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Rubovits E, Yedavalli A, Sadruddin S, Lavari K, Mudar R, Leung V, Cothran FA, Raj M. Engaging Asian American Family Caregivers in Clinical Trials: Awareness, Preferences, and Concerns. J Appl Gerontol 2024:7334648241271354. [PMID: 39101877 DOI: 10.1177/07334648241271354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Abstract
The purpose of this study was to evaluate Asian American caregivers' experiences and concerns related to clinical trials and the types of information they trust, use, and prefer before enrolling their older relative in a clinical trial. We conducted an online, cross-sectional survey with Asian American family caregivers between July 2022 and April 2023. Of all respondents (n = 98), 62.2% reported knowing only a little about clinical trials. Respondents expressed wanting information about (a) the purpose, design, and components of the trial; (b) trial research ethics and safety; and (c) their responsibilities as the caregiver. Greater engagement between clinicians and family caregivers of culturally diverse older adults could help minimize sociocultural barriers to participation in clinical trials. Providing key information to family caregivers in a comprehensive and accessible way without adding burden could help caregivers understand their responsibilities through the clinical trial process.
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Affiliation(s)
- Eve Rubovits
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Anjali Yedavalli
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Sabeen Sadruddin
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Kavin Lavari
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Raksha Mudar
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Vania Leung
- Department of Geriatric Medicine, University of Illinois Chicago, Chicago, IL, USA
| | | | - Minakshi Raj
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
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Esiaka D, Yarborough CC, Fausto BA, Gluck MA. A Mini-Review of Strategies for Recruiting Older African Americans to Alzheimer's Disease Research. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:419-428. [PMID: 36120808 PMCID: PMC11025449 DOI: 10.1177/0272684x221118493] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face discussions, remote access, and referral and partnership with local organizations. Across different locations, these strategies increased the number of African Americans enrolled into AD research, the number of people that signed up to donate their brains for AD research upon death, and the knowledge and perception of AD in the communities. Targeted efforts are effective in increasing AD research participation among older African Americans, especially when combined with approaches that emphasize transparency and mutual trust and involve the community as stakeholders in the research process.
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Affiliation(s)
- Darlingtina Esiaka
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, USA
| | - Christina C. Yarborough
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, USA
| | - Bernadette A. Fausto
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, USA
| | - Mark A. Gluck
- Aging and Brain Health Alliance, Center for Molecular and Behavioral Neuroscience, Rutgers University–Newark, Newark, NJ, USA
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Meyer K, Lee K, Thorngthip S, Burant P, Lippe M, Neidre D, White C, Norman R, Choi BY, Glover CM, Bell J, Hepburn K. A randomised controlled trial of the Learning Skills Together (LST) intervention to improve dementia family caregivers' self-efficacy with complex care. Trials 2024; 25:369. [PMID: 38851719 PMCID: PMC11161926 DOI: 10.1186/s13063-024-08204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Nearly two-thirds of family caregivers of persons living with Alzheimer's disease or related dementias (AD/ADRD) provide complex care, including medical care. Family caregivers typically receive little to no training on how to provide this care. Furthermore, family caregivers simultaneously grapple with the presence of behavioral and psychological symptoms of dementia (BPSD), diminished communication abilities, and comorbidities such as diabetes. We developed Learning Skills Together (LST), a 6-week digitally delivered psychoeducational program, to facilitate family caregiver abilities to administer complex care tasks. The goal of the present study is to test the efficacy of LST and to reduce adverse outcomes associated with caregiving, such as depressive symptomology and negative appraisal of BPSD. METHODS To test the efficacy of LST, we will conduct a two-arm single-site randomized controlled trial (RCT) with N = 200 family caregivers of persons living with AD/ADRD. Eligible family caregivers will be randomly assigned to participate in either the LST intervention or a structurally equivalent control condition focused on healthy living. All family caregivers will complete four surveys, including a baseline survey administered prior to randomization, a post-intervention survey, and a 3- and 6-month follow-up survey to assess change in study outcomes. Between-group comparisons of each outcome will be evaluated using generalized estimating equation models. Mediation analyses will assess family caregiver self-efficacy as the intervention's mechanism of change in depressive symptomology and BPSD. We will also examine caregiver race, ethnicity, and gender as effect modifiers of the intervention. DISCUSSION LST findings will inform the field of AD/ADRD and caregiving regarding optimally supporting family caregivers in managing complex care tasks. If efficacious, the LST intervention will support family caregivers in preserving their own mental health while providing complex care. TRIAL REGISTRATION Clinical Trials.gov NCT05846984 . This study was registered on May 6, 2023.
