Discuss initial findings of a randomized clinical trial comparing the effects of telephone-based and face-to-face (f-to-f) cognitive-behavioral therapy (CBT) on changes in caregiver (CG) burden, assistance support, depression, and health status for African American (AA) CGs with depression. Pilot study using a prepost, two-group design with 14 enrolled and randomized participants. Subjective Burden subscale of the Caregiver Appraisal Inventory, Assistance Support subscale of the Interpersonal Support Evaluation List, Physical Symptoms subscale of the Caregiver Health and Health Behavior Inventory and the Center for Epidemiologic Studies Depression Scale. Prepost improvements were found on 11 completers across all measures for both telephone and f-to-f CBT. Moderate and similar effects sizes for CG subjective burden and assistance support were found for both the telephone and f-to-f groups. Effect sizes for physical symptoms and depression varied from low to moderate, respectively, with a trend toward smaller improvements in f-to-f CBT than in telephone CBT. Qualitative analysis highlighted CGs' perceptions of the active ingredients of treatment and provided indirect support for similar gains in emotional and psychosocial functioning across the two treatment modalities. Both telephone-based and f-to-f CBT showed improvements in depression, subjective burden, and assistance support in dementia AA CGs. Replication with a larger sample size (N = 106) is currently in progress. Study limitations and future directions for research are also addressed.
21 May 2021 in International Journal of Telemedicine and Applications
Objective. The purpose of this study was to provide an in-depth analysis of the components and outcomes of telehealth interventions for family caregivers of individuals with chronic health conditions. Methods. A systematic review of 17 databases was conducted for randomized controlled trials published between January 2002 and January 2017. Interventions were analyzed based on type of telecommunication modality, caregiver and care recipient characteristics, intervention components, and caregiver outcomes. Results. A total of 57 articles met criteria for inclusion. Telephone was the most frequently used mode of telehealth delivery and focused primarily on caregivers of older adults with dementia and stroke. Skills training was the most prevalent treatment strategy across telephone, web, and combined telephone and web modalities. Improved psychological functioning was reported most frequently across telehealth modalities. Conclusion. Telehealth is an effective tool in delivering caregiver interventions and leads to significant improvement in caregiver outcomes. Telephone was used most often to deliver cognitive-behavioral and psychoeducational strategies as compared to web and combined telephone and web modalities. Further research is needed to examine the effects of telehealth interventions on caregiving skills and self-efficacy, as well as health outcomes.
Women living with HIV (WLH) face challenges related to stigma, disclosure of HIV status, and negotiating safer sex. Several effective behavioral interventions, such as Healthy Relationships (HR), help WLH address these challenges and are disseminated by the USA Centers for Disease Control and Prevention's (CDC) Diffusion of Effective Behavioral Interventions project. However, many WLH living in poor urban or rural locations cannot access interventions such as HR because implementation is not feasible. Video-conferencing technology holds promise for expanding access to effective behavioral interventions for WLH. Following a systematic adaptation to the video-conferencing format, this pilot study tested the delivery of HR via video-group (VG) among WLH. The video-conferencing-based intervention, HR-VG, consisted of six, two-hour sessions led by two facilitators, and used structured activities and video-clips to build disclosure and safer sex skills. Four minority WLH received HR-VG at four different community-based intervention sites in a private room equipped with a video-phone for participating in HR-VG and a desktop computer for completing assessments via Audio Computer-Assisted Self Interview. Participants completed a baseline assessment prior to HR-VG and post-session assessment after each HR-VG session. The post-intervention assessment and video-focus group were completed following the last HR-VG session. Facilitators completed an assessment after each HR-VG session and an open-ended questionnaire following HR-VG. HR-VG was implemented in its entirety with minimal challenges. Both participants and facilitators reported feeling either “very comfortable” or “completely comfortable” with the technology and the overall intervention. Participants also reported high levels of unity and togetherness among the group. These preliminary findings suggest VG delivery of HR for WLH is both feasible and highly valued by participants. A follow-up randomized controlled trial is under way to test the feasibility and efficacy of HR-VG with a larger sample of WLH.
8 October 2021 in Journal of Communication Disorders
Discuss initial evaluation of a program for training faith community nurses (FCNs) to conduct cognitive-behavioral and spiritual counseling (CBSC) for rural dementia caregivers (CGs), and present 2 case studies on the use of CBSC for treating depression in this population. Pre-post evaluation of the effectiveness of CBSC training and a case study analysis of the effectiveness of CBSC on CG problem improvement and depression. For FCN training, we used the FCN Counseling Comfort Scale, FCN Counseling Efficacy Scale, and the FCN Counseling Workshop Satisfaction Survey. The Problem Severity Scale and Center for Epidemiologic Studies Depression Scale were used in the case studies. Significant post-training increases in FCN counseling comfort and perceived counseling efficacy were obtained. Case study findings provided evidence of substantial improvement in caregiving problems and reductions in depression. Preliminary outcomes of FCN training and CBSC for dementia CGs were promising. However, replication across the sample is required to evaluate the overall effectiveness of CBSC for reducing CG depression. Specific competencies and ethical considerations in supervising this form of intervention are also addressed.
26 July 2010 in Journal of the American Society for Information Science and Technology