iSupport, an online training and support program for caregivers of people with dementia: study protocol for a randomized controlled trial in India

• Published in: Current controlled trials in cardiovascular medicine Vol. 19; no. 1; p. 271
• Main Authors: Mehta, Kala M, Gallagher-Thompson, Dolores, Varghese, Mathew, Loganathan, Santosh, Baruah, Upasana, Seeher, Katrin, Zandi, Diana, Dua, Tarun, Pot, Anne Margriet
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.05.2018; BioMed Central; BMC
• Subjects: Alzheimer's disease; Anxiety; Care and treatment; Caregivers; Caregivers - education; Caregivers - psychology; Cognitive Behavioral Therapy; Dementia; Dementia - therapy; Economic aspects; High income; Humans; Industrialized nations; Internet; Internet access; Mental depression; Mental health; Methods; Older people; Online education; Online instruction; Outcome Assessment, Health Care; Patient-centered care; Practice; Problem Solving; Psychological aspects; Quality of Life; Randomized Controlled Trials as Topic; Self help; Self-Help Groups; Social aspects; Social networks; Study Protocol; Support groups; Training; India
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-018-2604-9

Dementia has a huge physical, psychological, social and economic impact upon caregivers, families and societies at large. There has been a growing impetus to utilize Internet interventions given the potential scalability, and presumed cost-effectiveness and accessibility. In this paper, we describe the design of a randomized controlled trial (RCT) aiming to study the impact of online self-help programs on caregivers of people with dementia in India. The experimental group will receive an interactive training and support program and the comparison group will receive an education-only e-book. It will be among the first online support intervention RCTs for a mental health condition in a lower-middle income country. Two hundred and eight participants are expected to be recruited via several strategies (email, Internet and social media, telephone and face-to-face) starting in the Bangalore region of India. The inclusion criteria for participation in the trial are: (1) being 18 years or older, (2) being a self-reported caregiver of a person with dementia, (3) self-report that a family member has a diagnosis of dementia (AD8 ≥ 2), and experience caregiver distress (≥ 4 on a 1-item burden scale ranging from 1 to 10 or ≥ 4 or < 20 on the Center for Epidemiologic Study-Depression (CES-D) scale (10-item) or ≥ 4 or < 15 on the Generalized Anxiety Disorder Scale (7-item). The intervention group will be offered iSupport, an online self-help training and support program, enabling a personalized education plan with a maximum of 23 lessons. These modules present a range of topics from "what is dementia?" to "dealing with challenging behaviors like aggression." The comparison group will receive an education-only e-book containing similar content. The outcomes of this trial are: caregiver burden as measured by the 22-item Zarit Burden Scale, depressive symptoms, anxiety symptoms (primary outcomes), quality of life, person-centered attitude, self-efficacy and mastery (secondary outcomes). Based on the findings of this trial, we will examine the potential use and scale up of iSupport for caregiver distress in India. This style of online self-help programs could be expanded to other regions or countries or to other suitable caregiver groups. Clinical Trials Registry-India (CTRI), ID: CTRI/2017/02/007876 .