Improving Person-Environment Fit of Community-Residing Older Adults with Dementia Through Assessment and Individualized Intervention

通过评估和个体化干预改善社区痴呆症老年人的人-环境适应性

基本信息

批准号：
10525127
负责人：
Elizabeth Rhodus
金额：
$ 16.51万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10525127
关键词：
Active Learning Address Adoption Adult Advisory Committees Aggressive behavior Aging Agitation Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Analysis of Covariance Anxiety Disorders Behavior Behavior Therapy Behavior assessment Behavioral Behavioral Mechanisms Behavioral Model Behavioral Symptoms Caregiver Burden Caregivers Caring Client satisfaction Clinic Clinical Clinical Trials Design Clinical assessments Communities Country Cues Data Dementia Dementia caregivers Development Development Plans Diagnosis Dimensions Elderly Environment Extramural Activities Faculty Fellowship Fostering Foundations Funding Future Goals Grant Health Health Services Accessibility Home Home environment Individual Institutes Institution Intervention Interview Kentucky Letters Measurement Measures Medicine Mental Depression Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Morbidity - disease rate Neurology Neurosciences Pamphlets Performance Persons Physiological Population Positioning Attribute Protocols documentation Proxy Psychiatrist Psychophysiology Quality of life Randomized Controlled Trials Reporting Research Research Activity Research Personnel Research Project Grants Residencies Rural Rural Appalachia Rural Community Safety Scholarship Science Scientist Single-Blind Study Sleep Disorders Stimulus Surveys Teacher Professional Development Testing Time Training Underrepresented Populations United States National Institutes of Health Universities Work aging in place arm base behavior change behavioral response career career development caregiver education college community based research dementia care environmental intervention evidence base experience feasibility trial follow-up health disparity health equity improved in-home care innovation knowledge base mortality novel strategies patient home care programs psychiatric symptom response rural area satisfaction sensor social standard of care supportive environment symptom management telehealth tenure track therapy development tool

项目摘要

Project Summary Aging with Alzheimer's disease and related dementias (ADRD) is compounded by onset of behavioral and psychiatric symptoms (BPSD) seen in over 80% of those with the condition. BPSD often precipitate caregiver burden, institutionalized care, and increased rates of mortality. Despite the critical need, there currently are few non-pharmacological interventions to manage BPSD and those that exist have weak evidence. Research: The project titled, Improving Person-Environment Fit of Community-Residing Older Adults with Dementia Through Assessment and Individualized Intervention, identifies person-environment relationships as a mechanism of action to guide assessment of and intervention for functional behavior within the home context for persons with ADRD. By improving the relationship between persons with ADRD and their home environment (person- environment fit), it is hypothesized that people with ADRD will have improved BPSD and activity engagement within their home. We will employ the NIH Stage Model of Behavioral Intervention Development to define assessment of person-environment fit (Stage 0; Aim 1) and pilot the feasibility of a telehealth intervention to maximize person-environment fit within the homes of community-residing adults with ADRD within rural communities (Aim 2). Findings of this research will inform discovery of best practices for a non-pharmacological, environmental approach to BPSD for persons with ADRD living in their home. Candidate: Dr. Elizabeth Rhodus is an early-career investigator, who is transitioning from a NIH T32-funded postdoctoral fellowship to a full-time tenure-track faculty position at the University of Kentucky (UK) College of Medicine. Three training goals will enhance her trajectory toward becoming an independent, successfully funded investigator: 1) Develop a strong knowledge base on integrated physiological and behavioral assessment of person-environment interactions on community-dwelling people living with ADRD, 2) Build expertise in development and implementation of behavioral interventions among older adults with ADRD, and 3) Expand understanding of research strategies for inclusion of underrepresented populations in aging studies. Mentors/Environment: The current career development plan includes substantial mentorship, didactic training, and experiential learning at the UK Center for Health Equity Transformation with Director, Dr. Nancy Schoenberg (primary mentor), UK Sanders-Brown Center on Aging with Associate Director, Dr. Donna Wilcock (co-mentor), Dr. Anton Porsteinsson (mentor), a prominent clinical researcher and psychiatrist for treatment of BPSD, and a renowned, interdisciplinary advisory committee. Dr. Rhodus will receive support from her institution through internal grants, faculty education, networking, and scholarship. Dr. Rhodus has full support from UK (see institutional letter of support) to advance her career development and research activities. Thus, the overall objective of this K23 application is to propel the career development of Dr. Rhodus to an independent scientist in ADRD research using the findings of this project to inform a future extramural R01 targeting non-pharmacological interventions for BPSD management.

项目概要阿尔茨海默氏病和相关痴呆症 (ADRD) 的衰老因行为和相关痴呆症的出现而变得更加复杂。超过 80% 的患者出现精神症状 (BPSD)。 BPSD 经常促使护理人员负担、机构化护理和死亡率上升。尽管需求迫切，但目前还很少管理 BPSD 的非药物干预措施和现有的干预措施证据薄弱。研究：项目名为“通过改善社区居住的痴呆症老年人的人与环境的契合度” 评估和个性化干预，将人与环境的关系识别为一种机制采取行动指导患有以下疾病的人在家庭环境中进行功能行为的评估和干预 ADRD。通过改善 ADRD 患者与其家庭环境之间的关系（人- 环境适应性），假设患有 ADRD 的人会改善 BPSD 和活动参与度在他们的家里。我们将采用 NIH 行为干预发展阶段模型来定义评估人与环境的契合度（阶段 0；目标 1）并试点远程医疗干预的可行性最大限度地提高农村地区 ADRD 社区居民的家庭环境适应性社区（目标 2）。这项研究的结果将为发现非药物的最佳实践提供信息，针对家中 ADRD 患者的 BPSD 环境方法。候选人：伊丽莎白·罗德斯博士是一名早期职业研究员，正在从 NIH T32 资助的博士后奖学金过渡到全职肯塔基大学（英国）医学院的终身教职。三个训练目标增强她成为一名独立的、成功资助的研究者的轨迹：1) 培养强大的人与环境相互作用的综合生理和行为评估知识库患有 ADRD 的社区居民，2) 积累开发和实施相关专业知识患有 ADRD 的老年人的行为干预，以及 3) 扩大对 ADRD 研究策略的理解将代表性不足的人群纳入老龄化研究。导师/环境：当前职业发展计划包括在英国中心的大量指导、教学培训和体验式学习与英国 Sanders-Brown 主任 Nancy Schoenberg 博士（主要导师）一起进行健康公平转型老龄化中心副主任 Donna Wilcock 博士（共同导师）、Anton Porsteinsson 博士（导师）治疗 BPSD 的杰出临床研究员和精神病学家，以及著名的跨学科顾问委员会。罗杜斯博士将通过内部拨款、教师教育、网络和学术。 Rhodus 博士得到英国的全力支持（参见机构支持信）以推进她的职业发展和研究活动。因此，这个 K23 应用程序的总体目标是推动 Rhodus 博士利用本研究的发现，将其职业发展为 ADRD 研究的独立科学家项目旨在为未来针对 BPSD 管理非药物干预的外部 R01 提供信息。