School
of Nursing
Funded Projects:
Aging and Elder Care
PREP:
Family-Based Care for Frail Older Persons
Principal Investigator:
Patricia G. Archbold
Abstract:
The Family Care Study
is a randomized controlled efficacy trial of PREP, and a home health intervention
designed to increased Preparedness Enrichment, and Predictability in family
care for frail elders. PREP is distinguished by its family focus and has
three parts: (1) the family and nurse working together of family care
issues, (2) 24-hour PREP Advice Line; and (3) follow-up contact by the
nurse using Keep-in-Touch. The abbreviated primary aims (full aims on
page 98) are to: (1) describe the care issued identified by PREP families,
the strategies implemented to resolve these issues, and the effectiveness
of the strategies; (2) determine whether compared to Extended Home Health
(EHH) and Standard Home Health (SHH), PREP significantly improves family
care variables (e.g., caregiver [CG] skill, CG role strain etc.) And health
status, including care receiver (CR) function; (3) determine whether PREP
is differentially effective in Black versus White and in low versus middle
income families; (4) determine whether EHH, compared to SHH, has beneficial
effects on family care variables and health; and (5) determine whether
any effects of PREP and EHH on family care variables and health continue
after the intervention is withdrawn. The proposed study will also address
two secondary aims related to measuring use and cost of formal and informal
health care services for CRs and CGs in PREP, EHH, and SHH. The study
will use a 3-group design. The sample will include 360 older people who
meet Medicare criteria for skilled home care at a large not-for- profit
HMO. At least 60 Black and 60 low-income White families will be included
in the sample. All samples will be randomized to PREP, EHH, or SHH. PREP
will be delivered to families by PREP nurses within the context of an
interdisciplinary team for a period of 12 months. In EHH, a home health
time comparable in composition to the PREP team will be given the same
resources as PREP team will be given the same resources as PREP to deliver
care but will not use the goals and principles of PREP. SHH will be the
usual home health care provided by the HMO. Six research measures and
data sources will be used: The Family Care Inventory, Quality of Family
Care Scale, Family Health Diary, KPNW Home Health automated clinical information
system (DOCPLUSR), KPNW automated data systems, and the Family Expense
Calendar. Utilization and cost data will be obtained for 12 months prior
to and 20 months after study entry. Analyses will include regression,
survival analysis, and repeated measures ANOVA.
Dates of Project:
9/15/1999 – 8/31/2005
Funded by: National Institute of Aging, Agency for Healthcare Research
and Quality, National Institute of Nursing Research