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In reports of randomized controlled trials, thorough description of the attention control condition has been recommended, yet is frequently lacking. The Tele-Savvy Caregiver program for informal caregivers of persons living with dementia was tested in a randomized controlled trial with an attention control condition. The purpose of this trial was to test Tele-Savvy's efficacy in reducing the negative effects of caregiving on caregivers, promoting quality of life for persons living with dementia, and improving caregiver mastery. We describe the design and implementation of and examine the outcomes associated with the attention control condition. Caregivers were randomized to the immediate Tele-Savvy (active condition), Healthy Living (attention control), or waitlist. The attention control content was focused on healthy lifestyle and was not intended to affect the outcomes that Tele-Savvy targeted. The attention control group was similar to Tele-Savvy in the intervention structure and duration: it consisted of seven weekly group videoconferences and 36 video lessons. Data on outcomes of caregivers and persons living with dementia were collected at baseline and 3 and 6 months postbaseline. Multilevel mixed effects models were used to determine changes in the outcomes. One hundred and eleven caregivers were randomized to the attention control condition (attrition 21.6%). Eighteen formative assessment interviews focusing on caregivers' experience in the attention control condition were conducted. The attention control condition completers had no statistically significant changes in the variables that Tele-Savvy targeted. These results may be used in the design and implementation of attention control conditions in behavioral intervention research., (© 2022 Wiley Periodicals LLC.)

African American caregivers for persons living with dementia frequently experience emotional strain, burden, social isolation, and depression. One source of support for them when in distress is their church community. However, many African American churches do not have programs to support families and congregants living with dementia. Dementia often restricts persons living with dementia and their caregivers from attending church. Both become increasingly uncomfortable in church settings due to fear of embarrassment, uncertainty about the behavior of the person living with dementia, and shame. Church attendance and religion has been shown to be beneficial for caregivers and elders living with dementia. However, there is little work exploring how involvement in religious practices together (caregivers and persons living with dementia) might enhance the quality of life for these families. This protocol is written to detail the designing and testing of the feasibility and preliminary efficacy of a dementia-friendly faith village worship service. In the study, we will examine how dementia-friendly faith village worship services support the well-being of caregivers and care recipients in three African American churches through observation, interviews, and surveys. A sample of 30 dyads of African American caregivers and persons living with dementia will be asked to attend six modified worship services together over 6 months. In this study, we hope to demonstrate the significant role of churches in the lives of African American family caregivers and persons living with dementia and show that a faith-based, family-oriented approach can promote a greater quality of life for African American families living with dementia., (© 2019 Wiley Periodicals, Inc.)

Purpose: This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved., Design: This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics., Methods: Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making., Findings: Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing., Conclusions: Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices., Clinical Relevance: Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers., (© 2018 Sigma Theta Tau International.)

Many informal caregivers of persons with dementia suffer adverse health consequences. Although established psychoeducation programs are known to benefit caregivers, attending in-person programs is challenging for them. To address this challenge, the Savvy Caregiver Program, an evidence-based psychoeducation program with demonstrated effectiveness for caregiving and disease-related outcomes, was transformed into an on-line program, Tele-Savvy. This article describes the rationale for and design of a prospective longitudinal randomized controlled trial (targeted N = 215), currently underway. The trial aims to establish Tele-Savvy's efficacy in (i) reducing the negative effects of caregiving on caregivers; (ii) promoting care recipients' quality of life; (iii) improving caregiver mastery; and to explore (iv) Tele-Savvy's efficacy among caregivers of different races/ethnicities. The mediating role of mastery will be assessed. Participants are randomized to the active condition (immediate Tele-Savvy participation), attention control, or usual care. Participants in the two latter conditions will complete Tele-Savvy 6 months post-baseline. Multilevel mixed effects models will be used to examine changes in outcomes and to model group by time (months since baseline) interactions. The exploratory aim will be addressed using analysis of covariance and qualitative analysis. This trial's results may be used by healthcare and community organizations to implement Tele-Savvy in dementia care, increasing caregivers' access to this evidence-based intervention., (© 2018 Wiley Periodicals, Inc.)