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Affiliation(s)
- Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA.
| | - Kyungmi Lee
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Sutthinee Thorngthip
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Patricia Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Megan Lippe
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Daria Neidre
- Biggs Institute on Alzheimer's Disease and Related Dementias, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA
| | - Carole White
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rocio Norman
- Biggs Institute on Alzheimer's Disease and Related Dementias, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA
| | - Byeong Yeob Choi
- School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Crystal M Glover
- Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, RUSH Medical College, Chicago, IL, USA
- Department of Neurological Sciences, RUSH Medical College, Chicago, IL, USA
- Rush Alzheimer's Disease Center, RUSH Medical College, Chicago, IL, USA
| | - Janice Bell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Meyer K, Lee K, Thorngthip S, Burant P, Lippe M, Neidre D, White C, Norman R, Choi BY, Glover CM, Bell J, Hepburn K. A randomised controlled trial of the Learning Skills Together ( LST) intervention to improve dementia family caregivers' self-efficacy with complex care. RESEARCH SQUARE 2024:rs.3.rs-3950114. [PMID: 38853904 PMCID: PMC11160901 DOI: 10.21203/rs.3.rs-3950114/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Nearly two-thirds of family caregivers of persons living with Alzheimer's disease or related dementias (AD/ADRD) provide complex care, including medical care. Family caregivers typically receive little to no training on how to provide this care. Furthermore, family caregivers simultaneously grapple with the presence of behavioral and psychological symptoms of dementia (BPSD), diminished communication abilities, and comorbidities such as diabetes. We developed Learning Skills Together (LST), a six-week digitally delivered psychoeducational program, to facilitate family caregiver abilities to administer complex care tasks. The goal of the present study is to test the efficacy of LST and to reduce adverse outcomes associated with caregiving, such as depressive symptomology and negative appraisal of BPSD. Methods To test the efficacy of LST, we will conduct a two-arm single-site randomised controlled trial (RCT) with N = 200 family caregivers of persons living with AD/ADRD. Eligible family caregivers will be randomly assigned to participate in either the LST intervention or a structurally equivalent control condition focused on healthy living. All family caregivers will complete four surveys, including a baseline survey administered prior to randomisation, a post-intervention survey, and a three- and six-month follow-up survey to assess change in study outcomes. Between-group comparisons of each outcome will be evaluated using generalized estimating equation models. Mediation analyses will assess family caregiver self-efficacy as the intervention's mechanism of change in depressive symptomology and BPSD. We will also examine caregiver race, ethnicity, and gender as effect modifiers of the intervention. Discussion LST findings will inform the field of AD/ADRD and caregiving regarding optimally supporting family caregivers in managing complex care tasks. If efficacious, the LST intervention will support family caregivers in preserving their own mental health while providing complex care.
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Affiliation(s)
- Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Kyungmi Lee
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Sutthinee Thorngthip
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Patricia Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Megan Lippe
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Daria Neidre
- Biggs Institute on Alzheimer’s Disease and Related Dementias, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA
| | - Carole White
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rocio Norman
- Biggs Institute on Alzheimer’s Disease and Related Dementias, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA
| | - Byeong Yeob Choi
- School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Crystal M Glover
- Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, RUSH Medical College, Chicago, IL, USA
- Department of Neurological Sciences, RUSH Medical College, Chicago, IL, USA
- Rush Alzheimer’s Disease Center, RUSH Medical College, Chicago, IL, USA
| | - Janice Bell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Kroenke CH, Kurtovich E, Aoki R, Shim VC, Chan TD, Brenman LM, Bethard-Tracy J, Adams AS, Kennedy DP. Evaluation of approaches to recruitment of racially and ethnically diverse breast cancer patients from an integrated health care setting for collection of observational social network data. Cancer Causes Control 2023; 34:705-713. [PMID: 37147410 PMCID: PMC10162650 DOI: 10.1007/s10552-023-01709-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE We compared approaches to recruitment of diverse women with breast cancer in a study designed to collect complex social network data. METHODS We recruited 440 women from the Kaiser Permanente Northern California population newly diagnosed with breast cancer, either in person at a clinic, by email, or by mailed letter. In clinic and mail recruitment, women completed a brief 3-page