Caregiver Support Interventions Research Articles

Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study.

Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.

Group-based caregiver support interventions for children living with disabilities in low-and-middle-income countries: Narrative review and analysis of content, outcomes, and implementation factors

Group-based caregiver support interventions for children living with disabilities in low-and-middle-income countries: Narrative review and analysis of content, outcomes, and implementation factors

Qualitative Analysis of Implementation Factors of an Embedded Caregiver Support Intervention into Adult Day Services.

Adult day services (ADS) are an important and often underutilized support resource for older adults. For persons living with dementia (PLWD), ADS is an optimal access point to not only receive therapeutic and rehabilitative activities, but as a vehicle for respite/relief for dementia caregivers. Yet, there is currently a lack of research on integrating caregiver interventions into home and community-based services such as ADS. This paper reports on qualitative findings from the Improving Outcomes for Family Caregivers of Older Adults with Complex Conditions: The Adult Day Plus (ADS Plus) Program Trial. Drawing from semi-structured interviews conducted with family caregivers and ADS site staff, we conducted a thematic analysis to examine the implementation process of ADS Plus. Themes address the relational nature of the intervention, learning, influence of the administrative infrastructure, and receptivity of ADS Plus. Our analysis determined that implementation of ADS Plus was feasible and accepted by site staff and dementia caregivers but also calls for additional evaluation of embedded caregiver support interventions across different contexts (e.g., staff size, limited technology environments) to further identify and test implementation mechanisms across settings.

A scoping review of ICT-based caregiver support interventions for children with cancer

A scoping review of ICT-based caregiver support interventions for children with cancer

PRELIMINARY FEASIBILITY, UTILITY, AND ACCEPTABILITY OF THE TBI-AD/ADRD CAREGIVER SUPPORT INTERVENTION (TACSI)

Abstract Research has established that dementia care partners may encounter socio-emotional and physical health concerns as a consequence of providing dementia care. Similarly, care partners for people living with Traumatic Brain Injury (TBI) often experience a range of stressors and negative mental health outcomes due to their care demands. This study aims to support the unique subset of family care partners facing the challenge of caring for relatives who have both diseases, Alzheimer’s Disease/Alzheimer’s Disease related dementia (AD/ADRD) and a history of TBI. Phase I of this study focused on the design and subsequent refinement of the TBI-AD/ADRD Caregiver Support Intervention (TACSI). TACSI is a six-session telehealth intervention providing tailored psychosocial and psychoeducational coaching. Session topics include education on TBI and dementia, stress management, lifestyle planning, and communication skills. In partnership with the Minneapolis VA and the Mayo Clinic-Rochester, we enrolled 15 care partners for Phase I. Mixed methods data from 3-month follow-up surveys and qualitative data from post-intervention interviews established the feasibility, utility, and acceptance of TACSI. Care partners found the program valuable and would recommend it to others. They reported that TACSI helped with their stress management. Some participants shared that TACSI would provide greater benefit to newer caregivers needing more education on the diseases and/or caregiving. Phase I feedback will be applied to improve TACSI content and delivery for the Phase II randomized controlled trial evaluation. TACSI Phase I utility, acceptance, and feasibility outcomes will be highlighted as well as next steps for evaluation.

DAILY FACTORS ASSOCIATED WITH EMOTIONAL DYSREGULATION AMONG DEMENTIA CAREGIVERS

Abstract Family dementia caregivers experience increased burden and stress that can negatively impact emotion regulation and overall well-being. Further, a lack of social connection may contribute to emotion dysregulation among dementia caregivers. The purpose of this study was to examine relationships between daily caregiving stress, social isolation, emotion regulation, and depression in a sample of community-dwelling dementia caregivers. Participants (N=30) completed a baseline survey and a series of daily diaries over a 14-day period (n=323 data points) that asked about day-to-day caregiving experiences. Data were analyzed using mixed-level modeling. Higher than average stress related to behavioral symptoms of dementia was associated with an increase in the odds of experiencing feelings of losing control over one’s emotions (OR=1.08, 95% CI [1.01, 1.15], p<0.05). Similarly, higher perceived social isolation on a given day was associated with an increase in the daily odds of feeling a loss of control over one’s emotions (OR=1.28, 95% CI [1.00, 1.27], p<0.05). Further, feeling a loss of control over one’s emotions was associated with an increase in the daily odds of depression-related symptoms (OR=3.39, 95% CI [1.43, 8.08], p<0.01). These findings highlight the importance of addressing the emotional well-being of family dementia caregivers, particularly in the context of stress related to behavioral symptoms of dementia and social isolation. Caregiver support programs and interventions that focus on improving emotion regulation and reducing social isolation may help promote the mental health and well-being of dementia caregivers.

