Vietnamese Caregiver Intervention Study
| Status: | Recruiting |
|---|---|
| Conditions: | Alzheimer Disease, Cognitive Studies, Cognitive Studies |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 7/21/2018 |
| Start Date: | May 22, 2017 |
| End Date: | June 30, 2020 |
| Contact: | Oanh L Meyer, PhD, MAS |
| Email: | olmeyer@ucdavis.edu |
| Phone: | 916-734-5218 |
A Culturally-Relevant Approach to Reducing Dementia Caregiver Stress in an Underserved Population
The purpose of this study is to develop and implement a culturally-appropriate intervention
to reduce stress in Vietnamese dementia caregivers. A pilot intervention will be done to test
the feasibility and acceptability of the intervention in a community setting. This will be
done by randomly assigning a family triad (primary caregiver, secondary caregiver, and their
care recipient) into an active intervention or a control condition and monitoring findings at
baseline, post-intervention, and at three months.The intervention will consist of multiple
components -enhanced psycho-education that includes discussion of Alzheimer's Disease (AD)
and cultural impacts on beliefs about dementia and caregiving, management of problem
behaviors, facilitation of support seeking, and mindful Tai Chi. A secondary caregiver who
the primary caregiver identifies as providing him/her with the most support will be invited
to join all components, but the intervention will be flexible depending on caregivers'
needs/preferences. The care recipient is not required to join the sessions but will be able
to if he/she or the family wishes. During the intervention, community partners will provide
respite care for the care recipient.
to reduce stress in Vietnamese dementia caregivers. A pilot intervention will be done to test
the feasibility and acceptability of the intervention in a community setting. This will be
done by randomly assigning a family triad (primary caregiver, secondary caregiver, and their
care recipient) into an active intervention or a control condition and monitoring findings at
baseline, post-intervention, and at three months.The intervention will consist of multiple
components -enhanced psycho-education that includes discussion of Alzheimer's Disease (AD)
and cultural impacts on beliefs about dementia and caregiving, management of problem
behaviors, facilitation of support seeking, and mindful Tai Chi. A secondary caregiver who
the primary caregiver identifies as providing him/her with the most support will be invited
to join all components, but the intervention will be flexible depending on caregivers'
needs/preferences. The care recipient is not required to join the sessions but will be able
to if he/she or the family wishes. During the intervention, community partners will provide
respite care for the care recipient.
Twenty-four (24) caregivers, the identified secondary caregiver, and a care recipient will be
randomly assigned into the active intervention or a control condition: 16 triads in the
intervention condition, 8 in the control.
For the primary caregivers: Primary caregivers will attend six weekly intervention sessions
lasting 2 hours each. Based on previous Randomized Controlled Trials (RCTs) of a successful
behavior change (i.e., smoking cessation) intervention in Vietnamese using only 2-3 sessions,
six sessions were chosen as a middle ground. In the first 45 minutes, primary caregivers and
a secondary caregiver (who the primary caregiver identifies) will participate in family
psycho-education delivered by a Master's level trained, bilingual facilitator. Each group
will consist of no more than four dyads (4 different groups totaling 16 dyads). The
curriculum will be adapted based on what the Alzheimer's Association and REACH II have
successfully used as well as what the UC Davis Alzheimer's Disease Center (ADC) has
implemented. The sessions will cover the following: a clinical model of dementia and helping
family members come to a shared understanding of the nature and cause of dementia. The
innovative component is a discussion of cultural values typical of individuals in Vietnamese
and American cultures and how this can influence perceptions of dementia and caregiving
strategies. This is important because it will help family members who disagree on the
etiology of dementia and strategies for care to empathize with each other's perspective.
Subsequent sessions will help caregivers learn skills and develop self-efficacy in dealing
with patient symptoms, accessing resources (e.g., in-home support), and gaining family
support in culturally-congruent ways. Facilitating the use of formal and informal support is
a critical piece as Vietnamese caregivers may be looking for basic and concrete assistance
rather than help in coping with caregiving.
The last part of the intervention is mindful Tai Chi that was chosen for several reasons. In
a recent review and meta-analysis, Tai Chi showed beneficial effects on depression, anxiety,
stress management, and self-efficacy. Second, Tai Chi is rooted in East Asian traditions and
philosophies that promote balance and healing of the mind and body, thus addressing holistic
beliefs Vietnamese have about wellness. An RCT of Tai Chi recently was successfully completed
in Vietnam, demonstrating its growing acceptance in the Vietnamese population. The protocol
will be adapted to meet caregivers' needs and highlight meditation that involves accepting
stressful circumstances, thus capitalizing on emotion regulation strategies.
