Knowledge and Interpersonal Skills to Develop Exemplary Relationships

Study Overview
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Brief Summary
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This pilot study will test the effect of an online asynchronous psychoeducational intervention to improve relationship quality and prevent verbal-type elder mistreatment in caregiving dyads. The investigators will use a pre-post test design to test the feasibility and acceptability of this video-based intervention, and to determine the likelihood that participation in this program may improve caregiver relationship quality.

Official Title
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Knowledge and Interpersonal Skills to Develop Exemplary Relationships

Conditions
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Caregivers, Family Relations, Domestic Violence, Elder Abuse

Intervention / Treatment
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* Behavioral: KINDER


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Provides assistance to someone over the age of 60 with an illness or a disability (care recipient) who requires personal assistance from another person (e.g., bathing, preparing meals). (Assistance provided with at least 1 activity of daily living and/or at least 2 instrumental activities of daily living.) Person receiving care from the study participant has a cognitive impairment. This does not have to be diagnosed. Participant provides at least 8 hours of assistance to the care recipient per week Participant does not intend to place the care recipient in a skilled nursing facility or assisted living facility within 3 months of consenting into the study Exclusion Criteria: Does not read and speak English Cannot access a computer and internet (needed to complete lessons)

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: The investigators will evaluate the KINDER program using pre- and post-test analysis. Eligible and consented subjects enrolled on a rolling basis. After enrollment, all caregivers will complete a baseline assessment. Caregivers will receive the intervention (8 lessons, delivered once per week) and will be asked to complete a reassessment after 10 weeks. Two months later, participants will be asked to complete a second reassessment.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: KINDER Participant<br>The intervention will be provided with a 8-part psychoeducational intervention delivered online on a weekly basis. Online modules will be comprised of a short (approximately 3 minute) videos followed by more specific text-based information and links to additional resources. At the end of the module, participants will complete a short quiz, followed by a reflection exercise to reinforce learning. Each model, participants will be asked to select a goal to complete a pleasurable activity and receive an option to set a text or email reminder to do so. | Behavioral: KINDER<br>* KINDER is an online course for people assisting an older adult with dementia. It is intended to improve the quality of caregiver's relationship with the care recipient and reduce the chance of risky relationship behavior (e.g., yelling). Courses will cover topics including understanding cognitive impairments, navigating evolving roles, and dealing with frustration. During this course, participants will learn skills to deal with difficult situations caregivers frequently encounter in ways that support a healthy caregiving relationship. Videos will be story-based and represent different types of caregiving relationships and challenges encountered.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in frequency of verbal mistreatment | This scale will measure frequency of verbal mistreatment using a measure based on the Conflict Tactics Scale (Straus et al., 1996), with additional questions from other items (Acierno et al., 2010; Beach et al., 2005; Conrad et al., 2011; Deliema et al., 2012) | This measure will be asked immediately before the intervention, immediately after the intervention, and 2 months after the intervention is complete. The question asks participants about events in the previous 2 months. | 
| Change in the number of positive aspects of the relationship with the care recipient (Dyadic Relationship Scale) | Participants are asked how much they agree with positive statements about their relationship with the care receiver on a 0 to 3 scale. This item comes from Sebern & Whitlatch (2007) | This measure will be asked immediately before the intervention, immediately after the intervention, and 2 months after the intervention is complete. The question asks participants about events in the previous 2 months. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in caregiver competence (Caregiving Competence Scale) | We will use the Caregiving Competence Scale developed by Pearlin and colleagues (1990) | This measure will be asked immediately before the intervention, immediately after the intervention, and 3 months after the intervention is complete. The question asks participants about events in the previous 3 months. | 
| Change in perceived stress (Perceived Stress Scale) | We will use the Perceived Stress Scale developed by Cohen & Williamson (1988) | This measure will be asked immediately before the intervention, immediately after the intervention, and 3 months after the intervention is complete. The question asks participants about events in the previous 3 months. | 
| Change in caregiver burden (Zarit Burden Index) | We will use the Zarit Burden Index developed by Zarit and colleagues (1980) | This measure will be asked immediately before the intervention, immediately after the intervention, and 3 months after the intervention is complete. The question asks participants about events in the previous 3 months. | 
| Change in depression (Patient Health Questionnaire-9) | We will use the Patient Health Questionnaire-9 (Kroenke et al., 2001) | This measure will be asked immediately before the intervention, immediately after the intervention, and 3 months after the intervention is complete. The question asks participants about events in the previous 3 months. | 
| Change in caregiver mastery (Caregiver Mastery Scale) | We will use the Caregiver Mastery Scale developed by Pearlin & Schooler (1978) | This measure will be asked immediately before the intervention, immediately after the intervention, and 3 months after the intervention is complete. The question asks participants about events in the previous 3 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pilot Study, Cognitive Behavioral Therapy, Intervention Study