Virtual Health Coach for Caregiver Stress

(iCare4Me T Trial)

Recruiting at 2 trial locations

Overseen By Aderike Adesanya, MPH

Age: 18+

Sex: Any

Trial Phase: Phase 3

Sponsor: University of Pennsylvania

Disqualifiers: Cognitive deficits, Untreated psychiatric illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Pivotal Trial (Near Approval) This treatment is in the last trial phase before FDA approval

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 11

250 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, it mentions that using anti-anxiety or anti-depressant medicines is acceptable.

What data supports the effectiveness of the treatment Virtual Health Coach for You, iCare4Me, Virtual Caregiver Coach for You?

Research shows that virtual health coaching and internet-based interventions can effectively reduce caregiver stress and improve their quality of life. Studies have found that caregivers using telehealth tools report significant improvements in their outcomes and are generally satisfied with these interventions. ^{1 2 3 4 5}

How is the Virtual Health Coach for You treatment different from other treatments for caregiver stress?

The Virtual Health Coach for You is unique because it provides a personalized, internet-based program that offers stress management training specifically for caregivers, making it more accessible and tailored compared to traditional in-person therapies. ^{6 7 8 9 10}

What is the purpose of this trial?

The goal of this randomized controlled trial is to examine the effect of a virtual face-to-face health coach intervention to improve self-care among caregivers of hospitalized older adults during care transitions compared to web-based resource information alone to determine the effectiveness of each intervention. The main questions it aims to answer are: 1. compare the efficacy of the virtual health coaching intervention vs. web-based information alone in improving self-care in caregivers of hospitalized community-dwelling older adults with multiple chronic conditions (MCCs) who transition from hospital to home, 2. compare outcomes among Black/African American and White caregivers who receive the intervention vs. digital health information alone, and 3. explore the estimated the cost of the interventions and acute care resource use among patients of caregivers who received virtual intervention vs. digital health information alone. Participants who enroll will agree to enroll will: * be randomly assigned to either the health information group or the health coaching intervention plus health information group for six months, and * be asked to complete a baseline interview, a check-in call at one month post-hospital discharge, and two follow-up interviews at 3- and 6-months after enrollment. Researchers will compare the two groups of caregivers on the following outcomes: self-care, caregiver self-efficacy (aka confidence), coping, stress, and health status.

Research Team

Karen Hirschman, Ph.D.

Principal Investigator

University of Pennsylvia

Eligibility Criteria

This trial is for caregivers aged 18+ who provide at least 8 hours of weekly care to hospitalized adults over 65, have poor self-care habits, are willing and able to use technology, and speak English. Those with cognitive deficits, enrolled in similar trials, or with untreated major psychiatric illnesses cannot participate.

Inclusion Criteria

Willing to use technology (e.g., computer, smartphone, iPad/tablet)

Able to complete the protocol, e.g., adequate vision and hearing

English speaking

Exclusion Criteria

I have no untreated major mental health conditions.

Participation in another similar support or care transition trial

Cognitive deficits in orientation and/or recall (Six Item Screener score less than 3)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants are randomly assigned to either the digital health information group or the virtual health coaching plus digital health information group for six months

6 months

10 virtual health coaching sessions for the intervention group

Follow-up

Participants are monitored for outcomes such as self-care, caregiver self-efficacy, coping, stress, and health status

6 months

Baseline interview, check-in call at 1 month, follow-up interviews at 3 and 6 months

Treatment Details

Interventions

• Virtual Health Coach for You

Trial Overview The study compares a virtual health coach intervention against web-based health information alone for improving self-care among caregivers of older adults transitioning from hospital to home. It will also assess the interventions' cost-effectiveness and impact on caregiver stress and confidence.

Participant Groups

Group I: Virtual Health Coaching + DHI Experimental Treatment 2 Interventions

Study participants in the intervention group will receive 10-session virtual health coaching intervention sessions delivered over 6 months.

Group II: Digital Health Information (DHI) Active Control 1 Intervention

Digital health information is delivered through a website tailored with care transitions and self-care information for all participants over the 6-month study.

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

This case report highlights the successful use of health and wellness coaching (HWC) for a 44-year-old woman caring for a cancer patient, showing potential benefits in managing her physical health issues like hypertension and high cholesterol over a 1-year period.

The intervention, consisting of 10 sessions, addressed various health components and demonstrated that HWC can lead to positive physical and psychosocial outcomes for cancer caregivers, suggesting it as a valuable support option for this group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Health and Wellness Coaching With an Adult Cancer Caregiver. Smith, K., Hays, L., Yen, L., et al.[2022]

A pilot study showed that a Virtual Mindfulness Coach is more effective than self-administered training in helping students establish a regular mindfulness practice, indicating its potential for enhancing patient education and behavior change.

Participants using the virtual coach reported higher self-efficacy and were in more advanced stages of change according to the transtheoretical model, suggesting that the interactive and adaptive features of the coach contribute significantly to its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual training and coaching of health behavior: example from mindfulness meditation training. Hudlicka, E.[2022]

A systematic review of 24 trials (8 open-label and 16 randomized) found that internet-based interventions can effectively reduce caregiver stress, with 6 out of 16 randomized trials showing positive benefits.

