Effectiveness of My Tools for Care-in Care: A Pragmatic Randomized Controlled Trial

Abstract

Objectives: Few supports exist for family/friend care partners when the care recipient is a person living with dementia in a care home. This study assessed the effectiveness of My Tools for Care-In Care (MT4C-In Care), a self-administered, web-based psychoeducational intervention.

Design: The overall study was a mixed methods pragmatic randomized controlled trial, with concurrent process evaluation and an active (educational) control. The intervention group received a link to MT4C-In Care for 2 months.

Setting and participants: Participants were eligible if they were an adult (aged ≥18 years) who provided care to an older person (aged ≥65 years) living with dementia in a care home in Canada (Alberta, Saskatchewan, Manitoba, or Ontario). An email address and internet access were required to participate.

Methods: Process evaluation included a study participation tracking form and a checklist to assess use of MT4C-In Care. We completed telephone interviews (February 2020 to October 2021) at baseline, 2 months, and 4 months to assess outcomes of social support, hope, grief, self-efficacy, loneliness, and mental health. In an intention-to-treat analysis, generalized estimating equations models were used to assess intervention impact, adjusting for covariates. Sensitivity analysis assessed whether exclusion of nonusers impacted the results.

Results: Participants (N = 234) were primarily white women, and spouses or an adult child of the person living with dementia. No effect between groups was observed for the primary outcome (mental health). We observed a small benefit of MT4C-In Care for a secondary outcome, social support. Use of MT4C-In Care within the intervention group was low (∼1 h/mo). Dropping nonusers from the analysis did not have a substantial impact on the main conclusions.

Conclusions and implications: Future research will explore use of MT4C-In Care by more diverse participant groups, and will clarify its core mechanisms, advancing understanding of impacts of psychoeducational interventions.

Keywords: Phase 3 trial; family carers; long-term care; mental health; social support; web-based intervention.