Telehealth transition assistance program for new spinal cord injury caregivers: A randomized clinical trial

Context Caregivers of individuals with spinal cord injury (SCI) frequently assume demanding roles immediately after SCI, placing them at risk for burden, depression, and diminished well-being. Few interventions have been tailored to support caregivers during this critical initial transition period.Design This randomized clinical trial developed and tested the Transition Assistance Program (TAP), which provides structured telehealth support targeting caregiver psychosocial adjustment and care quality as they learn to be caregivers for the first time.Setting The study recruited caregiver-care recipient dyads from two acute SCI units at an academic medical center and a Veterans Affairs hospital.Participants Dyads (N = 31 completing follow-up) were randomized to TAP or usual care.Interventions The TAP consisted of five sessions (one in person before discharge, four via telehealth-to-home) combining structured education, a caregiver guidebook, and supportive problem-solving.Outcome Measures Primary outcomes – caregiving quality, depression, relationship satisfaction, and positive affect and well-being – were assessed at baseline, 2, and 4 months post-discharge.Results Caregivers in the TAP group reported higher caregiving quality across the two follow ups (P = .041, ηp² = .141), a large effect. For all other caregiver and patient outcomes, TAP participants consistently demonstrated more favorable scores with small-to-medium effect sizes, though differences did not reach statistical significance.Conclusion The TAP improved caregiver-reported caregiving quality and showed promising effect sizes across multiple psychosocial outcomes. Findings support the feasibility and potential utility of telehealth-based caregiver interventions during the transition from inpatient rehabilitation to home, warranting larger-scale trials.Trial registration: ClinicalTrials.gov identifier: NCT03244098.