Study protocol: pragmatic randomized control trial of an internet-based intervention (My tools 4 care) for family carers
Open accessAbstract
BACKGROUND: Family carers of older persons with Alzheimer's' disease and related dementia (ADRD) and multiple chronic conditions (MCC) experience significant, complex, and distressing transitions such as changes to their environment, roles and relationships, physical health, and mental health. An online intervention (My Tools 4 Care) was developed for family carers of persons with ADRD and MCC living at home, with the aim of supporting these carers through transitions and increasing their self-efficacy, hope, and health related quality of life (HRQoL). This study will evaluate My Tools 4 Care (MT4C) by asking the following research questions: 1. Does use of MT4C result in a 3 month (immediately post intervention) and 6-month (3 months after intervention) increase in HRQoL, self-efficacy, and hope, in carers of persons with ADRD and MCC compared to an educational control group? 2. Does use of MT4C help carers of community-dwelling older adults with ADRD and MCC deal with significant changes they experience as carers? and 3. Are the effects/benefits of the MT4C intervention achieved at no additional cost compared to an educational control group? METHODS/DESIGN: Using a pragmatic mixed methods randomized controlled trial design, 180 family carers of community dwelling older persons (65 years of age and older) with ADRD and MCC will participate in the study. Data will be collected from the intervention and an educational control group at four time points: baseline, 1 month, 3 and 6 months. We expect to find that family carers using MT4C will show greater improvement in hope, self-efficacy and HRQoL, at no additional cost from a societal perspective, compared to those in the educational control group. General estimating equations will be used to determine differences between groups and over time. DISCUSSION: Data collection began in Ontario and Alberta Canada in June 2015 and is expected to be completed in June 2017. The results will inform policy and practice as MT4C can be easily revised for local contexts and is scalable in terms of posting on websites such as those hosted by the Alzheimer Society. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02428387.
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Interventions to support carers were limited.
“Interventions to support carers were limited, though online self-care education showed potential to improve mental health, wellbeing, and self-efficacy, helping carers feel more confident in their roles, and supported higher engagement in patient-focused interventions (CMOC30) [28, 44, 52, 63, 68, 100, 101].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [100]
The Background describes a lack of resources and insufficient information for family carers of people with dementia, while the Discussion says there is a great need for effective interventions. But the Discussion also says multiple internet interventions are available, so the paper does not establish that carer-support interventions generally were limited. Page numbers were not available in our copy. (LLM, conf=0.80)
Experimental — accuracy not yet measuredOnline self-care education showed potential to improve mental health, wellbeing, and self-efficacy, helping carers feel more confident in their roles, and supported higher engagement in patient-focused interventions.
“Interventions to support carers were limited, though online self-care education showed potential to improve mental health, wellbeing, and self-efficacy, helping carers feel more confident in their roles, and supported higher engagement in patient-focused interventions (CMOC30) [28, 44, 52, 63, 68, 100, 101].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [100]
The Background and Study purpose sections describe an online intervention intended to improve carers’ self-efficacy and health-related quality of life, including mental health; the paper defines self-efficacy as confidence in handling difficult situations. This is a study protocol, so it does not establish that those improvements occurred. It also does not support the claim that the intervention increased engagement in patient-focused interventions. (LLM, conf=0.85)
Experimental — accuracy not yet measuredExisting structures that had been adapted for dementia reported some improvement in preparing carers to support the patient's needs during transitions, but often neglected to provide health and wellbeing support for the carer.
“Existing structures that had been adapted for dementia (e.g., online education programmes) reported some improvement in preparing carers to support the patient’s needs during transitions, but often neglected to provide health and wellbeing support for the carer [28, 44, 52, 63, 68, 100, 101].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [100]
The Discussion (page unavailable) says most existing dementia-carer interventions focus on information and skills for becoming a better caregiver, rather than supporting carers through transitions. It does not establish that those programmes improved preparation for patients’ needs during transitions or that they often neglected carers’ health and wellbeing; the Background reports that some online interventions improved caregiver health outcomes. (LLM, conf=0.83)
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References 34 · Cited by 17
- Authors
- Duggleby, W., Ploeg, J., McAiney, C., Fisher, K., Swindle, J., Chambers, T., Ghosh, S., Peacock, S., Markle-Reid, M., Triscott, J., Williams, A., Forbes, D., & Pollard, L.
- Affiliations
- University of Alberta (CA)
- McMaster University (CA)
- University of Saskatchewan (CA)
- Corresponding author
- Duggleby, Wendy
- ORCID
- Venue
- BMC Geriatrics
- Published
- 2017-08-14
- Volume
- 17
- Issue
- 1
- Pages
- 181-181
- ISSN
- 1471-2318 (ISSN-L)
- PMC
- PMC5557259
- OpenAlex
- W2749853641
- Cited by
- 17
- References
- 34
- Citations by year
- 2025: 3 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 4
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Geriatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research (TTF 128261)
- 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 › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- family caregivers, Alzheimer's disease and related dementias, multimorbidity, online intervention, self-efficacy, hope, health-related quality of life, caregiver transition, community-dwelling older adults, cost-effectiveness
- MeSH terms
- Multiple Chronic Conditions, Adult, Aged, Alzheimer Disease, Canada, Computer-Assisted Instruction, Female, Humans, Male, Quality of Life, Research Design, Stress, Psychological, Intergenerational Relations, Caregivers, Independent Living
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