Spanish Online & Telephone Intervention for Caregivers of Veterans with Stroke

Takeaway: This intervention is expected to lead to the implementation of a culturally relevant, accessible, and cost-effective intervention for Hispanic caregivers of Veterans who have suffered a stroke.

Stroke is a major cause of disability and a leading cause of outpatient care within the VA healthcare system. Non-paid caregivers, particularly family members, are the major sources of support for stroke survivors. Unlike other chronic diseases, strokes occur suddenly, and family members have little time to prepare and adjust to their new caregiving roles. Previous research has found that family members, particularly Hispanics, have high rates of depression and burden when their stroke survivors return home. Providing caregivers with culturally appropriate information, support, and skills has the potential to reduce negative caregiver outcomes and increase the likelihood that stroke survivors remain in the community. Thus far, no studies have focused on support interventions for Hispanic caregivers.

This ongoing study (October 2017 – September 2022) seeks to test the efficacy of a brief telephone and online problem-solving intervention using the Spanish version of the VA RESCUE stroke caregiver website. This study is the first known randomized controlled trial to test a Spanish-language telephone and online intervention for caregivers in VA and addresses the need for culturally appropriate health information for an understudied population. Specific objectives are to:

• Reduce caregivers’ burden and symptoms of depression;
• Improve caregivers' problem-solving abilities, self-efficacy, and quality of life;
• Improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare use;
• Evaluate cost impact; and
• Determine caregivers' perceptions of the intervention.

The long-term goal is to partner with leaders to implement a culturally relevant, accessible, and cost-effective intervention for caregivers of Veterans post-stroke throughout VA.

Methodology

This is a two-arm (8-session intervention vs. standard care) randomized controlled clinical trial. Investigators have a sample of 290 Hispanic caregivers, who each provide care for a Veteran who suffered a stroke. Participants are randomly assigned to either an intervention or a standard care group. The intervention consists of a problem-solving intervention and information/tools on the previously developed, evidence-based Spanish version of the RESCUE stroke caregiver website. The intervention is conducted via telephone by a trained healthcare professional. Baseline measurements are conducted with the caregivers prior to the intervention.

Post-test assessments are collected at 1 and 12 weeks following the intervention. In addition, investigators will obtain pre- and post-test measures of Veteran-related variables via VA’s electronic health records. Qualitative interviews are conducted to assess caregivers' perceptions of the intervention. Investigators also will measure the budgetary impact of providing the intervention by comparing costs of the intervention group to costs of the control group.

Findings

There are no findings to report at this time.

Anticipated Impact

It is anticipated that caregivers in the intervention group will have improved caregiver outcomes (lower depressive symptoms and burden, and increased problem-solving skills and health-related quality of life), and that Veterans with stroke will have reduced healthcare use and improved functional ability compared to the standard care group.

Principal Investigator

Ivette Magaly Freytes, PhD, MEd, is a Research Health Scientist at the North Florida/South Georgia Veterans Health System.

Publications

Freytes MI, Schmitzberger M, Rivera-Rivera N, et al. Serving underserved Veterans and their caregivers: Developing tailored culturally relevant interventions. Innovation in Aging. November 2019;3(Supp 1):S674.

View study abstract

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