Virtual Coaching to Maximize Dementia Caregivers' Respite Time-Use: A Stage 1 Pilot Test for Feasibility and Efficacy

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Respite, defined as time away from caregiving, has been identified as the most needed and desired service for family caregivers, especially the 16 million dementia caregivers who are faced with long term and demanding caregiving circumstances. Findings on the effectiveness of respite services have been mixed -- how caregivers spend their respite time seems to be a key factor behind these inconsistent findings. We have developed a novel intervention called “Time for Living & Caring” (TLC) that shows promise in improving respite time-use and maintaining caregiver wellbeing. However, it relies on trained facilitators and up to 15-20 individual home visits or phone calls with each caregiver, limiting its scalability to real world practice. The purpose of this study is to redevelop the TLC intervention, in which AD/ADRD caregivers are taught strategies to assess and identify ways to spend upcoming periods of respite time, to a fully online, self-administered virtual coaching format, and then to pilot-test the new TLC intervention for feasibility and efficacy. Aim 1 is to modify, adapt, and refine the existing intervention modules. This phase of the project utilizes a community- engaged design process where stakeholders (i.e., current or former caregivers, diverse community leaders, respite providers) will work alongside the research, technical, and creative teams to develop and provide feedback on the TLC design, features, and prototypes. Aim 2 is to conduct a pilot test with dementia caregivers who are currently using respite. This phase uses a full powered pilot sample (n=120) and a randomized waitlist control experimental design where participants are exposed to the redeveloped TLC intervention for 8 weeks and will provide assessments of daily respite use, respite time-use satisfaction, and wellbeing. These pilot data will be used to assess feasibility and to explore hypotheses regarding the potential efficacy of the intervention, as well as the mechanism (i.e., time-use satisfaction) underlying the intervention's effect on wellbeing. Wellbeing is measured with two primary outcome of anxiety and caregiver burden, both thought to be closely related and responsive to intervention's purpose. Aim 3 is intended to explore future implementation of the redeveloped TLC intervention with respite providers. This provides yet another layer of the tool's feasibility. We will host webinars to demonstrate the features and functionality of the TLC intervention as well as to preview pilot study results from Aim 2, then ask providers for feedback on their likelihood of implementation and barriers to using TLC with their clients. Together, these three aims represent a comprehensive approach to Stage 1 research activities, with the overall goal of developing an intervention that is scalable to real world applications. Throughout all stages of the proposed project, our team is committed to community-engaged research practices, where community partners will provide input and connect us with potential research participants. Given this pragmatic yet scientifically rigorous approach, the results have the potential to guide and accelerate the eventual implementation of the TLC intervention to community and health care practice.