Taking Care of Us: A Dyadic Intervention for Heart Failure

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Heart failure (HF) is a major public health problem affecting 6.5 million Americans and is the most common reason for hospitalization and rehospitalization among older adults. Although there is evidence that clinical and patient-oriented HF outcomes are improved with effective self-care, engagement in self-care is generally poor among adults with HF. Family care partners (e.g., spouses, adult-children) make substantial contributions to the management of HF, but frequently at the expense of their own physical and mental health and significant care- related strain. The majority of non-pharmacologic HF management interventions involve patient education and behavioral counseling, with limited evidence of success. Family-based interventions have been shown to be more successful in the broad illness context, but within HF results have been mixed and few family-based interventions have included care partner outcomes. Thus, there is a critical need for theoretically- and empirically-driven dyadic interventions to improve the outcomes of both HF patients and their care partners. The proposed study will evaluate a novel, dyadic HF program, Taking Care of Us, versus an educational counseling control condition using a randomized controlled trial on 72 HF care dyads. Specifically, we will 1) determine the efficacy of the Taking Care of Us intervention on dyadic health; 2) determine the efficacy of the Taking Care of Us intervention on dyadic appraisal and dyadic management; and 3) determine the feasibility and acceptability of the Taking Care of Us intervention. The proposed dyadic intervention will be one of the first to target the outcomes of both the HF patient and their care partner simultaneously through a team-based approach centered on collaboration, communication and confidence. Results of this study will provide vital information to move us closer to translating successful programs into clinical practice and shed important light on whether, for whom, and how the Taking Care of Us program benefits both members of the HF care dyad.