# Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2022 · $695,926

## Abstract

PROJECT ABSTRACT
In family caregiving situations, those with Alzheimer’s disease and related dementia (ADRD) are more likely to
experience elder abuse and neglect (EAN) than older adults living alone or not requiring assistance with care.
Elder abuse and neglect (EAN) is defined as acts committed by a person in a trusted relationship that cause
actual or increased risk of harm to an older adults’ health and wellbeing. EAN consists of different subtypes such
as physical and psychological abuse and neglect. About half of family caregivers for persons with dementia self-
report doing at least one of these three EAN subtypes. This proposal evaluates an evidence-based tele-coaching
intervention, Care-Resistant Behavior Internet Training (CuRB-IT) to enhance coping skills of family caregivers
and reduce elder abuse and neglect (EAN). CRB includes actions taken by a person with ADRD to resist or
refuse assistance with care, such as refusing to open their mouth for oral care or using physical aggression. Our
tele-coaching intervention (CuRB-IT), which increases problem-solving coping skills by teaching practical
strategies to manage CRBs, effectively reduces CRB-related caregiver distress. We will test the effectiveness of
CuRB-IT in a delayed-intervention randomized clinical trial, within a multi-time series approach. Caregivers in
immediate- and delayed-intervention groups (N=266) will complete 4 waves of instrument completion and daily
diary surveys describing the frequency of CRB and EAN over a 21-day period at baseline, 3 months, 6 months,
and 9 months. Delayed-intervention caregivers will receive weekly texts to reduce inflated intervention effects
inherent in many wait-list control designs.22 After the 3-month follow-up, the delayed-intervention group will then
receive the CuRB-IT intervention. This design allows us to maximize power to examine efficacy (between-group),
mechanism-of-action, and intervention delay (within-group). Thus, we propose the following Specific Aims: 1)
Test the efficacy of an online care-resistant behavior coaching intervention in reducing frequency of EAN (a)
among the experimental (immediate-intervention group) as compared to the control (delayed-intervention group)
(between groups) and (b) within-person from pre- to post- intervention.; 2) Test hypothesized mechanism of
action through multi-level structural equation modeling to assess the relationships between CRB-stress
appraisal, use of CuRB-IT problem-focused coping strategies and EAN; and 3) Examine intervention decay at
3- and 6-months post intervention to determine performance of intervention and inform scheduling of booster
sessions. We will also assess the efficacy of the CuRB-IT intervention in preventing onset of EAN use by family
caregivers as an exploratory aim. This proposal directly addresses high-priority research gaps identified by the
NIH Office of Disease Prevention and US Preventative Task Force. Next steps in this research program will
focus on trans...

## Key facts

- **NIH application ID:** 10478199
- **Project number:** 5R01AG074255-02
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** RITA A JABLONSKI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $695,926
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10478199

## Citation

> US National Institutes of Health, RePORTER application 10478199, Testing Dementia Caregiver TeleCoaching to Reduce Episodes of Abuse and Neglect by Recognizing and Managing Care-Resistant Behaviors (5R01AG074255-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10478199. Licensed CC0.

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