UNMET NEEDS OF CAREGIVERS OF HOSPITALIZED VETERANS LIVING WITH DEMENTIA: A QUALITATIVE STUDY

Abstract Family caregivers are essential to safe care transitions for hospitalized adults living with dementia. We aimed to identify resource and training needs of dementia caregivers during care transitions. We conducted semi-structured interviews with caregivers (6 Spouses, 5 Children, 1 Friend) of hospitalized Veterans with dementia at the Michael E. DeBakey Veterans Affairs (VA) Medical Center. Interviews were recorded and transcribed verbatim. Rapid qualitative analysis using structured summaries and matrices were conducted. Although caregivers received information about the Veteran’s admitting medical condition, health professionals did not ask about dementia or provide dementia-related health information to the caregiver. Caregivers were willing to assist Veterans with activities of daily living in the hospital; however, caregivers were either prevented from assisting or did not receive training to assist Veterans safely. Caregivers desired information on how to get the Veteran “back on track” and address cognitive and functional declines experienced in the hospital. Although pre-hospital services and supports were easy to restart, caregivers needed earlier and more consistent communication regarding new services and supports starting after discharge, such as rehabilitation at skilled nursing facilities and respite care. Caregivers expressed a need for health professionals to help set “realistic expectations” for post-discharge care as some services and supports did not meet their expectations. Caregivers valued access to support groups for themselves but received inconsistent referrals to the VA Caregiver Support Program. These results will inform the adaptation of a dementia caregiver support intervention for caregivers of hospitalized Veterans living with dementia.

CORRELATES OF DENTAL CARE UTILIZATION AMONG US INFORMAL DEMENTIA CAREGIVERS

Abstract Informal dementia caregivers tend to report more negative health impacts from the caregiving role, higher levels of unmet needs, and lower levels of service utilization compared to caregivers of persons with other types of illnesses. There remains a gap in knowledge of understanding unique correlates of dental care utilization among informal dementia caregivers. As guided by the Andersen model, this study examined correlates of dental care utilization among U.S. informal dementia caregivers. Data came from the Behavioral Risk Factor Surveillance System collected in 2016, 2018, and 2020 (n=2,931). Respondents were selected when they reported providing regular care or assistance to a friend or family member who has Alzheimer’s disease, dementia, or other cognitive impairment disorder. Dental care utilization was dichotomized into “yes” versus “no” within the past year. Caregiving-related characteristics included caregiver role (e.g., spouse, adult child, other relative, and friend), intensity of care, duration of care, and type of care. Other correlates included caregiver characteristics, health behaviors, and physical and oral health needs. Findings from stepwise logistic regression models demonstrate that being a spousal caregiver, providing more than 20 hours of care per week, being male, having high school or less education, being low-income, unemployed, current smoker, having no health insurance, no current alcohol use, or less than adequate sleep was associated with a lower likelihood of vising a dentist within the past year. The findings suggest targeting spousal caregivers and those who provide intensive care to improve dental care-seeking behaviors in dementia caregiver support intervention strategies.

