Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III...

Area of Science:

• Implementation Science
• Health Services Research
• Caregiver Support

Background:

• Family caregiver training programs like Caregivers FIRST reduce caregiver burden and improve quality of life.
• National dissemination of Caregivers FIRST is underway via the Veterans Health Administration (VHA) National Caregiver Support Program (CSP).
• Optimal implementation support levels for cost-effective scaling remain undetermined.

Purpose of the Study:

• To compare the effectiveness of high-touch versus low-touch implementation support for Caregivers FIRST.
• To evaluate the impact of Caregivers FIRST on Veteran outcomes.
• To conduct a business case analysis of different implementation support models.

Main Methods:

• A pragmatic type III hybrid implementation-effectiveness study design.
• Randomization of 24 VA medical centers to either high-touch or low-touch implementation support.
• Measurement of implementation outcomes (penetration, fidelity, adoption) and Veteran outcomes (days at home).

Main Results:

• High-touch support is hypothesized to increase Caregivers FIRST penetration, fidelity, and adoption.
• Mixed methods will explore site experiences with enhanced support.
• Analysis of Veteran outcomes and cost-effectiveness of support models.

Conclusions:

• This trial will refine implementation tools for efficient national spread and sustainability of Caregivers FIRST.
• Findings will inform optimal resource allocation for caregiver support programs.
• The study aims to enhance the delivery of evidence-based caregiver interventions within the VHA.