Abstract
PURPOSE/OBJECTIVE: Caregivers of veterans with comorbid traumatic brain injury (TBI) and dementia face many challenges managing their loved ones' neurobehavioral functioning and, importantly, their own well-being. This study developed and tested Resources for Enhancing All Caregivers' Health (REACH) Hope, which provides caregivers with one-on-one telehealth education, support, skills building, and personalized digital information. METHOD: Caregivers (N = 110) of veterans with both TBI and dementia were randomly assigned to either REACH Hope (n = 56) or a waitlist-control group (n = 54) for 3 months; waitlist participants then received REACH Hope. Data collection occurred by telephone at baseline, 3 months (postintervention/waitlist switch), 6 months, and 9 months (for waitlist-control only). The 12-item short-form Zarit Burden Interview (ZBI-12) at 3 months (posttreatment) was the primary outcome. Secondary outcomes included caregiver depression, anxiety, self-efficacy, and number of veteran safety risks. RESULTS: REACH Hope reduced burden and anxiety for caregivers with moderate to high levels of burden and anxiety compared to the waitlist group. Caregivers with ZBI-12 scores ≥ 21 had increasing treatment benefits with higher burden. Caregivers with Generalized Anxiety Disorder-7 scores ≥ 13 showed the same pattern for higher anxiety levels. There were no significant treatment group effects for depression, self-efficacy, or veteran safety. CONCLUSION: This is the first clinical trial to evaluate the efficacy of a telehealth intervention for caregivers of veterans with both TBI and dementia. REACH Hope represents the first evidence-based intervention of its kind and one that warrants further study and implementation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).