Online Program

Effects of a lifestyle physical activity intervention on family caregivers of persons with dementia: A randomized controlled trial

Monday, November 4, 2013 : 11:06 a.m. - 11:18 a.m.

Caryn Etkin, PhD, MPH, American Joint Replacement Registry, Rosemont, IL
Carol J. Farran, DNSc, RN, FAAN, College of Nursing, Rush University Medical Center, Chicago, IL
Judith J. McCann, PhD, RN, College of Nursing, Rush University Medical Center, Chicago, IL
Amy Eisenstein, PhD, Buehler Center on Aging, Health & Society, Northwestern University Feinberg School of Medicine, Chicago, IL
Kumar Rajan, PhD, Department of Internal Medicine, Rush Medical College, Chicago, IL
Cynthia M. Castro, PhD, School of Medicine, Stanford University, Palo Alto, CA
Abby C. King, PhD, Stanford Prevention Research Center, Stanford University, Stanford, CA
Maryam Navaie, DrPH, Advance Health Solutions, LLC, San Diego, CA
Background: The selfless and honorable actions of over 15 million Americans who provide unpaid care to persons with Alzheimer's disease (AD) benefit care recipients but often result in adverse health consequences for the caregivers themselves. Interventions that support these caregivers have almost exclusively been psychosocial or psychoeducational, with little attention to lifestyle modifications. To address this dearth, we conducted a study to help caregivers increase physical activity as a conduit to maintaining better health and well-being. Methods: A 12-month randomized controlled trial was conducted with N=211 caregivers of persons with AD. Participants received either the Enhanced Physical Activity Intervention (EPAI, n=106) or Caregiver Skill Building Intervention (CSBI, n=105). Interventions were delivered through one home visit at baseline and by telephone at weekly, bi-weekly, then monthly intervals. EPAI promoted physical activity in the context of caregiving whereas CSBI concentrated on dementia care tasks, stress management, and optimizing resource use. Standardized instruments were utilized to measure care burden, physical activity, and mental and emotional health. Assessments were completed at baseline, 3, 6, 9, 12 and 18 months. Results: Adjusted multivariate models revealed that the EPAI group significantly increased their physical activity over time as compared to the CSBI group (p=0.02). Significant baseline correlates of improvement in physical activity were higher care recipient cognition (p=0.01), higher general and physical self-efficacy (p=0.01 and p<0.001, respectively), and having more positive affective emotions (p=0.04). Conclusions: EPAI is an effective intervention that helps family caregivers increase their physical health by adopting and sustaining a more active lifestyle.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related nursing

Learning Objectives:
Evaluate the impact of a lifestyle intervention on improving physical activity among family caregivers of persons with dementia. Demonstrate positive correlates of improvement in physical activity among family caregivers of persons with dementia. Compare the Enhanced Physical Activity Intervention benefits to improving physical health and well-being relative to The Caregiver Skillbuilding Intervention.

Keyword(s): Caregivers, Dementia

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as Project Director for this study from its inception. As such, I trained, supervised and evaluated project personnel; Managed all aspects of data collection; developed quality control procedures and manuals for study operations; oversaw subject recruitment; and directed the preparation of IRB documents, reports, data management requests, and manuscripts.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.