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Evaluating the Effectiveness of an Online Small-Group Self-Management Workshop for Rural Caregivers of Individuals With Alzheimer’s Disease and Related Dementias


Brief Summary:

These caregivers are a vulnerable group due to their physical isolation and well-documented
rural disparities in health care access and quality. Many rural dementia caregivers
experience serious health consequences due to caregiving responsibilities that can limit
their ability to maintain their caregiving role. Thus, there is a pressing need for
effective, scalable, and accessible programs to support rural dementia caregivers.

Online programs offer a convenient and readily translatable option for program delivery
because they can be accessed by caregivers in the home and at the convenience of the user.
Building Better Caregivers is an online 6-week, interactive, small-group self-management,
social support, and skills-building workshop developed for caregivers of individuals with
Alzheimer’s disease or related dementia.

The investigators will conduct a hybrid effectiveness-implementation randomized controlled
trial that will enroll and randomize 640 rural dementia caregivers into two groups: 320 in
the intervention (workshop) group and 320 in the attention control group. Caregivers will be
recruited throughout the United States. Primary outcomes will be caregiver stress and
depression symptoms. The investigators hypothesize that stress scores and depression symptoms
will be significantly improved at 12 months in the intervention group versus control group.
The investigators will also identify key strengths (facilitators) and weaknesses (barriers)
of workshop implementation. The investigators will use the RE-AIM implementation framework
and a mixed methods approach to identify implementation characteristics pertinent to both
caregivers and rural community organizations.

If the Building Better Caregivers workshop is proven to be effective, this research has the
potential to open new research horizons, particularly on how to reach and effectively support
isolated dementia caregivers in rural areas with an intervention that is scalable, even in
low-resourced settings. If the workshop can achieve its goals with rural dementia caregivers,
some of those most isolated, it would also be expected to be scalable in other low-resourced
settings (e.g., in urban or suburban environments).


Inclusion Criteria:

– Aged 18 years or older

– Caring for person with dementia

– Able to read and write in English

– Able to access the internet

– Providing care for ≥ 10 hours per week

– Reporting a minimum stress level of 4 or more on a 10-point scale

– Living in rural area of United States (self-identify or zip code is a Rural Urban
Commuting Area Codes (RUCA) defined rural area)

Exclusion Criteria:

– Have an anticipated inability to complete the 12-month follow-up (e.g., planned

– Care partner living in a skilled nursing or similar facility


  • University of California, San Francisco, San Francisco, California, United States, 94118
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