Better Together: Reablement and Caregivers

Study Overview
=================
Brief Summary
-----------------
Hospitalization creates opportunities for older adults to accumulate prolonged periods of sitting and lying (defined as sedentary behavior) which can result in mobility loss. We propose a Type 1 Hybrid Effectiveness-Implementation Trial with 1:1 randomization to test the effect of a caregiver intervention on older patients' physical activity at 3 months (home). We will recruit 61 patients and family caregivers from hospital units and follow them for 3 months; the primary outcome is patients' daily step count at 3 months.

Official Title
-----------------
Out and About: Reablement for Older Adults in the Hospital Setting

Conditions
-----------------
Older Adults, Sedentary Behavior, Physical Activity, Caregiver

Intervention / Treatment
-----------------
* Behavioral: Better Together
* Behavioral: Usual Care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Older adults (60 years and older) with a recent hospitalization and their caregiver. Exclusion Criteria: Caregivers and older adults with a dementia diagnosis, head injury, significant neurological impairment, or receive treatment for medical conditions that preclude exercising.

Ages Eligible for Study
-----------------
Minimum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br> | Behavioral: Better Together<br>* Patient and caregiver dyads from both groups will receive usual care during hospitalization and following discharge. This will include a handout on strategies for safely remaining active. Caregiver participants in the intervention group will receive up to six telephone or video calls with the research assistant or Clinical Resource Therapist. Sessions will review the knowledge translation (KT) product with family members ( 15 minutes), art goals, brainstorm strategies, and discuss setbacks. The calls with the caregiver may occur 1 to 2 times in the hospital, within one week of going home, and then in Months 2 and 3.<br>|
| Active Comparator: Usual Care<br> | Behavioral: Usual Care<br>* Patient and caregiver dyads from both groups will receive usual care during hospitalization and following discharge. This will include a handout on strategies for safely remaining active.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Veterans Rand-12 Quality of Life | 12 item quality of life survey | baseline and 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily minutes sedentary behavior | daily minutes of sedentary behavior measured with an activity monitor | baseline to 3 months | 
| Daily minutes of physical activity | daily minutes of physical activity measured with an activity monitor | baseline to 3 months | 
| Patient Assessment with Chronic Illness Care Survey | 20-item survey with questions related to experience with hospitalization. | 3 months | 
| Brief Action Planning (BAP) | Goal setting | baseline and 3 months | 
| Action Plans behaviors | self-reported health behavior questions | baseline and 3 months | 
| Coping Plans | self-reported health behavior questions | baseline and 3 months | 
| Physical Activity Intentions | self-reported health behavior questions | baseline and 3 months | 
| Physical Activity Self-efficacy | self-reported health behavior questions | baseline and 3 months | 
| Physical Activity Risk Perceptions | self-reported health behavior questions | baseline and 3 months | 
| Physical Activity Outcome Expectancies | self-reported health behavior questions | baseline and 3 months | 
| Self-reported Habit Index | self-reported health behavior questions | baseline and 3 months | 
| Program implementation | Semi-structured interviews or focus groups with patients, caregivers, and heath providers to understand factors related program implementation. | baseline and 3 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
caregiver, patient, e-Course