paper survey (epidemiologic data only), and women had the option to complete a separate, longer (30-40 min) personal social network survey online. In email recruitment, we administered epidemiologic and personal social network measures together in a single online survey. In email and mail recruitment, we limited the sample of non-Hispanic white (NHW) women to 30% of their total. We used descriptive analysis and multinomial logistic regression to examine odds of recruitment vs. mailed letter. RESULTS Women responded to the social network surveys on average 3.7 months post-diagnosis. Mean age was 59.3 (median = 61.0). In-person clinic recruitment was superior with a 52.1% success rate of recruitment compared with 35.6% by mail or 17.3% by email (χ2 = 65.9, p < 0.001). Email recruitment produced the highest completion rate (82.1%) of personal network data compared with clinic (36.5%) or mail (28.7%), (χ2 = 114.6, p < 0.001). Despite intentional undersampling of NHW patients, response rates for Asian, Hispanic, and Black women by email were lower. However, we found no significant differences in recruitment rates by race and ethnicity for face-to-face clinic recruitment vs. by letter. Letter recruitment produced the highest overall response. CONCLUSION Mailed letter was the best approach to representative recruitment of diverse women with breast cancer and collection of social network data, and further yielded the highest absolute response.
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Affiliation(s)
- Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5th floor, Oakland, CA, 94612, USA.
| | - Elaine Kurtovich
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5th floor, Oakland, CA, 94612, USA
| | - Rhonda Aoki
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5th floor, Oakland, CA, 94612, USA
| | - Veronica C Shim
- Kaiser Permanente Northern California Oakland Medical Center, Oakland, CA, USA
| | - Tracy D Chan
- Kaiser Permanente Northern California Oakland Medical Center, Oakland, CA, USA
| | | | - Jane Bethard-Tracy
- Kaiser Permanente Northern California Oakland Medical Center, Oakland, CA, USA
| | - Alyce S Adams
- Departments of Health Policy, Epidemiology and Population Health, and (By Courtesy) Pediatrics, Stanford School of Medicine, Stanford, CA, USA
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Sloan DH, Johnston D, Reuland M, Spliedt M, Samus QM, Fabius C, Pyatt T, Antonsdottir I. Transcending inequities in dementia care in Black communities: Lessons from the maximizing independence at home care coordination program. DEMENTIA 2022; 21:1653-1668. [DOI: 10.1177/14713012221085808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose We examine care partners’ experience of the Maximizing Independence at Home (MIND) intervention, a multicomponent, home-based dementia care coordination program designed to provide high quality, wholistic care coordination for people and families living with dementia. The goal of the study was to understand 1. the unique dementia-related needs of Black care partners and barriers and challenges to caregiving experienced within the Black community, 2. perceived benefits of the MIND program, and 3. ways to improve the program and make it more culturally responsive to the Black community. Method We conducted three focus groups totaling 20 care partners of people living with dementia; who participated in the MIND intervention (2014–2019); all Black/African American and English speaking. Verbatim transcriptions were independently analyzed line-by-line by two coders using inductive approaches. Findings Participants noted three overarching themes related to dementia care needs and challenges in the Black community: difficulty finding and accessing dementia information and relevant services and supports; familial conflict/lack of sibling and familial support; and lack of effective communication about dementia within Black Communities. Regarding MIND at home program benefits, four themes emerged: 1. perceived to help locate resources (formal and informal); 2. provided care partners an opportunity for socialization and interaction; 3. included comprehensive assessments and helpful linked information; and 4. resulted in a “much needed break for care partners.” Increased diversity of the MIND program personnel, greater clarity and consistency in MIND program promotion, and better communications were themes for how the program could be improved. Conclusion Care partners participating in the MIND program perceived common benefits in aspects related to care for the persons living with dementia as well as benefits to themselves, believed the program addressed important challenges and gaps in education, services, and social support, and could be enhanced in its delivery and cultural responsiveness.
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Affiliation(s)
- Danetta H Sloan
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Deirdre Johnston
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Melissa Reuland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Morgan Spliedt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Quincy M Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chanee Fabius
- Department of Health, Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tabitha Pyatt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Inga Antonsdottir
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Johns Hopkins School of Nursing, Baltimore, MD, USA
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