Reduce Caregiver Stress Research Articles

Changes in care provision to older parents during COVID-19 and the well-being of adult children: The moderating roles of the child-parent relationship and pandemic-related measures

Objective: The study addresses the associations between changes in care provision to older parents since the pandemic and worsened depression and anxiety in adult children. It also explores whether pandemic-related control measures and child-parent relationships moderated these associations. Background: Changes in informal care during the pandemic, such as increased or decreased caregiving frequency, may have affected caregivers’ psychological well-being. Limited research exists on how stressors and resources shape the well-being of adult children caregivers. Method: Data from 740 respondents in the first SHARE Corona Survey (SCS) who provided care for their parents during the pandemic were analyzed. Changes in depression and anxiety were assessed using data from SCS and pre-pandemic Wave. Logistic regression analyses were conducted, with added interactions between the moderators - pandemic measures and child-parent relationship characteristics - and changes in care frequency. Results: Increased caregiving frequency during the pandemic was associated with worsened depression. Stricter pandemic measures intensified this effect but also reduced the likelihood of anxiety for those who provided care less often. A higher quality of relationship with the mother in childhood was marginally associated with lower depression among those increasing caregiving but worsened depression for those decreasing it. Conclusion: To address post-pandemic caregiving challenges, efforts should focus on reducing caregiver stress and considering the enduring influence of early child-parent relationships.

Effect of a single-session mindfulness-based intervention for reducing stress in family caregivers of people with dementia: study protocol for a randomized controlled trial

BackgroundCaregiver stress can pose serious health and psychological concerns, highlighting the importance of timely interventions for family caregivers of people with dementia. Single-session mindfulness-based interventions could be a promising yet under-researched approach to enhancing their mental well-being within their unpredictable, time-constrained contexts. This trial will evaluate the effectiveness and feasibility of a blended mindfulness-based intervention consisting of a single session and app-based follow-up in reducing caregiver stress.Methods/DesignThe study is a single-blinded randomized controlled trial with two arms (intervention versus an education session on dementia care) and assessments at baseline, 8 weeks, and 6 months. The eligibility criteria include: family caregivers aged 18 years or older; providing care for an individual with a confirmed medical diagnosis of dementia for at least 3 months prior to recruitment, with a minimum of 4 hours of daily contact; and exhibiting a high level of caregiver stress. The intervention comprises a 90-minute group-based session with various mindfulness practices and psychoeducation. Participants will receive a self-practice toolkit to guide their practice over a duration of 8 weeks. Sharing activities will be implemented through an online social media platform. The primary outcome is perceived caregiving stress. The secondary outcomes include depressive symptoms, positive aspects of caregiving, dyadic relationship, trait mindfulness, and neuropsychiatric symptoms of care recipients. The feasibility outcomes include eligibility and enrollment, attendance, adherence to self-practice, and retention, assessed using mixed methods.DiscussionThe study will contribute to the evidence base by investigating whether a single-session mindfulness intervention is effective and feasible for reducing caregiver stress among family caregivers of people with dementia.Trial registrationClinicalTrials.gov, NCT06346223. Registered on April 3, 2024.

Intervention for the Management of Neuropsychiatric Symptoms to Reduce Caregiver Stress: Protocol for the Mindful and Self-Compassion Care Intervention for Caregivers of Persons Living With Dementia.

