Emergency preparedness and support of caregivers of persons with dementia: The Disaster PrepWise study

痴呆症患者护理人员的应急准备和支持：Disaster PrepWise 研究

• 批准号: 10446310
• 负责人: Sato Ashida
• 金额: $ 64.73万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10446310
• 关键词: Address; Aging; Alzheimer' s Disease; Area; Behavior; COVID-19 pandemic; Caregiver support; Caregivers; Caring; Communities; Control Groups; Data; Dementia; Disasters; Distress; Elderly; Elements; Emergency Situation; Ensure; Family; Feeling; Floods; Foundations; Fright; Future; Geography; Goals; Health; Health Personnel; Home; Household; Hybrids; Individual; Infrastructure; Intervention; Iowa; Knowledge; Lead; Life; Mediating; Medical; Mental Health; Modeling; Modernization; Outcome; Participant; Patients; Perception; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pilot Projects; Practical Robust Implementation and Sustainability Model; Process; Public Health; Randomized; Randomized Controlled Trials; Reach Effectiveness Adoption Implementation and Maintenance; Readiness; Reporting; Research; Resources; Rural; SARS-CoV-2 infection; Security; Self Efficacy; Social Network; Social support; Stress; Surveys; System; Testing; Tornadoes; Training; United States National Institutes of Health; Vulnerable Populations; Work; arm; base; care giving burden; caregiving; coping; efficacy evaluation; efficacy testing; experience; extreme weather; family support; group intervention; hazard; implementation evaluation; implementation strategy; improved; informal support; innovation; intervention participants; intervention program; medical supply; pandemic disease; physical conditioning; pilot test; pragmatic trial; programs; resilience; response; rural area; rural setting; service providers; skills; social; social stigma; support network; volunteer

Individuals with Alzheimer’s disease or related dementias (ADRD) and their families are especially vulnerable during a disaster. Disasters it limit caregivers’ ability to continue with care due to disaster related stress and reduced access to resources and support. The COVID-19 pandemic showed the extreme vulnerability of persons with ADRD and their caregivers as they struggled to access support and resources due to fear associated with COVID-19 infection; such impact was exacerbated in rural areas where caregivers are geographically isolated and disaster management resources are scarce. With the number of federally declared disasters increased dramatically over the past 50 years, active public health efforts are needed to support caregivers develop emergency caregiving plans usable in disasters such pandemics and extreme weather emergencies. The long-term goal of this project is to enhance emergency preparedness and support networks of caregivers of individuals with ADRD to increase their resilience and minimize distress by implementing an intervention program, Disaster PrepWise (DPW). In the DPW program, a trained Medical Reserve Corp (MRC) volunteer will provide step-by-step guidance to caregivers to jointly develop emergency preparedness plans and personal support networks. The objectives for this proposed study are to 1) test the impact of DPW on caregiver outcomes (i.e., resilience, stress) and perceptions that may mediate the association between DPW and outcomes (caregiver self-efficacy, preparedness, social support); and 2) evaluate implementation strategies in a real-world setting to optimize future dissemination. We will conduct a randomized control trial of 200 caregivers of persons with ADRD involving two arms: DPW intervention group and information-only control group (print information on disaster preparedness). Assessments will occur before randomization (baseline), and 3- and 6-month after the baseline. This study is innovative in its use of highly personalized disaster preparedness program with built-in assistance to support caregivers; the support will be provided through an existing national-level public health infrastructure (MRC) that has a great potential to reach older adults and caregivers in rural areas. The knowledge and data obtained through this study will lay the foundation for a future larger-scale multi-state pragmatic trial to assess dissemination potentials.

阿尔茨海默病或相关痴呆症 (ADRD) 患者及其家人在灾难期间尤其容易受到伤害，由于灾难相关的压力以及获得资源和支持的机会减少，因此限制了护理人员继续护理的能力。 ADRD 患者及其护理人员由于担心感染 COVID-19 而难以获得支持和资源，因此处于极度脆弱状态；在护理人员地理位置偏僻且灾害管理资源稀缺的农村地区，这种影响更加严重。联邦地过去 50 年来，宣布的灾害急剧增加，需要积极的公共卫生努力来支持护理人员制定可用于流行病和极端天气紧急情况等灾害的紧急护理计划。该项目的长期目标是加强应急准备和支持网络。 ADRD 患者的护理人员可以通过实施 Disaster PrepWise (DPW) 干预计划来增强他们的恢复能力并最大程度地减少痛苦。在 DPW 计划中，经过培训的医疗储备公司 (MRC) 志愿者将向他们提供逐步指导。这项拟议研究的目标是 1) 测试 DPW 对护理人员结果（即复原力、压力）的影响以及可能介导 DPW 与结果（护理人员）之间关系的看法。自我效能、准备、社会支持）；2) 评估现实环境中的实施策略，以优化未来的传播。我们将对 200 名 ADRD 患者的护理人员进行一项随机对照试验，涉及两名患者。手臂：DPW 干预组和纯信息对照组（有关备灾的印刷信息）将在随机化之前（基线）以及基线后 3 个月和 6 个月进行。准备计划，内置援助以支持护理人员；将通过现有的国家级公共卫生基础设施（MRC）提供支持，该基础设施具有巨大的潜力，可以覆盖农村地区的老年人和护理人员通过此获得的知识和数据。学习将为未来进行更大规模的多州务实试验，以评估传播潜力。