Racial and Ethnic Differences in the Delivery of the Resources for Enhancing Alzheimer's Caregiver Health II Intervention.
To determine whether there are racial and ethnicity group differences in Resources for Enhancing Alzheimer's Caregiver Health (REACH II) intervention delivery.



Randomized controlled trial.



Community-based intervention delivered at five sites across the United States.



Family caregivers of persons with dementia who were randomized to the active intervention condition (N = 323).



Nine in-home sessions (90 minutes each) and three telephone sessions (30 minutes each) were intended to be delivered and designed to reduce caregiver burden and depression, improve caregiver self-care and social support, and help caregivers manage behavior problems in persons with dementia.



Interventionists recorded the type of intervention (home or telephone), start and stop times, and whether specific intervention content modules (e.g., stress management, social support) were administered in each session.



Overall, REACH II intervention delivery was high, with more than 80% of randomized caregivers completing at least five in-home sessions and receiving eight or more hours of intervention contact, but black caregivers completed fewer in-home sessions (mean 6.98) than Hispanics (mean 7.84) or whites (mean 8.25) and received less total intervention contact time (mean 683 minutes) than Hispanics (mean 842 minutes) or whites (mean 798 minutes). No significant differences in exposure to content according to race or ethnicity were found after controlling for demographic covariates.



Blacks in REACH II received significantly less intervention contact. Similar multicomponent interventions should examine whether there are systematic differences in intervention delivery across specific demographic subgroups and explore implications for treatment outcomes.
THREAD Institute, Baltimore, Maryland.
Anita
A
Graham-Phillips
Center on Aging and Health, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
David L
DL
Roth
Center on Aging and Health, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Jin
J
Huang
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Peggye
P
Dilworth-Anderson
Center for Innovative Care in Aging, Department of Community-Public Health, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
Laura N
LN
Gitlin
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000208:ethnology / Q000517:prevention & control; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005192:Family Health / Q000208:ethnology* / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000600:supply & distribution*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006699:Home Care Services / Q000600:supply & distribution; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D012648:Self Care / Q000523:psychology; D012944:Social Support
dementia caregiving; intervention delivery; race