RACIAL AND ETHNIC DIVERSITY IN FAMILY CARE INTERVENTIONS: A CALL FOR ACTION

Abstract In the United States, women are disproportionately represented as family caregivers and racial and ethnic minority families experience the challenges of caregiving at greater rates, such as poorer health and psychological distress. Recent research results demonstrate the effectiveness of family care interventions through improvements for caregiver depression, anxiety, and caregiver knowledge; yet most of these programs were developed for and evaluated with White families. The extent to which caregiver support interventions attend to racial and ethnic diversity is inadequate. Limited understanding of intervention results by racial and ethnic subgroups may ultimately further exacerbate disparities across groups by limiting our ability to account for any differences in treatment outcomes. Advances in research on caregiver interventions warrant an examination of the degree to which gender and/or racial differences are considered in the field of caregiver intervention research. Using a combined theoretical lens of symbolic internationalism and gender role theory, we argue for the development of care programs for racially and ethnically diverse family care perspectives. Thus, we conducted a systematic review of caregiver interventions and further explored whether common evidence-based care interventions are efficacious with non-White populations. Additionally, we emphasize the importance of developing targeted intervention programs by reviewing the impact of recently develop programs for specific target populations. This work underscores the gap in current family care interventions and identifies the need for evidence-based family care programs for diverse populations. Our systematic review will further our understanding about disparities in intervention outcomes to develop culturally appropriate interventions.

Multiphase optimization of a multicomponent intervention for informal dementia caregivers: a study protocol

BackgroundFamily caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components. To optimise intervention, we adopt the multiphase optimisation strategy (MOST) to test the implementation fidelity and determine the effect of each component and the interactions between each component and the corresponding outcome.MethodsA prospective, assessor-blinded, randomised clinical trial with fractional factorial design using the MOST principle. Two hundred fifty family dementia caregivers will be randomised to one of 16 experimental conditions in a fractional factorial design involving six intervention components: (1) dementia and caregiving education; (2) self-care skills; (3) behavioural symptom management; (4) behavioural activation; (5) modified mindfulness-based cognitive therapy; and (6) support group. The first one is the core component, and the five remaining will be examined. Physical health, caregiver burden, stress, psychological well-being, anxiety and depressive symptoms, and social support will be assessed over the 12-month study period. Following the intention-to-treat principle, linear mixed models and regression analyses will be used to examine the specific effect of the five components and their two-way interactions to propose the most effective combination.DiscussionThis is the first study adopting the multiphase optimisation strategy to identify the most active and engaging components of a psychological intervention for caregivers of patients with dementia. In view that dementia caregiver interventions are increasingly diversified and complex, such knowledge is important to maximise the intervention efficacy and allow the intervention to be implemented within an efficient timeframe and dosage. The optimisation of caregiver support interventions is critical to enhance the health outcomes of caregivers and care recipients, thereby, delaying possible institutionalisation and reducing the costs of long-term dementia care.Trial registrationThis study was retrospectively registered in the WHO Primary Registry – Chinese Clinical Trials Registry (ChiCTR2300071235). (Protocol date 30/10/2020; version identifier 2020–2021-0045). Registered on 9 May, 2023.Reporting methodSPIRIT guideline was followed.Patient or public contributionNo patient or public involvement.

Analysis of Latino family caregiver engagement with CuidaTEXT, a text message intervention for dementia caregiver support

AbstractBackgroundThe potential of text message caregiver support interventions to improve dementia care outcomes is still to be exploited. This study aims to explore participants’ engagement with a text message intervention for dementia caregiver support, and its association with acceptability and clinical outcomes. We hypothesize that a higher engagement with CuidaTEXT will be associated with increases in caregivers’ satisfaction with the intervention and decreases in depression.MethodCuidaTEXT is a six‐month, bilingual, and bidirectional intervention tailored to caregiver needs (e.g., education, problem‐solving, resources). We enrolled 24 Latino caregivers in a one‐arm feasibility trial. Participants received approximately one automatic daily text message. Participants could receive automatic on‐demand messages by sending specific keywords (e.g., STRESS for messages about stress coping) and on‐demand responses during business hours by chat‐texting with a live coach. In this secondary analysis, we calculated associations between the total number of text messages (engagement) and outcomes (primarily caregiver satisfaction and depression).ResultParticipants sent 1,847 messages to CuidaTEXT; 6.5% sent no messages (no engagement), 0.0% less than 10 (low), 29.0% between 10 and 49 (medium), 22.6% between 50 and 99, and 19.4% more than 100 (high). Engagement was associated with intervention satisfaction (r = 0.6, p = 0.007) and secondary acceptability outcomes (perceptions that CuidaTEXT provided help for their loved one with dementia: r = 0.6, p = 0.003; and to understand dementia: r = 0.6, p = 0.008) except for perceptions that CuidaTEXT provided help for themselves as caregiver (r = 0.3, p = 0.173). Engagement was not associated with change in caregiver depression (r = ‐0.0, p = 0.922) or secondary clinical outcomes (caregiving competence: r = 0.4, p = 0.104; and behavioral symptom‐related distress: r = 0.4, p = 0.076).ConclusionText message engagement is associated with satisfaction but not depression. Encouraging interaction with CuidaTEXT might lead to higher levels of satisfaction with the intervention. However, future research should determine the directionality of these associations.

