Date of Award

Summer 8-11-2015

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Patricia C. Clark


Urinary Incontinence (UI) is a prevalent and burdensome condition affecting care-dependent, community-dwelling elders (CRs) and their informal caregivers (CGs). Although treatable, UI remains inadequately managed resulting in negative medical, physical, psychosocial and economic impacts.

A quasi-experimental, pre-posttest design was used to explore the feasibility and acceptability of a technology-facilitated behavioral intervention designed to enhance the home environment of CRs with UI and strengthen informal CG self-efficacy. CGs received a 6-week evidence-based, prompted voiding and educational program delivered via tablet-personal computer. CGs also received a supportive component in the form of weekly telephone calls from a UI nurse expert. Care-recipient (% change in wetness) and CG outcomes (technology usage, perceived ease of use, UI knowledge, self-efficacy, burden) were measured at 3-weeks and 6-weeks and analyzed descriptively. Qualitative feedback regarding CG satisfaction and perceptions of the intervention were obtained at the conclusion of the study.

The development and implementation of the intervention were feasible. The major challenge to feasibility was the recruitment of eligible participants. CGs were adherent to technology usage, however adherence to prompted voiding was inconsistent. CGs demonstrated slight increases in UI-related self-efficacy, UI knowledge, and decreases in UI-related bother. CRs demonstrated a mean 62.53% reduction in wet checks. CGs consistently rated the intervention extremely high and found access to a UI expert beneficial.

These preliminary findings suggest that the use of telehealth systems to deliver an evidence-based, UI intervention may be a feasible and acceptable way to improve CG confidence and knowledge in UI management and reduce CR wetness.