Reducing COVID-19 Related Disability in Rural Community-Dwelling Older Adults Using Smart Technology

利用智能技术减少农村社区老年人中与 COVID-19 相关的残疾

• 批准号: 10688192
• 负责人: Rachel Marie Proffitt
• 金额: $ 64.96万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10688192
• 关键词: 2 arm randomized control trial; Adoption; Affect; Algorithms; Anxiety; Area; Assisted Living Facilities; Behavior; Behavioral; COVID-19; COVID-19 pandemic; COVID-19 risk; Care given by nurses; Caregiver Burden; Caring; Characteristics; Chronic; Communities; Competence; Contracts; Coupled; Data; Discipline of Nursing; Disparity; Elderly; Evaluation; Family member; Future; Goals; Health; Health behavior; Health education; Healthcare; Home; Home Nursing Care; Independent Living; Individual; Intervention; Learning; Mental Depression; Missouri; Monitor; Nursing Staff; Occupational; Occupational Therapy; Outcome; Participant; Pattern; Performance; Population; Preventive healthcare; Quality of life; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Resources; Rural; Rural Community; Self Management; Site; Social Distance; Social Work; Social isolation; System; Technology; Testing; Translations; Visit; aging in place; arm; care coordination; cost; demographics; disability; economic impact; falls; functional decline; health care availability; health management; health related quality of life; high risk; high risk population; improved; multidisciplinary; preference; prevent; rural area; satisfaction; scale up; sensor; social; stay-at-home order; success; two-arm study; urban area

Project Summary/Abstract. Over 85% of Missouri is rural and individuals in these areas are older and have reduced access to regular healthcare, compared to individuals living in urban areas of Missouri. Those with disabilities, particularly older adults, are at higher risk for contracting COVID-19. There is a critical need to reduce disability and improve quality of life for community-dwelling older adults with disabilities for successful aging-in-place during the COVID-19 pandemic. We have developed, with our partner company Foresite Healthcare, a proven sensor- based technology solution for monitoring health-related behaviors in the home. In a multi-site randomized controlled trial, we demonstrated that the sensor system with nursing care coordination prevents declines in function for older adults living in assisted living facilities. The long-term goal of this research is to support independent living for older adults with disabilities for as long as possible. The purpose of this project is to deploy the sensor system in the homes of rural community-dwelling older adults with disabilities and evaluate the effect of the sensor system on reducing disability and improving health-related quality of life. Using a two- arm randomized controlled trial, the sensor system will be installed in the homes of 64 older adults. Participants randomized to Study Arm 1 will receive a multidisciplinary (nursing, occupational therapy, and social work) self-management intervention paired with the sensor system. This intervention is based on the 5As self-management approach and is a direct translation of the nursing care coordination in our prior research. Participants randomized to Study Arm 2 will have standard health education paired with the sensor system. An implementation guide for future use with different partner agencies will be developed using individual and setting level data collected from Aims 1, 2 and 3 using the RE-AIM framework. The project will be accomplished in three aims. In Aim 1, we evaluate the effect of a sensor system paired with a multidisciplinary self-management intervention as compared to the sensor system paired with standard health education care on disability and health-related quality of life after 1 year. In Aim 2, we will evaluate the effect of the sensor system on secondary health outcomes (depression, anxiety, occupational performance, and caregiver burden), rates of falls, and healthcare usage. In Aim 3, we will collect individual participant data for satisfaction and adoption and stakeholder data about organizational setting. Data from Aims 1, 2 and 3 will be analyzed using RE-AIM to produce implementation guidance contextualized by organizational setting. For older adults with disabilities living in rural areas, the sensor system has the potential to change the approach to healthcare and disability management.

项目摘要/摘要。 超过85％的密苏里州是乡村，这些地区的个人年龄较大，可以降低获得常规的机会 与居住在密苏里州城市地区的个人相比，医疗保健。残疾人，尤其是年龄较大的人 成年人患有COVID-19的风险更高。迫切需要减少残疾并改善 社区居住的老年人残疾人的生活质量 2019冠状病毒病大流行。我们已经与合作伙伴公司的前瞻性医疗保健一起开发了一个经验丰富的传感器 - 基于监测家庭中与健康相关行为的基于技术解决方案。在多站点随机中 对照试验，我们证明了具有护理协调的传感器系统可防止下降 居住在辅助生活设施中的老年人的功能。这项研究的长期目标是支持 尽可能长时间地为残疾老年人生活。这个项目的目的是 将传感器系统部署在居住在农村社区的残疾老年人的家庭中，并评估 传感器系统对减少残疾和改善与健康相关的生活质量的影响。使用两个 手臂随机对照试验，传感器系统将安装在64名老年人的家中。 随机研究部门1的参与者将获得多学科（护理，职业疗法和 社会工作）自我管理干预与传感器系统配对。这种干预是基于 5AS自我管理方法，是我们先前的护理协调的直接翻译 研究。随机研究ARM 2的参与者将与传感器配对标准的健康教育 系统。将使用不同合作伙伴机构的未来使用指南 使用RE-AIM框架从目标1、2和3收集的个人和设置级别数据。该项目将 以三个目标完成。在AIM 1中，我们评估了传感器系统与A配对的效果 与标准健康配对的传感器系统相比，多学科的自我管理干预 一年后，关于残疾和健康相关生活质量的教育护理。在AIM 2中，我们将评估 传感器系统关于中等健康结果（抑郁，焦虑，职业表现和 护理人员负担），跌倒率和医疗保健使用率。在AIM 3中，我们将收集个人参与者数据 满意度和采用以及有关组织环境的利益相关者数据。目标1、2和3的数据将是 使用Re-AIM分析以通过组织环境来产生实施指南。为了 居住在农村地区的残疾老年人，传感器系统有可能改变方法 医疗保健和残疾管理。