Improving Self-Care of Behavioral Variant Frontotemporal Dementia Caregivers

Study Overview
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Brief Summary
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The research study is being conducted to evaluate the efficacy of a virtual support intervention to reduce stress and poor self-care for caregivers of persons with behavioral variant Frontotemporal Degeneration (bvFTD) compared to receiving health information alone.

Detailed Description
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Informal caregivers of persons with Frontotemporal degeneration (FTD) are an understudied population with unique needs. FTD is a common cause of young-onset dementia with no known cure. Behavioral variant FTD (bvFTD) is the most common of the FTD syndromes and involves a progressive disorder of emotional regulation and personality, and significant impairment in executive function. bvFTD caregivers face unique challenges which are particularly stressful, including young age at which the disorder appears, behavioral symptoms like apathy and disinhibition that are severe and appear early in bvFTD, and the lack of appropriate supportive services. Indeed, numerous studies have demonstrated that stress, depression and burden are higher in FTD caregivers than in any of the other ADRDs, yet caregiver interventions tested in specifically in the FTD population have been limited to a few small studies that focus on education around patient behavior management, not caregiver self-care. The research study is being conducted to evaluate the efficacy of a virtual support intervention to reduce stress and poor self-care for caregivers of persons with behavioral variant Frontotemporal Degeneration (bvFTD) compared to receiving health information alone. 30 caregivers will be randomized 1:1 to a health information: health information + health coaching group. Catered information will be delivered via tablets over 6 months with testing dispersed at baseline, 1 month, 3 months, and 6 months.

Official Title
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Efficacy of a Virtual Intervention for Informal Caregivers of Adults With Frontotemporal Dementia

Conditions
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Behavioral Variant of Frontotemporal Dementia, Caregiver Stress Syndrome

Intervention / Treatment
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* Behavioral: Health Information + Health Coaching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Informal caregiver providing care at least 8 hours/week Reporting poor self-care on screening (Health Self-Care Neglect Scale, score ≥ 2) Able to complete the protocol, e.g., adequate vision and hearing, English speaking Caregiver of a patient diagnosed bvFTD Exclusion Criteria: Participation in another support randomized, controlled trial Untreated major psychiatric illness (Use of anti-anxiety/anti-depressant medicines is acceptable and will be adjusted in analysis if group imbalance is identified.) Caregiver with Cognitive Impairment based on Telephone Interview for Cognitive Status (TICS) score <25

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ViCCY: Health Information + Health Coaching<br>This group will receive 10 front-loaded sessions of virtual health coaching by trained Health Coaches over 6 months with content based on the theoretical framework our prior research. Sessions are provided using tablets. Initially, sessions are weekly to build the relationship, but the frequency of sessions decreases over time | Behavioral: Health Information + Health Coaching<br>* Virtual Health Coaching for You: The focus of these sessions is helping caregivers take care of themselves. These are virtual health coaching sessions by trained Health Coaches over 6 months with content based on the theoretical framework from our prior research<br>* Other names: ViCCY;|
| No Intervention: Health Information<br>Caregivers in the Health Information group are asked to spend at least 30 minutes weekly using the computer tablet provided to you by the study team to access recommended websites | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in the Self-Care Inventory | 30 items scored 0-100. A higher score indicates better self-care. This theoretically-derived instrument has construct validity. The self-care confidence scale is embedded within this instrument. | 3 months and 6 months | 
| Change from Baseline in Frontotemporal Dementia Rating Scale | Commonly used scale to quantify behavioral and psychological symptoms of dementia | 3 months and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Perceived Stress Scale | The Perceived Stress Scale, a 14-item instrument that provides a global rating of an individual's belief in the severity and frequency of stressful experiences during the last month. The Perceived Stress Scale includes 14 items designed to assess symptoms of stress and global measures of the degree of stress experienced in the past month. Each item is scored from 0 (never) to 4 (very often), with total sum scores ranging from 0 to 56; higher scores indicate higher perceived stress. Cronbachs alpha of the scale ranges from 0.84 to 0.86, and was 0.91 for older African American and European American females. | 3 months and 6 months | 
| Change from Baseline in Center for Epidemiologic Studies Depression Scale (CES-D) | CES-D is a valid and reliable scale for detecting caregiver depression in dementia. | 3 months and 6 months | 
| Change from Baseline in Ways of Coping Questionnaire, short form | This 42-item questionnaire measures the use of five different coping styles: avoidance, problem-focused, seeking social support, self-blame, and wishful thinking. The original scale has been used widely since developed by Lazarus in 1985. The short version (30 items) uses a 4-point Likert-scale response format (0 = not used to 3 = used a great deal). Scores range from 0-90 with higher scores indicating greater coping. It is reliable (alpha 0.95) and has construct validity. This instrument has been used numerous times in studies with older adult caregivers. | 3 months and 6 months | 
| Change from Baseline in Zarit Burden Interview (ZBI) | The ZBI has been used in numerous informal dementia caregiver studies to capture burden associated with providing care to a loved one. Total scores are summed and a range is provided for little to no burden (0-21) to severe burden (61-88). | 3 months and 6 months | 
| Change from Baseline in Medical Outcomes Study Short Form (SF-36) | subjective review of caregiver health information | 3 months and 6 months | 
| Change from Baseline in Neuropsychiatric Inventory | Commonly used scale to quantify behavioral and psychological symptoms of dementia | 3 months and 6 months |