E-HEALTH INTERVENTION FOR INTERGENERATIONAL CAREGIVERS OF CHRONICALLY ILL OLDER ADULTS

Abstract

Family-clinician communication is important for chronic disease self-management and improves outcomes for older adults and their family caregivers. In this e-health program based on principles from Social Cognitive Theory, adults assisting a parent with medical appointments and medication management were randomly assigned to one of two internet-based education interventions: (I.) Written didactics and video clips from medical experts, or (II.) Multimedia vignettes depicting actors responding to common healthcare challenges. Participants (N=136) had access to these materials for one month and completed pre- and post-intervention assessments. Post-intervention hierarchical regression analyses showed an intervention effect after controlling for pre-intervention scores. Relative to the didactics comparison group, the vignettes intervention reduced perceptions of caregiving role overload (F change (1, 133) = 4.68, p≤.05). The ethnicity X condition interaction was also significant, with African American caregivers showing stronger reductions in perceptions of role overload in the vignettes condition compared to other caregivers (F change (1, 132) = 4.88, p≤.05). When elders were identified as more physically unhealthy (> 15 days in the past month), caregivers in the vignettes condition reported improved communication with the relative’s health provider. When in the didactics condition, caregivers of comparably ill relatives described post-intervention decreases in effective communication (F change (1, 129) = 3.64, p≤ .05). These data suggest that the intervention holds most promise for caregivers of physically ill/frail elders. In keeping with Social Cognitive Theory, exposure to vignettes showing others successfully overcoming caregiving difficulties led to improved outcomes compared to information presented in didactic formats.