title: Comparison of two psycho-educational family group interventions for improving psycho-social outcomes in persons with spinal cord injury and their caregivers: a randomized-controlled trial of multi-family group intervention versus an active education control condition.
abstract: BACKGROUND
  Over 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating long-term, complex adjustments and responsibilities for patients and their caregivers. Despite growing evidence that family education and support improves the management of chronic conditions for care recipients as well as caregiver outcomes, few systematic efforts have been made to involve caregivers in psycho-educational interventions for SCI. As a result, a serious gap exists in accumulated knowledge regarding effective, family-based treatment strategies for improving outcomes for individuals with SCI and their caregivers. The proposed research aims to fill this gap by evaluating the efficacy of a structured adaptation of an evidence-based psychosocial group treatment called Multi-Family Group (MFG) intervention. The objective of this study is to test, in a randomized-controlled design, an MFG intervention for the treatment of individuals with SCI and their primary caregivers. Our central hypothesis is that by providing support in an MFG format, we will improve coping skills of persons with SCI and their caregivers as well as supportive strategies employed by caregivers.
  
  
  METHODS
  We will recruit 32 individuals with SCI who have been discharged from inpatient rehabilitation within the previous 3 years and their primary caregivers. Patient/caregiver pairs will be randomized to the MFG intervention or an active SCI education control (SCIEC) condition in a two-armed randomized trial design. Participants will be assessed pre- and post-program and 6 months post-program. Intent to treat analyses will test two a priori hypotheses: (1) MFG-SCI will be superior to SCIEC for SCI patient activation, health status, and emotion regulation, caregiver burden and health status, and relationship functioning, and (2) MFG will be more effective for individuals with SCI and their caregivers when the person with SCI is within 18 months of discharge from inpatient rehabilitation compared to when the person is between 19 and 36 months post discharge.
  
  
  CONCLUSIONS
  Support for our hypotheses will indicate that MFG-SCI is superior to specific education for assisting patients and their caregivers in the management of difficult, long-term, life adjustments in the months and years after SCI, with increased efficacy closer in time to the injury.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02161913 . Registered 10 June 2014.
authors.affiliation: Department of Psychology, Washington State University Spokane, 412 E. Spokane Falls Blvd., Spokane, WA, 99202, USA. dyck@wsu.edu.
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Dyck
authors.affiliation: St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.|Department of Biomedical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99202, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Weeks
authors.affiliation: St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gross
authors.affiliation: College of Nursing, Washington State University Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Lederhos Smith
authors.affiliation: St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.
authors.forename: Hilary A
authors.initials: HA
authors.lastname: Lott
authors.affiliation: St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.
authors.forename: Aimee J
authors.initials: AJ
authors.lastname: Wallace
authors.affiliation: St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.
authors.forename: Sonya M
authors.initials: SM
authors.lastname: Wood
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D000067250:Psychiatric Rehabilitation / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life; D012944:Social Support; D013119:Spinal Cord Injuries / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Caregiver; Multi-family group treatment; Psycho-educational intervention; Spinal cord injury; Study protocol