Fidelity and acceptability of an adaptive intervention for caregivers: An exploratory study

Abstract

Objective: There has been growing interest in providing tailored or adaptive interventions to family caregivers as a way of addressing their heterogeneity of risk factors and other needs. A particular challenge in an adaptive study is to implement the individualized intervention protocol as planned (program fidelity). This study explores the fidelity of implementation of an adaptive intervention for family caregivers of persons with dementia and its acceptability to caregivers.

Method: Using a sample of 35 caregivers of person with dementia who participated in a program development study, we gathered information on acceptability and fidelity of the program from multiple sources, including caregiver and counselor reports and ratings of recordings of sessions.

Results: Findings show that caregivers have high levels of acceptance of the intervention plan and high ratings of satisfaction with the program. Ratings of satisfaction and counselor competence were not associated with the amount of treatment provided. Ratings by counselors and independent raters found good fidelity for two of the three program domains.

Discussion: The results demonstrate that trained counselors can follow a tailored intervention plan and that caregivers’ experience of the program did not differ depending on how much intervention was provided. A next step is to determine how an adaptive protocol would affect caregiver outcomes.

Keywords:

• caregiving
• dementia
• psychosocial interventions
• treatment evaluation

Acknowledgments

This study was supported by Grant R34 MH073559 funded by the National Institute of Mental Health (Drs S. Zarit, C. Whitlatch, and E. Femia, Principal Investigators) and Grant P50 AG08012 from the National Institute of Aging. The authors thank Silvia Orsulic-Jeras, Jeffrey Mostade, Tami Pentek, Beth Piotrowicz, and Branka Primetica for their contributions to this project and our coders: Sara Guthrie, Alex Gibberman, Jessica Katz, and Michael McShane.