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Table 2 Residential Care Transition Module Intervention Characteristics

From: The Residential Care Transition Module: a single-blinded randomized controlled evaluation of a telehealth support intervention for family caregivers of persons with dementia living in residential long-term care

Dimension

Definition

Options

Delivery Characteristics

  

Mode

Method of contact between interventionist and participant

• Telephone contact with primary caregiver only or including other family members at primary caregiver’s discretion

• Secure web conferencing with primary caregiver only or including other family members at primary caregiver’s

• Email

• Text, if preferred by primary caregiver

• Mail, if preferred by primary caregiver

Materials

Materials used in the delivery of the intervention

• Treatment manual

• Internet resources, including links to websites, videos, and articles

• Printed resource materials for those without internet access

Location

Where the intervention is delivered

• Tele-health: Telephone or secure web conference calls are placed to location of primary caregiver’s preference (often their home; cell phone use is common, so location is frequently varied)

Schedule

Duration and intensity of intervention

• Six intervention sessions within 1st 4 months

• Minutes of contact per session (Duration range: 45–150 min, with an average of 75 min; data current as of 11/18/19)

• Dates of intervention sessions (first three occur weekly, next three occur monthly)

• Number of ad-hoc sessions (varies; range: 0–38 sessions; data current as of 11/18/19)

• Minutes of contact per ad-hoc session (Duration range: 10–120, with an average of 42 min; data current as of 11/18/19)

• Dates of ad-hoc sessions (can occur any time during the participant’s 12 months in the study, i.e., in between intervention sessions as needed as well as after the six intervention sessions have been completed)

Scripting

Level of detail guiding interaction between the interventionist and the participant

• Semi-structured intervention with protocol provided

• Some specific language provided with elaboration encouraged

• Topics specified, but not necessary to discuss. Decision of which topics and when discussed is personalized based on the primary caregiver’s needs and preference

• General guidelines provided

Sensitivity to participant characteristics

Extent to which participant background, experience and abilities are incorporated in the delivery of intervention

• Outside of personalization of session content/topics, language preferences, literacy, visual supplements/augmented communication have not been incorporated (nor requested by participants)

Interventionist characteristics

Qualifications and training, concordance with participant characteristics

• Master’s degree or higher in marriage and family therapy, social work, counseling, or psychology

• Personal or professional experience working with individuals with dementia and their families

• Understanding and experience working with family systems

• Training including: thorough understanding of treatment manual; shadowing of intervention sessions; and holding regular meetings to discuss intervention, available resources, and address questions as they arise for participants

• Competence in tele-health delivery

• Interventionist knowledgeable of cultural views and values of participants

Adaptability

Extent to which intervention can be modified.

• What can be modified

• On what basis modifications are made

• When in the course of the study modifications can be made

What:

• Ad-hoc sessions may be added at any time

• Duration of sessions

• Location

• Mode of delivery

• Content

On what basis:

• Participant request

• Participant availability

• Participant preference

• Clinical judgment

When:

• Any time while enrolled in study

Treatment implementation

Treatment Delivery: Documentation of interventionist compliance to intended treatment and modifications

Treatment Receipt: Extent to which processes are implemented by participant and/or goals are met

Treatment Enactment: Extent to which knowledge and skills acquired during treatment are applied inreal world settings outside of treatment

• Number and duration of sessions

• Content delivered

• Participant completion of review checklist at 4, 8, and 12 months

• Participant self-report during sessions

• Counselor appraisal of participant knowledge, skills, motivation, self-efficacy, and social support/integration via counseling notes

• Semi-structured interviews conducted with purposively sampled primary caregivers at conclusion of participation

Content and Goals

Treatment content strategies

Specific strategies aimed at improving outcomes

• Provision of information

• Didactic instruction

• Skill-Building techniques

• Problem-Solving techniques

• Stress management techniques

• Facilitation of family and social support

• Support provision for guilt and grief

• Effective communication and conflict resolution skills

Mechanisms of action

Key processes, goals, or mediators of desired treatment outcomes

• Increased knowledge of dementia

• Enhanced communication and conflict resolution skills

• Acquisition of problem-solving skills

• Increased prioritization and engagement in self-care

• Increased caregiving self-efficacy

• Increased caregiving competence

• Increased comfort with residential long-term care

• Increased social and family support