COVID-19 Silver Linings - Experience of Spousal Caregivers of Persons with Dementia Engaged in Support Program

Caring for a person with dementia (PWD) has been consistently associated with negative effects on health, including increases in caregiver depression, anxiety, and burden. Emerging studies have shown that the COVID-19 pandemic has increased these factors due to reported increases in caregiver workload and cognitive and behavioral symptoms of the PWD. We interviewed 10 spousal caregivers of PWD from the NYU Langone Alzheimer’s Disease and Related Dementias Family Support Program in Summer 2020 during the COVID-19 pandemic in order to gain feedback about their experiences during the pandemic and the transition from in-person to videoconferencing that could be used to improve services and support. Caregivers discussed the challenges faced during the pandemic but also the unique opportunities the situation presented. We report here on those positive aspects of COVID-19 from the perspective of the caregivers we interviewed. Methods Interviews of caregivers residing with their spouses in the New York City area were conducted via videoconferencing, transcribed, deidentified, and analyzed using framework analysis methods. Results We found that caregivers reported some positive reaction to videoconferencing that included increased support group cohesion, increased convenience, feeling less obligated to participate in events, and new opportunities for social contact. Participants also discussed positive inter-couple relationship changes such as increased quality time spent together. Our findings resonate with a body of literature focused on understanding the positive aspects of caregiving. Understanding the full presentation of the caregiver experience, including both positive and negative aspects, is important for developing interventions and resources for this unique group.

IMplementation and evaluation of the school-based family support PRogram a Healthy School Start to promote child health and prevent OVErweight and obesity (IMPROVE) – study protocol for a cluster-randomized trial

Background IMPROVE aims to conduct a hybrid type 3 evaluation design to test the effectiveness of bundled implementation strategies on intervention fidelity of the Healthy School Start (HSS) program, while simultaneously monitoring effects on health outcomes of children and parents. The HSS is a 4-component family support program for children starting school (5–7 years of age) promoting healthy dietary habits and physical activity in the home environment to prevent childhood obesity and parents’ risk of developing type 2 diabetes. Methods IMPROVE is a cluster-randomized controlled trial with two arms to evaluate and compare the effects of two different bundles of implementation strategies on intervention fidelity expressed as adherence and responsiveness at 12 and 24 months (primary outcomes). Thirty schools in two municipalities will participate in the study reaching about 1400 families per school year. In stakeholder workshops, key implementation determinants were identified according to the domains of the Consolidated Framework for Implementation Research. Through a consensus process with stakeholders, two bundles of implementation strategies were tailored to address context-specific determinants. Schools randomly assigned to group 1 will receive bundle 1 (Basic) and group 2 will receive bundle 1 + 2 (Enhanced). Bundle 2 consists of external facilitation, fidelity monitoring and feedback strategies. Secondary outcomes will include change in acceptability, appropriateness, feasibility, and organisational readiness as perceived by school staff. In addition, child weight status and diet, and parents’ feeding practices and risk of type 2 diabetes will be monitored. Linear and ordinal regression analysis will be used to test the effect on the primary and secondary outcomes, taking clustering and covariates into consideration where needed. Process evaluation will be conducted through key stakeholder interviews to investigate experiences of the program and perceptions on sustainability. Discussion This systematic approach to investigating the effectiveness of two different bundles of implementation strategies tailored to context-specific determinants on the fidelity of the HSS intervention will provide new insight into feasible implementation strategies and external support needed for the HSS to be effective and sustainable. Results will help inform how to bridge the gap between the research on school-based health programs and routine practice in schools. Trial registration Registered prospectively at ClinicalTrials.gov ID: NCT04984421, registered July 30, 2021

Familias multiproblemáticas y el programa de apoyo a familias en Soria

El siguiente artículo es un estudio de las familias multiproblemáticas a través de una investigación con familias usuarias del Programa de Apoyo a Familias. En él se analizan una serie de características que hemos considerado importantes para entender este tipo de familias y la causa de muchos de los problemas a los que se enfrentan. Se prende con esto, llegar a entenderlas mejor y conseguir resultados más positivos en intervenciones sociales que se realicen con ellas.The following article is a study of multi-problem families through an investigation with families which are users of the Family Support Program. The article analyzes a series of characteristics which we have considered important in order to understand this type of families as well as the cause of many of the problems they face.The aim of this article is to understand them better and reach more positive results in social interventions that are carried out with them.

THE BUDDY PROGRAM: IMPACT ON PERSONS LIVING WITH DEMENTIA AND FAMILY CAREGIVERS

Psychosocial interventions have the potential to offer substantial benefit to people with dementia and their family caregivers. The Buddy Program is an experiential learning program that pairs students with persons with dementia for activities and relationship-building. Previous studies have demonstrated the program’s positive impact on student knowledge and attitudes. New York University’s (NYU) Alzheimer’s Family Support Program began replicating the Buddy Program in 2017 and has enrolled 80 students. Northwestern University’s (NU) Buddy Program, in its 22nd year, has enrolled 260. This presentation describes the impact of the program on the mentors (NU) and the caregivers (NYU). Post program focus groups with mentors and student journals describing interactions with the caregiver were thematically analyzed. Mentors describe feelings of pride in the mentorship role, enjoyment being with student, and the opportunity to develop a new friendship. Caregivers enjoyed the respite provided by the buddies, knowing that their relatives with dementia were enjoying themselves and seeing their relatives with dementia in the role of valued companion. Qualitative data from caregivers and mentors participating in the buddy programs at NU and NYU underscore the possibility that people with dementia can still make contributions to society. The buddy program has a positive impact on quality of life for persons living with dementia and their family members, while providing a valuable educational experience for students. Further research on the buddy program’s benefits is warranted.