Winter 2007.

Study characteristics
Methods	Design: parallel group randomised trial. No. of participant centres: A service organization, Supportive Older Women’s Network, and an academic research centre in Philadelphia; USA. Study dates: Not reported.
Participants	Inclusion criteria: Female caregivers, 50 years of age or older, providing care for a minimum of 6 months to a relative with a physician’s diagnosis of ADRD, and having weekly access to a telephone for at least 1 hour. Exclusion criteria: Male caregivers. No. of participants randomised to interventions: ‐ Telesupport (n = 58). ‐ Usual care (n = 45). Baseline characteristics: Caregivers: Mean age for participants was 66.6 years (SD = 9.1), a 42% were spouses of care recipients. Average years of caregiving were 4.4 (SD = 4.0). Caregivers presented a CES‐D score of 15.1 (SD = 10.9). Care recipients: Mean age for patients was 80.2 years (SD = 9.1).
Interventions	Experimental: Telesupport treatment; professionally led telephone‐based support groups conducted by trained social workers who used conference‐ calling technology service to link 5 caregivers per group for an hour weekly. Caregivers used their own telephones with no charge. Control: Usual care, control group. Lenght of intervention: 6 months.
Outcomes	Primary outcomes: ‐ Caregiver depression, assessed by the 20‐item Centers for Epidemiological Studies–Depression Scale (CES‐D), (score range 0 to 30, higher scores denote more depressive symptoms). ‐ Caregiver burden, assessed by the 22‐item Zarit burden scale, (score range 0 to 88, higher scores denote higher burden). ‐ Personal gains, were measured with a 6‐item scale adapted from Kaye’ Gain Through Group Involvement Scale, (score range 6 to 18, higher scores represent more personal gain). Secondary outcomes: None stated. Outcomes assessment: At 6 months.
Notes	Clinical trial registration code: Not reported Funding: Funds from the Alzheimer’s Association. Conflicts of interest: None declared.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: Study reported as randomised but without information on the randomization procedure.
Allocation concealment (selection bias)	Unclear risk	Quote: "The Supportive Older Women’s Network was notified of caregivers randomised to intervention and contacted caregivers to enrol them in a group."
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: Participants and personnel were not blinded to interventions.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: Intervention components and procedures were not comparable. This and the unblinded participants and subjective participant‐reported outcomes makes blinding outcome assessments highly unlikely.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Comment: There is no data on attrition by treatment arms. Overall, 22 participants of 103 (21.4%) dropped out.
Selective reporting (reporting bias)	Unclear risk	Comment: There is no trial registration and/or available protocol.
Other bias	High risk	Comment: There is an imbalance in numbers randomised (58 to experimental group, 45 to control group), and differences in age at baseline (participants randomised to experimental group are older, about a mean of 5 years, than those randomised to control group).

AAL: Active Assisted Living; AD: Alzheimer Disease; ADKS: Alzheimer’s Disease Knowledge Scale; ADL: Activities of Daily Living; ADRD: Alzheimer’s Disease and Related Dementias; BA: Behavioral activation; BDI: Beck Depression Inventory; BDI: Beck Depression Inventory; BSFC: Burden Scale for Family Caregivers; CA: California; CCS: Caregiver Competence Scale; CDR: Clinical Dementia Rating; CES‐D: Center for Epidemiological Studies – Depression scale; D‐CHESS: Dementia–Comprehensive Health Enhancement Support System; DES: Differential Emotions Scale; DRS: Dyadic Relationship Scale; DSM: Diagnostic and Statistical Manual; DVD: Digital Versatile Disc​; EOC: Education Only Condition; EQ: EuroQol; ESBR‐m: Education and Skill Building Rehabilitation‐mobile ; FAS: family Assessment Service; FITT‐C: Family Intervention Telephone Tracking‐Caregiver; FITT‐D: Family Intervention Telephone Tracking‐Dementia; FTD: Frontotemporal Dementia, GDRS: Geriatric depression Rating scale; GDS: Global Deterioration Scale; GPS: Global Positioning System; GSES: General‐Self‐Efficacy Scale; HADS‐A: Hospital Anxiety and Depression Scale‐ anxiety; HADS: Hospital Anxiety and Depression Scale; HHI: Herth Hope Index; HSSUI: Health and Social Services Utilization Inventory; ICC: iCare Condition; ICD: International Statistical Classification of Diseases and Related Health Problems; ICT: Information and Communication technology; IESS: Instrumental and Expressive Social Support Scale; IQ; CODE: Informant Questionnaire on Cognitive Decline in the Elderly; ISEL: Interpersonal Support Evaluation List; ITT: Intention to treat ; IVR: Interactive Voice Response; LEAF: Life Enhancing Activities for Family; LSI‐Z: Life Satisfaction Inventory‐Z; MCS: Mental Component Summary; MMSE: Mini Mental State Examination; MoD: Mastery over Dementia; MT4C: My Tools 4 care; NHP: Nottingham Health Profile; NIH: National Institutes of Health; NINCDS‐ADRDA: National Institute of Neurological and Communicative Disorders and the Alzheimer`s Disease and Related Disorders Association; NPI: Neuropsychiatric Inventory; PAC: Positive aspects of caregiving; PQoL: Perceived Quality of Life; PSS: Perceived stress scale; PsyED: Psychoeducation; QoL: Quality of Life; QOLS: Quality of life Scale; RCSE: Revised Scale for Caregiving Self‐Efficacy; RCSS: Revised Caregiving Satisfaction Scale; REACH: Resources for Enhancing Alzheimer's Caregiver Health; RMBPC: Revised Memory and Behavioral Problem Checklist; RSCS: Revised Scale for Caregiving Self‐Efficacy; SCB: Screen for Caregiver Burden; SD: standard deviation; SEQ: Self‐efficacy Questionnaire; SF: Short Form; SPPIC: Self‐perceived Pressure from Informal Care Scale; SSCQ: Short Sense of Competence Questionnaire; STAI: State ‐Trait Anxiety Inventory; STAR: Skills Training and Reskilling; TAM: Technology Acceptance Model; TBA: Telephone behavioral activation; TGM: Telephone general monitoring; TLC: Telephone‐Linked Care; TOA: Trust in Own Abilities; TV: Television; UCSF: University of California, San Francisco; UK: United Kingdom; USA: United States of America; VA: Veterans Affairs; VCR: videocassette recorder; VU: Vrije Universiteit; ZBI: Zarit burden interview.