A cluster randomized controlled trial to test the feasibility and preliminary effectiveness of a family dementia caregiver intervention in Vietnam: The REACH VN study protocol

Tuan Anh Nguyen, Huong Nguyen, Thang Pham, Trong Hung Nguyen, Ladson Hinton, Tuan Anh Nguyen, Huong Nguyen, Thang Pham, Trong Hung Nguyen, Ladson Hinton

Abstract

Background: Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) is an evidence-based intervention supporting family dementia caregivers that has been shown to improve caregiver outcomes for culturally diverse populations in the United States. However, this model has not been tested in low- and middle-income countries (LMICs) including Vietnam, where community-based psychosocial interventions are urgently needed. The objectives of this study are to assess the feasibility and preliminary effectiveness of a culturally adapted version of the Resources for Enhancing All Caregivers Health in Vietnam (REACH VN).

Methods: A cluster randomized controlled trial (RCT) will be conducted over a 6-month period in Soc Son district located in Hanoi. An expected sample of 10 to 12 communes, representing approximately 50 dementia primary caregivers, will be randomized to either the REACH VN intervention or an enhanced control condition. Inclusion criteria for the caregiver include age ≥18, family member who provides the most day-to-day care for person with dementia, and a total score for the brief (4 item) Zarit Burden Scale of ≥6. Over the course of 2 to 3 months, each participant in the intervention group will receive the REACH VN intervention comprised of 4 core sessions on problem solving, mood management/cognitive restructuring, stress management, and communication, and up to 2 additional sessions based on caregiver's needs. The enhanced control group will receive a single session that provides verbal and written information on dementia. Caregiver outcomes will be assessed at baseline (i.e., time of enrolment) and 3 months. The feasibility will be assessed with regard to recruitment, retention, treatment adherence, treatment fidelity, and assessment processes. For preliminary effectiveness, we will examine caregiver burden as the primary outcome and changes in caregiver depressive symptoms and in Alzheimer disease knowledge as secondary outcomes.

Discussion: This is the first study to test community-based family dementia caregiver intervention in Vietnam. Results from this study will provide the foundation for a larger effectiveness trial and broader dissemination in Vietnam and may help inform efforts to develop similar community-based family dementia caregiver support programs in other LMICs.

Trial registration: ClinicalTrials.gov, ID: NCT03587974. Published online July 16, 2018.

Conflict of interest statement

The authors declare that they have no competing or conflicting interests.

References

    1. United Nations - Department of Economic and Social Affairs - Population Division. World Population Prospects - The 2015 Revision; 2015. Available at: Accessed December 16, 2017.
    1. Le TV. Epidemiological features of dementia in older people in two districts of Hanoi; 2014.
    1. Nguyen VK. A study of dementia characteristics in community. J Pract Med 2009;10:16–8.
    1. Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015. The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer's Disease International; 2015.
    1. WHO A. Dementia: A Public Health Priority. UK: World Health Organization; 2012.
    1. Hulstaert F, Thiry N, Eyssen M, et al. Pharmaceutical and Nonpharmaceutical Interventions in Alzheimer's Disease, A Rapid Assessment - KCE Reports. Brussels, Belgium: Belgian Health Care Knowledge Centre; 2009.
    1. Gitlin LN, Kales HC, Lyketsos CG. Nonpharmacologic management of behavioral symptoms in dementia. JAMA 2012;308:2020–9.
    1. Gitlin LN, Marx K, Stanley IH, et al. Translating evidence-based dementia caregiving interventions into practice: state-of-the-science and next steps. Gerontologist 2015;55:210–26.
    1. Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012;169:946–53.
    1. Cheung KS, Lau BH, Wong PW, et al. Multicomponent intervention on enhancing dementia caregiver well-being and reducing behavioral problems among Hong Kong Chinese: a translational study based on REACH II. Int J Geriatr Psychiatry 2015;30:460–9.
    1. Nichols LO, Martindale-Adams J, Burns R, et al. REACH VA: moving from translation to system implementation. Gerontologist 2016;56:135–44.
    1. Schulz R, Burgio L, Burns R, et al. Resources for enhancing Alzheimer's caregiver health (REACH): overview, site-specific outcomes, and future directions. Gerontologist 2003;43:514–20.
    1. Bernal G, Jiménez-Chafey MI, Domenech Rodríguez MM. Cultural adaptation of treatments: a resource for considering culture in evidence-based practice. Profess Psychol Res Pract 2009;40:361–8.
    1. Nichols LO, Martindale-Adams J, Burns R, et al. Translation of a dementia caregiver support program in a health care system–REACH VA. Arch Intern Med 2011;171:353–9.
    1. Chowdhary N, Jotheeswaran AT, Nadkarni A, et al. The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review. Psychol Med 2014;44:1131–46.
    1. Wainberg ML, McKinnon K, Mattos PE, et al. A model for adapting evidence-based behavioral interventions to a new culture: HIV prevention for psychiatric patients in Rio de Janeiro, Brazil. AIDS Behav 2007;11:872–83.
    1. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412–4.
    1. Bedard M, Molloy DW, Squire L, et al. The Zarit Burden Interview: a new short version and screening version. Gerontologist 2001;41:652–7.
    1. Belle SH, Burgio L, Burns R, et al. Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Ann Intern Med 2006;145:727–38.
    1. Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res 2011;45:626–9.
    1. Kroenke K, Spitzer RL, Williams JB, et al. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 2009;50:613–21.
    1. StataCorp. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC; 2017.
    1. Dias A, Dewey ME, D'Souza J, et al. The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PLoS One 2008;3:e2333.
    1. Fung WY, Chien WT. The effectiveness of a mutual support group for family caregivers of a relative with dementia. Arch Psychiatr Nurs 2002;16:134–44.
    1. Au A, Li S, Lee K, et al. The Coping with Caregiving Group Program for Chinese caregivers of patients with Alzheimer's disease in Hong Kong. Patient Educ Couns 2010;78:256–60.
    1. Chien WT, Lee IY. Randomized controlled trial of a dementia care programme for families of home-resided older people with dementia. J Adv Nurs 2011;67:774–87.
    1. Chu H, Yang CY, Liao YH, et al. The effects of a support group on dementia caregivers’ burden and depression. J Aging Health 2011;23:228–41.

Source: PubMed

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