Adapting an Evidence-Based Intervention for ADRD Caregivers with Limited English Proficiency

针对英语水平有限的 ADRD 护理人员采用循证干预措施

• 批准号: 10190623
• 负责人: YURI JANG
• 金额: $ 23.04万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10190623
• 关键词: Adherence; Administrative Supplement; Alzheimer' s Disease; Award; Back; Caregivers; Caring; Clinical Trials; Communities; Data; Dementia; Dementia caregivers; Development; Eligibility Determination; Ensure; Equilibrium; Evaluation; Evidence based intervention; Exclusion; Exploratory/Developmental Grant; Family member; Feedback; Foundations; Future; Goals; Grant; Hour; Individual; Intervention; Knowledge; Korean American; Koreans; Language; Limited English Proficiency; Linguistics; Manuals; Methodology; Methods; Modeling; Modification; National Institute on Aging; Nature; Outcome; Participant; Persons; Population; Population Heterogeneity; Primary Health Care; Process; Protocols documentation; Research; Research Personnel; Research Project Grants; Rest; Review Literature; Services; Solid; Source; Structure; Surface; System; Testing; Training; Translations; Well in self; Work; acceptability and feasibility; base; caregiver interventions; caregiving; cultural competence; dementia caregiving; design; ethnic minority population; evidence base; improved; information gathering; primary caregiver; programs; recruit; satisfaction; skills; tool; translational model

PROJECT SUMMARY Limited English proficiency (LEP) among caregivers for individuals with Alzheimer's disease or related dementias (ADRD) poses a critical barrier to the caregivers' access to evidence-based interventions (EBIs). Cultural adaptation, a promising method to close the gap, requires a systematic approach to ensure the balance between fidelity and fit. Using Korean Americans as a target group and the Savvy Caregiver Program (SCP) as a target EBI, we plan to test a systematic model of cultural adaptation that can be applied to other EBIs and other LEP groups. As a first step toward the goal, we will use the R21 grant award to employ a three- step model of cultural adaptation: (1) Information Gathering, (2) Preliminary Adaptation Design and Testing, and (3) Full Adaptation Design and Testing. Building on the team's prior work on Information Gathering, we aim to design and test preliminary adaptation (surface-level language attunement) and full adaptation (deep structure-level modification) of the SCP. Through a back-translation method followed by expert reviews, we will prepare a Korean version of the SCP caregiver/trainer manuals. We will recruit and train two Korean-speaking interventionists, and each of them will deliver the linguistically attuned SCP to six participants (total n = 12). Eligibility criteria include Korean Americans who provide primary care for a family member with ADRD and who speak English less than “very well.” Each participant will receive the 12-hour (2 hours weekly for 6 weeks) in- person group SCP sessions and be evaluated for adherence, acceptability, and satisfaction. In addition, we will develop an SCP Key Principles Test to assess the intactness of the SCP core principles after adaptation modifications. We will use a mixed quantitative and qualitative methodology to seek feedback on cultural relevance of each program component from both participants and interventionists. All SCP sessions will be video-recorded for fidelity assessment and subsequent cultural adaptations. We will develop a Full Cultural Adaptation Worksheet to conduct a deep structure-level adaptation via a data-driven cultural assessment (e.g., video-recorded session analysis, feedback from preliminary testing participants, and examples of cultural adaptation in literature review), followed by iterative feedback loops involving multiple stakeholders (SCP developer, researchers with cultural competence, content and cultural experts, and a community advisory board). The interventionists will deliver the fully adapted SCP to three new groups of six caregivers (total n = 18) following the refined protocols. Although the study is explorative in nature, we anticipate that preliminary linguistic attunement will help the SCP reach out to ADRD caregivers with LEP, but that we will observe better engagement outcomes in the fully adapted SCP. We will compile the entire process of cultural adaptation, along with a worksheet and evaluation tools, into a manual for use with other LEP groups. The findings will form a solid foundation for a larger, definitive study with a clinical trial (e.g., R01) to examine program efficacy and provide a translational model for reducing barriers to EBIs for diverse LEP groups.

项目摘要 在患有阿尔茨海默氏病或​​相关患者的患者的看护人中，英语水平有限（LEP） 痴呆症（ADRD）对看护人获得基于证据的干预措施（EBIS）的关键障碍。 文化适应是一种缩小差距的有前途的方法，需要一种系统的方法来确保 在忠诚与拟合之间的平衡。使用韩裔美国人作为目标群体和精明的照顾者计划 （SCP）作为目标EBI，我们计划测试可以应用于其他的文化适应模型 EBIS和其他LEP组。作为实现目标的第一步，我们将使用R21赠款奖给员工三个 文化适应的步骤模型：（1）信息收集，（2）初步适应设计和测试， （3）完整的适应设计和测试。在团队先前在信息收集方面的工作，我们 旨在设计和测试初步适应（表面级的语言尝试）和完全适应（深度 SCP的结构级修改）。通过反向翻译方法，然后进行专家评论，我们将 准备SCP护理人员/培训师手册的韩语版本。我们将招募和训练两个讲朝鲜语的 干预主义者，每个人都会向六名参与者提供语言调整的SCP（总n = 12）。 资格标准包括为ADRD的家庭成员提供初级保健的韩裔美国人 说英语的说法不如“很好”。每个参与者将收到12小时（每周2个小时，持续6周） 人群SCP会议，并进行评估以确保，可接受性和满意度。此外，我们将 制定SCP关键原理测试，以评估适应后SCP核心原理的完整性 修改。我们将使用混合定量和定性方法来寻求有关文化的反馈 参与者和干预主义者的每个计划组成部分的相关性。所有SCP会议将是 视频录制以进行忠诚度评估和随后的文化适应。我们将发展一个完整的文化 适应工作表通过数据驱动的文化评估进行深层结构级适应（例如， 视频录制的会话分析，初步测试参与者的反馈以及文化示例 文献综述中的适应），其次是涉及多个利益相关者的迭代反馈循环（SCP） 开发人员，具有文化能力，内容和文化专家的研究人员以及社区咨询 木板）。干预主义者将将完全适应的SCP交付给三个新组，包括六个护理人员（总n = 18）遵循精制协议。尽管该研究是从本质上探讨的，但我们预计这是初步的 语言调整将帮助SCP与LEP接触Adrd护理人员，但我们会发现更好 完全适应的SCP中的参与结果。我们将编译整个文化适应过程， 与其他LEP组一起使用的手册，以及一份手册。调查结果会 为临床试验（例如R01）进行研究效率，构成了更大，确定的研究的坚实基础 并提供了一个翻译模型，以减少潜水LEP组的EBIS障碍。