- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03023332
Tailored Health Self-Management Interventions for Highly Distressed Family Caregivers
Study Overview
Status
Intervention / Treatment
Detailed Description
The study has two aims: The primary aim (A1) is to examine differences across the four groups (control, usual care, SM-need, and SM-preference) on caregiver health (health risks and mental and physical health) over time. We hypothesize that the caregivers who receive a self-management intervention based on need (SM-need) or preference (SM-preference) will have better health outcomes than those in the usual care or control groups.
Secondary aims are to: A2) explore whether caregiver baseline need or preference for intervention (i.e. choice) is associated with: a) care recipient's symptoms; b) caregiver reactions; and c) caregiving involvement, and A3) build caregiver profiles from demographic/ contextual factors that are associated with their needs and preferences for the self-management interventions.
All caregivers will complete assessment measures and measures of health risks, and physical and mental health at baseline (T1), 6 months (T2) and 12 months (T3). Caregivers will randomly assigned to one of four groups. The control group will receive no intervention. The usual care group will receive bipolar education. The SM-need group will receive a self-management intervention tailored to meet their need for bipolar education, biofeedback training, or resourcefulness training, as determined by baseline cut scores. Caregivers in the SM-preference group will choose one of the three self-management intervention according to their personal preference.
All three self-management interventions (bipolar education, biofeedback training, resourcefulness training) are delivered over four weeks (between T1 and T2). Caregivers may use the one SM intervention whenever and as often as they wish (i.e. self-tailoring) for the remainder of the study period. The bipolar education and resourcefulness training interventions will be delivered initially using an iPad. These interventions involve providing educational information about bipolar disorder or teaching self-help (stress-management, problem-solving) and help-seeking skills, respectively. Biofeedback training consists of use of a hand-held device that shows the participant their changes in heart rate based on changes in their breathing pattern (as they relax); caregivers who need or prefer the biofeedback will be given a device to use for 28 days. All study participants receiving the intervention will also be asked to keep a journal to record their experience with the intervention.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ohio
-
Cleveland, Ohio, United States, 44106
- CWRU School of Nursing
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- English-speaking
- At least 18 years old
- Have a family member with bipolar disorder
- Have cared/supported them for at least the last 6 months in the last year
- Be capable of performing the informed consent and participate in interventions
Exclusion Criteria:
- Does not have family member with bipolar disorder
- Has not cared for family member for at least 6 months in the last year
- Knowledge of another family member in the same household enrolled in the study
- Is pregnant
- Has a pacemaker
- Lives outside of the study area (Cuyahoga, Lake, Geauga, Portage, Summit, Medina, and Lorain counties)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Self-management need
SM-need (i.e.
need for bipolar education or resourcefulness training or HRV-focused biofeedback training or no need for any)
|
A cognitive-behavioral intervention delivered through iPad technology that consists of teaching and reinforcing personal (self-help) and social (help-seeking) resourcefulness skills.
Use of a heart-rate variability (HRV) tracking device to enable one to learn to alter physiology to improve health.
Devices are used to measure physiological activity, e.g., breathing and heart function, and provide rapid, accurate "feedback" to the user, thereby enabling desired physiological changes that can endure over time without continued use of the device and continue to influence behavior.
An educational program designed to teach family caregivers of about the types, causes, symptoms, episodes, warning signs, and treatments for individuals with bipolar disorder, as well as available resources for assisting a family member with bipolar disorder.
The content to be presented within an audiovisual format using iPad technology follows the recommendations and guidelines developed through research and by the Depression and Bipolar Support Alliance and the National Institute of Mental Health.
|
Experimental: Self-management preference
SM-preference (i.e.
preference for bipolar education or resourcefulness training or HRV-focused biofeedback training or no intervention)
|
A cognitive-behavioral intervention delivered through iPad technology that consists of teaching and reinforcing personal (self-help) and social (help-seeking) resourcefulness skills.
Use of a heart-rate variability (HRV) tracking device to enable one to learn to alter physiology to improve health.
Devices are used to measure physiological activity, e.g., breathing and heart function, and provide rapid, accurate "feedback" to the user, thereby enabling desired physiological changes that can endure over time without continued use of the device and continue to influence behavior.
An educational program designed to teach family caregivers of about the types, causes, symptoms, episodes, warning signs, and treatments for individuals with bipolar disorder, as well as available resources for assisting a family member with bipolar disorder.
The content to be presented within an audiovisual format using iPad technology follows the recommendations and guidelines developed through research and by the Depression and Bipolar Support Alliance and the National Institute of Mental Health.
|
No Intervention: Control
No intervention or treatment
|
|
Active Comparator: Usual care
Bipolar education
|
An educational program designed to teach family caregivers of about the types, causes, symptoms, episodes, warning signs, and treatments for individuals with bipolar disorder, as well as available resources for assisting a family member with bipolar disorder.
The content to be presented within an audiovisual format using iPad technology follows the recommendations and guidelines developed through research and by the Depression and Bipolar Support Alliance and the National Institute of Mental Health.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Caregiver Health - Health Risks
Time Frame: 12 months
|
Health risks were measured using the Change in Health Risk Behavior Scale.
The scale consists of 9 items measured on a 3-point scale, Scores range 9-27; higher score indicates greater risk
|
12 months
|
Change in Global Health - PROMIS (Patient Reported Outcomes Measurement Information System)
Time Frame: 12 months
|
Change in Global Health - PROMIS (Patient Reported Outcomes Measurement Information System) scale.
5 items - physical health; 5 items - mental health; 5-point scale; Scores range 0-40; higher scores indicate better health.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Bipolar Knowledge Assessment Scale
Time Frame: 12 months
|
The scale measures caregiver knowledge of bipolar disorder using a 16 item scale.
Scores range from 0-43, with higher scores indicating greater knowledge.
|
12 months
|
Change in Heart Rate Variability
Time Frame: 12 months
|
HRV is a physiological measure of the healthy functioning of the heart.
It is a well-established biomarker for detecting stress.
HRV was measured using the BioRadio portable limb-lead electrocardiogram recorder.
A sensor was placed on the radial area of the caregiver's forearm for 5 minutes; they were asked to remain still as possible to prevent artifacts in the readings.
The data obtained via this device was analyzed with compatible VivoSense software, which automatically computed 8 HRV parameters.
One of these was the SDNN score, which is the recognized and most commonly used gold standard biomarker indicative of stress.
The SDNN score is the standard deviation of all normal to normal R-R intervals between heartbeats and reported in milliseconds.
The SDNN was the outcome of interest for our study as a physiological indicator of stress.
For each caregiver, the software produced an average score for the 5-minute measurement
|
12 months
|
Change in Resourcefulness
Time Frame: 12 months
|
Participant Resourcefulness scale score.
Composite item comprising of responses to 28 items scored on a 6 point likert scale.
Scores range from 0-140, with higher scores indicating greater resourcefulness.
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jaclene Zauszniewski, PhD, Case Western Reserve University - Frances Payne Bolton School of Nursing
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 1R01NR016817-01 (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
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.
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