Helping Invested Families Improve Veterans' Experiences Study (HI-FIVES): study design and methodology.
Within the Veterans Health Administration (VHA), the largest integrated health care system in the US, approximately 8.5 million Veteran patients receive informal care. Despite a need for training, half of VHA caregivers report that they have not received training that they deemed necessary. Rigorous study is needed to identify effective ways of providing caregivers with the skills they need. This paper describes the Helping Invested Families Improve Veterans' Experience Study (HI-FIVES), an ongoing randomized controlled trial that is evaluating a skills training program designed to support caregivers of cognitively and/or functionally impaired, community-dwelling Veterans who have been referred to receive additional formal home care services. This two-arm randomized controlled trial will enroll a total of 240 caregiver-patient dyads. For caregivers in the HI-FIVES group, weekly individual phone training occurs for 3 weeks, followed by 4 weekly group training sessions, and two additional individual phone training calls. Caregivers in usual care receive information about the VA Caregiver Support Services Program services, including a hotline number. The primary outcome is the number of days a Veteran patient spends at home in the 12 months following randomization (e.g. not in the emergency department, inpatient or nursing home setting). Secondary outcomes include patient VHA health care costs, patient and caregiver satisfaction with VHA health care, and caregiver depressive symptoms. Outcomes from HI-FIVES have the potential to improve our knowledge of how to maximize the ability to maintain patients safely at home for caregivers while preventing poor mental health outcomes among caregivers.
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, 411 W. Chapel Hill Street, NC Mutual Building, Ste 500, Durham, NC 27710, USA. Electronic address: courtney.vanhoutven@duke.edu.
Courtney Harold
CH
Van Houtven
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, 411 W. Chapel Hill Street, NC Mutual Building, Ste 500, Durham, NC 27710, USA. Electronic address: eugene.oddone@dm.duke.edu.
Eugene Z
EZ
Oddone
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Division of Geriatrics, Department of Medicine, Duke University Medical Center, DUMC Box 3003, Durham, NC 27710, USA; Geriatric Research, Education, and Clinical Center, Durham VAMC 508 Fulton Street Durham NC 27705, USA; Center for the Study of Aging and Human Development Box 3003 DUMC, Room 3502 Busse Building, Blue Zone, Duke South, Durham, NC 27710, USA. Electronic address: susan.hastings@dm.duke.edu.
Susan N
SN
Hastings
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; School of Nursing, Duke University Medical Center, 307 Trent Drive, Box 102400, Durham, NC 27710, USA; Center for the Study of Aging and Human Development Box 3003 DUMC, Room 3502 Busse Building, Blue Zone, Duke South, Durham, NC 27710, USA. Electronic address: cristina.hendrix@dm.duke.edu.
Cristina
C
Hendrix
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Department of Biostatistics, Duke University Medical Center, 2424 Erwin Road, Suite 1102 Hock Plaza, Box 2721, Durham, NC 27710, USA. Electronic address: maren.olsen@dm.duke.edu.
Maren
M
Olsen
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Department of Biostatistics, Duke University Medical Center, 2424 Erwin Road, Suite 1102 Hock Plaza, Box 2721, Durham, NC 27710, USA. Electronic address: brian.neelon@duke.edu.
Brian
B
Neelon
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: jennifer.lindquist@va.gov.
Jennifer
J
Lindquist
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: hollis.weidenbacher@va.gov.
Hollis
H
Weidenbacher
Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, 411 W. Chapel Hill Street, NC Mutual Building, Ste 500, Durham, NC 27710, USA. Electronic address: jillian.boles@dm.duke.edu.
Jillian
J
Boles
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: jennifer.chapman2@va.gov.
Jennifer
J
Chapman
Center for Health Services Research in Primary Care, U.S. Department of Veterans Affairs, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA; Department of Health Policy and Management, 1105B McGavran-Greenberg Hall, Campus Box 7411, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Electronic address: mweinber@email.unc.edu.
Morris
M
Weinberger
D000223:Adaptation, Psychological; D017028:Caregivers / Q000193:education*; D003863:Depression / Q000453:epidemiology; D006233:Persons with Disabilities; D005190:Family; D006801:Humans; D061214:Patient Safety; D017060:Patient Satisfaction; D012107:Research Design; D013315:Stress, Psychological / Q000517:prevention & control / Q000628:therapy; D013689:Telephone; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
Days at home; Depressive symptoms; Health care costs; Informal care; Randomized control trial; Skills training