title: Reducing depression in stroke survivors and their informal caregivers: a randomized clinical trial of a Web-based intervention.
abstract: OBJECTIVE
  To develop and test the efficacy of a Web-based intervention for alleviating depression in male stroke survivors (SSs) and their spousal caregivers (CGs) that blends both peer and professional support.
  
  
  METHODS
  The research consisted of an intervention protocol evaluated by a focus group of rehabilitation professionals, a "think aloud" session conducted with female stroke CGs, and a usability test of the intervention's online features with 7 female stroke CGs. Efficacy of the final protocol was tested in a 2-group randomized clinical trial with a sample of 32 CG-SS dyads. The CGs in the intervention condition received an online group intervention. Intervention components were based on the Stress Process Model. Those CGs in a control condition received minimal support with individualized access to relevant online information. Measures of depression, as well as the secondary outcomes of mastery, self-esteem, and social support, were obtained from SSs and CGs at pretest, posttest, and 1-month later.
  
  
  RESULTS
  At posttest and 1 month later, CGs in the intervention condition reported significantly lower depression than CGs in the control condition with baseline depression controlled. There was no significant effect on depression among SSs. Although no significant treatment effects for either SSs or CGs were found on the secondary outcomes, posttreatment changes on some constructs were significantly correlated with change in depression.
  
  
  CONCLUSIONS
  CGs benefit from Web-based programs that help them better understand both their emotional needs and those of the SS.
authors.affiliation: School of Lifespan Development and Educational Sciences, Kent State University, Kent, OH 44242, USA. gsmith2@kent.edu
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Smith
authors.forename: Nichole
authors.initials: N
authors.lastname: Egbert
authors.forename: Mary
authors.initials: M
authors.lastname: Dellman-Jenkins
authors.forename: Kevin
authors.initials: K
authors.lastname: Nanna
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Palmieri
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003866:Depressive Disorder / Q000517:prevention & control*; D005260:Female; D006266:Health Education; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012657:Self-Help Groups; D060756:Social Networking; D018454:Spouses / Q000523:psychology; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D017741:Survivors / Q000523:psychology; D017216:Telemedicine / Q000379:methods*; D014481:United States