Diversity supplement to the U01 project-Care partner assisted intervention to improve oral health for person with mild dementia

U01项目的多样性补充-护理伙伴协助干预改善轻度痴呆症患者的口腔健康

• 批准号: 10076282
• 负责人: RUTH A ANDERSON
• 金额: $ 20.29万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-21 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10076282
• 关键词: Address; Adult; Agreement; Behavior; Behavior Therapy; Behavioral; Caregivers; Caring; Chronic; Chronic Disease; Clinical; Code; Cognitive; Communication; Communities; Cues; Data; Dementia; Dental Hygiene; Deterioration; Elderly; Family member; Feedback; Fostering; Frequencies; Frustration; Gingival Indexes; Goals; Health Benefit; Home environment; Impaired cognition; Individual; Informal Social Control; Instruction; Interdisciplinary Study; Intervention; Intervention Studies; Knowledge; Leadership; Learning; Mediating; Methods; Monitor; Names; National Institute of Dental and Craniofacial Research; New York City; North Carolina; Nurses; Nursing Homes; Oral; Oral health; Outcome; Parents; Participant; Persons; Pilot Projects; Play; Process; Protocols documentation; Publications; Publishing; Quality of life; Randomized; Reporting; Research; Research Activity; Rewards; Role; Self Care; Self Efficacy; Specific qualifier value; Supervision; Target Populations; Taxonomy; Techniques; Time; Toothbrushing; Work; associated symptom; behavior change; caregiving; cognitive ability; cognitive change; communication behavior; control trial; dementia care; design; effectiveness evaluation; health knowledge; high risk; human old age (65+); improved; indexing; innovation; mild cognitive impairment; neglect; novel; nursing intervention; oral care; parent grant; parent project; prevent; psychologic; public health relevance; scale up; skills; social; symptom management

Summary (Abstract) of Parent Grant (1U01DE027512-01) : Close to 9% of adults age 65 and older in the U.S. have dementia and individuals with dementia have significantly poorer oral health than cognitively intact older adults. Even individuals with mild dementia are at higher risk of poor oral health and evidence is strong to suggest that inadequate oral hygiene practices are a major contributing factor. Maintaining good oral hygiene is a critical step in preventing deterioration of oral health. A few studies conducted in nursing homes have shown that with routine oral hygiene care, the oral health of persons with dementia improves notably in a short period of time. Most individuals with mild dementia live at home where family members (i.e. care partners) provide supervision or assistance with daily activities, but often neglect oral hygiene. Because care partners play an essential role in supervising and caring for individuals with mild dementia at home, an intervention with both individuals with mild dementia and their care partners to improve oral self-care may have long term oral health benefits for the individuals with mild dementia. Yet, few interventions have addressed oral health problems among older adults in general and among individuals with mild dementia in particular, and to our knowledge, no oral health interventions have been conducted among community dwelling individuals with mild dementia. To address this gap in knowledge, we propose a novel intervention to help care partners learn how to adapt methods for guiding the individuals with mild dementia in carrying out oral hygiene. Mild dementia is an ideal time to intervene because individuals with mild dementia still retain sufficient cognitive ability to perform oral hygiene tasks successfully with minimal assistance. Using the results from a pilot study we conducted, we developed the intervention protocol and established our multidisciplinary research team (NIDCR 1R34DE023881). The results from our pilot study provide strong indication that our care partner-assisted intervention will generate positive oral health outcomes. Our team is ready to implement a U01 randomized control trial (RCT) in New York City and North Carolina. The intervention includes both a tailored oral care plan and a behavioral component using the Adaptive Leadership Framework for Chronic Disease that our team introduced to manage symptoms associated with chronic conditions, such as dementia. The specific aims are to: Aim 1: Evaluate the effectiveness of a care partner-assisted intervention to improve oral hygiene and oral hygiene behaviors in individuals with mild dementia. Aim 2: Assess changes in mediating factors/process outcomes, including communication between the dyads, oral health knowledge, and self-efficacy for both individuals with mild dementia and care partners to understand mechanisms of the intervention. This innovative care partner-assisted oral care behavior intervention will assist IMD and care partners in implementing a cooperative oral hygiene care plan to prevent deterioration of oral health, which in turn, will help our targeted population to maintain independence in completing daily activities and quality of life for an extended period of time.

父母赠款的摘要（摘要）（1U01DE027512-01）： 在美国，接近65岁及以上的成年人的9％患有痴呆症，患有痴呆的人患有痴呆症 与认知完整的老年人相比，口腔健康差得多。即使患有轻度痴呆的人也在 口腔健康不良和证据的较高风险强烈表明口腔卫生做法不足是一种 主要促成因素。保持良好的口腔卫生是防止口服恶化的关键步骤 健康。在疗养院进行的一些研究表明，通过常规的口服卫生护理，口服 痴呆症患者的健康在短时间内显着改善。大多数患有轻度痴呆的人 住在家里的家人（即护理伙伴）在日常活动中提供监督或帮助 但经常忽略口腔卫生。因为护理伙伴在监督和关怀中起着至关重要的作用 在家中有轻度痴呆的人，与患有轻度痴呆症患者的干预及其护理 改善口腔自我保健的伴侣可能会为患有温和的人带来长期的口腔健康益处 失智。然而，很少有干预措施解决一般的老年人的口腔健康问题， 在尤其是轻度痴呆的人中，据我们所知，没有口腔健康干预措施 是在温和痴呆症的社区住宅中进行的。为了解决知识的差距， 我们提出了一种新颖的干预措施，以帮助护理伙伴学习如何适应指导个人的方法 轻度痴呆进行口腔卫生。轻度痴呆是干预的理想时机，因为个人 轻度痴呆仍然保留足够的认知能力，可以成功执行口腔卫生任务。 协助。利用我们进行的试点研究的结果，我们制定了干预方案和 建立了我们的多学科研究团队（NIDCR 1R34DE023881）。我们的试点研究的结果 提供强烈的迹象表明，我们的护理合作伙伴辅助干预将产生积极的口腔健康状况。 我们的团队准备在纽约市和北卡罗来纳州实施U01随机控制试验（RCT）。 干预措施包括使用自适应的量身定制的口腔护理计划和行为成分 我们的团队引入的慢性病领导框架来管理与 慢性疾病，例如痴呆症。具体目的是：目标1：评估护理的有效性 伴侣辅助干预措施，以改善温和患者的口腔卫生和口腔卫生行为 失智。目标2：评估中介因素/过程结果的变化，包括 对患有轻度痴呆和护理伴侣的两个人的二元，口腔健康知识以及自我效能感 了解干预的机制。这种创新的护理伙伴辅助口腔护理行为 干预将帮助IMD和护理合作伙伴实施合作的口腔卫生护理计划，以防止 口腔健康的恶化，反过来将有助于我们的目标人群保持独立性 在很长一段时间内完成日常活动和生活质量。