Tools for Distance Delivery of an Evidence-based AD Family Caregiver Intervention
| Status: | Recruiting |
|---|---|
| Conditions: | Alzheimer Disease, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 21 - 125 |
| Updated: | 1/31/2019 |
| Start Date: | October 2015 |
| End Date: | September 2019 |
| Contact: | Tadessech Hailu, MS |
| Email: | tadessech.hailu@nyumc.org |
| Phone: | 646-754-2291 |
A 20+ year randomized controlled trial (RCT) demonstrated the many benefits of a counseling
and support intervention for spouse caregivers, the NYU Caregiver Intervention (NYUCI). The
NYU Caregiver Intervention (NYUCI) is an evidence-based intervention that provides counseling
and support for families involved in the care of a relative or friend with Alzheimer's
Disease and Related Dementias (ADRD). Most notably, the NYUCI substantially reduced
caregiver's depressive symptoms, improved their physical health, and extended the time
persons with ADRD remained at home by an average of 1.5 years (Mittelman et al., AG14634,
formerly MH42216; See http://www.ncbi.nlm.nih.gov/pubmed/17101889).
The intervention is now being widely implemented in-person, but there are barriers that
prevent many caregivers from receiving its benefits, including geographic distance;
impediments to older adults leaving their homes; and travel considerations for counselors
which make it impossible to provide the NYUCI in person.
The goal of this study is to evaluate the efficacy of an online videoconferencing version of
the NYUCI. This innovative application has massive implications for social service delivery
to older adults, because it will make it possible to deliver an in-person intervention, via
the internet, which is already evidenced based to older adult caregivers who cannot currently
be served. It will create the online reservation and management technology linking counselors
with families as well as the evidence of effectiveness of providing such services via secure
video teleconferencing vehicles. The proposed Telehealth Technology for Distance Counseling
(TTDC) and related online educational training modules will connect skilled providers to the
families of persons with dementia without regard to geographic location. Implications for
rural healthcare delivery are particularly persuasive. To the investigators knowledge, this
will be the first large-scale TTDC to be developed and rigorously tested with a randomized
controlled trial. The investigators hypothesize that such a system, coupled with online
training for providers and families on tele- counseling and distance caregiving, will have
similar benefits to those achieved with in-person counseling during the original NYUCI RCT.
This project includes an online reservation and management technology linking counselors with
families via secure videoconferencing vehicles. The Telehealth Technology for Distance
Counseling (TTDC), and online technology developed as part of this overall effort, will
connect skilled providers to the families of persons with dementia without regard to
geographic location. The related online clinical modules (i.e., interactive, computer-based
educational materials) developed as a part of this grant effort will prepare counselors to
provide the intervention, and caregivers to utilize the internet software, to be able to
participate in counseling.
The TTDC will include a scheduling system to link counselors to families at their mutual
convenience and assure delivery in a cost-effective manner. The TTDC has the additional
potential to transform ADRD care in ethnic and culturally diverse communities by connecting
highly trained NYUCI counselors with specialized language and cultural skills to families who
would not have access to these resources locally.
In this study investigators will have 240 caregivers navigate the online educational module
and the online reservation system for connecting caregivers with social workers. Half of the
caregivers will then be paired with social service providers to receive counseling over the
telephone, and the other half with be paired with social service providers to receive
counseling via Zoom, a video conferencing program. Recruiting across the United States and
Toronto, Canada.
and support intervention for spouse caregivers, the NYU Caregiver Intervention (NYUCI). The
NYU Caregiver Intervention (NYUCI) is an evidence-based intervention that provides counseling
and support for families involved in the care of a relative or friend with Alzheimer's
Disease and Related Dementias (ADRD). Most notably, the NYUCI substantially reduced
caregiver's depressive symptoms, improved their physical health, and extended the time
persons with ADRD remained at home by an average of 1.5 years (Mittelman et al., AG14634,
formerly MH42216; See http://www.ncbi.nlm.nih.gov/pubmed/17101889).
The intervention is now being widely implemented in-person, but there are barriers that
prevent many caregivers from receiving its benefits, including geographic distance;
impediments to older adults leaving their homes; and travel considerations for counselors
which make it impossible to provide the NYUCI in person.
