RAND Project Description

June 22, 2015
P&R 15-535

Ms. Rosemary Freitas Williams
Deputy Assistant Secretary of Defense
(Military Community and Family Policy)
Contract No. W91WAW-12-C-0030
Dear Ms. Williams:
Enclosed is a project description entitled “Improving Caregiver Outcomes Through
Structured Social Support Via Military Caregiver Peer Forums,” with Rajeev Ramchand as
the principal investigator. The work will be carried out under the auspices of the National
Defense Research Institute, the OSD-sponsored federally funded research and development
center at RAND. Total project funding is $500,000. Project funding required in FY15 is
$250,000 to be provided by P&R. Funding in the amount of $250,000 will be needed in
FY16 to complete the research. The estimated level of effort for the current fiscal year is 0.7
STE.
Sincerely,

K. Jack Riley
Vice President, RAND
Director, National Defense Research Institute
KJR:lb
Enclosure as noted
cc: Deborah Maraia
Sandra Mason

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PROPRIETARY

IMPROVING CAREGIVER OUTCOMES THROUGH STRUCTURED SOCIAL SUPPORT
VIA MILITARY CAREGIVER PEER FORUMS

Rajeev Ramchand
Principal Investigator

Prepared for the
READINESS AND FORCE MANAGEMENT
AND MILITARY COMMUNITY & FAMILY POLICY

by the
National Defense Research Institute

RAND
1776 Main Street
Santa Monica, CA 90407-2138
(310) 393-0411

June 2015

This material is considered proprietary to RAND. These data shall not be disclosed outside the
Government and shall not be duplicated, used, or disclosed in whole or in any part for any
purpose other than evaluation, provided, that if work is approved as a result of or in connection
with the submission of these data, the Government shall have the right to duplicate, use, or
disclose the data to the extent provided in the contract. This restriction does not limit the
Government’s right to use information contained in the data if it is obtained from another source
without restriction.

Contract No. W91WAW-12-C-0030

Project No. 2616

P&R 15-535

Project Description
IMPROVING CAREGIVER OUTCOMES THROUGH STRUCTURED SOCIAL SUPPORT
VIA MILITARY CAREGIVER PEER FORUMS

Rajeev Ramchand
Principal Investigator

OBJECTIVES

To evaluate whether participation in Military Caregiver PEER Forums improves
caregiver well-being by reducing caregiver burden and increasing knowledge about how to better
provide care for service members and veterans with wounds, illnesses, and injuries. A
complementary objective is to understand the specific benefits caregivers in the Military
Caregiver PEER Forums derive from their participation in the program relative to the landscape
of social services available to them.
BACKGROUND

There are over 5 million adults in the United States caring for a service member or
veteran who is dealing with a wound, illness, or injury for which they require support and
assistance. Of these, nearly 20 percent are caring for someone who served post-9/11, the majority
of whom have ailments that include back pain and behavioral health conditions related to their
service. Twelve percent of post-9/11 military and veteran caregivers provide 40 hours of
caregiving support per week. However, such caregiving comes at a cost: nearly 40% of post9/11 caregivers meet criteria for depression, and caregiving duties also impact their physical
health, work performance, and economic and financial well-being.1
One way to better support military caregivers is through peer support: analyses have
indicated that caregivers who participate in structured support groups have improved
psychological well-being, reduced depression, reduced burden, and increased social outcomes.2
This is particularly relevant for post-9/11 caregivers who frequently report having nobody to help
them with their caregiving responsibilities. For this reason, in its recent publication on better
supporting military and veteran caregivers, RAND recommended that organizations like the DoD
encourage and support caregivers by utilizing structured social support programs to mitigate some