Stress related to Alzheimer disease and related dementias (ADRD) is common, particularly among those who care for persons with challenging behaviors and personality or mood changes. Mindfulness and self-compassion programs are efficacious for managing stress. The skills of mindfulness and self-compassion, however, must be integrated with behavioral management skills in order to effectively improve caregiver stress. In this study, we aimed to describe the development of the Mindful and Self-Compassionate Care (MASC) program, the first program that combines mindfulness and self-compassion with behavioral management skills to decrease caregiver stress, and its evaluation in the Supporting Our Caregivers in ADRD Learning (SOCIAL) study. Using the National Institutes of Health (NIH) stage model, we describe 3 phases of work encompassing NIH Stages 1A and 1B. In phase 1, we conducted 5 focus groups (N=28) of stressed individuals caring for persons with ADRD and challenging behaviors. Rapid data analysis informed the development of a 6-week online intervention. Phase 2 (NIH stage 1A) includes an open pilot (N>10) with optional exit interviews. Phase 3 (NIH stage 1B) is a feasibility randomized controlled trial of the intervention versus the Health Education Program control. Primary outcomes focus on feasibility with secondary outcomes encompassing acceptability, credibility, fidelity, and signals of preliminary efficacy. Phase 1 follows traditional recommendations for qualitative analyses (at the point of thematic saturation) which was achieved after 5 focus groups (N=28). For the phase 2 open pilot, up to 12 participants will be recruited. For the phase 3 feasibility study, recruitment of 80 caregivers will allow the assessment of feasibility benchmarks. Data for phase 1 included 5 focus groups. In phases 2 and 3, data collection will occur through REDCap (Research Electronic Data Capture; Vanderbilt University) surveys and an optional qualitative exit interview. Analyses will include hybrid inductive-deductive analyses for qualitative data and assessment of changes in our intervention targets and outcomes using t tests and correlation analyses. In phase 1, caregivers reported interest in a brief, online stress management program. Participants held misconceptions about mindfulness and self-compassion, but after detailed explanation thoughts, these skills could be helpful when directly linked to implementation during caregiving routines. Phases 2 and 3 will be completed by the end of 2025. We describe the protocol for the Supporting Our Caregivers in ADRD Learning study, as well as the development and feasibility testing of the Mindful and Self-Compassionate Care intervention. Future work will include a fully powered efficacy-effectiveness randomized controlled trial. ClinicalTrials NCT05847153; https://clinicaltrials.gov/study/NCT05847153; and ClinicalTrials.gov NCT06276023; https://clinicaltrials.gov/study/NCT06276023. DERR1-10.2196/58356.

Through Alzheimer’s Eyes: A Virtual Pilot Intervention for Family Caregivers of People with Dementia

ABSTRACT Objective To evaluate the feasibility and acceptability of a virtually delivered psychoeducational skill-building intervention for ADRD caregivers. Methods A single-arm, pre-posttest pilot study design was employed to evaluate the intervention. Four 90-min group-based weekly sessions were combined with four individual coaching sessions via Zoom. Intervention components covered topics designed to reduce caregiver stress and distress, and a VR experience to help caregivers understand dementia. Data was gathered via REDCap pre- and post-intervention and through post-intervention interviews via Zoom. Results Results (N = 20) from individual interviews, surveys, and treatment implementation strategies suggest strong feasibility and acceptability. Key change exploration indicated medium effect sizes and statistical significance in preparedness for caregiving (t(19) = 2.69, p = .015, d = 63), communication (t(19) = 2.45, p = .024, d = 0.55), and a medium effect size for the mindful attention awareness scale (t(19) = 0.48, p = (0.637, d = 0.54). Further, participants reported their perceptions of improvement in outcomes such as the ability to care, increased understanding of memory loss, and confidence. Conclusions Through Alzheimer’s Eyes is a feasible and acceptable intervention that blends technology with skill-building strategies to help caregivers manage their stress and distress regardless of their location. Clinical Implications There is potential for interventions including VR to assist family caregivers in managing caregiving challenges and improve well-being.

Effect of a Web-Based Integrative Support Intervention to Improve Family Caregiver Positive Caregiving Experience and Quality of Life: A Randomized Controlled Trial.

