DepressionRESCUENCT03142841
Spanish Intervention for Caregivers of Veterans With Stroke
A study testing RESCUE Problem Solving Intervention in people with Depression, run by VA Office of Research and Development at 4 sites in 2 countries.
Trial summary
This research study will test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Depression
- What is being tested?
- RESCUE Problem Solving Intervention
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 210 participants
- Where
- 4 sitesin 2 countries
- Study dates
- 1 Jan 2018to 4 Mar 2024
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Inclusion Criteria: Hispanic caregivers of Veterans with a primary diagnosis of stroke are eligible for participation if they meet the following criteria: 1) are the primary caregiver and provide the majority of care for a Veteran who has a diagnosis of stroke (ICD9 codes for stroke: 430-438 or ICD 10 codes 160.0 through 169.998) within the last year and who has at least two activity of daily living (ADL) deficits or a new or worsening neurological problem, 2) have Internet access and ability, (either themselves or via a relative or friend) 3) are reachable by cell or home phone, 4) Spanish is their preferred language, 5) have moderate to severe stress, and 6) ) identify self as Hispanic, and 7) agree to random assignment to the intervention or standard care group.
Random assignment to the intervention or standard care group. The investigators will determine caregiver status.
Exclusion Criteria: The investigators will exclude caregivers who fail to meet one or more of the inclusion criteria or are managing end-of-life issues (stroke survivors are likely to die within five months following discharge).
Trial locations and contacts
4 sites in 2 countries.
4 sites in 2 countries
United States3 sites
North Florida/South Georgia Veterans Health System, Gainesville, FL
Gainesville, Florida, 32608-1135
Orlando VA Medical Center, Orlando, FL
Orlando, Florida, 32803
James A. Haley Veterans' Hospital, Tampa, FL
Tampa, Florida, 33612
Puerto Rico1 site
VA Caribbean Healthcare System, San Juan, PR
San Juan, 00927-3200
About this study
Official title: Spanish Online & Telephone Intervention for Caregivers of Veterans With Stroke
This research study will test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. The investigators will adapt their previously pilot-tested problem-solving intervention and make it culturally-relevant for Hispanic caregivers. The investigators' main goal is to test the efficacy of a brief, telephone and online problem-solving intervention. The objectives are: 1) reduce caregiver burden and depression, 2) improve caregivers' problem-solving abilities, self-efficacy, and quality of life, 3) improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare utilization, 4) determine budgetary impact, and 5) determine caregivers' perceptions of the intervention.
Read the detailed description
This research study will test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. The investigators will adapt their previously pilot-tested problem-solving intervention and make it culturally-relevant for Hispanic caregivers. The investigators' main goal is to test the efficacy of a brief, telephone and online problem-solving intervention. The objectives are: 1) reduce caregiver burden and depression, 2) improve caregivers' problem-solving abilities, self-efficacy, and quality of life, 3) improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare utilization, 4) determine budgetary impact, and 5) determine caregivers' perceptions of the intervention.
The investigators will conduct a two-arm (8-session intervention vs. standard care), , randomized controlled trial to test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. A sample of 290 stroke caregivers will be randomly assigned to either an intervention or a standard care group. Eligibility criteria: Hispanic caregivers of Veterans with a primary diagnosis of stroke are eligible for participation if they meet the following criteria: 1) are the primary caregiver and provide the majority of care for a Veteran who has a diagnosis of stroke (ICD9 codes for stroke: 430-438 or ICD 10 codes 160.0 through 169.998) within the last year and who has at least two activity of daily living (ADL) deficits or a new or worsening neurological problem, 2) have Internet access and ability, (either themselves or via a relative or friend) 3) are reachable by cell or home phone, 4) Spanish is their preferred language, 5) have moderate to severe stress, and 6) ) identify self as Hispanic, and 7) agree to random assignment to the intervention or standard care group. We will determine caregiver status.
Baseline measurements will be conducted with the caregivers prior to the intervention. Post-test assessments will be collected at 1 and 12 weeks post-intervention. In addition, the investigators will obtain pre- and post-test measures of Veteran-related variables via Computerized Patient Record System (CPRS) electronic health records. Qualitative interviews will be conducted to assess caregivers' perceptions of the intervention. A general linear mixed model for repeated measures will be used to examine the relationship between treatment assignment and each outcome over time. The investigators will measure the budgetary impact of providing intervention by comparing the costs of the intervention group to the costs of the control group.
