Northern-Manhattan Hispanic Caregiver Intervention Effectiveness Study
| Status: | Completed |
|---|---|
| Conditions: | Depression, Neurology |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 90 |
| Updated: | 12/6/2017 |
| Start Date: | March 2014 |
| End Date: | October 2016 |
The primary research question is which of the 2 best known dementia caregiver interventions,
the New York University Caregiver intervention (NYUCI) and Resources for Enhancing Caregivers
Health (REACH OUT), is more effective in alleviating depressive symptoms and caregiver burden
among Hispanic caregivers in New York City. The investigators hypothesize that the NYUCI will
be more effective than REACH OUT in reducing caregiver depressive symptoms and burden among
Hispanics because of its focus on family-centered counseling, which is posited to be more
important among Hispanic caregivers because of a cultural emphasis among Hispanics on family
interactions in interventions. In order to answer the primary question, the investigators
will conduct a pragmatic randomized trial comparing the NYUCI vs. REACH OUT in 200 Hispanic
caregivers of persons with dementia in the community of Northern Manhattan. The total time of
the intervention will be 6 months.
Our research question is which intervention, NYUCI or REACH OUT, is better in Hispanic
relative (any relative) caregivers of persons with dementia. Our objective is to obtain
effectiveness information that will help caregivers and health providers to make decisions
about which intervention to choose. Our primary aim is to compare the effectiveness of the
implementation of the NYUCI and REACH OUT in reducing depressive symptoms and burden. Our
exploratory aims are to examine and compare the predictors of effectiveness of the NYUCI and
REACH OUT and to examine additional outcomes such as caregiver stress and physical health,
and outcomes related to the person with dementia. METHODS. We will conduct a pragmatic
randomized trial of 200 relative caregivers of persons with dementia. Participants will be
randomized to the NYUCI or REACH OUT. The total duration of the intervention will be 6
months, with assessments at baseline and follow-up. All interventions and questionnaires will
be conducted in both English and Spanish. The study duration will be 3 years. The primary
outcomes will be changes in caregiver depressive symptoms, measured with the Geriatric
Depression Scale, and in caregiver burden using the Zarit caregiver burden interview.
the New York University Caregiver intervention (NYUCI) and Resources for Enhancing Caregivers
Health (REACH OUT), is more effective in alleviating depressive symptoms and caregiver burden
among Hispanic caregivers in New York City. The investigators hypothesize that the NYUCI will
be more effective than REACH OUT in reducing caregiver depressive symptoms and burden among
Hispanics because of its focus on family-centered counseling, which is posited to be more
important among Hispanic caregivers because of a cultural emphasis among Hispanics on family
interactions in interventions. In order to answer the primary question, the investigators
will conduct a pragmatic randomized trial comparing the NYUCI vs. REACH OUT in 200 Hispanic
caregivers of persons with dementia in the community of Northern Manhattan. The total time of
the intervention will be 6 months.
Our research question is which intervention, NYUCI or REACH OUT, is better in Hispanic
relative (any relative) caregivers of persons with dementia. Our objective is to obtain
effectiveness information that will help caregivers and health providers to make decisions
about which intervention to choose. Our primary aim is to compare the effectiveness of the
implementation of the NYUCI and REACH OUT in reducing depressive symptoms and burden. Our
exploratory aims are to examine and compare the predictors of effectiveness of the NYUCI and
REACH OUT and to examine additional outcomes such as caregiver stress and physical health,
and outcomes related to the person with dementia. METHODS. We will conduct a pragmatic
randomized trial of 200 relative caregivers of persons with dementia. Participants will be
randomized to the NYUCI or REACH OUT. The total duration of the intervention will be 6
months, with assessments at baseline and follow-up. All interventions and questionnaires will
be conducted in both English and Spanish. The study duration will be 3 years. The primary
outcomes will be changes in caregiver depressive symptoms, measured with the Geriatric
Depression Scale, and in caregiver burden using the Zarit caregiver burden interview.
The prevalence of dementia is increasing with the aging of the population and the absence of
prevention or cure. Thus, the burden of dementia on caregivers is also increasing. Hispanics
have a higher prevalence of dementia than non-Hispanic Whites (NHW), have higher caregiving
burden, and may have less economic resources to cope with the caregiving burden. However,
there is a paucity of evidence on the effectiveness of caregiver interventions in Hispanics.
We propose to compare 2 interventions with evidence of efficacy, the New York University
Caregiver intervention (NYUCI) and the translated Resources for Enhancing Caregivers Health
(REACH OUT). The NYUCI is a family centered counseling intervention that focuses on reducing
negative family interactions and improving family support of the primary caregiver. REACH OUT
focuses on caregiver skills training through action-oriented formal problem solving, goal
setting, and written action plans. The effectiveness of the NYUCI and the REACH OUT has never
been compared. Thus, there is no way for caregivers to decide which intervention to choose.
In addition, there is a paucity of data on the effectiveness of both interventions in
Hispanics.
prevention or cure. Thus, the burden of dementia on caregivers is also increasing. Hispanics
have a higher prevalence of dementia than non-Hispanic Whites (NHW), have higher caregiving
burden, and may have less economic resources to cope with the caregiving burden. However,
there is a paucity of evidence on the effectiveness of caregiver interventions in Hispanics.
We propose to compare 2 interventions with evidence of efficacy, the New York University
Caregiver intervention (NYUCI) and the translated Resources for Enhancing Caregivers Health
(REACH OUT). The NYUCI is a family centered counseling intervention that focuses on reducing
negative family interactions and improving family support of the primary caregiver. REACH OUT
focuses on caregiver skills training through action-oriented formal problem solving, goal
setting, and written action plans. The effectiveness of the NYUCI and the REACH OUT has never
been compared. Thus, there is no way for caregivers to decide which intervention to choose.
In addition, there is a paucity of data on the effectiveness of both interventions in
Hispanics.
Inclusion Criteria:
- Self identified Hispanic
- Between the ages of 18 and 90.
- Caregiver is related to persons receiving care either as a spouse (including common
law partners) or a blood or in-law relative.
- Person receiving care has been diagnosed with dementia and reports at least 1
memory/cognition and 1 daily functioning symptom in our screening questionnaire (see
appendix).
- Caregiver is physically able to provide care
- Caregiver does not have a diagnosis of major psychiatric disorder other than
depression.
- Caregiver does not have depression with psychotic features or suicidal ideation or
attempts in the last 5 years.
- Caregiver is expected to live in New York City in the next 6 months or is available
for study procedures in the New York City area.
- There is at least one relative or close friend living in the New York City
Metropolitan Area (New York, New Jersey, Connecticut).
Exclusion Criteria:
- Not Hispanic
- Caregiver is not a relative as defined in the inclusion criteria.
- Person receiving care does not have dementia
- Other than depression, caregiver has a major psychiatric disorder such as
schizophrenia
- Caregiver has depression with psychotic features or suicidal ideation in the last 5
years.
- Severe depression defined by a Patient Health Questionnaire (PHQ)-9 > 20.
- Previous or current participation in caregiver support programs with the NYUCI or the
REACH OUT
We found this trial at
1
site
Columbia University Medical Center Situated on a 20-acre campus in Northern Manhattan and accounting for...
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