Enhancing American Indian Caregiver Mastery through a Savvy Caregiver Peer Program

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Enhancing American Indian Caregiver Mastery through a Savvy Caregiver Program-Peer addresses the growing number of American Indian caregivers with limited knowledge of dementia. The high level of burden associated with providing care for those with dementia, along with uncertainty about managing disease conditions, problems with different psychosocial aspects of care, lack of culturally responsive training and education materials results in caregivers reporting feelings of isolation and depression. Despite the unique needs of American Indian caregivers, few resources support this group in a culturally appropriate way. The Savvy Caregiver Program is a multi-component, psychoeducational program consisting of 6 weekly 2-hour sessions for family caregivers of people living with dementia at home. Informed by Stress Mediation and Social Cognitive Theories, the Savvy Caregiver Program was developed to alleviate caregiving strains and strengthen knowledge, skills, and outlook through classes, interactive exercises, and home assignments. This study will use a community-based participatory research framework to enhance the Savvy Caregiver Program by adding a peer-based educational and support component, referred to as the Savvy Caregiver Peer Program, that incorporates Stress Mediation and Generativity Theories. Six sequential talking circles will be held with 5-8 previous American Indian dementia caregivers who are enrolled members of White Earth Nation (Aim 1) to develop the Savvy Caregiver Peer Program prototype. Participants will review the Savvy Caregiver Program curriculum and discuss the roles and expectations of peer mentors in the program, including peer selection, training, and a management structure to oversee peer mentors and caregiver engagement. The 6 planning and design talking circles will gather strategic, culturally appropriate information to (1) provide the peer mentors with an opportunity to directly define their role and expectations as part of the Savvy Caregiver Peer Program; (2) educate peers on the Savvy Caregiver Program core elements and their role in supporting the materials; and (3) gather insights about the peer mentor material to be provided to the caregiver. Upon completion of the sequential talking circles and development of the Savvy Caregiver Program-Peer training materials and infrastructure, a parallel arm randomized clinical trial of 30 caregivers (20 to intervention, 10 to control group) will be conducted for 12 weeks (6 biweekly sessions) (Aim 2). Qualitative and quantitative data from peer mentors and caregivers will be collected to assess the feasibility and acceptability of recruitment, randomization, intervention adherence, and administration of caregiver measures. During Year 4 (Aim 3), we will host talking circles to engage caregivers and peer mentors in the refinement and improvement of the Savvy Caregiver Program-Peer in preparation for testing in a larger, subsequent randomized clinical trial. This study will contribute cultural and contextual knowledge to inform the eventual development of caregiver interventions grounded in cultural values to improve the quality of life and outcomes for American Indian dementia caregivers.