Cancer caregivers experience significant stress due to their multifaceted role. Current support methods are limited by unidimensional assessments. The aim of this study was to evaluate a Web-based support system aimed at reducing caregiver stress and anxiety, and improving resilience, vigilance, and quality of life, using both subjective and objective measures. A randomized controlled trial with a single-center, 2-arm parallel design and longitudinal assessment was conducted in Taiwan. Caregivers of patients recently diagnosed with cancer were randomly allocated to either a standard care group or an intervention group that received enhanced nurse-led support. Metrics including psychological resilience, caregiver burden, anxiety, quality of life, stress levels, and vigilance were systematically evaluated on a monthly basis over a period of 5 months, starting from the initial baseline measurement. Following the intervention, participants in the intervention group exhibited statistically significant reductions in caregiver burden and anxiety, alongside a notable improvement in resilience. Objective evaluations revealed a significant reduction in stress levels within this group. However, there were no discernible differences in vigilance and quality of life metrics between the intervention and control groups. The Web-based program effectively reduced caregiver stress and burden, as indicated by multiple metrics. This accessible and efficient Web-based support is beneficial for cancer caregivers facing diverse challenges.

EXPLORING MINDMEND: AN INNOVATIVE MENTAL HEALTH SUPPORT APP FOR AUTISTIC ADOLESCENTS AND THEIR CAREGIVERS

Teenagers with mild autism spectrum disorders (ASD) and those who care for them face difficulties. Conventional mental health therapies frequently ignore culturally specific factors that are crucial to the patient's overall wellness. The paper aims to introduce and evaluate "MindMend" a smartphone software specifically designed for teenagers with mild autism spectrum disorders (ASD) and their caregivers. It focuses on examining the effectiveness of MindMend in reducing caregiver stress and alleviating autism symptoms. Additionally, it emphasises the significance of providing comprehensive support that considers the cultural and religious nuances of the target population. The software includes modules for social skills training, emotion regulation, and cognitive-behavioural therapy. Users may participate in a helpful online community, track their progress, and set goals. Early research demonstrates encouraging outcomes in reducing caregiver stress and autism symptoms. MindMend seeks to be a flexible instrument that enhances mental health while honouring subtleties related to culture and religion. The methodology integrates software development, evidence-based therapeutic approaches, and outcome evaluation. It aims to create a specialised mental health solution for teenagers with mild autism and their caregivers. The approach strongly emphasises addressing their unique challenges and providing comprehensive support. The development of MindMend involves creating an innovative smartphone application that offers specialised content. The paper assesses how well MindMend helps reduce stress for caregivers and alleviate autism symptoms in teenagers with mild ASD. The evaluation likely includes quantitative and qualitative methods to measure the digital system's impact on users' well-being.

First episode psychosis caregiver perspectives on motivational interviewing for loved ones training: A qualitative study.

Past research has found that family involvement in psychosis treatment leads to better patient outcomes. Thus, caregiver communication skills training can be a viable approach to reducing caregiver stress and increasing self-efficacy and communication. The purpose of this qualitative study was to describe family caregivers' perceptions of changes in themselves and their family member with psychosis following their participation in Motivational Interviewing in Loved Ones (MILO), a brief four to five-hour psychoeducational intervention for caregivers. Sixty-three participants in the MILO trials provided written qualitative responses to the prompt, "Since learning the ideas and techniques in this course, what is the most significant change you noticed in yourself, your family, or your relationships?" Responses were collected immediately following MILO participation and 12 weeks later. Qualitative themes were identified through an iterative consensus process. Most participants reported positive changes in multiple domains of their lives. Major themes included: (1) Changes in Self, (2) Changes in Relationships, (3) Changes in Mindset, (4) Use of MILO Skills, and (5) Challenges. Qualitative results support and add context to the previously reported quantitative results from this study. MILO is a promising family intervention that positively influenced family environment and communication in pilot trials. Adaptations of MILO for families outside of a highly educated North American context should be considered.

Risk and Protective Factors for Parental Involvement and Early Indicators of School Achievement in Alaska.

