title: Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study.
abstract: OBJECTIVE
  We determine the main outcome effects of a 12-month computer-mediated automated interactive voice response (IVR) intervention designed to assist family caregivers managing persons with disruptive behaviors related to Alzheimer's disease (AD).
  
  
  METHODS
  We conducted a randomized controlled study of 100 caregivers, 51 in the usual care control group and 49 in the technology intervention group, who received yearlong access to an IVR-mediated system. The system provided caregiver stress monitoring and counseling information, personal voice-mail linkage to AD experts, a voice-mail telephone support group, and a distraction call for care recipients. We conducted analyses by using a repeated measures approach for longitudinal data and an intention-to-treat analytic approach. Outcomes included the caregiver's appraisal of the bothersome nature of caregiving, anxiety, depression, and mastery at baseline, 6, 12, and 18 months.
  
  
  RESULTS
  There was a significant intervention effect as hypothesized for participants with lower mastery at baseline on all three outcomes: bother (p =.04), anxiety (p =.01), and depression (p =.007). Additionally, wives exhibited a significant intervention effect in the reduction of the bothersome nature of caregiving (p =.02).
  
  
  CONCLUSIONS
  Wives who exhibited low mastery and high anxiety benefited the most from the automated telecare intervention. Findings suggest that, to optimize outcome effects, similar interventions should be tailored to match the users' characteristics and preferences.
authors.affiliation: Family Caregiving Technology Research and Development, Hebrew Rehabilitation Center for Aged, Research and Training Institute, 1200 Centre Street, Boston, MA 02131-1097, USA. Mahoney@mail.hrca.harvard.edu
authors.forename: Diane Feeney
authors.initials: DF
authors.lastname: Mahoney
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Tarlow
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing*; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003201:Computers; D003863:Depression / Q000209:etiology / Q000628:therapy; D005260:Female; D006701:Home Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D019114:Remote Consultation / Q000379:methods*; D012657:Self-Help Groups; D012944:Social Support; D013315:Stress, Psychological; D013689:Telephone