REACH - Summary of Intervention Conference Call

11-07-01

Participants: Laura, Linda, Sara, Lou, David, Dolores, Sid, Mary, Laraine, Joy, Julie,

  1. We had a productive and lively discussion about the intervention goals and objectives and used the task analysis chart as a way of structuring our discussion.
  2. We revised the intervention goals as follows:

a)to identify and reduce modifiable risk factors and negative consequences of caregiving

b)to enhance quality of care of the care recipient

c)to enhance well-being of caregivers.

  1. We agreed in principle about the wording of the objectives and no new objectives were identified at this point. Objective #2 (support to caregivers) may need further definition and editing.
  2. While we agreed in principle that REACH II intervention will be multi-component, the driving therapeutic/theoretical framework of the intervention remains unclear. We discussed the importance of identifying a unifying theme – a framework that ties objectives together. Ideas presented included:

-a problem-solving approach

-a cognitive/behavioral approach

-an informational/education model

  1. One suggestion was to use the REACH stress process model as an overarching theoretical model to explicate the way in which each intervention objective/ component impacts a different level/stressor along this model as well as a way to emphasize the multi-component nature of our intervention. Nevertheless, it was raised that this does not provide a theoretically-based therapeutic framework to link/tie objectives or that reflects a common therapeutic framework.
  2. We discussed the need to derive a new therapeutic, theoretical framework that reflected the multi-component nature of the intervention and that would serve as the common thread. This may represent a major contribution of the REACH II endeavor. We determined that further reflection and discussion is required and specific feedback from Rich is important.
  3. Major issues in addition to the above that we identified include:

-To what extent and when does the intervention have just an informational role, referral role or more active, hands-on role

-Are there certain domains/risk factors/areas that require more in-depth therapeutic approaches than others

-In what ways can we tailor intervention and simultaneously assure everyone gets the same thing/ is there any merit in considering the “readiness” staging as a way of guiding intervention

-Specification of activities per objectives and mechanism of delivery (e.g., CTIS, information sheets, hands-on active teaching, etc.) need to be developed.

NEXT STEPS INCLUDE:

  1. Laura and Sara will work on revising the task analysis as per our discussion and include another level that attempts to unify the four objectives;
  2. Group members should actively give more thought to a multi-component theoretical framework (does anyone have ideas for a reading???)
  3. The group will be sent the next version of the risk appraisal form that will help inform the direction of the intervention. Also, the form may help guide ways of tailoring the intervention and prioritizing strategies introduced to caregiver.

4. Our next phone call will be Wednesday, November 21 at 11:00 Eastern