- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03988621
Improving Self-care of Heart Failure Caregivers
Improving Self-Care of Informal Caregivers of Adults With Heart Failure
Study Overview
Detailed Description
We will use a randomized controlled trial (RCT) design, randomizing informal heart failure (HF) caregivers meeting our inclusion and exclusion criteria 1:1 to an intervention or control group. After collecting baseline data, we will block randomize the caregivers to achieve equal distribution of key variables in each condition. We will block randomize on caregiver sex (male/female) and relationship to patient (e.g., spouse) - factors shown to influence perceived caregiving burden and receptivity to intervention. The randomization sequence will be generated a priori by a statistician independent of the study investigators using a randomly permuted blocks algorithm to ensure equal distribution of these variables in each study arm. The Project Manager will notify the study staff and participants of their group assignment (intervention or control) by telephone, email or message, as preferred by the individual. Although balance in sample size can be achieved with block randomization, the groups may not be fully comparable on other factors. Initial comparison of the groups will allow us to control for important covariates in the analyses. Investigators and all staff involved in collecting assessment data will be blinded to group assignment until after the data are locked. The nurse providing the intervention and the caregiver participants will not be blinded. All baseline data will be collected prior to randomizing. Timing of follow-up assessments will be based on day of randomization.
The study intervention will be provided to individual caregivers. All caregivers (both groups) will be provided with access to an Internet site with excellent health information (HI). In addition, we have developed and pilot tested a virtual support intervention (ViCCY ["Vicky"] - Virtual Caregiver Coach for You), that we will provide on tablet devices to caregivers in the intervention group. We will provide tablets to all the caregivers, assuring that they have wireless network access so they can access the Internet site providing HI content. Caregivers in the control group will receive only HI but caregivers in the intervention group will receive 10 front-loaded sessions of ViCCY over 6 months.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Gladys L Thomas, LMSW,MBA
- Phone Number: 215-898-5089
- Email: glthomas@nursing.upenn.edu
Study Contact Backup
- Name: Barbara Riegel, PhD, RN
- Phone Number: 215-898-9927
- Email: briegel@nursing.upenn.edu
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania Hospital Heart and Vascular Clinic
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria: Informal caregiver of adults with heart failure providing care at least 8 hours/week, reporting poor self-care on screening (Health Self-Care Neglect scale score >=2 based on our pilot data), able to complete the protocol, e.g., adequate vision and hearing, English speaking, and living within 50 miles of the research office in case home visits are required for enrollment or Internet set-up.
Exclusion Criteria: Cognitive impairment (Telephone Interview for Cognitive Status [TICS] <25), Participation in another clinical trial of a support intervention, Untreated major psychiatric illness (Use of anti-anxiety/antidepressant medicines is acceptable and will be adjusted in analysis if group inbalance is identified), and plans to move out of the area imminently.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
Caregivers randomized to the intervention ViCCY will receive 10 front-loaded sessions of virtual health coaching by trained registered nurses over 6 months with content based on the theoretical framework (based on the Transactional Model of Stress and Coping) and prior research.
Sessions are provided using tablets.
Initially, sessions are weekly but the frequency decreases over time as needed.
We help caregivers gain the knowledge and skills needed to achieve self-identified health goals through self-care using motivational interviewing.
We focus on identifying personal values, solving problems, and transforming goals into action.
ViCCY is standardized in a treatment manual.
Because stress does not affect all people equally, the intervention is tailored to individual appraisals and the factors most likely to influence demand and perceived burden.
|
Virtual Health Coaching for You
|
No Intervention: Health Information
The Health Information (HI) group will receive health resource information delivered through the internet.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in the Health Self-Care Neglect Scale
Time Frame: The primary outcome will be analyzed at 6 months (baseline compared to 6 months)
|
Self-care refers to those behaviors undertaken to maintain health.
The scale is a 9- item dichotomous scale with demonstrated reliability (alpha 0.76) and content validity.
Scores range from 0-9 with higher scores indicating more self-care neglect.
|
The primary outcome will be analyzed at 6 months (baseline compared to 6 months)
|
Change in the Self-Care Inventory
Time Frame: The primary outcome will be analyzed at 6 months (baseline compared to 6 months)
|
30 items scored 0-100.
A higher score indicates better self-care.
This theoretically-derived instrument has construct validity.