While many interventions were effective, there was no consistent pattern in study variables that predicted better outcomes, indicating a need for further research to optimize these interventions for caregivers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing caregiver stress with internet-based interventions: a systematic review of open-label and randomized controlled trials. Hu, C., Kung, S., Rummans, TA., et al.[2022]

A systematic review of 65 studies on telehealth interventions for family caregivers found that over 95% reported significant improvements in caregiver outcomes, indicating high efficacy of these interventions.

Caregivers expressed satisfaction and comfort with telehealth technologies, which included various methods like video and telephone, suggesting that telehealth can effectively support chronic disease management and home care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of telehealth tools and interventions to support family caregivers. Chi, NC., Demiris, G.[2018]

A pilot study involving 23 family caregivers showed that an internet-based psychological intervention significantly reduced care-associated stress, anxiety, and depressive symptoms after treatment.

Participants also experienced a notable increase in self-efficacy, suggesting that this online intervention is effective in helping caregivers manage their psychological stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[An internet-based intervention for health promotion in family caregivers--results of a pilot study]. Böttche, M., Klasen, M., Knaevelsrud, C.[2018]

The iCare Stress Management e-Training Program significantly reduced perceived stress among dementia family caregivers compared to an Education/Information-Only condition, indicating its potential efficacy in stress management.

Despite the positive results, the study faced a high dropout rate of about one-third of participants, highlighting the need for strategies to enhance engagement and retention in future interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the effectiveness of an internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program. Kajiyama, B., Thompson, LW., Eto-Iwase, T., et al.[2022]

A pilot study involving 64 family caregivers of frail older adults showed that an 8-week social media-based mind-body intervention, which included mindfulness meditation and self-administered acupressure, significantly reduced caregiver stress and improved sleep quality and mindfulness awareness compared to a control group.

The intervention demonstrated high feasibility with an 87.5% attendance rate and low attrition (1.6%), indicating that it is a practical and engaging option for caregivers, although it did not significantly reduce caregiver burden.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a Social Media-Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial. Sui, Y., Kor, PPK., Li, M., et al.[2023]

Home-based caregivers of individuals with dementia experience significant stress primarily due to challenges in medication management, memory loss, hygiene care, and disruptive behaviors, highlighting the need for targeted support.

Professional caregivers have better access to resources and technology, which could be beneficial if adapted for home-based caregivers, but any new technology must be designed with a focus on the human experience to effectively support both caregivers and those with dementia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stress in the Volunteer Caregiver: Human-Centric Technology Can Support Both Caregivers and People with Dementia. Huelat, B., Pochron, ST.[2021]

The Interprofessional Virtual Healthcare Neighborhood (VHN) provided support and resources to caregivers of individuals with dementia, but it did not significantly improve sleep quality or quantity for participants, as measured by actigraphy.

While insomnia severity decreased for both the VHN and usual care groups, self-efficacy remained stable for the VHN group, contrasting with a decline in the comparison group, highlighting the potential benefits of the VHN in maintaining caregiver confidence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Interprofessional Virtual Healthcare Neighborhood: Effect on Self-Efficacy and Sleep Among Caregivers of Older Adults With Dementia. Fowler, CN., Kott, K., Wicks, MN., et al.[2018]

The 'Partner in Balance' (PiB) program, which combines face-to-face coaching with online modules, was well-received by both caregivers and coaches, with a participation rate of 51.9% among eligible caregivers, indicating its potential effectiveness in supporting early-stage dementia caregivers.

Despite overall satisfaction, challenges such as recruitment barriers and the need for tailored content for specific subgroups, like younger caregivers, were identified, suggesting that further adaptation and awareness of blended care programs are necessary for successful implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of the Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Process Evaluation of a Randomized Controlled Trial. Boots, LM., de Vugt, ME., Smeets, CM., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effects of Health and Wellness Coaching With an Adult Cancer Caregiver. [2022]

2. Ireland pubmed.ncbi.nlm.nih.gov

Virtual training and coaching of health behavior: example from mindfulness meditation training. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Reducing caregiver stress with internet-based interventions: a systematic review of open-label and randomized controlled trials. [2022]

4. England pubmed.ncbi.nlm.nih.gov

A systematic review of telehealth tools and interventions to support family caregivers. [2018]

5. Germany pubmed.ncbi.nlm.nih.gov

[An internet-based intervention for health promotion in family caregivers--results of a pilot study]. [2018]

6. England pubmed.ncbi.nlm.nih.gov

Exploring the effectiveness of an internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program. [2022]

7. Canada pubmed.ncbi.nlm.nih.gov

Effects of a Social Media-Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial. [2023]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Stress in the Volunteer Caregiver: Human-Centric Technology Can Support Both Caregivers and People with Dementia. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

An Interprofessional Virtual Healthcare Neighborhood: Effect on Self-Efficacy and Sleep Among Caregivers of Older Adults With Dementia. [2018]

10. Canada pubmed.ncbi.nlm.nih.gov

Implementation of the Blended Care Self-Management Program for Caregivers of People With Early-Stage Dementia (Partner in Balance): Process Evaluation of a Randomized Controlled Trial. [2022]