Introduction: The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) adapted a collaborative improvement strategy to develop woreda (district) leadership capacity to support and facilitate continuous improvement of community maternal and neonatal health (CMNH) and to provide a model for other woredas, dubbed "lead" woredas. Community-level quality improvement (QI) teams tested solutions to improve CMNH care supported by monthly coaching and regular meetings to share experiences. This study examines the extent of the capacity built to support continuous improvement in CMNH care., Methods: Surveys and in-depth interviews assessed the extent to which MaNHEP developed improvement capacity. A survey questionnaire evaluated woreda culture, leadership support, motivation, and capacity for improvement activities. Interviews focused on respondents' understanding and perceived value of the MaNHEP improvement approach. Bivariate analyses and multivariate linear regression models were used to analyze the survey data. Interview transcripts were organized by region, cadre, and key themes., Results: Respondents reported significant positive changes in many areas of woreda culture and leadership, including involving a cross-section of community stakeholders (increased from 3.0 to 4.6 on 5-point Likert scale), using improvement data for decision making (2.8-4.4), using locally developed and tested solutions to improve CMNH care (2.5-4.3), demonstrating a commitment to improve the health of women and newborns (2.6-4.2), and creating a supportive environment for coaches and QI teams to improve CMNH (2.6-4.0). The mean scores for capacity were 3.7 and higher, reflecting respondents' agreement that they had gained capacity in improvement skills. Interview respondents universally recognized the capacity built in the woredas. The themes of community empowerment and focused improvement emerged strongly from the interviews., Discussion: MaNHEP was able to build capacity for continuous improvement and develop lead woredas. The multifaceted approach to building capacity was critical for the success in creating lead woredas able to serve as models for other districts., (© 2014 by the American College of Nurse-Midwives.)

Introduction: A number of factors affect Ethiopia's efforts to meet Millennium Development Goals 4 and 5 to reduce maternal and newborn mortality. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) project, as part of its overall strategy, implemented behavior change communication interventions to increase women's demand for and use of antenatal, birth, and postnatal services. Seeking to reach "media-dark" areas, MaNHEP implemented a mobile video show focused on maternal and newborn health. We report on the effect of the mobile video show on community knowledge, attitudes, and beliefs regarding maternal and newborn health, especially regarding care-seeking behavior and use of a skilled attendant for birth and postnatal care., Methods: Two main data sources are used: qualitative data gathered through mobile video show participant discussions in 31 randomly selected kebeles (villages with about 1000 households) and focus groups in 4 kebeles (2 from each region), and quantitative data generated from 510 randomly selected adults participating in MaNHEP's endline survey. Qualitative data were thematically analyzed by the research team, and the accuracy of the transcriptions and categorization was also checked., Results: The mobile video show reached a total of 28,389 mostly young or adult females in 51 kebeles. At endline, mobile video show attendees (vs nonattendees) reported significantly (P < .001) higher rates of recall of key MaNHEP messages about use of health extension workers for pregnancy registration, labor and birth notification, and postnatal care. Qualitative analysis yielded 3 overarching themes: mirrors to the community (the portrayal is accurate); call to action (we have to change this); and improvement ideas (suggested positive actions)., Discussion: The entertaining nature and local organization of the mobile video show event encouraged attendance. Building the video around recognizable characters (particularly the husbands) contributed to bringing about desired changes in people's knowledge and beliefs. Making the show readily available (through the mobile van) and bundling it with facilitated reflection sessions had a considerable impact on people's knowledge and confidence., (© 2014 by the American College of Nurse-Midwives.)

Although dementia caregiver stress and burden can be ameliorated with intervention, such interventions typically occur in specific caregiving contexts and at specific points in the progression of the dementing illness. We explored the ongoing learning needs and preferences of previously trained caregivers. Descriptive analysis of caregiver survey responses (N = 168) informed follow-up focus group interviews conducted with 26 family caregivers. Content analysis of focus group data showed that caregivers enjoyed the interactive problem-solving of the group related to preparing for the future, shaping the troubling behavior of the care recipient, reshaping the resource team, and caring for themselves. These findings support the need for advanced training as caregivers move through the trajectory of caring for persons with dementia., (Copyright © 2012 Wiley Periodicals, Inc.)