Development of an Intervention for Long-Distance Caregivers

为远程护理人员制定干预措施

• 批准号: 10300258
• 负责人: Verena Cimarolli
• 金额: $ 14.1万
• 依托单位: LEADINGAGE, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10300258
• 关键词: Address; Adult; Advisory Committees; Alzheimer' s disease related dementia; Behavior Therapy; Behavioral Model; Caregiver Burden; Caregivers; Caring; Characteristics; Clinical Trials; Committee Members; Communities; Data Collection; Dementia; Development; Elderly; Emotional; Ensure; Ethnic group; Evaluation; Evidence based intervention; Family Caregiver; Feasibility Studies; Fostering; Foundations; Funding; Geography; Goals; Home; Home Care Agencies; Home Health Aides; Hour; Impaired cognition; Individual; Intervention; Intervention Studies; Knowledge; Manuals; Mental Health; Modeling; Modification; Outcome; Outcome Measure; Participant; Personal Satisfaction; Procedures; Process; Provider; Public Health; Randomized Controlled Trials; Research; Role; Sampling; Services; Stress; Stress and Coping; Tablets; Technology; Testing; Training; United States National Institutes of Health; base; care recipients; caregiver interventions; caregiving; caregiving research; design; efficacious intervention; efficacy testing; ethnic diversity; evidence base; experience; family caregiving; feasibility testing; improved; insight; intervention effect; knowledge base; new technology; patient home care; primary caregiver; psychosocial; racial and ethnic; racial diversity; recruit; remote delivery; response; social culture; socioeconomics; therapy design; therapy development; usability

Project Summary Prior caregiving research has mostly focused on geographically close caregivers of older adults with Alzheimer’s disease and related dementias (AD/ADRD), not considering the unique circumstances of long-distance caregivers (LDCs). However, from our previously funded R21 on long-distance caregiving (LDC; NIA; R21- AG050018) we know that a large proportion of LDCs helped care recipients (CRs) with significant cognitive impairment who were community-dwelling and that these LDCs experienced significant caregiver burden. Hence, there is a need to develop psycho-social interventions that can meet the specific needs of LDCs. This R21 application in response to PAR-19-071 seeks to draw on the knowledge gained in our previous R21 study to adapt an existing evidence-based caregiver intervention (Community REACH) to the needs and circumstances of LDCs and to test the feasibility of implementing such an adapted model in the field. Following the NIH Stage Model for Behavioral Intervention Development, the first objective of this application is to develop a novel technology-based, remotely delivered psychosocial intervention for LDCs of older adults with AD/ADRD living in the community, by adapting an existing intervention developed for proximate caregivers (Stage IA) based on findings from our previous NIA funded study on LDC (Stage 0). A second objective is to conduct feasibility testing of such an intervention in the field (Stage IB). Our long-term research goal is to implement a randomized controlled trial testing the potential of a technology-based, remotely delivered intervention for LDC of individuals with AD/ADRD living at home. The current application focuses on Stage I (behavioral intervention development and feasibility testing) and is the next step toward attainment of our long-term goal of testing the efficacy of such an intervention utilizing a randomized controlled trial (Stage II and III – efficacy testing). The development of the intervention through adaptation of Community REACH to the needs of LDCs will be achieved by creating an advisory committee of caregiving experts. Committee members will be asked to help integrate a set of specific findings from our Stage 0 study related to the challenges of LDC into the Community REACH intervention plan. The sample of LDCs (N=40) for the feasibility study will be drawn from family caregivers of community-dwelling older adults with AD/ADRD receiving non-medical home care via the access to home care agencies serving racially and ethnically diverse older adults with dementia. This will ensure that home care aides can support CRs in managing the technology (tablet) used to connect LDCs with CRs and aides as part of the intervention. We will identify LDCs living 2+ hours away who experience significant caregiver burden and invite them to participate in the intervention and feasibility study. The intervention will be delivered remotely by staff of the Family Caregiver Alliance (FCA). Project outcomes will advance the field by addressing a significant knowledge gap and providing a foundation for the design, implementation, and evaluation of LDC-specific psychosocial interventions that can have a long-term impact on the well-being of LDCs and the older adults for whom they care.

项目概要 之前的护理研究主要集中在地理位置较近的阿尔茨海默病老年人的护理人员上 疾病和相关痴呆症（AD/ADRD），不考虑长途的独特情况 然而，根据我们之前资助的远程护理 R21（LDC；NIA；R21-）。 AG050018）我们知道，很大一部分最不发达国家帮助了具有显着认知能力的护理接受者（CR） 居住在社区的最不发达国家面临着巨大的照顾者负担。 有必要制定能够满足最不发达国家具体需求的心理社会干预措施。 响应 PAR-19-071 的申请旨在利用我们之前的 R21 研究中获得的知识 根据需求和情况调整现有的基于证据的护理人员干预措施（社区 REACH） 最不发达国家的情况，并测试在 NIH 阶段之后在该领域实施这种改编模型的可行性。 行为干预开发模型，该应用程序的第一个目标是开发一种新颖的 为居住在最不发达国家的 AD/ADRD 老年人提供基于技术的远程社会心理干预 社区，通过调整为近邻护理人员开发的现有干预措施（IA 阶段） 我们之前 NIA 资助的 LDC 研究结果（第 0 阶段）第二个目标是进行可行性测试。 我们的长期研究目标是实施随机试验。 对照试验测试基于技术的远程干预对最不发达国家个人的潜力 患有 AD/ADRD 的家庭目前的申请重点是第一阶段（行为干预发展）。 和可行性测试），这是实现我们测试此类有效性的长期目标的下一步 利用随机对照试验进行干预（第二阶段和第三阶段 - 功效测试）。 通过使共同体 REACH 适应最不发达国家的需要进行干预，将通过创建一个 护理专家咨询委员会将被要求帮助整合一组具体的内容。 我们的第 0 阶段研究结果涉及最不发达国家 (LDC) 进入社区 REACH 干预计划的挑战。 可行性研究的最不发达国家样本（N=40）将从社区住宅的家庭照顾者中抽取 患有 AD/ADRD 的老年人通过家庭护理机构接受非医疗家庭护理 这将确保家庭护理援助能够为 CR 提供支持。 作为干预措施的一部分，管理用于将最不发达国家与 CR 和援助联系起来的技术（平板电脑）。 将确定居住在 2 个多小时路程外且护理人员负担较重的最不发达国家，并邀请他们参与 干预和可行性研究将由家庭护理人员的工作人员远程进行。 联盟（FCA）的项目成果将通过解决重大知识差距并提供信息来推动该领域的发展。 为设计、实施和评估针对最不发达国家的社会心理干预措施奠定了基础， 对最不发达国家及其所照顾的老年人的福祉产生长期影响。