Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1
Belle, S. H., Burgio, L., Burns, R., Coon, D., Czaja, S. J., Gallagher-Thompson, D., et al. (2006). Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: A randomized, controlled trial. Annals of Internal Medicine, 145, 727-738. 
Supplementary Materials
Belle, S. H., Czaja, S. J., Schulz, R., Zhang, S., Burgio, L. D., Gitlin, L. N., et al. (2003). Using a new taxonomy to combine the uncombinable: Integrating results across diverse interventions. Psychology and Aging, 18(3), 396-405.
Burgio, L., Corcoran, M., Lichstein, K. L., Nichols, L., Czaja, S., Gallagher-Thompson, D., et al. (2001). Judging outcomes in psychosocial interventions for dementia caregivers: The problem of treatment implementation. The Gerontologist, 41(4), 481-489.
Czaja, S. J., Schulz, R., Belle, S. H., Burgio, L. D., Armstrong, N., Gitlin, L. N., et al. (2006). Data and safety monitoring in social behavioral intervention trials: The REACH II experience. Clinical Trials, 3, 107-118.
Gitlin, L. N., Belle, S. H., Burgio, L. D., Czaja, S. J., Mahoney, D., Gallagher-Thompson, D., et al. (2003). Effect of multicomponent interventions on caregiver burden and depression: The REACH multisite initiative at 6-month follow-up. Psychology and Aging, 18(3), 361-374.
List of additional references for outcome measures
Nichols, L. O., Chang, C., Lummus, A., Burns, R., Martindale-Adams, J., Graney, M. J., et al. (n.d.). The cost effectiveness of a behavior intervention with caregivers of Alzheimer's patients. Manuscript in progress.
REACH Coordinating Center (2004, July). REACH II data reports. University of Pittsburgh Epidemiology Data Center.
Schulz, R. (2006). Continuation report on REACH II trial. Grant report submitted to the National Institutes of Health.
Schulz, R. (2006). Progress report on REACH II trial. Grant report submitted to the National Institutes of Health.
Outcomes
| Outcome 1: Caregiver quality of life |
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Description of Measures
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Caregiver quality of life was assessed by the standardized differences between baseline and 6-month follow-up for five measures:
- Depression--measured by self-report on the 10-item version of the Center for Epidemiologic Studies Depression scale (CES-D), with respondents indicating how they felt during the past week on a scale from 0 to 3
- Caregiver burden--measured using the 12-item Zarit Caregiver Burden Interview, with caregivers rating each item on a 5-point scale
- Self-care--assessed using 11 questions pertaining to caregivers' diligence in looking after their own health, with self-report items scored as 0 or 1 (yes or no), yielding a total score of 0 to 11
- Social support--assessed using 10 items on support received, satisfaction with support, and negative interactions or support
- Problem behaviors--assessed by three questions based on the Revised Memory and Behavior Problem Checklist (memory, depression, and disruption), with clinicians scoring responses on a scale from 1 (substantial improvement) to 5 (substantial decline)
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Key Findings
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Hispanic or Latino and White or Caucasian caregivers in the intervention group experienced greater improvement in quality of life than comparable caregivers who received only educational materials and two brief "check-in" phone calls, p < .001 and p < .037, respectively.
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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3.8
(0.0-4.0 scale)
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| Outcome 2: Prevalence of caregiver clinical depression |
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Description of Measures
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Prevalence of caregiver clinical depression was assessed using self-reports on the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). For each item, respondents indicated how they felt during the past week using a scale from 0 (rarely or never) to 3 (most or all of the time). Caregivers with scores of 15 or higher had symptoms that were judged to be at the level of having clinical depression and requiring clinical intervention.
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Key Findings
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A smaller percentage of caregivers who received the intervention (12.6%) experienced clinical depression compared with caregivers who received educational materials and two brief "check-in" phone calls (22.7%), p = .001.
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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|
Quality of Research Rating
|
4.0
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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26-55 (Adult)
55+ (Older adult)
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57.3% Male
42.7% Female
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35.1% White
32.4% Black or African American
32.4% Hispanic or Latino
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Caregiver quality of life
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3.5
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3.5
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4.0
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4.0
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4.0
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4.0
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3.8
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2: Prevalence of caregiver clinical depression
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4.0
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4.0
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4.0
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4.0
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4.0
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4.0
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4.0
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Study Strengths
The outcome measures were selected by a subcommittee that sought to identify psychometrically sound and well-researched measures. A manualized approach was used with substantial training of intervention staff. The study had very good participant retention rate. Research included well-thought-out inclusion and exclusion criteria to control for potential confounds. Additionally, variables that might have been potential confounds were controlled in the statistical analysis. Sample size was calculated as adequate across caregiver groups, and control for repeated analyses was conducted. The development of intervention and study methods from earlier REACH I research is a particular strength.
Study Weaknesses
Additional details about the caregiver health (i.e., self-care) measure should have been provided, as this might be a possible confounding variable.