The self-care confidence scale is embedded within this instrument.
|
The primary outcome will be analyzed at 6 months (baseline compared to 6 months)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in the Perceived Stress Scale
Time Frame: Baseline, 3, 6, 9, and 12 months.
|
The Perceived Stress Scale, a 14-item instrument that provides a global rating of an individual's belief in the severity and frequency of stressful experiences during the last month.
The Perceived Stress Scale includes 14 items designed to assess symptoms of stress and global measures of the degree of stress experienced in the past month.
Each item is scored from 0 (never) to 4 (very often), with total sum scores ranging from 0 to 56; higher scores indicate higher perceived stress.
Cronbachs alpha of the scale ranges from 0.84 to 0.86, and was 0.91 for older African American and European American females.
|
Baseline, 3, 6, 9, and 12 months.
|
Change in the Ways of Coping questionnaire
Time Frame: Baseline, 3, 6, 9, and 12 months.
|
This 42-item questionnaire measures the use of five different coping styles: avoidance, problem-focused, seeking social support, self-blame, and wishful thinking.
The original scale has been used widely since developed by Lazarus in 1985.
The short version (30 items) uses a 4-point Likert-scale response format (0 = not used to 3 = used a great deal).
Scores range from 0-90 with higher scores indicating greater coping.
It is reliable (alpha 0.95) and has construct validity.
This instrument has been used numerous times in studies with older adult caregivers.
|
Baseline, 3, 6, 9, and 12 months.
|
Change in Health Status (physical and mental health status)
Time Frame: Baseline, 3, 6, 9, and 12 months.
|
Medical Outcomes Study Short Form (SF-36): measure of physical and mental health.The SF-36 has 36 items formatted in scales of varied format (3-, 5- and 6-pt scales and dichotomous [yes/no] scales).
Each component score is standardized a 0-100 point scale.
Reliability is varied samples is typically 0.80.
Convergent and divergent validity have been demonstrated in various populations, including caregivers.
A benefit of using the SF-36 is that it is one of the common data elements.
|
Baseline, 3, 6, 9, and 12 months.
|
Change in the Medical Outcomes Study short form 6-dimension (SF-6D)
Time Frame: Baseline, 3, 6, 9, and 12 months
|
derived from the SF-36 and used in the cost-effectiveness analysis
|
Baseline, 3, 6, 9, and 12 months
|
Difference in hospital and provider events
Time Frame: Baseline, 3, 6, 9, and 12 months
|
measure of acute care resource use
|
Baseline, 3, 6, 9, and 12 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1R01NR018196 (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
- ICF
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.
Clinical Trials on Heart Failure
-
Tufts Medical CenterMetro West Medical CenterCompletedCongestive Heart Failure | Diastolic Heart Failure | Systolic Heart FailureUnited States
-
Abbott Medical DevicesCompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure NYHA Class II | Heart Failure NYHA Class III | Heart Failure With Reduced Ejection Fraction | Heart Failure NYHA Class IV | Heart Failure With Normal Ejection Fraction | Heart Failure; With Decompensation | Heart Failure...United States, Canada
-
Manipal UniversityUnknownHeart Failure | Decompensated Heart Failure | Acute Heart Failure | Diastolic Heart Failure | Systolic Heart FailureIndia
-
VA Eastern Colorado Health Care SystemNational Institute on Aging (NIA)CompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure With Reduced Ejection Fraction | Heart Failure With Preserved Ejection Fraction | Heart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteUnited States
-
University Hospital, MontpellierCompletedHeart Failure | Diastolic Heart Failure | Systolic Heart Failure Stage CFrance
-
Wake Forest UniversityCompletedHeart Failure, Congestive | Heart Failure With Preserved Ejection Fraction
-
Lancaster General HospitalLouise von Hess Medical Research InstituteEnrolling by invitationDiastolic Heart FailureUnited States
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
Giresun UniversityIstanbul University - Cerrahpasa (IUC)RecruitingHeart Failure | Diastolic Heart Failure | Systolic Heart FailureTurkey
-
US Department of Veterans AffairsCompleted
Clinical Trials on ViCCY
-
University of PennsylvaniaCompletedBehavioral Variant of Frontotemporal Dementia | Caregiver Stress SyndromeUnited States
-
University of PennsylvaniaNational Institute on Aging (NIA)Recruiting