Rural Intervention for Caregivers' Heart Health (RICHH)

Grants and Contracts Details


In the patient-family caregiver dyad, emphasis traditionally has been on the patient and on helping the caregiver take care of the patient. This approach ignores the health of the caregiver. Family caregivers of patients with chronic disease are at uniquely high risk for development of cardiovascular disease (CVD). Because of the environment they share with the patient, lack of personal time due to caregiving, psychological distress, and the austere healthcare environment, rural caregivers of patients with chronic illness, particularly those living in Appalachian Kentucky are at elevated risk for CVD. To reduce this risk, cardiovascular health interventions aimed at (1) CVD risk reduction using a self-management focus, (2) reducing caregiver stress, and (3) preventing and managing depressive symptoms are required. Because Appalachia Kentucky is characterized by marked CVD health disparities, persistent poverty, and lack of social and healthcare resources, an innovative intervention program is needed to improve cardiovascular health among caregivers while overcoming personal and environmental barriers to achieving this goal. The Rural Intervention for Caregivers’ Heart Health (RICHH) program proposed in this study will address the important components of CVD risk reduction for rural caregivers of patients with chronic illness – most notably improved self-management of CVD risk reduction, including prevention and management of depressive symptoms. We propose an innovative delivery modality designed to overcome environmental barriers in socioeconomically austere rural areas. The purpose of the proposed 2-group (RICHH vs attention control) randomized clinical trial (RCT) is to examine short- and long-term effects of the RICHH intervention on CVD risk (i.e., lipid profile, body mass index, blood pressure, physical activity level), self-care behaviors (i.e., diet quality, physical activity level, self-reported adherence to health behaviors), depressive symptoms, caregiving burden, and quality of life compared to an attention control in rural caregivers of persons with chronic disease. A total of 280 caregivers of patients with chronic illness will be enrolled. Rural caregivers who are at risk for CVD will be randomly assigned to one of the two groups. We will stratify caregivers by sex in order to examine the moderating effect of sex on intervention outcomes. The RICHH intervention (6 interactive modules) will be delivered for 12 weekly sessions (60 to 90 minutes per session) followed by 6 biweekly (every other week) booster sessions (20-30 minutes per sessions) for 3 months, then monthly for 6 months using a video-conferencing program on a multimedia digital device (i.e., mini iPad). All participants will complete survey questionnaires (i.e., adherence to healthy behavior, depression, caregiving burden, and quality of life) and physical examination (i.e., lipid profiles, body mass index, waist circumference, and blood pressure) at baseline (pre-intervention) and at 4 and 12 months post-baseline. Keywords: Health promotion; Cardiovascular disease; self care
Effective start/end date9/26/166/30/22


  • National Institute of Nursing Research: $2,628,684.00


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