Dissemination & Implementation Core

传播

• 批准号: 10673673
• 负责人: Laura N. Gitlin
• 金额: $ 102.53万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673673
• 关键词: Address; Adoption; Adult; Alzheimer' s Disease; Alzheimer' s disease related dementia; Attention; Behavioral Symptoms; Caregiver well-being; Caregivers; Caring; Categories; Characteristics; Clinical; Committee Members; Communication; Communities; Complex; Conceptions; Dementia; Development; Dissemination and Implementation; Ethics; Failure; Family; Family Caregiver; Funding; Health Personnel; Healthcare Systems; Hospitals; International; Intervention; Knowledge; Leadership; Life Cycle Stages; Literature; Long-Term Care; Long-Term Care for Elderly; Managed Care; Methodology; Methods; Modeling; Monitor; Names; Nursing Homes; Outcome; Persons; Pilot Projects; Primary Care; Process Measure; Provider; Quality of life; Readiness; Regulation; Research; Research Personnel; Science; Services; Site; Specific qualifier value; Structure; System; Testing; Training; United States National Institutes of Health; Update; career development; clinically relevant; collaboratory; community based service; contextual factors; daily functioning; dementia care; design; diagnostic tool; diversity and inclusion; evidence base; experience; health care settings; implementation barriers; implementation facilitators; implementation research; improved; inattention; novel; payment; pragmatic trial; programs; protocol development; social media; statistics; success; systems research; therapy development; tool; trial design; web site

PROJECT SUMMARY Over the past four decades, a host of non-pharmacologic interventions tested in trials (NIA Stage I, II, or III) have demonstrated significant clinical benefits for people living with Alzheimer's disease (AD) or an AD-related dementia (AD/ADRD;PWD) and family caregivers. Yet, with few exceptions, proven interventions have neither been tested in health care settings (HCS) using embedded pragmatic trial (ePCTs) designs nor widely disseminated. The lack of pragmatic testing in HCS impedes the adoption of such interventions into practice, with families and health providers continuing to have limited knowledge of and access to evidence-based care. To address this critical gap, the Dissemination and Implementation Core (D&I) of the NIA AD/ADRD HCS Collaboratory (Collaboratory) will assist investigators, and stakeholders (HCS, PWD, caregivers, providers, payers) when implementing and disseminating their dementia care interventions in the context of ePCTs. This Core is based on a fundamental scientific assumption: D&I considerations are critical to address throughout a project’s life-cycle (from idea conception, protocol development and testing to wide scale implementation via the NIA Stage Model) to optimize an intervention’s potentiality for integration into HCS. A major contribution of the D&I Core will be to advance and evaluate the utility of a novel framework to ascertain level of “readiness” of an intervention to proceed to ePCTs. The D&I Core will be co-led by Drs. Laura N. Gitlin and Joseph Gaugler and include an Executive Committee (EC) of five internationally recognized experts in dementia implementation research. The D&I Core’s activities will be closely integrated with and informed by the AD/ADRD Collaboratory’s Stakeholder Engagement and Diversity/Inclusion Teams, HCS Leadership Council, and the Pilot, Training, Design/Statistics and Regulation/Ethics Cores. The Specific Aims are: Aim 1. Conduct, regularly update, and disseminate syntheses of the scientific literature regarding implementation of non-pharmacologic interventions for PWD and/or caregivers; Aim 2: Advance a framework for identifying stage of development of pilot studies and their readiness for conducting ePCT; and Aim 3: Provide ongoing technical assistance tailored to study needs of AD/ADRD Collaboratory-funded pilot project leaders and Career Development Awardees, and other NIA-funded investigators doing ePCTs from the outset of project development to enable them to advance their implementation and dissemination plans. IMPACT: The persistent failure of widespread implementation of proven interventions in HCS for PWD and caregivers is due in large part to inattention to D&I science from the inception of an intervention’s development. Conducting ePCTs will require systematic attention to evidentiary practices for implementing studies in complex, variegated HCS. The D&I Core is essential to assure implementation success of pilot studies, CDAs and ePCTs in order to enhance clinical relevance and change dementia care.

项目概要 在过去的四十年中，许多非药物干预措施在试验中进行了测试（NIA I、II 或 III 期） 已证明对阿尔茨海默病 (AD) 或 AD 相关疾病患者具有显着的临床益处 然而，除了少数例外，经过验证的干预措施对痴呆症（AD/ADRD；PWD）和家庭护理人员都没有影响。 已使用嵌入式实用试验 (ePCT) 设计在医疗机构 (HCS) 中进行了测试，也没有广泛使用 HCS 中缺乏实用测试阻碍了此类干预措施的付诸实践， 家庭和医疗服务提供者对循证医学的了解和获取途径仍然有限 为了解决这一关键差距，NIA AD/ADRD 的传播和实施核心 (D&I) HCS 合作实验室（Collaboratory）将协助研究人员和利益相关者（HCS、残疾人、护理人员、 提供者、付款人）在实施和传播其痴呆症护理干预措施时 该核心基于一个基本的科学假设：D&I 考虑对于解决这一问题至关重要。 整个项目的生命周期（从想法构思、协议开发和测试到大规模 通过 NIA 阶段模型实施）以优化干预措施融入 HCS A 的潜力。 D&I 核心的主要贡献将是推进和评估一个新颖框架的效用，以确定 D&I 核心将由 Laura N. 博士共同领导。 Gitlin 和 Joseph Gaugler 并包括一个由五位国际知名人士组成的执行委员会 (EC) D&I 核心的活动将与实施痴呆症研究的专家紧密结合。 由 AD/ADRD 合作实验室的利益相关者参与和多元化/包容性团队 HCS 提供信息 领导委员会，以及试点、培训、设计/统计和监管/道德核心。 目标是： 目标 1. 进行、定期更新和传播有关以下方面的科学文献的综合 对残疾人和/或护理人员实施非药物干预措施 目标 2：推进框架； 确定试点研究的发展阶段及其开展 ePCT 的准备情况和目标 3： 根据 AD/ADRD 合作实验室资助的试点项目的研究需求提供持续的技术援助 领导者和职业发展获奖者，以及其他 NIA 资助的从一开始就进行 ePCT 的研究人员 项目开发，使他们能够推进其实施和传播计划 影响： 针对残疾人和护理人员的 HCS 广泛实施行之有效的干预措施始终失败 很大程度上是由于从干预措施开发之初就忽视了 D&I 科学。 开展 ePCT 需要系统地关注在以下领域开展研究的证据实践： D&I 核心对于确保试点研究、CDA 的成功实施至关重要。 和 ePCT，以增强临床相关性并改变痴呆症护理。