- Conditions
- Depression
- Being tested
- RESCUE Problem Solving Intervention
- Keywords
- Depression, Burden, Problem Solving Ability, Caregivers, Stroke, Veterans
- Medical subject headings
- Depression, Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RESCUE Problem Solving InterventionOther
The RESCUE Problem Solving Intervention: This is an education and support intervention for caregivers of Veterans with stroke. The investigators taught study participants the COPE (Creativity, Optimism, Planning, Expert Advice) model of problem solving and guided them through the application of this model in their caregiver role. They also receive tailored stroke education, specific to their needs.
| Study group | Role | What they receive |
|---|---|---|
| Standard Care | No intervention | The standard care group will receive the usual standard care they would receive had they not been enrolled in this study |
| Problem Solving Intervention | Experimental | Participants in the intervention group received an 8-week problem-solving session conducted over the phone by a trainer interventionist. The intervention consists of four components: 1. Introduction to the RESCUE website and the problem-solving method; 2. Illustrative example on how to use the problem-solving approach and the RESCUE website to address caregiving problems; 3. Individualized practice exercise to develop a personalized problem-solving plan; and 4. Summary of the problem-solving method. Receives: Other: RESCUE Problem Solving Intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Caregiver Depression at 9 Weeks
Caregiver depression as measured by the Center for Epidemiologic Studies Depression-20. The CES-D is a 20 item, four point Likert scale ranging from never (0) to most of the time (3). The minimum value is 0 and the maximum value is 60. The higher score means a worse outcome (more depressed). This tool has good reliability and validity.
Measured: 9 weeks after baseline
Change in Caregiver Depression at 21 Weeks
Caregiver depression as measured by the Center for Epidemiologic Studies Depression-20. The CES-D is a 20 item, four point Likert scale ranging from never (0) to most of the time (3). The minimum value is 0 and the maximum value is 60. The higher score means a worse outcome (more depressed). This tool has good reliability and validity.
Measured: 21 weeks after baseline
Secondary outcomes (26)
Change in Caregiver Burden-Zarit - 9 Weeks
Changes in burden will be measured by the Zarit Burden Interview instrument. This 22 item instrument is scored on a 5-point Likert scale, ranging from 0 (Never) to 4 (Nearly Always). The minimum value is 0 and the maximum score is 88. Higher scores indicate higher burden.
Measured: 9 weeks
Change in Caregiver Burden-Zarit - 21 Weeks
Changes in burden will be measured by the Zarit Burden Interview instrument. This 22 item instrument is scored on a 5-point Likert scale, ranging from 0 (Never) to 4 (Nearly Always). The minimum value is 0 and the maximum score is 88. Higher scores indicate higher burden.
Measured: 21 weeks
Change in Caregiver Self-Efficacy-Obtaining Respite - 9 Weeks
Change in Self-Efficacy is measured by the Revised Scale for Caregiving Self-Efficacy- Obtaining Respite subscale. The subscale contains 5 items which asks caregivers to rate their level of confidence (from 0% to 100%) to ask for assistance. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 9 weeks
Change in Caregiver Self-Efficacy-Obtaining Respite - 21 Weeks
Change in Self-Efficacy is measured by the Revised Scale for Caregiving Self-Efficacy- Obtaining Respite subscale. The subscale contains 5 items which asks caregivers to rate their level of confidence (from 0% to 100%) to ask for assistance. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 21 weeks
Changes in Caregiver Self-Efficacy- Controlling Upsetting Thoughts - 9 Weeks
Measured by Revised Scale for Caregiver Self Efficacy - Controlling Upsetting Thoughts subscale (Steffen et al 2002). The subscale contains 5 items which ask caregivers to rate their level of confidence (from 0% to 100%) in their ability to control negative thoughts related to caregiving. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 9 weeks
Changes in Caregiver Self-Efficacy- Controlling Upsetting Thoughts - 21 Weeks
Measured by Revised Scale for Caregiver Self Efficacy - Controlling Upsetting Thoughts subscale (Steffen et al 2002). The subscale contains 5 items which ask caregivers to rate their level of confidence (from 0% to 100%) in their ability to control negative thoughts related to caregiving. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 21 weeks
Changes in Caregiver Self-Efficacy: Responding to Disruptive Behaviors - 9 Weeks
Measured by Revised Scale for Caregiver Self Efficacy - Responding to Disruptive Behaviors subscale (Steffen et al 2002). The subscale contains 5 items which ask caregivers to rate their level of confidence (from 0% to 100%) in their ability to control negative thoughts related to caregiving. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 9 weeks
Changes in Caregiver Self-Efficacy: Responding to Disruptive Behaviors - 21 Weeks
Measured by Revised Scale for Caregiver Self Efficacy - Responding to Disruptive Behaviors subscale (Steffen et al 2002). The subscale contains 5 items which ask caregivers to rate their level of confidence (from 0% to 100%) in their ability to control negative thoughts related to caregiving. The subscale score is obtained by calculating the mean of the items, with a total score range of 0-100. Higher scores indicate higher self-efficacy. The subscale shows strong internal consistency and adequate test-retest reliability.
