HEALTH EDUCATION IN AN HMO: EFFECTIVENESS AND EFFICIENCY

HMO 中的健康教育：有效性和效率

• 批准号: 2546231
• 负责人: RONALD W TOSELAND
• 金额: $ 32.52万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT ALBANY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-30 至 2000-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2546231
• 关键词: caregivers; clinical research; education evaluation /planning; frail elderly; health care service evaluation; health care service utilization; health education; human subject; managed care; mental health counseling; social support network

DESCRIPTION: This amended application from the State University of New York (SUNY) at Albany proposes to examine the short- and long-term effectiveness of a health education program (HEP) for frail elderly and their spouse caregivers. The HEP is a program that focuses on teaching small groups of caregivers several techniques for understanding, coping, and dealing with emotions and for solving problems. The program consists of a year-long intervention for the caregiver: eight weekly two-hour group sessions (eight caregivers per group) and ten monthly two-hour follow-up groups. One hundred-sixty pairs of spouses and frail elderly will be recruited from members of the Community Health Plan (from members enrolled in the traditional HMO plan) in two geographic areas. Eligibility criteria for caregivers include: married to and living with the care recipient, age 55 or older, being the primary care provider, having at least a moderate score on the Zarit burden scale (to ensure that they have the potential to benefit from the program), not participating in any other individual or group program for caregivers, and reporting that one's spouse has at least one chronic disease and is in poor health (based on preliminary studies in a VA, care recipients with these characteristics were most likely to benefit from the program in terms of cost and utilization reduction). The care recipient must be 55 or older and have at least one chronic health problem. Both caregiver and recipient must have been members of the CHP for at least one year and cannot be participating in a formal hospice program. The project uses a randomized control design; eligible volunteers will be randomly assigned to participate in HEP or receive usual care. Measurements will be taken at five intervals: one week prior to beginning the intervention (baseline), after the initial two-month intensive training period ("one week after the 8th group meeting"), and at 01, 02, and 03 years after the baseline interview. Both caregivers and recipients will be assessed for demographic variables initially and their health and functional status, emotional well-being, and social support at each time period. Caregivers will also be assessed for their burden level and knowledge and use of community resources; recipients will be assessed for cognitive impairment. The effect on outpatient, inpatient, and nursing home care utilization will be measured by HMO records and data collected from the study participants.

描述：纽约州立大学修订的申请 （SUNY）在奥尔巴尼（Albany）提议检查短期和长期有效性 脆弱的老年人及其配偶的健康教育计划（HEP） 照顾者。 HEP是一项专注于教授小组的计划 护理人员有几种理解，应对和处理的技术 情绪和解决问题。 该计划包括一年 护理人员的干预：八个每周两小时的小组会议（八个 每组的护理人员）和十个每月的两个小时随访小组。 一 将从中招募一百六十双配偶和脆弱的老年人 社区卫生计划的成员（来自参加的成员 传统的HMO计划）在两个地理区域。 资格标准 护理人员包括：已婚并与护理人员一起生活，55岁 或年龄较大，是初级保健提供者，至少具有适中的分数 在Zarit负担量表上（以确保他们有可能受益 从计划中），不参加任何其他个人或小组 护理人员计划，并报告一个人的配偶至少有一个 慢性疾病，健康状况不佳（基于VA的初步研究 具有这些特征的护理接收者最有可能从中受益 该计划在降低成本和利用方面）。 护理接收者 必须年满55岁或至少有一个慢性健康问题。 两个都 护理人员和接收者必须是CHP的成员 一年，不能参加正式的临终关怀计划。 该项目使用随机控制设计；合格的志愿者将 随机分配参加HEP或接受常规护理。 测量 将以五个间隔进行：在开始前一个星期 干预措施（基线），在初始两个月的密集培训之后 时期（“在第八届小组会议结束后一周”），在01、02和03年 基线面试之后。 护理人员和接收者都将 最初评估人口统计学变量及其健康和功能 每个时间段的地位，情感福祉和社会支持。 护理人员还将评估其负担水平和知识以及 使用社区资源；接受者将评估认知能力 损害。 对门诊，住院和疗养院护理的影响 利用率将通过HMO记录和从中收集的数据来衡量 研究参与者。