Online Program

Effectiveness of Circulo de Cuidado-a cognitive behavioral group intervention for Latino Alzheimer's families: A randomized controlled trial

Monday, November 4, 2013

Judith Gonyea, PhD, School of Social Work, Boston University, Boston, MA
By 2050, Alzheimer's disease (AD) rates among U.S. Latinos are projected to increase 6-fold, from 200,000 to 1.3 million. Yet, there is evidence that many Latino elders are not receiving services to reduce their risk or manage their dementia. We sought to address this gap through the development and testing of Circulo de Cuidado, a Spanish-language, culturally-sensitive approach which uses a cognitive behavioral framework to teach caregivers how to manage neuropsychiatric symptoms. Using a randomized controlled design, caregivers were assigned to 1 of 2 study arms: cognitive behavioral (CBT) experimental condition or psycho-educational (PE) control condition. The 2 conditions' structures were identical; 5-weekly, 90-minute group sessions followed by booster telephone calls at 3-, 6-, 9- and 12-weeks. However, the objectives and content differed; the CBT group taught the principles and skills of behavioral change through individualized exercises while the PE group provided information on topics such as disease stages and community resources. Participants were interviewed at baseline, post-intervention and 3-month follow-up on targeted outcomes. Repeated measures ANOVA was used; predictor variables were condition (experimental, control) and time (baseline, post-test, 3-month follow-up). We considered the condition x time interaction effects to be most important because we hypothesized significantly different changes over time in outcomes for participants in the two arms of the study. Results revealed statistically significant differences for condition by time interactions for AD relative's neuropsychiatric impairment (p<.05), caregiver neuropsychiatric symptom distress (p<.001), caregiver self-efficacy (p<.001), and depression (p<.01). No significant interactive effect was found, however, for caregiver anxiety (p>.05).

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Evaluate the effectiveness of a culturally sensitive, theoretically driven targeted cognitive behavioral intervention to reduce caregiver distress and increase caregiver self-efficacy among Latino families coping with Alzhimer's disease.

Keyword(s): Aging, Latino

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am professor and chair of the social research department at the Boston University School of Social Work. I have over 100 publications (journal articles, book chapters and books) in the field of aging. For over three decades, I have been the PI or co-PI on externally-funded research projects, most focused on vulnerable and marginalized older adults. I am a fellow in the Gerontological Society of America.
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.