Measured: 21 weeks
Change in Veteran's Functional Abilities- 9 Weeks
Changes in Veteran functional abilities as measured by the Stroke Impact Scale-16 (SIS-16). The SIS-16 is a 16 item physical dimension instrument, developed as a brief standalone tool for measuring the physical aspects of stroke recovery. We modified this instrument to be administered to the caregiver about their evaluation of Veteran's functional ability. Scoring is based on a 5-point Likert scale, ranging from 16-80 points with 1 = an inability to complete the item \& 5 = no difficulty experienced at all. Total Scores are transformed scores which have been standardized on a scale of 0-100 where higher scores indicate higher functional outcomes.
Measured: 9 weeks
Change in Veteran's Functional Abilities- 21 Weeks
Changes in Veteran functional abilities as measured by the Stroke Impact Scale-16 (SIS-16). The SIS-16 is a 16 item physical dimension instrument, developed as a brief standalone tool for measuring the physical aspects of stroke recovery. We modified this instrument to be administered to the caregiver about their evaluation of Veteran's functional ability. Scoring is based on a 5-point Likert scale, ranging from 16-80 points with 1 = an inability to complete the item \& 5 = no difficulty experienced at all. Total Scores are transformed scores which have been standardized on a scale of 0-100 where higher scores indicate higher functional outcomes.
Measured: 21 weeks
Changes in Caregiver Health-Related Quality of Life - Physical Component Score - 9 Weeks
Changes in health-related quality of life will be measured by the Rand 12-item Health Survey (VR-12). The VR12 items are scored on a 3-point or 5-point Likert scale. It consists of physical and emotional scales. Scores for each scale are calculated by using an algorithm and scores are standardized using a T-score metric with a mean of 50 and standard deviation of 10. Higher scores indicate better health-related quality of life. There is no composite or overall score for the VR-12.
Measured: 9 weeks
Changes in Caregiver Health-Related Quality of Life - Physical Component Score - 21 Weeks
Changes in health-related quality of life will be measured by the Rand 12-item Health Survey (VR-12). The VR12 items are scored on a 3-point or 5-point Likert scale. It consists of physical and emotional scales. Scores for each scale are calculated by using an algorithm and scores are standardized using a T-score metric with a mean of 50 and standard deviation of 10. Higher scores indicate better health-related quality of life. There is no composite or overall score for the VR-12.
Measured: 21 weeks
Changes in Caregiver Health Related Quality of Life - Mental Health Component - 9 Weeks
Changes in health-related quality of life will be measured by the Rand 12-item Health Survey (VR-12). The VR12 items are scored on a 3-point or 5-point Likert scale. It consists of physical and emotional scales. Scores for each scale are calculated by using an algorithm and scores are standardized using a T-score metric with a mean of 50 and standard deviation of 10. Higher scores indicate better health-related quality of life. There is no composite or overall score for the VR-12.
