Individual and program Characteristics May Drive Variability in Outcomes After Caregivers Participate in a Tailored Support Intervention.
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2022-08
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Critically needed programs designed to support family caregivers have shown inconsistent reductions in stress and burden. To explore drivers of improvement in caregiver outcomes after participation in a support intervention we analyzed data from a one-on-one, tailored problem-solving intervention targeting caregiver wellbeing (2015-2019, n = 503). We explored data patterns across 21 individual, household, and program-level variables using elastic net regression to identify drivers of improvements, and their relative importance. Baseline subjective burden, baseline depressive symptom scores, baseline caregiver problem solving, African American race, and site and coach fixed effects were the most consistent drivers of changes across the explored caregiver outcomes. Caregiver and program characteristics may be promising avenues to target to decrease distress and burden during intervention design. Interventions focusing on highly distressed caregivers may lead to greater improvements. More research is needed to identify how site or interventionists characteristics drive positive intervention effects.
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Shepherd-Banigan, Megan, Kelley A Jones, Caitlin Sullivan, Ke Wang, Amy G Clark, Courtney Van Houtven and Jennifer M Olsen (2022). Individual and program Characteristics May Drive Variability in Outcomes After Caregivers Participate in a Tailored Support Intervention. Journal of applied gerontology : the official journal of the Southern Gerontological Society, 41(8). pp. 1960–1970. 10.1177/07334648221091564 Retrieved from https://hdl.handle.net/10161/26117.
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Megan E Shepherd-Banigan
Dr. Megan Shepherd-Banigan designs research studies to improve the health, emotional well-being, and social functioning of adults with mental and physical disabilities. Her methods combine empirical approaches that address methodologically challenging research questions in health systems and policy research. Dr. Shepherd-Banigan uses large survey and administrative datasets to evaluate the impact of policies that support family members to care for adults with disabilities.
Dr. Shepherd-Banigan won a VA Career Development Award from 2019-2024 and is studying ways to strengthen family support for veterans under-going traumatic stress treatment. She also leads a project that surveys family caregivers of Vietnam-era veterans who might be eligible for expanded support services under the VA Mission Act to evaluate program impacts. As co-investigator on an NIA-funded CARE IDEAS study (Terri Wetle, PI) , she is investigating end-of-life-care planning and well-being among dementia care dyads. Finally, Dr. Shepherd-Banigan is leading a project in partnership with the Rosalynn Carter Institute for Caregivers to identify creative empirically-based approaches to support family caregivers.
Courtney Harold Van Houtven
Dr. Courtney Van Houtven is a Professor in The Department of Population Health Science, Duke University School of Medicine and Duke-Margolis Center for Health Policy. She is also a Research Career Scientist in The Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System. Dr. Van Houtven’s aging and economics research interests encompass long-term care financing, intra-household decision-making, unpaid family and friend care, and home- and community-based services. She examines how family caregiving affects health care utilization, expenditures, health and work outcomes of care recipients and caregivers. She is also interested in understanding how best to support family caregivers to optimize caregiver and care recipient outcomes.
Dr. Van Houtven is co-PI on the QUERI Program Project, “Optimizing Function and Independence”, in which her caregiver skills training program developed as an RCT in VA, now called Caregivers FIRST, has been implemented at 125 VA sites nationally. The team will evaluate how intensification of an implementation strategy changes adoption. She directs the VA-CARES Evaluation Center, which evaluates the VA’s Caregiver Support Program. She leads a mixed methods R01 study as PI from the National Institute on Aging that will assess the value of "home time" for persons living with dementia and their caregivers (RF1 AG072364).
Areas of expertise: Health Services Research and Health Economics
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