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。 密苏里州超过 85% 的地区是农村地区，这些地区的人年龄较大，获得常规医疗服务的机会较少 与居住在密苏里州城市地区的个人相比。残疾人士，特别是老年人 成年人感染 COVID-19 的风险较高。迫切需要减少残疾并改善 社区居住的残疾老年人的生活质量，以便在 2019冠状病毒病大流行。我们与我们的合作伙伴公司 Foresite Healthcare 一起开发了一种经过验证的传感器- 用于监测家庭健康相关行为的技术解决方案。在多地点随机 对照试验中，我们证明具有护理协调功能的传感器系统可以防止护理能力下降 为生活在辅助生活设施中的老年人提供功能。这项研究的长期目标是支持 尽可能让残疾老年人独立生活。该项目的目的是 在农村社区居住的残疾老年人家中部署传感器系统并评估 传感器系统对减少残疾和改善健康相关生活质量的影响。使用两 ARM 随机对照试验中，该传感器系统将安装在 64 名老年人的家中。 随机分配到第 1 研究组的参与者将接受多学科（护理、职业治疗和 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 5作为自我管理方法，是我们之前的护理协调的直接转化 研究。随机分配到研究组 2 的参与者将接受与传感器配对的标准健康教育 系统。将使用以下方法制定未来与不同合作机构一起使用的实施指南 使用 RE-AIM 框架从目标 1、2 和 3 收集的个人和环境级别数据。该项目将 实现三个目标。在目标 1 中，我们评估了传感器系统与 与标准健康配对的传感器系统相比，多学科自我管理干预 一年后有关残疾和健康相关生活质量的教育护理。在目标 2 中，我们将评估以下效果： 次要健康结果（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情况。在目标 3 中，我们将收集个人参与者数据 有关组织设置的满意度和采用率以及利益相关者数据。目标 1、2 和 3 的数据将是 使用 RE-AIM 进行分析，以根据组织环境制定实施指南。为了 生活在农村地区的残疾老年人，传感器系统有可能改变老年人的生活方式 医疗保健和残疾管理。