Implementing Dementia Caregiver Programs in Real-World Settings: Fidelity Considerations

Testing interventions in real-world settings requires fidelity monitoring to ensure implementation integrity. However, strategies to enhance, monitor, and measure fidelity deployed in efficacy trials may not be feasible in pragmatic trials or sustainable in practice. This paper reviews published translational or pragmatic studies of dementia caregiver support interventions to understand how fidelity was previously treated in order to derive recommendations for future pragmatic-like trials. A search using SCOPUS, EMBASE, and Google Scholar identified 31 translational caregiver intervention studies of which 20 (64.5%) referenced fidelity. Of these 20, 11 (55.0%) reported fidelity measurement, whereas 9 (45.0%) only recognized its importance. Of the 11 studies, fidelity was assessed using investigator-developed scoring forms, audio/video recordings, evaluations from caregivers and interventionists, and by comparing outcomes with the original efficacy trial. Additionally, 7 (63.6%) of 11 studies reported fidelity results, representing only 22.5% of 31 studies reporting outcomes demonstrating the inconsistency in the field concerning the reporting outcomes of fidelity. We conclude that fidelity methods used in translational studies to date are not practical nor sustainable for ongoing monitoring of evidence-based programs in real-world settings and that only 2 aspects of fidelity, intervention and adherence, are considered. New approaches are needed to ensure fidelity integrity in pragmatic trials and which can be sustained thereafter.

Family Caregiver Support Interventions’ Effectiveness Before and During the COVID-19 Pandemic

ABSTRACT The authors aimed to assess the impact of a family caregiver support intervention on caregiver burden and hospital readmission before and during the COVID-19 pandemic. By adopting a quasi-experimental design with no randomization, caregivers (n = 65) received a 90-day home visitation caregiver support intervention before the COVID-19 pandemic and caregivers (n = 41) received a 90-day phone-only visitation caregiver support intervention during the COVID-19 pandemic. Caregiver burden was collected in a survey, and hospital readmission of the care recipient was collected by hospital data. The results of a repeated-measures ANOVA demonstrated that participants of a family caregiver support intervention during the COVID-19 pandemic improved their caregiver burden statistically significantly more than those who received the intervention before the pandemic. There were no significant differences in hospital readmissions before or during the COVID-19 pandemic. The study demonstrates the efficacy of family caregiver support interventions over the phone during a pandemic.

How attachment style, mentalization and preparedness for death are associated with pre-loss grief symptoms’ severity: A network analysis study in caregivers of terminally ill cancer patients

Several psychological dimensions influence the psychological adjustment of terminally ill cancer patients’ caregivers, during the end-of-life phase. The present study explored the associations between attachment styles, mentalization, preparedness for death, and the severity of pre-loss grief symptoms in 102 caregivers of terminal cancer patients. The results of the network analysis showed that insecure attachment dimensions were positively associated with several central pre-loss grief symptoms. Mentalization and preparedness for death showed negative associations with several pre-loss grief symptoms. Interestingly, bitterness showed a negative association with need for approval and a positive association with mentalization. The results provided insight into the grieving process for palliative care providers to implement effective caregiver support interventions.

Effectiveness of the caregiver support intervention on child psychosocial wellbeing among Syrian refugees in Lebanon: Mediation and secondary analysis of a Randomized Controlled Trial

