# Resourcefulness Intervention to Promote Self-Management in Parents of Technology-Dependent Children

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2020 · $535,585

## Abstract

Project Summary/Abstract
Parent caregivers of children who require life-saving technology such as mechanical ventilation or feeding
tubes must maintain a high level of vigilance 24 hours a day, 7 days a week. They report greater levels of
stress, compromised self-management behaviors and poorer psychological and physical health than other
caregiver groups which dramatically increases their mortality risk. Technology-dependent children
(approximately 600,000) are among the sickest and most vulnerable subset of children with complex chronic
conditions in the United States. They comprise 20% of all children discharged from the hospital to home, yet
account for 61% of healthcare spending for children, up to $110 billion annually. Despite the adverse
consequences for caregivers, there are no interventions to meet their specific needs. Resourcefulness
Training, (cognitive-behavioral self-management intervention) has been shown to improve psychological and
physical outcomes, mediate the effects of stress, and enhance the care provided to care-recipients. A
Resourcefulness Training Intervention (RTI) will be tested in a randomized trial against an attention control
group. The RTI includes face-to-face session for teaching social (help-seeking) and personal (self-help)
resourcefulness skills, ongoing web access to the RTI video and video vignettes of caregivers of technology-
dependent children describing resourcefulness skill application in daily life, 4 weeks of skills' reinforcement
using daily journal writing, weekly phone calls for the first 4 weeks, and booster sessions at 2 and 4 months
post enrollment. The Attention Control group will receive weekly phone calls for the first 4 weeks and at 2 and
4 months post enrollment plus any usual care. The aims of the study are to: 1) Determine whether the RTI
versus Attention Control improves psychological (mental HRQoL depressive cognitions, depressive symptoms,
appraised stress, burden) and physical outcomes (physical HRQoL, chronic stress [hair cortisol]) over 9
months in parents of technology-dependent children, after controlling for covariates (parent race/ethnicity and
gender, family income, and children's functional status, type of technology). 2) Determine whether changes in
psychological and physical outcomes are mediated by changes in parents' levels of resourcefulness based on
intervention condition. 3) Compare self-management behavior (sleep, positive health practices) over 9 months
in parents who received RTI versus Attention Control. 4) Explore whether resourcefulness is a mediator
between intervention condition and self-management behaviors controlling for baseline self-management
behavior over 9 months. 5) Explore the relationship between self-management behavior and parent
psychological and physical outcomes based on intervention condition. Our study will be the first to test a
cognitive-behavioral RTI for this caregiver population. 6) Compare target children's ER visits, hospital days
over ...

## Key facts

- **NIH application ID:** 9843534
- **Project number:** 5R01NR017614-02
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Valerie Annette Toly
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $535,585
- **Award type:** 5
- **Project period:** 2018-12-28 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9843534

## Citation

> US National Institutes of Health, RePORTER application 9843534, Resourcefulness Intervention to Promote Self-Management in Parents of Technology-Dependent Children (5R01NR017614-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9843534. Licensed CC0.

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