Measured: 9 weeks
Changes in Caregiver Health Related Quality of Life - Mental Health Component - 21 Weeks
Changes in health-related quality of life will be measured by the Rand 12-item Health Survey (VR-12). The VR12 items are scored on a 3-point or 5-point Likert scale. It consists of physical and emotional scales. Scores for each scale are calculated by using an algorithm and scores are standardized using a T-score metric with a mean of 50 and standard deviation of 10. Higher scores indicate better health-related quality of life. There is no composite or overall score for the VR-12.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Positive Problem Orientation (PPO) at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Positive Problem Orientation (PPO) at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Negative Problem Orientation (NPO) at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Negative Problem Orientation (NPO) at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Rational Problem-Solving (RPS) at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Rational Problem-Solving (RPS) at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Impulsivity/Carelessness Style (ICS) at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Impulsivity/Carelessness Style (ICS) at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Avoidance Style (AS) at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Avoidance Style (AS) at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Problem Solving Total at 9 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Problem Solving Total at 21 Weeks
The Social Problem Solving Inventory Revised- Short Form (SPSI-R:S) is a 25-item, self-report instrument that evaluates characteristics of social problem solving, including problem solving orientation and problem solving performance. The SPSI-R:S consists of five subscores: positive problem orientation (PPO), negative problem orientation (NPO), rational problem solving style (RPS), impulsivity/carelessness style (ICS), and avoidance style (AS). Each sub-score contains five items that are scored on a five-point Likert-type rating scale, ranging from 0 (not at all true) to 4 (extremely true). Standardized scores range depending on the age of the person: Subscale PPO- 47-135; Subscale NPO= 74-162; Subscale RPS= 56-136; Subscale ICS= 73-162; Subscale AS= 76-157, Total SPSI= 29-140. Higher subscores on PPO and RPS, and lower subscores of NPO, ICS, and AS indicate good social problem solving.
Measured: 21 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 May 2017
- Study start1 Jan 2018
- Primary completion4 Mar 2024
- Study completion4 Mar 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for DepressionStudies of the same condition, open and under way.
- More trials run by VA Office of Research and DevelopmentThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A two-arm (8-session intervention vs. standard care), randomized controlled clinical trial with three assessment points will be conducted. Baseline measurements will be conducted with the caregivers prior to the intervention. Post-test assessments will be collected at 1 and 12 weeks post-intervention. In addition, the investigators will obtain pre- and post-test measures of Veteran-related variables via CPRS electronic health records. Qualitative interviews will be conducted to assess caregivers' perceptions of the intervention.
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 210 participants (actual)
Sponsor and investigators
- Lead sponsor
- VA Office of Research and Development
- Sponsor type
- US federal agency
- Responsible party
- Sponsor
- Investigators
- Ivette M Freytes, PhD MEd BA, Principal investigator, North Florida/South Georgia Veterans Health System, Gainesville, FL
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03142841
- Sponsor's protocol ID
- IIR 15-117
- Acronym
- RESCUE
- Status last verified
- Dec 2025
- First submitted
- 1 May 2017
- Last updated
- 18 Dec 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Freytes IM, Schmitzberger MK, Rivera-Rivera N, Lopez J, Motta-Valencia K, Wu SS, Orozco T, Hale-Gallardo J, Eliazar-Macke N, LeLaurin JH, Uphold CR. Study protocol of a telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial. BMC Prim Care. 2023 Mar 17;24(1):73. doi: 10.1186/s12875-022-01929-y.
PubMed 36932321Freytes IM, Schmitzberger M, Rivera-Rivera N, Lopez J, Mylott D, Motta-Valencia K, Uphold CR. Serving Underserved Veterans and Their Caregiver: Developing Tailored Culturally Relevant Interventions. [Abstract]. Innovation in aging. 2019 Nov 8; 3(Supp 1):S674.
Study at a glance
From the registry record, last updated by the sponsor on 18 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Spanish Online & Telephone Intervention for Caregivers of Veterans With Stroke
- ClinicalTrials.gov ID
- NCT03142841
- Acronym / sponsor ID
- RESCUE / IIR 15-117
- Conditions
- Depression
- Keywords
- Depression, Burden, Problem Solving Ability, Caregivers, Stroke, Veterans
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 210 participants (actual)
- Lead sponsor
- VA Office of Research and DevelopmentUS federal agency
- Study start
- 1 Jan 2018 (actual)
- Primary completion
- 4 Mar 2024 (actual)
- Study completion
- 4 Mar 2024 (actual)
- First posted
- 5 May 2017 (actual)
- Results
- Posted 18 Dec 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This research study will test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. The investigators will adapt their previously pilot-tested problem-solving intervention and make it culturally-relevant for Hispanic caregivers. The investigators' main goal is to test the efficacy of a brief, telephone and online problem-solving intervention. The objectives are: 1) reduce caregiver burden and depression, 2) improve caregivers' problem-solving abilities, self-efficacy, and quality of life, 3) improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare utilization, 4) determine budgetary impact, and 5) determine caregivers' perceptions of the intervention.
