"Safety in Dementia": An Online Caregiver Intervention

University of Colorado, Denver500 enrolled

Overview

In an online randomized trial of Safety in Dementia with national recruitment and longitudinal follow-up, we will recruit informal caregivers of community-dwelling adults with dementia who have firearm access.

Aim 1: To test the efficacy of Safety in Dementia (SiD) on firearm safety decision quality and behaviors, among a national sample of informal caregivers of community-dwelling people with dementia and firearm access (n=500). Aim 2: To compare varied methods in reaching informal caregivers. Aim 3: To explore stakeholder longitudinal experiences with SiD and firearm-related decisions.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

500

Conditions

Caregivers Decision Making Alzheimer Disease Social Media Safety Suicide

Interventions

Safety in DementiaBEHAVIORAL

Safety in Dementia is an online tool that, in a stepwise fashion, guides a caregiver individual through decisions related to firearm access for a person with dementia. It includes information and a comparison of the options and their risks and benefits. It guides the caregiver through clarification of personal feelings and values and identifying their decision/plan. The control group will view national Institute on Aging Home Safety Checklist.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Live in United States * Speak English or Spanish * Informal caregiver for community swelling person with dementia and firearm access * Access to the internet Exclusion Criteria: * In legal custody or institutionalized

Locations (1)

University of Colorado Anschutz

Aurora, Colorado, United States

Outcomes

Primary Outcomes

Change in Preparation for Decision Making

The Preparation for Decision Making Scale assesses perception of how useful a decision aid is in preparing for subsequent decision-making. Scores range from 1-5, calculated from the average of 9 constructs (each ranging from 1, strongly disagree to 5, strongly agree). The scale has high test reliability (0.944) and discriminates significantly between different decision support interventions. In our pilot RCT, participants had a mean score of 3.9 (SD 0.7) after viewing the SiD firearm section.

Time frame: During baseline assessment (specifically, after receiving randomization allocation), 2 weeks, 2 months, 6 months

Secondary Outcomes

Change in Decision Self-Efficacy

The Decision Self-Efficacy Scale measures confidence in ability to make decisions; transformed scores range from 0 (extremely low) to 100 (extremely high self-efficacy).

Time frame: baseline/pre-intervention, 2 weeks, 2 months, 6 months

Change in Firearm access

Firearm access for the person with ADRD will be assessed with scales we have used in prior work, allowing nuanced (but efficient) description of firearm access (on a scale ranging from access to multiple loaded firearms to no access to any firearms). For analysis, we will use binary categorization (any access to 1+ firearm versus no access to any firearms)

Time frame: baseline/pre-intervention, 2 weeks, 2 months, 6 months

Action to reduce firearm access

This will be self-report of taking action to reduce access to one or more firearms (e.g., locking of additional firearm or moving out of the home). The question and categories will allow identification of smaller, albeit important, changes; for analysis we will use binary categorization (any action versus no action).

Time frame: 2 weeks, 2 months, 6 months

Firearm injury

Data from ClinicalTrials.gov

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