BackgroundWar and violence have a serious negative impact on the wellbeing and mental health of many children. Caregivers play an important role in mitigating or exacerbating this impact. ObjectiveThis study evaluates the impact of the nine session Caregiver Support Intervention on improving children's wellbeing and examines putative mediators of changes in children's psychosocial wellbeing. Participants and setting240 female caregivers were randomly allocated (1:1) to the CSI or a waitlist control comparison condition. The study was implemented in Lebanon, in an area characterized by high levels of poverty and a high number of the Syrian refugees. MethodsA parallel group Randomized Controlled Trial reporting on caregiver-reported child-level wellbeing. We used a combination of the Kid- and Kiddy-KINDL (parent version) for index children ages three to 12. Putative mediators of the CSI on children's psychosocial wellbeing included harsh parenting, caregiver psychological distress, caregiver wellbeing. Measurements were conducted at baseline, post-intervention and 3-months follow-up. ResultsWe demonstrated a statistically significant change in caregiver reported children's psychosocial wellbeing at post-intervention (Mdiff =4.39, 95 % CI = 1.12, 7.65, p < 0.01, d = 0.28) but not at follow-up (Mdiff = −0.97, 95 % CI = -4.27, 2.32, p > 0.05). The proportion of the total effect of the CSI intervention on child psychosocial wellbeing mediated by caregiver distress, caregiver wellbeing and harsh parenting was 77 %. ConclusionThe CSI holds potential for down-stream short-term effect on improving children's psychosocial wellbeing, beyond the previously reported positive caregiver outcomes. This effect was not sustained three months post intervention. The study confirms caregiver wellbeing and parenting support as dual pathways mediating child psychosocial wellbeing.Prospective trial registration: ISRCTN22321773

Coping and Managing ALS Disease in the Family during COVID-19: Caregivers' Perspective

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons, the nerve cells in the brain and the spinal cord that enable voluntary muscle movement. Managing ALS is complex and increasingly requires informal care, most often by the patient's companions/spouses or children. The COVID-19 pandemic posed additional critical issues, particularly the disruption of home care and the increased time caregivers spent on patient care. One aim of this research was to assess caregivers’ health conditions and to understand how the lockdown has affected their lives and the management of their relatives’ illnesses. Another was to observe whether a psychological support intervention for caregivers’ minor children could indirectly impact caregivers. The study involved Italian participants: 26 caregivers (31% males and 69% females) aged between 20 and 69 years (M = 43.85 years, SD = 10.17). The following variables were measured at t0 and t1: reflective functioning with the Reflective Functioning Questionnaire (RFQ), depression with the Beck Depression Inventory-I (BDI-I), hopelessness with the Beck Hopelessness Scale (BHS) and burden of care with Family Strain Questionnaire (FSQ). At t1 only 18 participants also participated in a semi-structured interview to explore the impact of the COVID-19 pandemic, specifically on caregivers of the psychological support participants' children received. The results at t0 showed that caregivers exhibit significant distress symptoms, high stress levels and burden of care. At t1 it was found that the pandemic hurt caregivers' emotions; however, they do not show a worsening but a decrease in hopelessness. The interviews showed that the intervention on their children had a positive effect by allowing containment of the negative effects on well-being. This suggests that it is essential that ALS management also includes a whole-family intervention.

Home Hospice Family Caregivers' Use of Audio Diaries and Reported Prevalence of Patient and Caregiver Symptoms.

Family caregivers are essential to home hospice care for patients with advanced cancer, including reporting patient symptoms to hospice providers for follow-up. Hospice caregiving can also impact personal well-being. 1) Assess home hospice caregivers' use of prospective, longitudinal audio diaries tracking patient and caregiver wellbeing; 2) Explore how patient-focused vs. caregiver-focused diary prompts perform; 3) Examine the prevalence of interactive voice response (IVR)-tracked symptoms and whether diaries revealed additional symptoms. Caregivers (N=102) were asked to report patient and caregiver symptoms via daily IVR calls and could record optional diaries responding to patient-focused or caregiver-focused prompts. Diaries were transcribed, classified by presence/absence of new information, and compared by prompt type. Content coding for IVR-tracked symptoms and inductive coding for additional symptoms were summarized by frequency counts and exemplary quotes. Sixty-nine percent of participants (n=70) recorded diaries, and of these 72.86% (n=51) recorded ≥ one new-information diary. The median recording length was 53.00 seconds (SD=53.36). Participants responding to the caregiver-focused prompt (n=33) recorded more diaries than those in the patient-focused group (n=37; U=437.500, P=0.04. Most prevalent IVR-tracked symptoms were patient fatigue/weakness (26.54% of symptoms mentioned) and pain (23.08%), and caregiver anxiety/nervousness (47.51%) and fatigue (22.10%). The most prevalent additional symptoms were patient increasing sleepiness/sleeping (26.32%) and breathing difficulties (24.32%), and negative caregiver emotions (e.g., guilt, resentment, anger; 29.17%). Prospective audio diaries offer a viable avenue for communicating symptoms and support needs. Future research will focus on leveraging longitudinal data for developing focused and tailored caregiver support interventions.