Parental involvement can affect child school readiness, which in turn influences subsequent child learning outcomes. While social support, stress, caregiver psychological distress, and drinking could affect parental involvement, it is unknown whether and how these factors influence downstream child learning outcomes through parental involvement and child school readiness. This study tests those associations. Using de-identified data provided by the Alaska Longitudinal Child Abuse and Neglect Linkage project (N = 683), we use Structural Equation Modeling to assess direct and indirect effects of paths embedded in the proposed model. This study found statistically significant indirect effects: (1) path linking stress faced by caregivers to child reading proficiency through caregiver psychological distress, parental involvement, and child school readiness, (2) path linking stress faced by caregivers to child reading proficiency through caregiver drinking, parental involvement, and child school readiness, and (3) path linking social support for caregivers to child reading proficiency through caregiver psychological distress, parental involvement, and child school readiness. Post-estimation showed that the sum of the magnitude of total effects of stress and the magnitude of total effects of support is significantly larger than either alone. Findings suggest that reducing caregiver stress and offering social support could not only benefit caregivers but learning outcomes of their children as well. For child learning outcomes, simultaneously reducing stress and offering social support for caregivers, rather than just one of them alone, is suggested. These results are important for children, particularly for those raised by caregivers experiencing psychological distress or drinking issues.

Use of Nursing Support Among Nurses for Caregiver Burden in Family Caregivers of Terminally Ill Patients with Cancer in Palliative Care Units in Japan: Multisite Cross-Sectional Study.

This study explores the use of nursing support among nurses for caregiver burden in family caregivers of terminally ill patients with cancer in palliative care units (PCUs). Requests were sent to 389 institutions, and cooperation was received from 162 PCUs. Nurses at 162 PCUs were asked to participate in an Internet survey regarding nursing practices for caregiver burden in Japan. The frequency of six nursing support practices (extracted in a scoping review) was reported using a 5-point Likert scale. The response rate was 22.3% (539/2448). Support for reducing caregiver stress was the most frequently provided nursing support (mean Likert score: 2.41 for monthly prognosis and 2.42 for weekly prognosis). Psychological and educational support was mainly provided via non-face-to-face (telephone) (mean Likert score: 2.26 for monthly prognosis and 2.21 for weekly prognosis) and face-to-face methods (mean Likert score: 2.32 for monthly prognosis and 2.29 for weekly prognosis). Nursing support was provided through telephone support and face-to-face interactions and aimed at reducing caregiver stress among nurses and family caregivers of patients with terminal cancer in PCUs. In this study, the trends in nursing support were similar for patients with a prognosis of weeks or months.

IT’S A FAMILY AFFAIR: ADDRESSING THE NEEDS OF BLACK DEMENTIA CAREGIVERS THROUGH COMMUNITY-BASED RESEARCH

Abstract Racial disparities exist in dementia diagnosis, co-morbid health conditions, and socioeconomic characteristics between older Black and White adults, compounding caregiving responsibilities for Black families; yet few dementia caregiving programs offer culturally competent, family-centered dementia caregiving programs for Black individuals. In a collaboration between two community-based organizations (CBO) and an academic medical center, a culturally tailored, family-centered, dementia caregiving program for Black individuals on Chicago’s Far South Side was proposed. Local CBOs convened community members to co-design a key informant interview guide and conducted 30 interviews among Black dementia caregivers. The caregivers interviewed were primarily caring for parents or grandparents and shared caregiving responsibilities with other family members. Caregivers recommended the program focus on five top concerns related to their caregiving experience: 1) feelings of stress and burden while being committed to their family member with dementia, 2) education on the progression of dementia and discussion of cultural beliefs, 3) personal experiences with racism and intersectional identities, 4) kinship responsibilities and managing dementia-specific changes that occur with loved ones, and 5) a need for respite and local medical and community-based resources. Anticipated barriers to participation in this program included time, an accessible location to members of the far south, and care for family members during participation. Though a community-directed approach, we elevated Black dementia caregiver experiences to better understand the influence that race and culture has on Black caregivers, which will provide the foundation for a Black family-centered dementia caregiving program to build capacity in routine caregiving and reduce caregiver stress.

