Authors

  1. Kreitzer, Natalie MD, MS
  2. Adeoye, Opeolu MD, MS
  3. Wade, Shari L. PhD
  4. Kurowki, Brad G. MD, MS
  5. Thomas, Stephanie MEd
  6. Gillespie, Lauren MD
  7. Bakas, Tamilyn PhD

Abstract

Objectives: (1) To iteratively design a web/phone-based intervention to support caregivers of adults acutely following traumatic brain injury (TBI), Caregiver Wellness (CG-Well), and (2) to obtain qualitative and quantitative feedback on CG-Well from experts and caregivers to refine the intervention.

 

Setting: A level I trauma and tertiary medical center.

 

Participants: Convenience sample of a total of 19 caregivers and 25 experts.

 

Design: Multistep prospective study with iterative changes to CG-Well: (1) developed intervention content based on qualitative feedback from a prior study and literature review; (2) obtained qualitative feedback from 10 experts; (3) refined content using a modified Delphi approach involving 4 caregivers and 6 experts followed by qualitative interviews with 9 caregivers; (4) designed CG-Well website and videos; and (5) obtained feedback on program acceptability, appropriateness, and feasibility from 6 caregivers and 9 experts.

 

Interventions: CG-Well included content on TBI, self-care and support, and skill-building strategies delivered through a website and telephone calls.

 

Main Outcome Measure(s): Qualitative data were analyzed using content analysis. Caregivers and experts completed Likert-type scales to rate module relevance, clarity, accuracy, utility and website acceptability, appropriateness, and feasibility (1 = strongly disagree to 5 = strongly agree). Means and standard deviations (SD) characterized ratings.

 

Results: Qualitative findings were instrumental in designing and refining CG-Well. Ratings were positive for modules (means and SD for relevant [4.9, 0.33], clear [4.6, 0.53], accurate [4.9, 0.33], and useful [5, 0]) and the website (means and SD for acceptable [4.8, 0.36], appropriate [4.8, 0.35], and feasible [4.8, 0.36]).

 

Conclusions: The iterative design process for CG-Well resulted in a highly acceptable program. An early-stage randomized controlled trial is underway to estimate treatment effects for a future well-powered clinical trial.