Family members provide the vast majority of informal care to people with dementia and experience significant caregiving-related stress that contributes to mental and physical illness and increases their risk of death. As the number of people diagnosed with dementia is expected to exceed 11 million by 2050, there is a growing need for interventions that can effectively buffer these negative psychological and physical consequences in informal caregivers. The purpose of this randomized clinical trial is to test the Life Enhancing Activities for Family Caregivers (LEAF) intervention, a positive emotion skill-building program designed to improve psychological well-being (positive and negative affect, stress, burden, strain, mood) and coping. The LEAF one-hour training sessions will be conducted weekly for 5 weeks by a trained facilitator. The skills include: noticing and capitalizin on positive events, gratitude, mindfulness, positive reappraisal, personal strengths, and acts of kindness. The intervention is unique in that it is delivered via video conference, as opposed to in-person, which vastly increases the accessibility for caregivers. Also, the nature of the skills taught enable caregivers to use them at any time without needing to schedule an appointment with a provider, travel to a facility, arrange coverage for caregiving in their absence, or incur ay additional financial liability associated with service utilization. Given that sociodemographic factors, specifically age and geographic location, can influence individual caregiver's experiences, the study will test the effects of the LEAF intervention in a diverse cohort of informal caregivers of individuals with dementia.
The specific aims are to: 1) Test the effect of the LEAF intervention compared to the wait list control condition on psychological well-being (positive and negative affect, stress, burden, strain, mood) and coping at end of intervention and 1 month post intervention; 2) Test the effects of caregiver age and geographic location on psychological and coping outcomes;and 3) Assess the longer-term effects of the LEAF intervention on psychological well-being and coping outcomes at 3 and 6 months post intervention. The LEAF intervention has the potential to substantially decrease the public health burden of caregiving. It is innovative in numerous respects in that it focuses on positive emotion, focuses on the caregiver, and has the potential for sustained beneficial effects. It is also easily accessible to geographically dispersed caregivers whose responsibilities and remote location often pose barriers to participation in more traditional caregiving interventions.

Public Health Relevance

This proposal is submitted in response to the National Institute of Nursing Research RFA-NR-13-001, Addressing Needs of Informal Caregivers of Individuals with Alzheimer's Disease in the Context of Sociodemographic Factors (R01). It is relevant to the Institute's mission to promote and improve the health of individuals, families, communities and 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 California San Francisco
Other Health Professions
Schools of Nursing
San Francisco
United States
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