POWERFUL TOOLS FOR CAREGIVERS: THE ESTABLISHED BENEFITS OF A PERSON-CENTERED CARE INTERVENTION

Abstract Family caregivers account for 89% of caregivers in the United States, yet few evidence-based family care programs focus specifically on the caregiver’s needs rather than the care receiver. The challenges that caregivers experience, such as increased depression symptoms and feelings of burden, impede their ability to fulfill their role as care partner and can lead to lasting health and financial issues. Intervention literature underscores the importance of using person-centered models to incite behavior change, yet many caregiver interventions do not address the caregiver’s needs and instead approach caregiving from a practical perspective to caregiving such as establishing a power of attorney or educating caregivers about dementia. Powerful Tools for Caregivers (PTC) is a six-week program designed to provide caregivers with the skills to address their unique care challenges. Within in-person or virtual sessions, caregivers are provided with the skills to improve caregiver self-efficacy, emotional management, self-care, and resource access and knowledge. The study integrates empirical findings and demonstrates the effectiveness of PTC in improving caregiver well-being in each focus area. Findings also highlight the benefits of the group-based activities as well as improved depressive symptoms and reduced caregiver stress and burden. This research also demonstrates the same effectiveness of delivery format (in-person or virtual mediums) and location (rural or urban settings). The success of PTC sheds light on the need for more programs to approach family care through the lens of a person-centered model and emphasizes the benefit of evidence-based programs.

ONLINE MEDICAL RECORD (OMR) USE IN CAREGIVERS OF PEOPLE WITH DEMENTIA IN THE UNITED STATES

Abstract Objective Studies have found that there are higher levels of stress among informal caregivers of individuals with dementia. As a result, it is important to seek ways to reduce their burden. Online Medical Records (OMRs), often referred to as patient portals, provide effective communication tools to caregivers and the use of OMRs have been found to have the potential to ease their stress levels. This study examined OMR usage in informal caregivers of people with dementia and identified factors that were associated with their usage. Methods Data came from the HINTS, a National Cancer Institute (NCI)-sponsored survey of American adults. We merged data from HINTS 5 cycles 2, 3, and 4 administered between 2018 and 2020 into 1 data set. Our analytical sample included a total of 304 informal caregivers of people with Alzheimer’s disease. The outcome variable was OMR use in the last 12 months, and independent variables included age, sex, race and ethnicity, education, household income, marital status, employment status, relationship to care recipient, and the number of chronic conditions. Data was analyzed using multivariate logistic regression. Results 53% of caregivers have used OMRs at least once in the past 12 months. Caregivers with a higher level of education and greater number of chronic conditions are more likely to have used OMRs. Conclusion Being able to access OMRs could reduce caregiver stress. There are certain caregiver characteristics that increase the likelihood of them utilizing this resource. Targeted approaches may be necessary to increase the range of use.

Caregiver Attributions of Cause to Behavioral Symptoms of Dementia

AbstractBackgroundMost individuals with Alzheimer’s disease and related dementias (ADRD)exhibit behavioral and psychological symptoms of dementia (BPSD) which can negatively impact quality of life for both caregiver and care recipient, yet there is a lack of knowledge on mechanisms of symptom development and triggers that can exacerbate a symptom. Thus, the aim of this study is to explore family caregiver perceptions’ of why a particular BPSD occurred.MethodThis study used a micro‐longitudinal design with family caregivers (N = 69) completing 8 days of diaries four times a day. Diaries were sent randomly three times a day and once in the evening. Data for this study were derived from the three random diaries (n = 982 responses) from the open‐ended question, “why do you think the behavior occurred?” This question was a follow‐up question to the caregiver’s report of the last observed behavioral symptom. Content analysis was used to identify initial codes for thematic analysis. Focused coding was used to further refine and organize into thematic categories.ResultThe sample was 54% African American and 69% female with a mean age of 74 caring for a close family member with dementia. Final analysis of data revealed 5 themes describing the caregivers’ perceptions of the cause of the behavioral symptom. These themes included describing the cause as: 1) the care recipient experiencing a loss of autonomy, 2) behavioral symptom as a direct result of the disease, “it’s Alzheimer’s, stupid.” 3) attributing negative emotions to the care recipient, anger, fear 4) environmental factors such as too much conversation, TV show, being cold 5) physical symptoms, “knee pain, “lack of rest,” ill‐fitting dentures. Responses among many of the individual caregivers varied daily from diary to diary based on the behavior reported or they simply answered, I do not know.”.ConclusionThere are many interventions which aim to reduce caregiver stress and improve management of BPSD though they often have small effect sizes and do not sustain the effect over time. Incorporating insights from caregivers on how BPSD occur in daily life may provide for more ecologically valid interventions.