The goal of this study is to evaluate the efficacy of an online videoconferencing version of
the NYUCI. This innovative application has massive implications for social service delivery
to older adults, because it will make it possible to deliver an in-person intervention, via
the internet, which is already evidenced based to older adult caregivers who cannot currently
be served. It will create the online reservation and management technology linking counselors
with families as well as the evidence of effectiveness of providing such services via secure
video teleconferencing vehicles. The proposed Telehealth Technology for Distance Counseling
(TTDC) and related online educational training modules will connect skilled providers to the
families of persons with dementia without regard to geographic location. Implications for
rural healthcare delivery are particularly persuasive. To the investigators knowledge, this
will be the first large-scale TTDC to be developed and rigorously tested with a randomized
controlled trial. The investigators hypothesize that such a system, coupled with online
training for providers and families on tele- counseling and distance caregiving, will have
similar benefits to those achieved with in-person counseling during the original NYUCI RCT.
This project includes an online reservation and management technology linking counselors with
families via secure videoconferencing vehicles. The Telehealth Technology for Distance
Counseling (TTDC), and online technology developed as part of this overall effort, will
connect skilled providers to the families of persons with dementia without regard to
geographic location. The related online clinical modules (i.e., interactive, computer-based
educational materials) developed as a part of this grant effort will prepare counselors to
provide the intervention, and caregivers to utilize the internet software, to be able to
participate in counseling.
The TTDC will include a scheduling system to link counselors to families at their mutual
convenience and assure delivery in a cost-effective manner. The TTDC has the additional
potential to transform ADRD care in ethnic and culturally diverse communities by connecting
highly trained NYUCI counselors with specialized language and cultural skills to families who
would not have access to these resources locally.
In this study investigators will have 240 caregivers navigate the online educational module
and the online reservation system for connecting caregivers with social workers. Half of the
caregivers will then be paired with social service providers to receive counseling over the
telephone, and the other half with be paired with social service providers to receive
counseling via Zoom, a video conferencing program. Recruiting across the United States and
Toronto, Canada.
Inclusion Criteria:
Inclusion criteria for caregivers to become research participants include:
1. access to an Internet-connected computer with a camera, microphone, and speakers
either at home, or at another location that affords privacy;
2. fluent in spoken and written English; and
3. caregivers who participate must be spouses or partners of people with dementia living
with them at home when they enter the study. In addition, all caregivers must have at
least one family member (or close friend) with whom they are in communication about
the person with dementia, and/or their issues related to being a caregiver, who can
participate in family counseling sessions; if not, they are excluded from the study.
Inclusion criteria for counselors to be research participants in both the pilot study and
the RCT:
1. Certified or Master's level social worker, a nurse with an RN and at least two years'
experience working with older adults and their family members evaluated on an
individual basis by the PIs);
2. counselors who have received training online or in person in conducting the NYUCI and
provided the intervention to at least one caregiver in person;
3. counselors who have completed the online training to conduct the NYUCI via
videoconferencing;
4. counselors who have demonstrated the ability to contact caregivers and families via
videoconferencing by interacting with HealthCare Interactive (HCI) staff in mock
sessions (HCI is the technology developer for this Phase II effort); and
5. counselors who have confirmed they have personal liability and malpractice insurance.
Exclusion Criteria:
Exclusion criteria for caregivers to be participants are:
1. no access or severely limited access to an Internet-connected computer with a camera;
2. not fluent in spoken and written English;
3. not having a family member with whom they are in communication about the person with
dementia; and
4. apparent severe mental or physical illness (e.g., self report of clinical depression).
Exclusion criteria for counselors include:
1. not a certified or Master's level social worker or nurse with an RN and at least two
years' experience working with older adults and their family members, or other
professional with at last two years' experience working with older adults and their
family members (to be decided by the PIs);
2. counselors who have not received training online or in person in conducting the NYUCI;
3. counselors who have not completed the online training to conduct the NYUCI via
videoconferencing;
4. counselors who cannot demonstrate ability to contact caregivers and families via
videoconferencing by interacting with HCI; and
5. counselors who do not have personal liability and malpractice insurance.
We found this trial at
1
site
New York, New York 10016
Principal Investigator: Mary S Mittelman, DrPH
Phone: 646-754-2291
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