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. 2021 Sep 22;5(9):e30990.
doi: 10.2196/30990.

Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Marian E Betz  1   2 , Evan Polzer  1 , Kathryn Nearing  2   3 , Christopher E Knoepke  4   5 , Rachel L Johnson  6 , Lauren Meador  1 , Daniel D Matlock  2   3
Affiliations

Feasibility and Acceptability of a Web-Based Caregiver Decision Aid (Safety in Dementia) for Firearm Access: Pilot Randomized Controlled Trial

Marian E Betz et al. JMIR Form Res. .

Abstract

Background: Firearms are common in the households of persons with Alzheimer disease and related dementias (ADRD). Safety in Dementia (SiD) is a free web-based decision aid that was developed to support ADRD caregivers in addressing firearm access.

Objective: We aimed to evaluate the feasibility and acceptability of SiD among a web-based sample of ADRD caregivers.

Methods: SiD was tested in 2 phases by using participants who were recruited from a web-based convenience sample (Amazon Mechanical Turk participants). In phase 1, caregivers were randomized to view either the intervention (SiD) or the control (Alzheimer's Association materials), and the blinding of participants to the study arms was conducted. In phase 2, caregivers of individuals with ADRD and firearm access were recruited; all of these participants viewed the firearm section of SiD. In both phases, participants viewed SiD independently for as long as they wanted. Measures for evaluating decision-making and SiD acceptability were used, and these were assessed via a self-administered web-based questionnaire.

Results: Participants were recruited for phases 1 (n=203) and 2 (n=54). Although it was feasible to collect the study outcome data in a web-based format, in phase 1, there were no significant differences between SiD and the control in terms of decision-making and self-efficacy. The majority (137/203, 67.5%) of phase 1 participants spent between 5 and 10 minutes reviewing the resources. In phase 2, 61% (33/54) of participants spent 5 to 10 minutes viewing the firearm section, and 31% (17/54) spent 10 to 20 minutes viewing this section. Usability and acceptability were high across the phases.

Conclusions: SiD represents a new resource for promoting safety among people with dementia, and high acceptability was achieved in a pilot trial. In this sample, SiD performed similarly to Alzheimer's Association materials in supporting decision-making and self-efficacy.

Keywords: Alzheimer disease; caregiver support; caregivers; cognitive impairment; decision aid; dementia; feasibility; firearm; pilot trial; safety.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Plots showing the distribution of scores for participants' (A) preparation for decision-making and (B) decision self-efficacy. The results for each randomized group are stratified by participants' self-selected topic (phase 1: n=203). Bars represent the 25th and 75th percentiles. In the Preparation for Decision Making Scale, higher scores represent greater preparedness. In the Decision Self-Efficacy Scale, transformed scores range from 0 (extremely low) to 100 (extremely high self-efficacy). SiD: Safety in Dementia.
See this image and copyright information in PMC

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