1

Ramchand, Tanielian, et al. 2014. Hidden Heroes: America’s Military Caregivers. Santa
Monica: RAND Corporation.
2
Chien et al. 2011. “Caregiver support groups in patients with dementia: a meta-analysis.”
International Journal of Geriatric Psychiatry 26, 1089-1098. Chien et al. 2009. “The
effectiveness and active ingredients of mutual support groups for family caregivers of people with
psychotic disorders: a literature review.” International Journal of Nursing Studies 46, 1604-1623.
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of the adverse consequences of caregiving. Heeding this recommendation, in 2014, the Joining
Forces Initiative announced the Military Caregiver Support Initiative. As part of the initiative,
the Office of the Secretary of Defense established Military Caregiver PEER (Personalized
Experiences, Engagement and Resources) Forums on military bases across the country where
caregivers can “convene, converse among their peers, share resources and best practices, and
provide support for the challenges they face.”
To better understand how the PEER Forums are performing, the RAND National Defense
Research Institute (RAND NDRI) proposes a study to assess how participants are using the PEER
Forums, how participating in the PEER Forums benefits them, and the role that PEER Forums
play in the landscape of social support services available to caregivers. RAND NDRI will use
existing data (e.g., participants’ comments about the PEER Forums from existing evaluation
forms; service members’ case files from Recovery Care Coordinators) to evaluate caregivers’
needs and perspectives on the program – data that will be complemented with additional, primary
data that RAND NDRI proposes to collect through discussions with key stakeholders (e.g.,
caregivers participating in the PEER Forums, caregivers who do not participate in the PEER
Forums, Recovery Care Coordinators, and others). In support of continuous quality improvement
of the program, RAND NDRI will provide recommendations for creating an evidence-based data
collection tool for the DoD to use to monitor and track relevant outcomes among participants. In
addition, RAND NDRI will consolidate findings from this effort in a report prepared specifically
for R&FM/MC&FP and work with the sponsor to create a strategic dissemination plan that
ensures relevant DoD officials, policymakers, clinicians, and the scientific community are aware
of the evaluation findings.
APPROACH

RAND NDRI will perform the following five tasks.
Task 1: Conduct information-gathering discussions with key stakeholders. RAND

NDRI will work with the sponsor to identify the key and most relevant stakeholders and conduct
information-gathering discussions with them. The goal of these interviews is to better understand
the primary objectives of the PEER Forums, how they complement other social services offered
by the DoD, VA, or other outside organizations, how the PEER Forums operate in practice, why
caregivers participate in the Forums and how such participation benefits them. As such, key
stakeholders may include policy officials, Recovery Care Coordinators, caregivers, and others. In
addition, we plan to reach out to caregivers who do not participate in the PEER Forums either
because they do not choose to participate in those that are available to them or because the
installation they are affiliated with does not yet offer the PEER Forums.

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Task 2: Identify and analyze existing data. RAND NDRI will work with the sponsor

to identify existing data that may provide additional insight about the PEER Forums. This could
be in the form of actual datasets or aggregated data for select items used to compile monthly
reports, etc. We anticipate that this will include comments that participants provide on the
evaluation forms they complete when they participate in the PEER Forums as well as aggregated
data on attendance at the forums, demographic characteristics of participants, and topics that were
discussed. This may also include aggregated data collected by Recovery Care Coordinators. The
purpose of this task is both to gain existing insight from forms that do exist, but also to examine
the type of content available that can help inform the development of more structured feedback
forms, described in Task 4.
Task 3: Observe monthly Military Caregiver PEER Forums. RAND NDRI will work

with the sponsor to identify when and where monthly peer forums occur and attend a handful of
such forums to observe who participates and what is discussed. Discussions between RAND, the
sponsor, and the forum facilitators will guide when and how these observations are conducted.
Although such observations will not be representative of all such meetings, observing these
forums provides rich contextual information that can aid in understanding program benefits and
make realistic recommendations for improvements, if needed.
Task 4: Identify relevant tools for monitoring program outcomes, and provide
recommendations for a standard template DoD could administer to PEER Forum
participants for continuous quality improvement. With better understanding of program goals

and operations provided from Tasks 1-3, RAND NDRI will identify the most relevant and
practical outcomes the DoD should monitor to continuously track the performance of the PEER
Forums. RAND NDRI will review existing measures for capturing these outcomes, weigh the
benefits and limitations of candidate measures (e.g., length, validity), and provide
recommendations on the set of measures that it believes would be most useful for measuring
outcomes. In conjunction with Task 3, RAND NDRI may be able to test the measures we
identify with program participants to ensure that it is simple to complete and easy to understand,
as well as provide a snapshot of the type of information DoD can expect to gain from
administering the tool to participants.
Task 5: Describe and disseminate results. RAND NDRI will work with the sponsor

to identify optimal strategies to disseminate results and recommendations. In addition to the final
report, this can include briefings to present to DoD officials and/or at scientific conferences. It
can also include peer-reviewed publications, op-eds, blog posts, or commentaries.