Mindfulness Processes that Mitigate COVID-Related Stressors in Caregivers in the United States

Mitigating the effects of COVID-19 on child development involves understanding the impact of the pandemic on caregiver well-being and factors that protect against stress associated with the virus and measures used to reduce disease transmission. Mindfulness has become popularized in the West, with promising evidence that it may reduce caregiver stress. There is limited research examining the specific elements of mindfulness as it relates to caregiving instead of studying mindfulness as a singular construct. We examined whether the number of COVID-related stressors was related to caregivers’ stress, and whether this stress was reduced by their reported level of mindfulness. We examined whether four mindfulness processes: self-compassion, nonreactivity, nonjudging, and acting with awareness – buffered the impact of stressors on caregivers’ stress one month later in a sample of caregivers in the United States (N = 330). When accounting for other mindfulness processes, acting with awareness was the only significant moderator of COVID-related stressors and caregivers’ stress one month later. We discuss implications for recommendations to mitigate the effects of COVID-19 on caregivers’ stress through reducing stress and thus promoting well-being in caregivers.

Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review.

Purpose: To identify nursing support for caregiver burden in family caregivers of patients with cancer. Methods: This scoping review was guided by Arksey and O'Malley's six-stage scoping review framework. All available published articles from database inception to July 31, 2023 were systematically searched through PubMed, CINAHL, CENTRAL, and Ichushi-Web of the Japan Medical Abstract Society databases with additional relevant studies from the article list. Each key journal was manually searched. Results: Overall, 502 articles were screened, and 34 were finally included. The results of the qualitative thematic analysis were categorized into 7 components of nursing support: psychological and educational support, psychological and educational support using mainly non-face-to-face (Information and Communication Technology), psychological and educational support mainly using non-face-to-face (telephone) methods, mindfulness to support, support aimed at reducing caregiver stress, support for both patients and caregivers, and others. Of the 34 studies, 23 were randomized controlled trials (RCT), and the remaining 11 were non-RCTs. Conclusion: The results of the scoping review categorized nursing support for caregiver burden in the family caregivers of patients with cancer into 7 components. Future research should examine the feasibility of implementing these components.

Evaluating the Impact of PWS Smart-Start: A Behavior Analytic Caregiver Training Program for Prader-Willi Syndrome

PWS Smart-Start is a behavioral caregiver training program developed specifically for caregivers of children with Prader-Willi syndrome (PWS) aged 3 to 14. The purpose of the current study was to evaluate the acceptability and preliminary efficacy of the program. Thirty-four caregivers of children with PWS received the PWS Smart-Start training using online live video-coaching across a 10-week period. The impact of the training on a variety of variables including caregiver and child behavior, caregiver stress and burnout, and family functioning were evaluated using a quasi-experimental pretest posttest design. Results indicated statistically significant decreases across child behavior challenges and parental stress and burnout following the training. Statistically significant improvements were also seen in parenting practices, the quality of the parent–child relationship, and family quality of life. Results of social validity measures indicated caregiver satisfaction with the program. These preliminary results indicate that the PWS Smart-Start program has the potential to not only support children with PWS through behavioral challenges but also reduce caregiver stress and burnout and improve a variety of aspects of family life. Future research is needed to replicate and further validate these results and to extend the exploration of other behavior analytic interventions for this population.

Empathy, emotional intelligence and cohabitant caregiver stress: caring for persons with severe mental health disorders

Caregiving for persons with severe mental health disorders is associated with higher stress levels and a lower quality of life. As rates of mental health disorders increase worldwide, the need for assisting familial caregivers with strategies to reduce stress is paramount. The present study examines the relationships between empathy (cognitive and affective), emotional intelligence and stress in these caregivers. A parallel mediation model demonstrates that cognitive empathy, in particular, partially mediated the negative relationship between emotional intelligence and stress, indicating the importance of cognitive empathy in caregiving. The results of this study can help design targeted interventions to reduce caregiver stress.

