Randomized controlled trial of a facilitated online positive emotion regulation intervention for dementia caregivers

Contact Information

Keywords

Judith T Moskowitz，

caregivers, stress, randomized controlled trial, positive emotion, patient reported outcomes

Abstract

Objective: To test the effects of Life Enhancing Activities for Family Caregivers (LEAF), a 6-week positive emotion regulation intervention, on outcomes of positive emotion, depression, anxiety, and physical health as measured by the Patient-Reported Outcomes Measurement Information System® (PROMIS®). Method: A randomized controlled trial (N = 170) comparing LEAF (N = 86) to an emotion reporting/waitlist condition (N = 84) in dementia caregivers. LEAF was individually delivered online by trained facilitators. Participants in the control condition completed daily online emotion reports and then crossed over into the intervention condition after 6 weeks. The study was registered with Clinicaltrials.gov (NCT01825681) and funded by R01NR014435. Results: Analyses of difference in change from baseline to 6 weeks demonstrated significantly greater decreases in PROMIS® depression (d = -.25; p = .02) and Quality of Life in Neurological Disorders (NeuroQOL) anxiety (d = -.33; p < .01), as well as improvements in PROMIS® physical health (d = .24; p = .02) in the intervention condition compared to the emotion reporting/waitlist control. The intervention also showed greater improvements in positive emotion (d = .58; p < .01) and positive aspects of caregiving (d = .36; p < .01). Increases in positive emotion significantly mediated the effect of LEAF on depression over time. Conclusions: This randomized controlled trial of the online-facilitated positive emotion regulation intervention in dementia caregivers demonstrated small to medium effect sizes on caregiver well-being and shows promise for remotely delivered programs to improve psychological well-being in caregivers of people with dementia and other chronic illnesses. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Citation

Moskowitz, J. T., Cheung, E. O., Snowberg, K. E., Verstaen, A., Merrilees, J., Salsman, J. M., & Dowling, G. A. (2019). Randomized controlled trial of a facilitated online positive emotion regulation intervention for dementia caregivers. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 38(5), 391–402. https://doi.org/10.1037/hea0000680

DOI

10.1037/hea0000680

EWB Constructs:

(3) positive affect; (4) quality of life;

EWB Measures:

(1) Differential Emotions Scale.
(2) Quality of Life in Neurological Disorders measurement system

data availability:

data availability details:

N/A

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

Exclusion criteria were active psychosis or significant cognitive impairment as evidenced in the screening phone call.

Inclusion Criteria

(1) be a primary family caregiver of a person diagnosed with a degenerative dementia condition,
(2) live with the care recipient or visit daily,
(3) be able to speak and read English,
(4) have reliable WiFi Internet at home or access from another location (e.g., a library) convenient for them.

Non-EWB Behavioral
Measures:

(1) Patient-reported Outcomes Measurements Information System
(2) Caregiver burden, strain, and positive aspects of caregiving:The Zarit Burden Interview
(3) Global health: Global Health Scale
(4) Dementia Severity Rating Scale
(5) Positive aspects of caregiving
(6) Perceived Stress Scale

First author:

Judith T Moskowitz

species:

Human

sample size:

170

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

Facilitated Online Positive Emotion Regulation Intervention

study population:

(1) cognitively healthy adults

sex (% female):

84.10%

ethnicity (%white)

88.2%(US)

Age (mean, sd):

62.91, 9.69

biological/Physiological Measures:

N/A