For the care recipients: Care recipients will receive the Montreal Cognitive Assessment
(MoCA) measure to assess their mental status at baseline. The purpose of the Quality of Life
- Alzheimer's Disease (QoL-AD) measure is to assess the caregiver intervention affects the
care recipient's quality of life. The total time to complete these questionnaires is about 30
minutes per session.
Participants not randomized to the active intervention will receive educational
materials/pamphlets on dementia and occasional phone-calls by research assistants to maintain
contact, as is the standard of care in most caregiver intervention studies. Including a
control condition will allow for mirroring of the actual larger trial as closely as possible,
and also ascertain the feasibility of randomization.
randomly assigned into the active intervention or a control condition: 16 triads in the
intervention condition, 8 in the control.
For the primary caregivers: Primary caregivers will attend six weekly intervention sessions
lasting 2 hours each. Based on previous Randomized Controlled Trials (RCTs) of a successful
behavior change (i.e., smoking cessation) intervention in Vietnamese using only 2-3 sessions,
six sessions were chosen as a middle ground. In the first 45 minutes, primary caregivers and
a secondary caregiver (who the primary caregiver identifies) will participate in family
psycho-education delivered by a Master's level trained, bilingual facilitator. Each group
will consist of no more than four dyads (4 different groups totaling 16 dyads). The
curriculum will be adapted based on what the Alzheimer's Association and REACH II have
successfully used as well as what the UC Davis Alzheimer's Disease Center (ADC) has
implemented. The sessions will cover the following: a clinical model of dementia and helping
family members come to a shared understanding of the nature and cause of dementia. The
innovative component is a discussion of cultural values typical of individuals in Vietnamese
and American cultures and how this can influence perceptions of dementia and caregiving
strategies. This is important because it will help family members who disagree on the
etiology of dementia and strategies for care to empathize with each other's perspective.
Subsequent sessions will help caregivers learn skills and develop self-efficacy in dealing
with patient symptoms, accessing resources (e.g., in-home support), and gaining family
support in culturally-congruent ways. Facilitating the use of formal and informal support is
a critical piece as Vietnamese caregivers may be looking for basic and concrete assistance
rather than help in coping with caregiving.
The last part of the intervention is mindful Tai Chi that was chosen for several reasons. In
a recent review and meta-analysis, Tai Chi showed beneficial effects on depression, anxiety,
stress management, and self-efficacy. Second, Tai Chi is rooted in East Asian traditions and
philosophies that promote balance and healing of the mind and body, thus addressing holistic
beliefs Vietnamese have about wellness. An RCT of Tai Chi recently was successfully completed
in Vietnam, demonstrating its growing acceptance in the Vietnamese population. The protocol
will be adapted to meet caregivers' needs and highlight meditation that involves accepting
stressful circumstances, thus capitalizing on emotion regulation strategies.
For the care recipients: Care recipients will receive the Montreal Cognitive Assessment
(MoCA) measure to assess their mental status at baseline. The purpose of the Quality of Life
- Alzheimer's Disease (QoL-AD) measure is to assess the caregiver intervention affects the
care recipient's quality of life. The total time to complete these questionnaires is about 30
minutes per session.
Participants not randomized to the active intervention will receive educational
materials/pamphlets on dementia and occasional phone-calls by research assistants to maintain
contact, as is the standard of care in most caregiver intervention studies. Including a
control condition will allow for mirroring of the actual larger trial as closely as possible,
and also ascertain the feasibility of randomization.
Inclusion Criteria:
- Caregivers will be included if they (a) are Vietnamese; (b) are age 21+; (c) speak
Vietnamese and/or English (d) provide day-to-day, hands on care to a family member
with Alzheimer's disease (AD) or cognitive impairment related to AD (e) have at least
one family member who will also participate in the intervention; (f) volunteer
informed consent; (g) are physically able to participate; and (g) expect to stay in
the Sacramento area for the duration of the study
- Care recipients will be included if they are (a) Vietnamese; (b) are age 21+; (c) have
reported Alzheimer's disease (AD) or cognitive impairment related to AD; (d) have at
least one caregiver who is participating in the intervention (e) volunteer informed
consent or surrogate consent, and (f) expect to stay in the Sacramento area for the
duration of the study
Exclusion Criteria:
- If the care recipient expresses dissent to participation or to the use of surrogate
consent, then he/she will be excluded from the study.
We found this trial at
1
site
1 Shields Ave
Sacramento, California 95616
Sacramento, California 95616
(530) 752-1011
Principal Investigator: Oanh Meyer, PhD, MAS
Phone: 916-734-5218
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