MONITORING OF INFANT CRYING USING ML

This study focuses on the creation of a system for machine learning model designed, monitor, detect, and classify the underlying reasons behind infant crying. Leveraging acoustic features, the model will differentiate between various causes, including hunger, discomfort, pain, and more, with the goal of providing real- time insights for caregivers and healthcare professionals. This innovative technology aims to enhance infant care by facilitating early detection and appropriate responses to the infant's needs, ultimately contributing to the well-being and overall health of newborns and reducing caregiver stress. Keywords: Machine learning, Acoustic analysis, Infant cry, MFCC, KNN, python_speech_features, Django, MySQL.

Surveying Early Intervention Providers to Identify Opportunities for Workforce Support to Strengthen Family-Centered Care.

Traditional provider-to-child models of early intervention (EI) service provision have been increasingly replaced by service guidelines that promote a broader family-centered approach to support improvement in the child's primary area of delay. These guidelines include working directly with caregivers and addressing needs of the family that might impact a caregivers' capacity to engage in developmentally supportive interactions with children (e.g., caregiver distress). Knowledge of provider skills, practices, and attitudes would inform efforts to broaden and enhance practice in line with these guidelines. Within an academic-community partnership to support EI, we surveyed 88 providers in Miami and Boston about their usual practice, perceptions of their skills, general attitudes towards evidence-based practices, and interest in specific training opportunities. Findings indicated that providers spent more time working directly with children than caregivers. Providers reported high interest in training to manage caregiver distress, support preschool readiness, and align work with family culture. Negative overall attitudes towards using evidence-based interventions and provider exhaustion were related to less interest in obtaining training in culturally-responsive practice. Exhaustion also related to less interest in training on other topics that represent a broadened scope of care, including building warm parent-child relationships. Findings are informing efforts to design EI training opportunities to improve parent-provider relations, enhance parent-child interactions, and reduce caregiver stress.

Evaluating video telemedicine for providing virtual health care for cats via mock spay recheck examinations

Cat caregivers face many potential barriers when accessing veterinary care, such as cat-related challenges with carriers, travel, and the clinic environment, as well as time away from home and/or work, distance to the veterinary clinic, and costs of veterinary care. A potential solution to overcoming some of these barriers may be the use of video telemedicine: using video technology to deliver health and behavior care, education, and information remotely. This study recruited companion cat caregivers and their cats (n = 30) to participate in two mock spay re-check examinations: an in-clinic appointment and a virtual video telemedicine appointment. During the mock examinations, cat behavioral and physiological responses were assessed. Order of appointment was counterbalanced, and caregivers completed a pre- and post- appointment questionnaire to assess attitudes and experience with the in-clinic versus video appointments before and after participation. The study results show that cats had a higher respiratory rate (p < 0.001), larger pupil dilation (p < 0.001), and more negative ear positions (p = 0.015) during the mock clinic appointment compared to the video appointment. Cats were also more likely to leave the handling area after the mock clinic examination compared to the video examination (p = 0.001). In addition, caregiver ratings of the video appointment were very positive (62.1%) or somewhat positive (34.5%), and participants stated it was very easy to access the technology (58.6%), internet (65.5%), and video conferencing platform (75.9%) needed. Post-survey participant ratings indicated that video telemedicine was perceived to be more helpful than in-clinic visits for reducing caregiver stress (p = 0.029) and cat stress (p < 0.0001). There was also a post-survey difference in caregiver ratings on accessibility of veterinary care between video telemedicine and clinic appointments (p < 0.0001), with results indicating that video telemedicine increases caregivers’ access to cat care. Thus, from cat caregiver perspectives, video telemedicine may reduce stress and increase accessibility to cat health care compared to clinic visits. Results also suggest that video appointments reduce negative responses in cats compared to in-clinic visits, and thus may be particularly useful for cats who show higher levels of stress in a clinic environment. More research is needed to evaluate cat responses during other appointment types for further assessment and replication of the study results.