December 2018

In This Issue: Advances in Telehealth
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Spanish Telehealth Intervention for Caregivers of Veterans with Stroke

Feature Article

Stroke is major cause of disability and a leading cause of outpatient medical utilization within the VA healthcare system. Non-paid caregivers, particularly family members, are the major sources of support for stroke survivors. Previous research has found that family members, particularly Hispanics, have high rates of depression and burden when their stroke survivors return home. Providing caregivers with culturally-appropriate information, support, and skills has the potential to reduce negative caregiver outcomes and increase the likelihood that stroke survivors remain in the community. Unfortunately, no studies have focused on support interventions specifically for Hispanic caregivers.

This ongoing (2017–2021) HSR&D study is testing the efficacy of a brief telephone and online problem-solving intervention using the Spanish version of the VA RESCUE (Resources & Education for Stroke Caregivers’ Understanding and Empowerment) website (RESCUE En Espanol). The objectives are to:

• Reduce caregiver burden and depression;
• Improve caregivers' problem-solving abilities, self-efficacy, and quality of life;
• Improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare utilization;
• Determine budgetary impact; and
• Determine caregivers' perceptions of the intervention.

The long-term goal is to partner with leaders to implement a culturally relevant, accessible, and cost-effective intervention for caregivers of Veterans post-stroke throughout VA.

Study investigators will conduct a two-arm, randomized controlled clinical trial with 290 Hispanic stroke caregivers who will be randomly assigned to either an intervention or a standard care group. The intervention consists of a problem-solving intervention and information/tools on the previously developed, evidence-based Spanish version of the RESCUE stroke caregiver website to improve stroke caregiver outcomes. The intervention will be conducted via telephone by a trained healthcare professional. Baseline measurements will be conducted with the caregivers prior to the intervention. Post-test assessments will be collected at 1 and 12 weeks post-intervention. In addition, investigators will examine pre- and post-test measures of Veteran-related variables via electronic health records, and interviews will be conducted to assess caregivers' perceptions of the intervention. In addition, investigators will measure the budgetary impact of providing the RESCUE intervention by comparing the costs of the intervention group to the costs of the control group.

Findings: To be determined.

Impact:
This study addresses the need for culturally appropriate health information for an under-studied population—Spanish-speaking Hispanic caregivers—by providing education and support and, ultimately, helping to reduce stroke caregiver depression and burden.

Principal Investigator: Ivette Magaly (Maggie) Freytes, PhD, MEd, is part of the North Florida/South Georgia Veterans Health System in Gainesville, FL.

Publications: None at this time.

View project abstract.