Sponsors. National Institute on Aging and National Institute of Nursing Research.
Purpose. The REACH II intervention seeks to increase caregiver knowledge, skills, and well-being while enhancing support to the caregiver. Specifically, the study is designed to (a) test a multi-component intervention for caregivers, (b) assess the intervention's impact on ethnically diverse populations, (c) provide new measurements for assessing the quality of care provided by caregivers and tools for identifying caregivers at risk for adverse outcomes, and (d) evaluate the cost effectiveness and public health significance of the intervention.17
Description. The REACH II intervention comprises 10 home visits by trained staff plus five contacts with trained staff through an innovative computer/telephone technology system over a 6-month period. The technology provides access to formal services for both family and other caregivers. The intervention begins with the administration of a health risk appraisal following a battery of baseline assessments. Project staff prioritize risk areas for each caregiver, and then develop a stepped intervention approach that addresses risk in multiple health areas (including caregiver health and self-care, caregiver burden/depression, social support, problem behaviors of recipient, and safety of both the patient and caregiver).18
The care plans developed and services recommended vary based on the results of the health risk appraisal; they range from home-based exercise programs to computer-based monitoring systems and individual consultations with medical providers.18
The study design is a multisite, two-group randomized clinical trial, comparing outcomes in the active intervention group to those in an information-only control group; the intervention and control groups are of equal size. Unlike REACH I, which implemented a variety of active interventions at six different sites, this study will implement the same two interventions at each of five participating sites: Birmingham, Memphis, Miami, Palo Alto, and Philadelphia. Across the five sites, 600 caregiver-care recipient dyads (120 per site) will be enrolled; the goal is for 510 dyads to complete the intervention.17
The study will be conducted in two Phases. Phase 1 is for refining the intervention and training staff to conduct the intervention protocol; in Phase 2, the randomized clinical trial is conducted. A uniform battery of baseline and outcome measures is being collected at baseline and 6 months. Cost-effectiveness and clinical significance of the intervention will also be evaluated. Final follow-up will occur 12 months after initial enrollment in the program.17
Results to Date. The study is ongoing. Data are being collected on caregivers in both the intervention and control groups. Approximately 50 percent of all caregivers have completed the protocol.18
Next Steps. The final results of the REACH II initiative will be disseminated widely on the Internet and in peer-reviewed journals, and will be presented at national conferences.
Dr. Richard Schulz
University Center for Social and Urban Research
University of Pittsburgh
121 University Place, Room 607
Pittsburgh, PA 15260
Phone: (412) 624-5442
Fax: (412) 624-4810
Website address: http://www.edc.gsph.pitt.edu/REACH2/public/about.html