African American Alzheimer's Caregiver Training and Support Project 2 (ACTS2) Pilot Study: Outcomes Analysis

• Published in: Rehabilitation psychology 2022-11, Vol.67 (4), p.437-448
• Main Authors: Glueckauf, Robert L., Kazmer, Michelle M., Nowakowski, Alexandra C. H., Wang, Yuxia, Thelusma, Naomi, Williams, Dominique, McGill-Scarlett, Cordy, Lampe, Nik M., Norton-Brown, Tomeka, Davis, W. Shuford, Sharma, Dinesh, Willis, Floyd B.
• Format: Article
• Language: English
• Subjects: Alzheimer's Disease; Black People; Caregiver Burden; Caregivers; Caregiving; Cognitive Behavior Therapy; Dementia; Female; Human; Intervention; Male; Social Support; Telemedicine; Training
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000470

Purpose/Objective: The purpose of this study was to conduct an initial evaluation of the quantitative and qualitative outcomes of the African American Alzheimer's Caregiver Training and Support Project 2 (ACTS2). Quantitative objectives focused on assessing changes in caregiver depression and health status, as well as the severity of caregiving and self-care problems from pre- to postintervention. Secondary quantitative analyses examined posttreatment changes in social support and caregiver burden. Qualitative objectives included examining caregivers' perceptions of the effectiveness of in-session training activities, quality of relationships among group participants and their facilitator, and appraisals of spiritual elements of the program. Research Method/Design: Nine African American family caregivers of older adults with dementia completed the ACTS2 lay pastoral care facilitator-led, telephone cognitive-behavioral intervention. The 12-week training program included seven skills-building groups and five individual problem-solving sessions. Results: Significant improvements were found on the majority of dependent measures, including caregiver depression, health status, problem severity, and social support. Qualitative analysis highlighted the value caregivers placed on relationships with coparticipants and group facilitators, the role of spirituality in the program, and the importance of goal setting for improving caregiver distress and self-care. Conclusions/Implications: Convergence was found between quantitative and qualitative findings, particularly improvements in caregiver distress, health status, and social support. Overall, the findings of the pilot study were promising. Replication using a randomized controlled design with a larger sample size is needed to test the reliability of the findings. The benefits of tailoring intervention to caregivers' sociocultural preferences and spiritual values are also addressed. Impact and Implications Although the number of studies on the effects of telehealth-based, cognitive-behavioral intervention for distressed African American caregivers of older adults with dementia has increased over the past few years, most investigations have not tailored treatment to the cultural preferences and faith traditions of this at-risk population. The present study represents the initial stage of a grant-funded program addressing these shortcomings in telehealth and dementia caregiving research. Despite the widespread recogni