a broad range of psychosocial risk factors as well as blood pressure and heart rate during both rest and stress conditions in post-CABG patients (Bishop et al., American Heart Journal 2005;150:602-609). The WLV was developed with support from an NIMH SBIR Phase II grant and presents 10 skill modules -- 1) increased awareness of thoughts and feelings arising in stressful situations; 2) evaluation of those thoughts and feelings to decide whether to try to change them or to take action to try to change the situation; 3) deflection skills to change one's thoughts and feelings; action skills to change stressful situations, including 4) assertion, 5) problem-solving, and 6) saying no; and relationship skills - 7) speaking clearly, 8) listening, 9) empathy, and 10) increasing the positives - using dramatizations of scenarios in which the skill is first not used and then used to produce a better outcome. A randomized clinical trial evaluating it in stressed community volunteers showed that it is superior to a wait list control condition in reducing psychosocial (anxiety, depression and perceived stress; (Kirby et al.Psychosomatic Medicine,2006;68:816-823.

In the research conducted in Phase I of this SBIR-supported study, we adapted the scenarios used for the 10 skills to represent more closely the real life situations faced by caregivers and we developed a telephone coaching manual. Now in Phase II of this study, we will produce the complete Caregiver LifeSkills Video (CLV) evaluate its effects on measures of psychosocial distress and biomarkers of stress in a randomized clinical trial with 120 caregivers of a relative with AD or other major dementias. If successful in reducing the psychosocial and biological markers of stress that are elevated in caregivers, this new WLS product, the CLV, could have a major impact in reducing the health damaging effects of stress among the millions of Americans who are caregivers for relatives with AD and other dementias.

• Study Type: Interventional
• Enrollment (Actual): 116
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27705
      • Williams LifeSkills, Inc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Must be a primary caregiver for a relative with Alzheimer's Disease or other dementia

Exclusion Criteria:

• Presence of a major medical or psychiatric illness that would prevent completion of low risk study procedures

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Active treatment; Subjects randomized to this arm will receive the Family Caregiver Kit composed of the Williams LifeSkills Family Caregiver Video and Workbook and will also receive telephone coaching	Behavioral: Video-based coping skills training with telephone coaching; Subjects will view the 10 modules of Williams LifeSkills Caregiver Video, do Workbook exercises for each module, and receive telephone coaching to enhance their ability to apply the skills taught in each module to caregiver situations.; Other Names: Williams LifeSkills Family Caregiver Kit
No Intervention: Control; Subjects randomized to this arm will receive no intervention and serve as wait list controls. They will undergo the same evaluations as the Intervention arm subjects at comparable times. In a crossover design, once subjects have finished serving as controls, they will be given the video, workbook, and telephone calls from a social worker and tested one more time.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Center for Epidemiological Studies Depression scale	Pre- and post-training, 3 months and 6 months
Spielberger State-Trait Anger and Anxiety Scales	Pre-and post-training, 3 months and 6 months
Perceived Stress Scale	Pre- and post-training, 3 months and 6 months
Pittsburgh Sleep Quality Index	Pre-and post-training, 3 months and 6 months
Heart rate and blood pressure at rest and during recall of caregiver situation	Pre-and post-training, 3 months and 6 months
Salivary cortisol upon awakening, 30 minutes later, and prior to going to bed at night	Pre-and post-training, 3 months and 6 months

Collaborators and Investigators

• Sponsor: Williams LifeSkills
• Collaborators: National Institute on Aging (NIA)
• Investigators: Principal Investigator: Virginia P Williams, Ph.D., Williams LifeSkills

Publications and helpful links

General Publications

• Williams VP, Bishop-Fitzpatrick L, Lane JD, Gwyther LP, Ballard EL, Vendittelli AP, Hutchins TC, Williams RB. Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer's disease family caregivers. Psychosom Med. 2010 Nov;72(9):897-904. doi: 10.1097/PSY.0b013e3181fc2d09. Epub 2010 Oct 26. Erratum In: Psychosom Med. 2016 Sep;78(7):886.

Study record dates

Study Major Dates

• Study Start: January 1, 2007
• Primary Completion (Actual): May 1, 2009
• Study Completion (Actual): May 1, 2009

Study Registration Dates

• First Submitted: November 6, 2006
• First Submitted That Met QC Criteria: November 7, 2006
• First Posted (Estimate): November 8, 2006

Study Record Updates

• Last Update Posted (Estimate): August 13, 2012
• Last Update Submitted That Met QC Criteria: August 10, 2012
• Last Verified: August 1, 2012

More Information

Terms related to this study

• Keywords: Alzheimer's Disease; Stress management; Care giving
• Other Study ID Numbers: 2R44AG025593-04A;; 2R44AG025593 (U.S. NIH Grant/Contract)