Advancing family dementia caregiver interventions in low‐ and middle‐income countries: A pilot cluster randomized controlled trial of Resources for Advancing Alzheimer's Caregiver Health in Vietnam (REACH VN)

Abstract

Introduction Low‐ and middle‐income countries have rapidly increasing numbers of people with dementia, yet little evidence on family caregiving interventions. We tested the preliminary efficacy and feasibility of a family caregiving intervention in northern Vietnam. Methods Nine clusters comprising 60 family caregivers were randomized to a culturally adapted version of a four‐ to six‐session, multicomponent intervention delivered in‐home over 2 to 3 months, or enhanced control. Eligible caregivers were ≥18 years of age and scored ≥6 on the Zarit Burden Inventory (ZBI). Results Fifty‐one caregivers (85%) completed the study. Using analysis of covariance with 3‐month assessment as the outcome and baseline assessment as a covariate, intervention group caregivers had an average ZBI (primary outcome) score 1.2 standard deviation (SD) lower (P = .02) and Patient Health Questionnaire‐4 (psychological distress) score 0.7 SD lower (P = .03) than controls. Discussion In the first study of its kind in Vietnam, a culturally adapted, manualized, family caregiver intervention was both efficacious and feasible.

“It’s extremely hard but it’s not a burden”: A qualitative study of family caregiving for people living with dementia in Vietnam

“…Our study is based on thematic analysis of 21 in-depth qualitative interviews conducted with key informants, including family caregivers of persons with dementia, national and local healthcare providers, and community leaders. This study was conducted as part of a larger project as the first step in a process to develop and culturally adapt a family caregiving intervention in Vietnam [ 15 , 16 ].…”

Empowering Dementia Carers With an iSupport Virtual Assistant (e-DiVA) in Asia-Pacific Regional Countries: Protocol for a Pilot Multisite Randomized Controlled Trial

“…One of the most comprehensive multi-component carer intervention is the REACH (Resources for Enhancing Alzheimer’s Caregiver Health) model [ 20 ]. The REACH model was used in Vietnam with preliminary findings showing significant improvement for carer mental health and caregiving burden [ 22 , 36 ]. However, this model is resource-intensive with interventionists going to carers’ home to deliver the intervention over 3 months.…”

“…The e-DiVA study builds on our team’s prior work and expertise, strengthens and expands existing collaborations between investigators in high-income countries (Australia and the United States) and Vietnam. These include our pilot iSupport adaptation study in Australia [ 14 ] and other studies to develop Vietnam’s National Dementia Plan [ 40 ] and to support Vietnamese dementia family carers [ 41 ]. This project proposal keeps laying the continual foundation for extramural support for both research and capacity-building.…”

Resources for Enhancing Alzheimer’s Caregiver Health in Vietnam (REACH VN): study protocol for a cluster randomized controlled trial to test the efficacy of a family dementia caregiver intervention in Vietnam

“…An evidence-based intervention, Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) [ 17 , 21 ], was adapted in Vietnam and tested in a pilot cluster randomized controlled trial (RCT) of 60 family caregivers [ 22 ], showing strong evidence of feasibility and preliminary efficacy. In this pilot study, caregivers who received the intervention showed significantly lower caregiver burden and psychological distress levels than those in the control group [ 23 ]. This study builds upon our pilot study to test the efficacy of Resources for Enhancing Alzheimer’s Caregiver Health in Vietnam (REACH VN) in a larger cluster RCT embedded in a community setting outside Hanoi using a Phase III clinical trial design [ 24 ].…”