Detailed description
This research study will test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. The investigators will adapt their previously pilot-tested problem-solving intervention and make it culturally-relevant for Hispanic caregivers. The investigators' main goal is to test the efficacy of a brief, telephone and online problem-solving intervention. The objectives are: 1) reduce caregiver burden and depression, 2) improve caregivers' problem-solving abilities, self-efficacy, and quality of life, 3) improve Veterans' functional abilities and determine the intervention's impact on Veterans' healthcare utilization, 4) determine budgetary impact, and 5) determine caregivers' perceptions of the intervention.
The investigators will conduct a two-arm (8-session intervention vs. standard care), , randomized controlled trial to test a problem-solving intervention for Spanish-speaking stroke caregivers that will be delivered over the telephone and online via the previously developed and nationally available Spanish version of the RESCUE website. A sample of 290 stroke caregivers will be randomly assigned to either an intervention or a standard care group. Eligibility criteria: Hispanic caregivers of Veterans with a primary diagnosis of stroke are eligible for participation if they meet the following criteria: 1) are the primary caregiver and provide the majority of care for a Veteran who has a diagnosis of stroke (ICD9 codes for stroke: 430-438 or ICD 10 codes 160.0 through 169.998) within the last year and who has at least two activity of daily living (ADL) deficits or a new or worsening neurological problem, 2) have Internet access and ability, (either themselves or via a relative or friend) 3) are reachable by cell or home phone, 4) Spanish is their preferred language, 5) have moderate to severe stress, and 6) ) identify self as Hispanic, and 7) agree to random assignment to the intervention or standard care group. We will determine caregiver status.
Baseline measurements will be conducted with the caregivers prior to the intervention. Post-test assessments will be collected at 1 and 12 weeks post-intervention. In addition, the investigators will obtain pre- and post-test measures of Veteran-related variables via Computerized Patient Record System (CPRS) electronic health records. Qualitative interviews will be conducted to assess caregivers' perceptions of the intervention. A general linear mixed model for repeated measures will be used to examine the relationship between treatment assignment and each outcome over time. The investigators will measure the budgetary impact of providing intervention by comparing the costs of the intervention group to the costs of the control group.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- A two-arm (8-session intervention vs. standard care), randomized controlled clinical trial with three assessment points will be conducted. Baseline measurements will be conducted with the caregivers prior to the intervention. Post-test assessments will be collected at 1 and 12 weeks post-intervention. In addition, the investigators will obtain pre- and post-test measures of Veteran-related variables via CPRS electronic health records. Qualitative interviews will be conducted to assess caregivers' perceptions of the intervention.
| Arm | Type | Receives |
|---|---|---|
| Standard Care | No intervention | –The standard care group will receive the usual standard care they would receive had they not been enrolled in this study |
| Problem Solving Intervention | Experimental | Other: RESCUE Problem Solving InterventionParticipants in the intervention group received an 8-week problem-solving session conducted over the phone by a trainer interventionist. The intervention consists of four components: 1. Introduction to the RESCUE website and the problem-solving method; 2. Illustrative example on how to use the problem-solving approach and the RESCUE website to address caregiving problems; 3. Individualized practice exercise to develop a personalized problem-solving plan; and 4. Summary of the problem-solving method. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RESCUE Problem Solving InterventionThe RESCUE Problem Solving Intervention: This is an education and support intervention for caregivers of Veterans with stroke. The investigators taught study participants the COPE (Creativity, Optimism, Planning, Expert Advice) model of problem solving and guided them through the application of this model in their caregiver role. They also receive tailored stroke education, specific to their needs. | Other | Problem Solving Intervention |
Primary outcome
Change in Caregiver Depression at 9 Weeks
Time frame: 9 weeks after baseline
Caregiver depression as measured by the Center for Epidemiologic Studies Depression-20. The CES-D is a 20 item, four point Likert scale ranging from never (0) to most of the time (3). The minimum value is 0 and the maximum value is 60. The higher score means a worse outcome (more depressed). This tool has good reliability and validity.