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SCHEDULE AND DELIVERABLES

The period of performance for this effort is 24 months from contract execution.
The following table outlines the anticipated deliverables and timeline. Progress reports
and interim results will also be provided to OSD sponsors as requested. RAND NDRI anticipates
regular and frequent communication with the project monitor throughout the performance of this
project.
Deliverable / Related Task

Format

Due Date+

Work Plan

Project Memorandum

1 month following award

Interim Briefings

Briefing

Upon Request*

Interim Annotated Briefing

Annotated Briefing

12-months following award

Publish reports and conduct

TBD

18-24 months following award

briefings**
+Note: Meeting these deadlines is contingent upon timely receipt of needed regulatory approvals,
data and FY16 funding.
* Interim briefings will be limited to two per year.
** The final deliverables and briefings will be agreed upon between the Project Officer and
RAND NDRI and will include opportunity for technical review and approval by the sponsor. All
publicly releasable documents will be submitted for public affairs clearance before publication
and/or submission to peer-reviewed journals; these documents will have not have gone through
copyediting or proofing upon submission, but will go through these processes before final
publication.
CORE STATEMENT

This research is consistent with RAND NDRI's mission and purpose. It will support
specific analytic requirements of the sponsor and assist the sponsor in its policy development
efforts, as well as help develop analytical capabilities required by the sponsor community. The
research draws upon RAND NDRI's core competencies in military health care and mental health
care, as well as specific knowledge and experience with evaluation methodology. It will benefit
from and contribute to the long-term continuity of RAND NDRI's research program in forces and
resources policy. It depends in part on the special FFRDC-sponsor relationship that affords
special familiarity with the sponsor's mission and a close working relationship with the sponsor.

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PROJECT MONITORS

Deborah Maraia
(571) 372-5409
[email protected]

Sandra Mason
(703) 428-7630
[email protected]

FUNDING AND LEVEL OF EFFORT

This is a directed research project award under the RAND NDRI Studies and Analyses
Center FFRDC contract, which was awarded by DoD in 2005 for a period of five years with a
five year option. Prior to contract award, and again prior to the option being exercised, a
comprehensive review was conducted by DoD and approved by the USD(AT&L). The RAND
NDRI FFRDC contract is subject to the Cost Accounting Standards (CAS) for government
contracting and the Federal Acquisition Regulation (FAR), with resident DCAA auditors. RAND
has a currently approved CAS disclosure statement and has certified that costs estimated for this
effort are consistent with established practices and procedures.
Total project funding is $500,000. Project funding required in FY15 is $250,000 to be
provided by P&R. Funding in the amount of $250,000 will be needed in FY16 to complete the
research. The estimated level of effort for the current fiscal year is 0.7 STE. The sponsoring
office has reviewed the detailed cost breakout provided separately and evidenced by the signature
on this document has found it to be reasonable for the work to be performed.

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__________________________________________________
K. Jack Riley
Vice President, RAND
Director, National Defense Research Institute

Date: 22 June 2015

__________________________________________________
Rosemary Freitas Williams
Deputy Assistant Secretary of Defense
(Military Community and Family Policy)

Date: _____________________

__________________________________________________
Robert M. Flowe
Contracting Officer’s Representative
OSD Studies and FFRDC Management
OUSD(AT&L)/ARA

Date: _____________________

Contract No. W91WAW-12-C-0030

National Defense Research Institute
Contract #: W91WAW-12-C-0030
Budget Estimate
22-Jun-15

PD#:

P&R 15-535

Project Title:

Improving Caregiver Outcomes Through Structured Social
Support Via Military Caregiver Peer Forums

Project Leader(s):

Rajeev Ramchand

Sponsor Funding
Requested:

250,000
Budget Estimate

Labor

238,321

Travel

3,121

Computing

7,558

ODC

1,000

Publications

-

Survey

-

Subcontract

-

Total Estimate

250,000

This proposal budget estimate reflects our estimating and/or actual costs as of the date of this
submission based upon an analysis of the work to be undertaken and the cost experience of similar
RAND NDRI projects.

20150955.001.1