Understanding attrition: Feasibility and acceptability of a behavioral intervention for dementia care partners

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INTRODUCTION: Behavioral intervention studies for family care partners for those with dementia need to be both feasible and acceptable in order implement and complete the investigative work. Our study, Tele-STELLA (Support via Technology: Living and Learning with Advancing dementia), was as single arm clinical trial completed in 2025. While 188 care partners enrolled, the attrition rate was high (44%). Here we describe the feasibility, acceptability, fidelity processes and preliminary efficacy of Tele-STELLA. METHODS: Quantitative measures were used to assess care partner burden, study participation, feasibility and acceptability. Our weekly survey assessed the prevalence of adverse events. Qualitative methods paralleled our quantitative findings, in that care partners generally found the study acceptable, but dementia progression and life demands made participation difficult for some. RESULTS: The total attrition rate was 44% but was attenuated by increasing the sample size. This adequately-powered study found that the intervention significantly reduced burden. Overall, care partners found the study feasible, but care demands made participation difficult for 28 of the care partners resulting in their withdrawal. In addition, 21 care recipients died, and thus their care partners had to be removed from the study. Protocol deviations and losing care partner contact also added to the attrition rate. DISCUSSION: Our findings reveal that, even in the later stages of dementia, care partners are willing to participate in intervention research. However, care demands and death can affect the sample size. Our data and recommendations for future studies will inform caregiving scientists in designing behavioral interventions in late-stage dementia.

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