A Training and Fidelity Model to Move and Scale Evidence-based Dementia Care and Caregiver Support Programs into Practice: The Case for COPE in PACE service settings

将循证痴呆症护理和护理人员支持计划付诸实践的培训和保真模型：PACE 服务环境中的 COPE 案例

• 批准号: 10468726
• 负责人: Laura N. Gitlin
• 金额: $ 50.03万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468726
• 关键词: Activities of Daily Living; Address; Caregiver Burden; Caregiver support; Caregivers; Caring; Communities; Competence; Computational Linguistics; Day Care; Dementia; Dementia caregivers; Development; Distress; Elderly; Enrollment; Environment; Evidence based program; Family; Family Caregiver; Home; Impaired cognition; Intervention; Long-Term Care; Long-Term Care for Elderly; Measures; Medicaid; Medicare; Modality; Modeling; Monitor; Natural Language Processing; Nursing Homes; Occupational Therapist; Outcome; Participant; Patient-Focused Outcomes; Personal Satisfaction; Persons; Physical Function; Procedures; Process; Protocols documentation; Quality of life; Randomized; Registered nurse; Science; Service setting; Site; Techniques; Testing; Training; Training Programs; base; biobehavior; care providers; care systems; comparative efficacy; dementia care; design; evidence base; implementation barriers; improved; neuropsychiatric symptom; pragmatic trial; programs; quality assurance; randomized trial; response; satisfaction; scale up; simulation; uptake; user-friendly

This NIA Stage I study is designed to address two leading barriers to implementation of evidence-based dementia care and caregiver support programs into long-term care settings: (1) lack of streamlined, user-friendly, and tested training modalities, and (2) lack of scalable, practical processes to accurately measure fidelity in “real world” settings. The aims of the study are to determine whether an online training program is the same or better in improving interventionist fidelity to an evidence based dementia program (COPE) and dementia patient outcomes when compared to a high intensity face-to-face traditional form of training. To accomplish these aims we will develop an online, principle-driven approach using state-of-the- science simulation and best practices and a scalable approach to assess fidelity to COPE by applying computational linguistics techniques. We will then conduct a noninferiority trial in Programs for All Inclusive Care for Elders (PACE) organizations randomly assigned to the training conditions. PACE staff will be evaluated post training on their fidelity outcomes. Dyads of persons with dementia and their caregivers will be evaluated at 4 months post COPE implementation on function, neuropsychiatric symptoms, quality of life, and caregiver burden. The findings from this project will lay the essential groundwork for a large scale, Stage III-IV, pragmatic trial of COPE in PACE settings throughout the US. Findings will also serve as a model for guiding the development of practical, scalable processes for training and fidelity monitoring in other long-term care settings and for other evidence-based support programs.

这项 NIA 第一阶段研究旨在解决实施的两个主要障碍 将基于证据的痴呆症护理和护理人员支持计划纳入长期护理机构：(1) 缺乏简化、用户友好且经过测试的培训方式，以及 (2) 缺乏可扩展、 在“现实世界”环境中准确测量保真度的实际过程 研究的目的。 是为了确定在线培训计划在改进方面是否相同或更好 干预主义者对基于证据的痴呆症计划 (COPE) 和痴呆症患者的忠诚度 与高强度面对面的传统培训形式相比，效果显着。 为了实现这些目标，我们将使用最先进的技术开发一种在线的、原则驱动的方法 科学模拟和最佳实践以及可扩展的方法来评估 COPE 的保真度 然后我们将进行非劣效性试验 老年人全包护理计划 (PACE) 组织随机分配给 培训条件。培训后将评估 PACE 员工的忠诚度结果。 痴呆症患者及其护理人员将在 COPE 后 4 个月接受评估 功能、神经精神症状、生活质量和护理人员负担的实施。 该项目的研究结果将为大规模的 III-IV 阶段奠定基础。 美国各地 PACE 环境中 COPE 的务实试验的结果也将作为一个参考。 用于指导开发实用的、可扩展的培训和保真度流程的模型 对其他长期护理机构和其他循证支持计划的监测。