The number of individuals and families impacted by Alzheimer's disease and related dementia (ADRD) is projected to triple by 2050 and many of those impacted will be African Americans (AAs). Similar to other dementia caregiving families, AAs provide the majority of care for their loved one at home and experience rewards as well as physical, financial, and emotional burden, including anxiety and stress. Moreover, AA families who live in rural areas have unique cultural, geographic, health-related and socio-economic needs, including relatively less access to, and willingness to engage with, formal supports and resources, and poorer health outcomes; however, there have been few interventions targeted to rural AA caregivers of persons with dementia. One effective intervention, mindfulness-based stress reduction (MBSR), has been found to be culturally acceptable in AA populations; however, no studies have assessed feasibility, acceptability and impact of an adapted mindfulness intervention targeting rural AA dementia caregivers. The proposed project will test the feasibility and acceptability of a telephone-delivered adaptation of an MBSR intervention for decreasing burden among rural African American caregivers of community-based persons with ADRD. We hypothesize that a telephone-delivered intervention will be accessible and feasible. Additionally, given the importance of informal family support reported in AA caregiving populations, the intervention will target both a primary caregiver and a care partner who shares care responsibilities (?caregiving team?) to explore potential positive impacts on burden, such as improved communication and reduced conflict. The project's specific aims are: 1) to determine the feasibility and acceptability of a telephone-delivered mindfulness training intervention (TMT) in decreasing caregiver burden among rural, African American informal caregiving teams of people with dementia; 2) to explore effects of the training on relevant secondary outcomes for both caregiving team members, including emotional regulation; tolerance of uncertainty; emotional and physical health; family conflict within the informal caregiving team; and self-efficacy; 3) to explore comfort with and willingness to adopt technologies (e.g. telephone-based, web-based) to access mindfulness practices and existing caregiving educational resources. This novel project will add important information regarding feasibility and acceptability of a telephone-delivered adaptation of an evidence-based mindfulness intervention involving caregiver teams, in reducing caregiver burden in an underserved, rural African American caregiver population. By targeting multiple family members from the caregiving team, we will extend knowledge regarding usefulness of mindfulness skills training beyond the typical intrapersonal benefits, and into interpersonal communication and relationship benefits. Findings will inform future larger-scaled RCT interventions, using educational control groups, aimed at improving outcomes for families caring for a person with dementia.
(Public Health Relevance Statement): The number of individuals and families impacted by Alzheimer's disease and related dementia (ADRD) is large and growing rapidly. African American caregivers living in rural areas provide the majority of care for their loved one at home and experience high burden, low access to resources, and poorer health outcomes. This innovative project tests the feasibility and acceptability of a culturally acceptable, telephone-delivered adaptation of a mindfulness training intervention for decreasing burden among rural African American family caregiving teams of community-based persons with ADRD.
