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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3132 — Improving Stroke Caregiver Outcomes: Evaluation of the RESCUE Website

Uphold CR, RORC REAP; GRECC; Findley K, RORC REAP; Wing KL, NF/SGVHS; Freytes IM, RORC REAP; Hanjian J, NF/SGVHS; Midolo JP, QUERI Program; Knauff L, NF/SGVHS; Rodriquez W, VA Caribbean HCS; Whittle JC, VAMC Milwaukee;

Objectives:
Our goal was to improve stroke caregivers' knowledge and skills by developing, implementing, and evaluating a VA website to serve as a patient education resource for providers and family members.

Methods:
We used the 4-stage, NIH health communication model to guide our 3-site study (Gainesville, Milwaukee, San Juan). In the development phase, we used community-based participatory research methods and partnered with VA and non-VA organizations. We used evidenced-based "best practices" to create a low-literate, senior-friendly VA website that is written in both English and Spanish languages. We pretested the website in multiple ways: a) focus groups with providers (total n = 32), b) in-person interviews with culturally-diverse family caregivers (n = 45), c) expert panel of clinicians (n = 11), and d) cognitive "think aloud" usability study with caregivers (n = 4) and providers (n = 3). We conducted a multi-prong, social marketing campaign (VHA Twitter/Facebook, eBlast emails, health fairs at 13 VA medical centers, consumer/professional publications) to motivate caregivers and providers to use the website. We evaluated the website by conducting online and telephone surveys with providers (total n = 53) and using Webtrends analysis.

Results:
After development and pretesting, we created the RESCUE (Resources and Education for Stroke Caregivers’ Understanding and Empowerment) website (http:www.rorc.resarch.va.gov/rescue). The website consists of a library of 45 factsheets, a problem-solving learning module, self-help tools, resource list, patient education newsletters, and a glossary with phonetic spellings. Survey results indicate that providers are using the website for educating caregivers and view the website as informative, comprehensive, credible and up-to-date. Webtrends analytics found that there were over 6000 visits to the website, and that website usage increased significantly following each promotional activity.

Implications:
Implementations science methods, social marketing approaches, and evidence-based principles for designing web-based health information led to the creation of a senior-friendly website for stroke caregivers. Ensuring that information for caregivers is consumer-oriented, culturally-sensitive, and at a low literacy level is a positive strategy to improve the home care of Veterans with stroke.

Impacts:
The RESCUE website is a resource to inform and empower caregivers, and ultimately to improve outcomes of Veterans with stroke. The website is a tool that providers can use for patient education and support interventions for caregivers.


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