Predictors of Adherence to a Skill-Building Intervention in Dementia Caregivers
Abstract
BACKGROUND: Treatment adherence is a widely recognized problem in health services but understudied in caregiver intervention research. This study examines caregiver sociodemographic and psychological characteristics, patient illness severity, and treatment implementation factors as predictors of caregiver adherence to a skills training intervention to help families manage dementia care problems at home. METHODS: The sample consisted of 105 caregivers randomized to the Home Environmental Skill-Building Program at the Philadelphia site of the National Institutes of Health (NIH) Resources for Enhancing Alzheimer's Caregiver Health (REACH I). The intervention, implemented by occupational therapists, consisted of education, problem solving, communication, environmental and task simplification techniques, and home modifications. Adherence was measured by a proportion score representing the percentage of strategies used by participants compared to the total number of strategies prescribed during intervention (Strategy Use). RESULTS: Regression analysis with intraclass correlation adjustment for interventionist effects revealed that caregivers with better physical health (p <.001), greater treatment exposure (p <.001), more problem areas addressed (p =.012), and for whom more active therapeutic techniques (role play) were used (p =.004) demonstrated greater adherence. Other caregiver characteristics, patient cognitive impairment, and troublesome behaviors were not significantly related to caregiver adherence. CONCLUSIONS: Modifiable caregiver and treatment implementation factors, including active engagement of caregivers, were associated with adherence, whereas patient characteristics were not. Caregivers with poor health may be at risk for not benefiting from intervention, suggesting that efforts, including instruction in preventive care and allocating time to attend to their own health care needs, be directed towards improving their health.
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Dementia caregivers are more likely to use skills they learned through the use of active techniques than those they learn through passive didactics.
“This is critical as dementia caregivers are more likely to use skills they learned through the use of active techniques than those they learn through passive didactics [37].”
From A novel two-day intervention reduces stress in caregivers of persons with dementia (2018) · cites this paper as [37]
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- Authors
- Chee, Y. K., Gitlin, L. N., Dennis, M. P., & Hauck, W. W.
- Affiliations
- Thomas Jefferson University (US)
- Corresponding author
- Chee, Y. K.
- ORCID
- Gitlin, L. N.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-06-01
- Volume
- 62
- Issue
- 6
- Pages
- 673-678
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2147312325
- Cited by
- 50
- References
- 28
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pennsylvania Department of Health
- National Institute on Aging (U01-AG13265, U01AG013265)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- medication adherence, dementia caregivers, caregiver skills training, occupational therapy intervention, caregiver physical health, role play, home modification, caregiver burden
- MeSH terms
- Adult, Aged, Aged, 80 and over, Attitude to Health, Communication, Dementia, Educational Status, Environment, Female, Forecasting, Health Status, Home Nursing, Humans, Male, Middle Aged, Occupational Therapy, Problem Solving, Role Playing, Work Simplification, Caregivers
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