A nurse‐led multicentre randomized controlled trial on effectiveness and cost‐effectiveness of Chinese iSupport for dementia program: A study protocol

Abstract

Aims To describe a nurse‐led multicentre randomized controlled trial protocol developed to evaluate the effectiveness and cost‐effectiveness of a Chinese iSupport for Dementia program in Australia and Greater China including mainland China, Taiwan, Hong Kong and Macau. Design A multicentre randomized controlled trial following the SPIRIT checklist. Methods Participants in the study will be recruited from Australia and Greater China and will be randomly assigned to the intervention group or the usual care group. Interventions will include self‐learning of the iSupport program, virtual peer support and nurse program facilitator support for 6 months. Primary outcome measures will be the 12‐Item Short‐Form Health Survey. Secondary outcome measures will include: Revised Scale for Caregiving Self‐efficacy; Quality of Social Support Scale; Revised Memory and Behaviour Problem Checklist; the Quality of Life in Alzheimer's Disease‐Proxy; usages of care services; and cost‐effectiveness of the intervention. Outcomes will be measured at baseline, 6 months and 9 months from the baseline. Caregivers' experiences of the peer support will be explored. This project was funded by the National Foundation for Australia‐China Relations, Australian Government (Project ID: NFACR216). The total amount is $440,000 Australian dollars (or £ 236,231). Discussion Approximately, 20% of people living with dementia in the world live in Australia and Greater China. Older Chinese are usually cared for by family caregivers at home due to the influence of Confucianism. However, free and online psychoeducation programs for this large cohort of caregivers are not available or accessible. The World Health Organization iSupport for Dementia is an evidence‐based online psychoeducation program for caregivers. Implementing a culturally adapted Chinese iSupport program will address this gap in supporting caregivers. Impact This study will provide research evidence on effectiveness and cost‐effectiveness of an online psychoeducation program for caregivers. Findings will inform policy and practice development.

Inclusive dementia care for ethnically diverse families

“…While it is crucial that this technological uptake be harnessed to innovate for dementia, this has yet to fully occur [52]. Research remains nascent in this space though there are several trials and other studies underway to explore technologies and digital media's impact on care outcomes [see for example: [53 ▪ ,54,55 ▪ ]). The current evidence suggests a moderate to strong effect of digital interventions on family carers’ mental health, but this evidence is strongest for various forms of telephone-based interventions and where study participants were overwhelmingly white women [56].…”

Cultural adaptation of World Health Organization iSupport for Dementia program for Chinese-Australian caregivers

“…The study is embedded within a larger ongoing project that includes the cultural adaptation of Chinese iSupport program in phase one using a qualitative study and an evaluation of the program in phase two using a multicentre randomised controlled trial across six study sites in Australia and Greater China including mainland China (two sites), Taiwan, Hong Kong and Macau. The study protocol for phase two is published elsewhere (Xiao et al 2022). In this study, we applied the ecological validity framework described by Bernal and Domenech Rodríguez (Bernal & Domenech Rodríguez, 2012a), Durlak and DuPre (2008) and Spanhel et al (2021) to inform the cultural adaptation of the program.…”

The Effectiveness of a Community Nurse-Led Support Program for Dementia Caregivers in Chinese Communities: The Chongqing Ageing and Dementia Study

“…Caregivers' self-efficacy is dominated by their confidence in coping effectively with different types of care [15]. Bandura's theory states that an individual's functioning is the product of the dynamically reciprocal interplay of personal factors, behavior, and environmental influences and that learning and supportive interactions with others are the basis of an individual's self-efficacy [16,17]. Because nurses play a vital role in supportive care, we developed a nurse-led support program based on Bandura's theory, the literature and China's actual conditions [18,19].…”

“…In this study, we found that the sense of competency, degree of caregiver distress, and quality of life (reflected by physical health and mental health) were improved in caregivers who received a 12-month nurse-led support intervention. Learning and supportive interactions with trained community nurses could build self-efficacy in caregivers of people with dementia and improve caregivers' cognitive, motivational, affective, and behavioral development [17]. Self-efficacy is related to competency and contributes to a better quality of life for caregivers [15,30,31].…”