Change in Caregiver Depression at 21 Weeks
Time frame: 21 weeks after baseline
Caregiver depression as measured by the Center for Epidemiologic Studies Depression-20. The CES-D is a 20 item, four point Likert scale ranging from never (0) to most of the time (3). The minimum value is 0 and the maximum value is 60. The higher score means a worse outcome (more depressed). This tool has good reliability and validity.
26 secondary outcomes
Change in Caregiver Burden-Zarit - 9 Weeks
Time frame: 9 weeks
Change in Caregiver Burden-Zarit - 21 Weeks
Time frame: 21 weeks
Change in Caregiver Self-Efficacy-Obtaining Respite - 9 Weeks
Time frame: 9 weeks
Change in Caregiver Self-Efficacy-Obtaining Respite - 21 Weeks
Time frame: 21 weeks
Changes in Caregiver Self-Efficacy- Controlling Upsetting Thoughts - 9 Weeks
Time frame: 9 weeks
Changes in Caregiver Self-Efficacy- Controlling Upsetting Thoughts - 21 Weeks
Time frame: 21 weeks
Changes in Caregiver Self-Efficacy: Responding to Disruptive Behaviors - 9 Weeks
Time frame: 9 weeks
Changes in Caregiver Self-Efficacy: Responding to Disruptive Behaviors - 21 Weeks
Time frame: 21 weeks
Change in Veteran's Functional Abilities- 9 Weeks
Time frame: 9 weeks
Change in Veteran's Functional Abilities- 21 Weeks
Time frame: 21 weeks
Changes in Caregiver Health-Related Quality of Life - Physical Component Score - 9 Weeks
Time frame: 9 weeks
Changes in Caregiver Health-Related Quality of Life - Physical Component Score - 21 Weeks
Time frame: 21 weeks
Changes in Caregiver Health Related Quality of Life - Mental Health Component - 9 Weeks
Time frame: 9 weeks
Changes in Caregiver Health Related Quality of Life - Mental Health Component - 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Positive Problem Orientation (PPO) at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Positive Problem Orientation (PPO) at 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Negative Problem Orientation (NPO) at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Negative Problem Orientation (NPO) at 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Rational Problem-Solving (RPS) at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Rational Problem-Solving (RPS) at 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Impulsivity/Carelessness Style (ICS) at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Impulsivity/Carelessness Style (ICS) at 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Avoidance Style (AS) at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) -Change in Caregiver Problem Solving Abilities- Avoidance Style (AS) at 21 Weeks
Time frame: 21 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Problem Solving Total at 9 Weeks
Time frame: 9 weeks
Social Problem-Solving Inventory-Revised Short Form (SPSI-R:S) - Change in Caregiver Problem Solving Abilities- Problem Solving Total at 21 Weeks
Time frame: 21 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Dec 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 36932321Freytes IM, Schmitzberger MK, Rivera-Rivera N, Lopez J, Motta-Valencia K, Wu SS, Orozco T, Hale-Gallardo J, Eliazar-Macke N, LeLaurin JH, Uphold CR. Study protocol of a telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial. BMC Prim Care. 2023 Mar 17;24(1):73. doi: 10.1186/s12875-022-01929-y.
- BackgroundFreytes IM, Schmitzberger M, Rivera-Rivera N, Lopez J, Mylott D, Motta-Valencia K, Uphold CR. Serving Underserved Veterans and Their Caregiver: Developing Tailored Culturally Relevant Interventions. [Abstract]. Innovation in aging. 2019 Nov 8; 3(Supp 1):S674.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ivette M Freytes, PhD MEd BA principal investigator
North Florida/South Georgia Veterans Health System, Gainesville, FL
4 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing RESCUE Problem Solving Intervention in people with Depression, run by VA Office of Research and Development at 4 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 4 sites in United States, Puerto Rico. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 18 Dec 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Caregiver Depression at 9 Weeks (time frame: 9 weeks after baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03142841, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Dec 2025.