Caring for the Caregivers of Veterans: Planning a National Program Evaluation

照顾退伍军人的照顾者：规划国家计划评估

• 批准号: 8789675
• 负责人: Veronica Yank
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-11-01 至 2015-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8789675
• 关键词: Area; Blast Cell; Caregivers; Caring; Characteristics; Chronic; Data; Data Collection; Development; Enrollment; Evaluation; Evidence based program; Family; Future; Health; Health Professional; High Prevalence; Injury; Intervention; Interview; Knowledge; Mental Depression; Methods; Outcome; Output; Participant; Patients; Personal Satisfaction; Post-Traumatic Stress Disorders; Process; Program Evaluation; Recommendation; Recruitment Activity; Reporting; Rewards; Role; Self Efficacy; Services; Site; Social support; Structure; Sum; Surveys; Testing; Time; Training Support; Transcript; Traumatic Brain Injury; Variant; Veterans; Work; base; caregiver education; caregiving; design; falls; implementation science; informant; instrument; meetings; operation; patient home care; programs; research study; skills; statistics; success

PROJECT SUMMARY The daily task of "caring for those that have borne the battle" falls not only to health care professionals, but also to the well over 20,000 informal caregivers who provide critical in-home care for Veterans with serious chronic conditions. The VA Central Office Caregiver Support Program (CSP), which has worked closely with us to develop this proposal, is tasked with developing programs that support caregiving activities and caregiver health and, by extension, Veteran well-being. Building Better Caregivers (BBC) is an online, evidence-based program designed to boost caregiver skills and self-efficacy. The CSP began its national dissemination throughout the VA in January 2013. Early data indicate wide variation in caregiver enrollment across VA facilities (0 to >40 dyads/facility), indicating a need for implementation evaluation and improvement. We conducted preliminary interviews using the PARIHS framework of implementation sciences to build knowledge and develop data collection instruments that would distinguish implementation characteristics of high enrollment sites. These data strongly suggest that this national experiment in implementation of caregiver support will yield valuable lessons on how best to disseminate this important program. This proposal will generate the pilot data necessary to plan a comprehensive implementation evaluation and to design and test an intervention to boost BBC implementation in a subsequent Service Directed Project (SDP). The proposal will proceed with three specific aims: Aim 1: Identify national & regional characteristics of successful rollout of caregiver support program We will conduct semi-structured interviews with 5 national and 5 regional leaders regarding implementation characteristics considered important to BBC rollout success. Questions will derive from the revised PARIHS constructs of evidence, context, facilitation, and implementation success. We will apply qualitative analytic approaches to transcripts to identify key implementation characteristics at national and regional levels. Aim 2: Identify facility characteristics associated with high caregiver enrollment We will survey and interview VA staff and caregivers at local VA facilities-two with high and two low BBC enrollment. We will recruit staff involved in the BBC rollout (20 total, 5/facility) and caregivers who have and have not enrolled in the BBC (9 total, 2-3/facility). We will perform surveys and semi-structured interviews (also using PARIHS-derived questions) that probe regarding implementation topics. We will summarize survey findings with descriptive statistics and apply qualitative analytic approaches to interviews to identify implementation characteristics likely specific to high enrollment facilities. Aim 3: With partners, integrate findings, make recommendations, & plan targets for future evaluation This Aim will culminate in a full-day development meeting of the evaluation team, Advisory Group, and other project partners. Meeting discussion will generate a collaborative report that (a) integrates proposal findings, (b) recommends implementation characteristics amenable to immediate refinement, (c) describes draft implementation interventions and characteristics that require comprehensive targeting, and (d) designs the future SDP, all of which comprise the deliverables of the proposal. In sum, this proposal will identify key characteristics of successful implementation of the BBC program. Upon its completion, we and our project partners will be able to target some implementation characteristics for immediate refinement and others for further study and implementation intervention in a subsequent SDP. This collaborative, step-wise approach will inform, galvanize, and spread national dissemination of a signature VA program for Veteran caregivers.

项目概要 “照顾那些战斗过的人”的日常任务不仅落在医护人员身上，还落在了他们身上。 还有超过 20,000 名非正式护理人员，他们为患有严重疾病的退伍军人提供重要的家庭护理 慢性病。与我们密切合作的 VA 中心办公室护理人员支持计划 (CSP) 为了制定此提案，其任务是制定支持护理活动和护理人员的计划 健康，以及退伍军人的福祉。 Building Better Caregivers (BBC) 是一项基于证据的在线计划，旨在提高护理人员技能 和自我效能感。 CSP 于 2013 年 1 月开始在整个 VA 进行全国传播。早期数据 表明各 VA 机构的护理人员注册情况存在很大差异（0 至 >40 人/机构），表明需要 实施评估和改进。我们利用 PARIHS 进行了初步采访 实施科学框架，以积累知识并开发数据收集工具， 区分高招生地点的实施特点。这些数据强烈表明，这 实施照顾者支持的国家实验将产生宝贵的经验教训，说明如何最好地 传播这一重要计划。 该提案将生成规划全面实施评估所需的试点数据 并设计和测试干预措施，以促进后续服务导向项目中 BBC 的实施 （社会民主党）。该提案将实现三个具体目标： 目标 1：确定成功推出护理人员支持计划的国家和地区特征 我们将就实施情况与 5 位国家领导人和 5 位地区领导人进行半结构化访谈 被认为对 BBC 成功推出非常重要的特征。问题将源自修订后的 PARIHS 证据、背景、促进和实施成功的构建。我们将应用定性分析 确定国家和区域层面关键实施特征的记录方法。 目标 2：确定与高护理人员入学率相关的设施特征 我们将调查和采访当地退伍军人事务部机构的退伍军人事务部工作人员和护理人员——其中两名具有高 BBC 性，两名具有低 BBC 性 注册。我们将招募参与 BBC 推出的工作人员（总共 20 名，每个设施 5 名）以及拥有和 尚未加入 BBC（总共 9 名，每个机构 2-3 名）。我们将进行调查和半结构化访谈（也 使用 PARIHS 派生的问题）来探讨实施主题。我们将总结调查 具有描述性统计的调查结果，并在访谈中应用定性分析方法来识别 实施特征可能是针对高入学率设施的。 目标 3：与合作伙伴一起整合调查结果、提出建议并规划未来评估的目标 这一目标最终将由评估小组、咨询小组和其他人员举行全天的开发会议。 项目合作伙伴。会议讨论将生成一份协作报告，其中 (a) 整合了提案调查结果， (b) 建议可立即完善的实施特征， (c) 描述草案 需要全面瞄准的实施干预措施和特征，以及 (d) 设计 未来的 SDP，所有这些都构成了提案的可交付成果。 总之，该提案将确定成功实施 BBC 计划的关键特征。 完成后，我们和我们的项目合作伙伴将能够针对一些实施特征 立即完善和其他进一步研究和实施干预随后的 SDP。这 协作、逐步的方法将告知、激励和传播标志性 VA 的全国传播 退伍军人护理人员计划。