Quality of life among family caregivers of people with schizophrenia in rural China.

To investigate quality of life (QoL) of family caregivers of people with schizophrenia and examine the influencing factors of the QoL in a Chinese rural area. This study included people with schizophrenia (n = 269) and their family caregivers (n = 269) from Xinjin district, Chengdu, China. Family caregivers' QoL was measured by the World Health Organization Quality of Life-Brief Form and its influencing factors was analyzed by the multivariate regression. Family caregivers of people with schizophrenia had very poor QoL across four domains. The regression analysis showed that physical domain of QoL was significantly associated with age, psychiatric symptoms of people with schizophrenia, and caregiving burden of family caregivers (p < 0.05). Psychological domain of QoL was significantly related to family caregivers' affiliate stigma, caregiving burden, and psychiatric symptoms of people with schizophrenia (p < 0.05). Social domain of QoL was significantly associated with age and psychiatric symptoms of people with schizophrenia, and affiliate stigma of family caregivers (p < 0.05). Environmental domain of QoL was significantly related to age and psychiatric symptoms of people with schizophrenia, and family caregivers' caregiving burden (p < 0.05). Family caregivers of people with schizophrenia had poor QoL in rural China. Family caregivers' QoL is significantly impacted by age and psychiatric symptoms of people with schizophrenia, caregivers' affiliate stigma and caregiving burden. Providing social support and psychosocial interventions for family caregivers of people with schizophrenia might be crucial to improve their QoL and caregiving.

WHEN AND WHERE: LESSONS LEARNED ABOUT TECHNOLOGY FROM AN INTERVENTION FOR CAREGIVERS OF PERSONS WITH HEART FAILURE

Abstract Use of technology in older adult populations is growing, therefore it is important to understand opportunities for healthcare initiatives that support older adults using technology. The aim of the pilot study was to test Caregiver Support, a self-care and social support intervention, for caregivers of persons living with heart failure (N=24). Originally, the protocol was designed with in-person visits. We expected this option to reduce participant burden: the caregiver would not have to travel, and the interventionist would gain more insight about the home context to aid with intervention delivery. However, due to the COVID-19 pandemic, it became necessary to conduct the visits virtually. All participants completed the 5-component intervention via virtual meeting and there were no dropouts related to technology use. When asked about the virtual modality, participants emphasized the flexibility of virtual meetings. In summary, the intervention visits conducted virtually were perceived as a caregiver-centered approach.

INTEGRATION OF DIGITAL TECHNOLOGY IN RESEARCH INVOLVING OLDER ADULTS: LESSONS FROM COMMUNITY-BASED TRIALS

Abstract Working with study participants in community-based clinical trials during COVID-19 pandemic has created diverse challenges to study teams. Globally, COVID-related restrictions were implemented including country-wide lockdowns and social distancing, and study teams had to quickly adjust their study protocols to work in a virtual environment. Meeting virtually for recruitment activities or intervention delivery may be particularly challenging when the target group is older adults—one of the vulnerable populations to experience the digital divide due to limited digital access and limited digital literacyThis symposium covers the lessons learned related to use of digital technology in participant recruitment and intervention delivery across a range of populations, including community-dwelling Korean American older adults to African American older women living with pain and low mood, caregivers of persons living with heart failure, and low-income cancer survivors with multiple chronic conditions. The discussion will include 1) findings from screening over 1,000 older Korean Americans to enroll them into a multi-site community-based trial, 2) lessons in diversifying intervention delivery methods to African American older women, 3) the integration of virtual modality into a self-care and social support intervention for caregivers of persons with heart failure, and 4) the deployment of mHealth to deliver a home-based exercise program to ethnically diverse low-income cancer survivors with co-morbid conditions in the setting of the COVID-19 pandemic. This symposium seeks to build the evidence related to recruitment and intervention delivery targeting diverse groups of older adults in community settings using technology by sharing common challenges, experiences, and opportunities.