An increasing number of adults in the U.S. provide care to someone aged 50+ years with Alzheimer's Disease (AD) or dementia. Numerous intervention programs have been developed to address the needs of caregivers and several studies have demonstrated small to moderate effects in improving both caregiver and patient outcomes. However, the impact of these programs has been shown to vary according to the characteristic of the caregiver. In addition, despite the availability of these programs, barriers such as transportation problems, insufficient support from others, lack of knowledge about available services, and cultural beliefs often limit caregivers, especially minority caregivers, frm participating in intervention programs and accessing needed resources. Computer and communication technologies may help remove these barriers and enhance caregiver access to needed programs and services. However, the effectiveness of technology-based intervention programs needs to be rigorously evaluated with diverse caregiver groups given the increasing numbers of elders from minority populations, and ethnic/cultural differences in response to the caregiving situation.
The aims of this project are to evaluate the acceptability and efficacy of a culturally tailored technology-based psychosocial intervention for reducing the stress and burden and enhancing quality of life of diverse family caregivers of AD patients. The intervention is designed to address known areas of caregiver risk and to foster the ability of caregivers to leverage the type of supports they need for themselves and the AD patient. The target population is Black/African American, Hispanic, and White non-Hispanic family caregivers of AD patients. These diverse cultural groups are predominant in the greater Miami community and in the larger United States older adult population. We will recruit and randomly assign 240 dyads (80 from each ethnic group) to one of two groups: 1) The Telecare Intervention Condition or 2) An Attention Control Nutrition Condition. The intervention will be home-based and delivered over 6 months using notebook technology in Spanish or English. Participants will be assessed at baseline, post-intervention (6 months after baseline), and six months later (12 months after baseline). Measures will include indices of distress, burden, health and social support and caregiving efficacy. We will also gather information on differences in response to the intervention among the three ethnic groups and the cost-effectiveness of the intervention. In addition, we will conduct moderation analyses to examine the influence of other caregiver characteristics (e.g., age~ relationship to the patient~ coping mechanisms) on responsiveness to the intervention and mediation analyses to identify specify components of the intervention that are linked to outcomes.

Public Health Relevance

The prevalence of family caregivers is projected to increase in concert with the projected increase in number of AD patients. The focus of the study is to gather systematic data on the acceptability and efficacy of a unique technology-based, culturally- tailored psycho-social intervention program that targets ethnically/culturally diverse family caregivers of patients with Alzheimer's disease. The overall goal of the project is to improve the lives of family caregivers as well as their ability to provide care to their loved one and to reduc disparities in access to needed services and support among caregiver populations.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
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Special Emphasis Panel (ZNR1)
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Tully, Lois
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University of Miami School of Medicine
Schools of Medicine
Coral Gables
United States
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Schulz, Richard; Wahl, Hans-Werner; Matthews, Judith T et al. (2015) Advancing the Aging and Technology Agenda in Gerontology. Gerontologist 55:724-34
Thorpe, Joshua M; Thorpe, Carolyn T; Schulz, Richard et al. (2015) Informal Caregiver Disability and Access to Preventive Care in Care Recipients. Am J Prev Med 49:370-9