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Article: Multiphase optimization of a multicomponent intervention for informal dementia caregivers: a study protocol

TitleMultiphase optimization of a multicomponent intervention for informal dementia caregivers: a study protocol
Authors
KeywordsCaregiving burden
Dementia caregiver
Depressive symptoms
Multicomponent
Multiphase optimization
Positive aspects of caregiving
Randomised controlled trial
REACH
Issue Date5-Dec-2023
PublisherBioMed Central
Citation
Trials, 2023, v. 24, n. 1 How to Cite?
Abstract

Background

Family caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components. To optimise intervention, we adopt the multiphase optimisation strategy (MOST) to test the implementation fidelity and determine the effect of each component and the interactions between each component and the corresponding outcome.

Methods

A prospective, assessor-blinded, randomised clinical trial with fractional factorial design using the MOST principle. Two hundred fifty family dementia caregivers will be randomised to one of 16 experimental conditions in a fractional factorial design involving six intervention components: (1) dementia and caregiving education; (2) self-care skills; (3) behavioural symptom management; (4) behavioural activation; (5) modified mindfulness-based cognitive therapy; and (6) support group. The first one is the core component, and the five remaining will be examined. Physical health, caregiver burden, stress, psychological well-being, anxiety and depressive symptoms, and social support will be assessed over the 12-month study period. Following the intention-to-treat principle, linear mixed models and regression analyses will be used to examine the specific effect of the five components and their two-way interactions to propose the most effective combination.

Discussion

This is the first study adopting the multiphase optimisation strategy to identify the most active and engaging components of a psychological intervention for caregivers of patients with dementia. In view that dementia caregiver interventions are increasingly diversified and complex, such knowledge is important to maximise the intervention efficacy and allow the intervention to be implemented within an efficient timeframe and dosage. The optimisation of caregiver support interventions is critical to enhance the health outcomes of caregivers and care recipients, thereby, delaying possible institutionalisation and reducing the costs of long-term dementia care.


Persistent Identifierhttp://hdl.handle.net/10722/339767
ISSN
2023 Impact Factor: 2.0
2023 SCImago Journal Rankings: 0.812
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwok, Jojo Yan Yan-
dc.contributor.authorCheung, Daphne Sze Ki-
dc.contributor.authorZarit, Steven-
dc.contributor.authorCheung, Karen Siu-Lan-
dc.contributor.authorLau, Bobo Hi Po-
dc.contributor.authorLou, Vivian Weiqun-
dc.contributor.authorCheng, Sheung-Tak-
dc.contributor.authorGallagher-Thompson, Dolores-
dc.contributor.authorChou, Kee-Lee-
dc.date.accessioned2024-03-11T10:39:09Z-
dc.date.available2024-03-11T10:39:09Z-
dc.date.issued2023-12-05-
dc.identifier.citationTrials, 2023, v. 24, n. 1-
dc.identifier.issn1745-6215-
dc.identifier.urihttp://hdl.handle.net/10722/339767-
dc.description.abstract<h3>Background</h3><p>Family caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components. To optimise intervention, we adopt the multiphase optimisation strategy (MOST) to test the implementation fidelity and determine the effect of each component and the interactions between each component and the corresponding outcome.</p><h3>Methods</h3><p>A prospective, assessor-blinded, randomised clinical trial with fractional factorial design using the MOST principle. Two hundred fifty family dementia caregivers will be randomised to one of 16 experimental conditions in a fractional factorial design involving six intervention components: (1) dementia and caregiving education; (2) self-care skills; (3) behavioural symptom management; (4) behavioural activation; (5) modified mindfulness-based cognitive therapy; and (6) support group. The first one is the core component, and the five remaining will be examined. Physical health, caregiver burden, stress, psychological well-being, anxiety and depressive symptoms, and social support will be assessed over the 12-month study period. Following the intention-to-treat principle, linear mixed models and regression analyses will be used to examine the specific effect of the five components and their two-way interactions to propose the most effective combination.</p><h3>Discussion</h3><p>This is the first study adopting the multiphase optimisation strategy to identify the most active and engaging components of a psychological intervention for caregivers of patients with dementia. In view that dementia caregiver interventions are increasingly diversified and complex, such knowledge is important to maximise the intervention efficacy and allow the intervention to be implemented within an efficient timeframe and dosage. The optimisation of caregiver support interventions is critical to enhance the health outcomes of caregivers and care recipients, thereby, delaying possible institutionalisation and reducing the costs of long-term dementia care.<br></p>-
dc.languageeng-
dc.publisherBioMed Central-
dc.relation.ispartofTrials-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCaregiving burden-
dc.subjectDementia caregiver-
dc.subjectDepressive symptoms-
dc.subjectMulticomponent-
dc.subjectMultiphase optimization-
dc.subjectPositive aspects of caregiving-
dc.subjectRandomised controlled trial-
dc.subjectREACH-
dc.titleMultiphase optimization of a multicomponent intervention for informal dementia caregivers: a study protocol-
dc.typeArticle-
dc.identifier.doi10.1186/s13063-023-07801-3-
dc.identifier.scopuseid_2-s2.0-85178851003-
dc.identifier.volume24-
dc.identifier.issue1-
dc.identifier.eissn1745-6215-
dc.identifier.isiWOS:001113383900004-
dc.identifier.issnl1745-6215-

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