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May 18, 2026Journal of Patient-Reported Outcomes0 citationsOpen Access

Goal attainment scaling in the heart failure and stroke resilience caregiver intervention pilot study

CCCatherine ClairSCSamantha CurrieroMSMartha Abshire Saylor

Key Result

The HEROIC caregiver intervention resulted in a non-significant mean difference of 6.6 in goal attainment scaling t-scores at 12 weeks compared to waitlist control.

Key Points

  • This study aims to evaluate the effectiveness of the Heart Failure and Stroke Resilience Intervention for Caregivers using goal attainment scaling.
  • Randomized waitlist control design for caregiver intervention
  • GAS data collected at baseline, 12 weeks, and 24 weeks
  • Feasibility and acceptability assessed through final interviews at 24 weeks
  • 80.8% of caregivers met/exceeded their goals at 12 weeks, and 84.2% at 24 weeks.
  • Immediate intervention group showed a mean change in GAS scores of 19.1 (SD: 9.4) pre-post intervention.
  • Participants reported high satisfaction and ease of completing GAS during interviews.

Study Design

Type

RCT (n=31)

Blinding

Single-blind

Randomization

Randomized waitlist-controlled

Multicenter

No

Structured PICO

Does the HEROIC caregiver support program improve goal attainment in caregivers of heart failure and stroke patients compared to a waitlist control?

P
Population
31 caregivers of heart failure and stroke patients, mean age 58, 84% female, 45% Black.
I
Intervention
Heart Failure and Stroke Resilience Intervention for Caregivers (HEROIC) program (immediate intervention)
C
Comparator
Waitlist control group
O
Outcome
Goal progress and achievement measured by Goal Attainment Scaling (GAS) at 12 and 24 weekspatient reported

Goal attainment scaling is a feasible, acceptable, and person-centered outcome measure for evaluating caregiver support interventions in heart failure and stroke.

Main Result

Effect estimate: Mean difference 6.6

Absolute Event Rate: 59.1% vs 52.5%

p-value: p=0.3092

Limitations

  • Small sample size as a pilot study
  • High attrition rate with 8 caregivers withdrawing after consent

Abstract

Abstract Background Caregivers often serve as proxies for patients or inform patient-caregiver dyadic findings in interventions. We conducted a randomized waitlist control pilot of a caregiver support program focused on caregivers (not dyads): Heart Failure and Stroke Resilience Intervention for Caregivers (HEROIC). Goal attainment scaling (GAS) was used to measure goal progress and achievement; this measure is person-centered but has not been used to test prior caregiving interventions. Methodology HEROIC was tested in a pilot study. Participants were randomized to immediate intervention or waitlist control groups. GAS data was collected at baseline, 12 weeks, and 24 weeks and a final interview to assess feasibility and acceptability was conducted at 24 weeks. Raw GAS data was converted to t-scores. We compared goal achievement for the overall sample, by group assignment (immediate intervention vs. waitlist control), and by goal domain. Two questions in the final interview focused on acceptability and feasibility of GAS were summarized. Results Fifty caregivers were consented, and 31 completed baseline data collection. Caregivers ( n = 31) were on average 58 years old (SD: 11), 84% identified as female and 45% identified as Black. Twenty-six participants completed GAS at 12 weeks, and 19 participants completed GAS at 24 weeks. Twenty-one (80.8%) and 16 (84.2%) caregivers met or exceeded their goal at 12 weeks and 24 weeks respectively. For the immediate intervention group, the mean change in scores pre-post intervention was 19.1 (SD: 9.4), ranging from 0 to 30. For the waitlist control group, the mean change in scores pre-post intervention was 13.8 (SD: 10.6), ranging from 0 to 30. For the immediate intervention group during their maintenance period (12 to 24 weeks), the mean change in scores was 20.9 (SD: 11.4), ranging from 0 to 30. All 19 caregivers were interviewed at 24 weeks and reported that GAS was simple to complete and reported satisfaction with the activity. Conclusions For clinical trials, GAS may serve as a key outcome and provide rich effectiveness data. While GAS represents investment of time and resources, the approach is valuable. We recommend future research to inform streamlining GAS while maintaining its person-centeredness. Trial registration ClinicalTrials.gov, NCT03963583, Registered 24 May 2019, https://clinicaltrials.gov/study/NCT03963583?term=Heart%25;20Failure%25;20Resilience%25;20Intervention%25;20for%25;20Caregivers%25;20(HEROIC)%26;rank=1 .

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Cite This Study

Clair et al. (2026) conducted an RCT in Caregivers of persons with heart failure or stroke (n=31). Heart Failure and Stroke Resilience Intervention for Caregivers (HEROIC) vs. Waitlist control was evaluated on Goal attainment scaling (GAS) t-score at 12 weeks (Mean difference 6.6, p=0.3092). The HEROIC caregiver intervention resulted in a non-significant mean difference of 6.6 in goal attainment scaling t-scores at 12 weeks compared to waitlist control.

synapsesocial.com/papers/6a0aacb35ba8ef6d83b700edhttps://doi.org/10.1186/s41687-026-01082-5
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