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Home > "E" Clinical Trials Conditions > Effectiveness of a Health Education Program in a Primary Care Setting  Effectiveness of a Health Education Program in a Primary Care Setting
Effectiveness of a Health Education Program in a Primary Care Setting
For Condition: Caregivers,Aging,Frail Elderly
Status: Completed
Sponsor(s): Department of Veterans Affairs , Department of Veterans Affairs Health Services Research and Development Service
Synopsis: The population of older adults is increasing more rapidly than any other segment of the population and, with increasing age, health care utilization and costs increase dramatically. The study is designed to assess the short-term and long-term effectiveness of a Health Education Program (HEP) for improving the well-being and reducing the health care utilization and cost of care of frail elderly outpatients, and for improving the well-being of their spouse caregivers. HEP will be tested using a 2x4x3x2x2 randomized control group design (2 conditions, 4 times of measurement, 3 sites, 2 leaders, 2 levels of illness severity). Ninety-six spouse caregivers will be randomized at each site, 48 to usual care (UC) and 48 to six eight-member HEP groups, for a total of 288 spouse caregivers. HEP is a multi-component group program for spouse caregivers that includes emotion-focused and problem-focused coping strategies, and social support. It will be implemented in eight weekly two hour group sessions, and ten monthly two hour follow-up sessions. HEP is being implemented in VAMCs in Albany, Buffalo and Canandaigua, NY. After screening, both caregivers and care recipients will be assessed within two weeks prior to the start of the intervention program, within two weeks after the eighth group meeting, and again one and two years after the baseline interview on the following domains: health and functional status, emotional well-being, and social support. Also, caregivers will be assessed for change in burden level, pressing problems, and knowledge and use of community resources, and care recipients will be assessed for level of cognitive impairment. Demographic data will be collected on caregivers and care recipients at baseline. The effect of HEP on the health care utilization and health care costs of care recipients will be investigated by examining changes from baseline to one and two years in outpatient, inpatient, and total costs. VA databases and Medicare files will be used to collect data about survival, utilization, and cost variables. Outpatient utilization variables include: primary care, medical, surgical, emergency department and home care visits. Inpatient utilization data include: number of admissions, (acute and long-term care), bed days of care for each level. Cost variables include: total outpatient, inpatient, and total health care costs. Most utilization and cost of care data will be obtained from VA but some non-VA utilization data will be collected from Medicare, and from subjects using weekly post card dairies. Data will be analyzed using Repeated Measures MANOVA, Random Regression, and other statistical procedures. A cost effectiveness analysis will also be performed.
Details:
Eligibility:
Study Type: Interventional, Educational/Counseling/Training, Randomized, Open Label, Active Control, Factorial Assignment
Minimum Age/Maximum Age: 55 Years/
Genders: Both
Protocol Entry Criteria: 1) married to, and living with, the care recipient; 2) age 55 or older; 3) being the primary care provider for the care recipient and reporting at least a moderate level of burden on The Caregiver Strain Index; 4) reporting that their spouse is in "fair", "poor", or "very" poor health and has at least one chronic health problem; and 5) not participating in any other individual or group program for caregivers. Criteria for inclusion of care recipients in the study include 1) age 55 or older; 2) suffering from one or more chronic health problems; and 3) VA medical center outpatients for at least one year.
Total Enrollment: 288
Location and Contact Information:
VA Medical Center
Canandaigua, New York, 14424
United States
VA Health Care Network Upstate New York
Albany, New York, 12208
United States
Additional Information:
Study ID Numbers: IIR 95-118;
Study Start Date: October 1998
Record last reviewed: November 2000
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00012779
Other Aging Studies:
1. The Effect of Testosterone Supplementation on Rehabilitation Outcomes
2. Effects of Functional Incidental Training in VA NHCU Residents
3. Safe-Grip Fall/Injuries Intervention: A Randomized Trial
4. Rehabilitation for Older Adults From Acute Medical Conditions
5. Comparison of Subacute and Hospital Based Rehabilitation Care
Related Studies:
Other Aging Clinical Trials
Other New York Clinical Trials
Other Albany Clinical Trials
Effectiveness of a Health Education Program in a Primary Care Setting
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