This is a resubmission of a previously reviewed project. Older rural home health care recipients are a group overlooked in gerontological research. These persons experience significant problems with emotional well-being and decrements in quality of life that are not being adequately addressed by existing resources. The present study will investigate the effectiveness of a psychosocial intervention for improving the quality of life of these frail and sick elders. The treatment will be delivered in the homes of the care recipients and the primary family caregiver will participate in the therapy as a facilitator. Improved quality of life and emotional well being should result in the care recipient's reduced use of health care services.
Aim 1 of the study is to test the efficacy of a brief, in-home psychosocial treatment in improving thew quality of life of rural home health care recipients. The treatment will be delivered by clinical social workers and will entail the provision of 16 sessions of cognitive-behavioral therapy. Family caregivers will attend therapy sessions and will facilitate the therapy by providing reminders, prompts and assistance to the care recipients in implementing therapeutic tasks. A delayed treatment control group design will be used to evaluate effectiveness of the treatment package on measured quality of life and emotional well-being. The investigators will also assess whether teaching problem solving skills and using the caregiver as treatment facilitator has a positive effect on such factors as caregiver burden and the caregiver care recipient relationship.
Aim 2 of the study is to assess the effects of the intervention on the home health care recipient's use of home health care services. The conceptual framework on which the intervention is based posits that improvements in quality of life and emotional well being will mediate decreases in health care use. This model will be empirically evaluated through the assessment data collected in this study.
Aim 3 is to investigate the success of efforts to make the intervention responsive to white and African-American home care recipients. One-half of the participants, as well as half of our therapists and research assistants, will be African-American. It is expected that there will be no differences in the effectiveness of the intervention among African-Americans and white participants. The research team is interdisciplinary and includes two clinical geropsychologists, a doctoral level clinical social worker, a nurse scientist (Ph.D.) and a geriatrician. The investigators have prior experience, publications, and preliminary data on the implementation of treatment protocols with older adults, community caregivers, and rural dwelling home health care recipients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG016311-04
Application #
6532510
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Program Officer
Stahl, Sidney M
Project Start
1999-09-01
Project End
2004-07-31
Budget Start
2002-08-01
Budget End
2003-07-31
Support Year
4
Fiscal Year
2002
Total Cost
$695,692
Indirect Cost
Name
University of Alabama in Tuscaloosa
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
City
Tuscaloosa
State
AL
Country
United States
Zip Code
35487
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Scogin, Forrest; Morthland, Martin; DiNapoli, Elizabeth A et al. (2016) Pleasant Events, Hopelessness, and Quality of Life in Rural Older Adults. J Rural Health 32:102-9
LaRocca, Michael A; Scogin, Forrest R (2015) The Effect of Social Support on Quality of Life in Older Adults Receiving Cognitive Behavioral Therapy. Clin Gerontol 38:131-148
Hyams, Adriana V; Wayde, Ernest N; Crowther, Martha R et al. (2015) NEW AND EMERGING PROFESSIONALS: Does Race Moderate Social Support and Psychological Distress Among Rural Older Adults? Clin Gerontol 38:412-427
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Presnell, Andrew; Harris, Grant; Scogin, Forrest (2012) Therapist and client race/ethnicity match: an examination of treatment outcome and process with rural older adults in the deep south. Psychother Res 22:458-63
Scogin, Forrest; Morthland, Martin; Kaufman, Allan et al. (2011) Maintenance of quality of life improvements in diverse rural older adults. Psychol Aging 26:475-9
Scogin, Forrest; Morthland, Martin; Kaufman, Allan et al. (2007) Improving quality of life in diverse rural older adults: a randomized trial of a psychological treatment. Psychol Aging 22:657-65
Kaufman, Allan V; Scogin, Forrest R; Burgio, Louis D et al. (2007) Providing mental health services to older people living in rural communities. J Gerontol Soc Work 48:349-65