Attention control group activities and perceived benefit in a trial of a behavioral intervention for older adults.
Sarah E LaFave, Marianne Granbom, Thomas K M Cudjoe and 3 others
PMID 31647125WHAT IT FOUND
In the attention control arm of a home-based trial, older adults with daily-living difficulty often chose conversation and games.
They reported perceived benefit, but this is self-report, not proof an intervention works.
Key findings
01Of 148 participants randomized to the attention control group, 73 (49%) received the full dose of 8 to 10 visits, 56 (37.8%) received fewer than 3 visits, and 123 (83.1%) completed the 5-month survey; the mean number of visits was 6.8 and the mean visit length was 60.1 minutes.
02The most commonly reported visit activity was conversation, followed by playing games, then learning to use an electronic device or a shared media experience; reading aloud, life review, and arts and crafts were least common.
03Among attention control participants, 63.4% perceived a great deal of overall benefit, 26.8% perceived some benefit, and 5.7% perceived no overall benefit; for six of eight specific benefits, the largest fraction reported a great deal, and 87.8% said participation required not at all too much work.
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What it does not show
This paper analysed only the attention control group. The trial's primary outcomes and intervention comparisons are not reported here. Only 73 of 148 randomized participants received the full dose, and 56 received fewer than 3 visits, so the described experience was not uniform. Perceived benefit was self-reported on a survey with no reported reliability or validity. The study took place in one city and used one attention visitor, who was an older white man while most participants were African American women. Conversation was not tracked by type, so small talk and meaningful conversation were not separated. Visit time allocation required assumptions when two activities occurred in one visit. Baseline social connections and family or social support were not measured and may have influenced perceived benefit. Participants with cognitive impairment, apartment residence, terminal diagnosis, or current in-home therapy were excluded, so the results may not apply to those groups.
Declared interests
The authors declared no conflicts of interest. The supplied publication types list NIH extramural research support; the article text does not give a funding declaration.
The easy way to misread this
Do not read the 63.4% who reported a great deal of overall benefit as proof that attention visits improve health, function, or safety. This was self-reported perceived benefit in the attention control arm, the survey had no reported reliability, and this paper does not report the trial's primary outcomes.