Translating the REACH caregiver intervention for use by area agency on aging personnel: the REACH OUT program.
OBJECTIVE
The aim of this study was to translate the evidence-based Resources for Enhancing Alzheimer's Caregiver Health (REACH) II intervention for use in 4 Area Agencies on Aging (AAAs). A secondary aim was to examine possible moderators of treatment outcome.


METHODS
We used a quasi-experimental pre-post treatment design with no control group. A partnership was formed between the Alabama Department of Senior Services and the University of Alabama. The partnership trimmed the REACH II intervention used in the clinical trial for feasible use in a social service agency. The condensed REACH intervention, termed REACH OUT, was delivered to 272 dementia caregivers during 4 home visits and 3 phone calls for a period of 4 months. The assessment examined pre-post treatment effects on a number of outcomes, including care recipient risk, mood, memory, and behavior problems; caregiver stress and emotional well-being; caregiver health; and program satisfaction. All aspects of the program except for training, periodic consultation, and data analysis were controlled by the AAA staff.


RESULTS
Analyses were conducted on the 236 dyads that completed at least 3 of the 4 planned sessions. Significant positive pre-post effects were found on caregiver subjective burden, social support, caregiver frustration, depression, caregiver health, care recipient behavior problems and mood, and 2 of 4 care recipient risk behaviors. Site of intervention and certain participant characteristics (e.g., caregiver relationship) moderated several pre-post differences. A caregiver survey and interventionist focus group reported high acceptability of the program


CONCLUSIONS
This project suggests that the REACH II intervention can be modified for feasible and effective use in AAAs. The next step is to integrate the intervention into usual service delivery to achieve sustainability.
University of Michigan, School of Social Work, Ann Arbor, MI. 48109, USA. lburgio@umich.edu
Louis D
LD
Burgio
Irene B
IB
Collins
Bettina
B
Schmid
Tracy
T
Wharton
Debra
D
McCallum
Jamie
J
Decoster
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D017028:Caregivers / Q000523:psychology; D003159:Community-Institutional Relations; D003704:Dementia; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult