Developing a Mobile App-Based Intervention to Promote Cognitive Health in Older Chinese Americans

开发基于移动应用程序的干预措施以促进老年华裔美国人的认知健康

• 批准号: 10576849
• 负责人: Hanzhang Xu
• 金额: $ 24.4万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576849
• 关键词: Accounting; Address; Adherence; Adult Children; Alzheimer' s disease related dementia; Asian; Asian Americans; Asian population; Behavior Therapy; Cellular Phone; Chinese; Chinese American; Clinical Research; Cognition; Cognitive; Cognitive aging; Collaborations; Communities; Complex; Country; Cues; Dementia; Development; Economics; Educational Intervention; Educational workshop; Elderly; Elements; Ethnic Origin; Focus Groups; Friendships; Future; Generations; Health; Health Services Accessibility; Immigrant; Immigration; Impaired cognition; Inequity; Intervention; Intervention Studies; Knowledge; Limited English Proficiency; Linguistics; Maintenance; Memory; Mental Health; Methods; Minority; Modeling; North Carolina; Not Hispanic or Latino; Older Population; Outcome; Pattern; Persons; Physical Function; Population; Poverty; Problem Solving; Property; Protocols documentation; Provider; Quality of life; Randomized, Controlled Trials; Recording of previous events; Research; Risk; Science; Services; Site; Social Network; Socioeconomic Status; Standardization; Structure; Target Populations; Testing; Training; Training Activity; Training Programs; Treatment Efficacy; United States; United States National Institutes of Health; Vulnerable Populations; Work; care systems; cognitive enhancement; cognitive function; cognitive training; community organizations; cost; cultural values; dementia care; design; digital; efficacy testing; ethnic minority; experience; health belief; high risk; implementation facilitation; implementation science; improved; industry partner; intervention refinement; mHealth; member; mild cognitive impairment; minority communities; mobile application; novel; prevent; prevention service; programs; remote intervention; research study; skills training; social; socioeconomic disadvantage; systematic review; therapy development; visual search

ABSTRACT Older Chinese Americans are one of the fastest growing populations in the United States, who face many social and economic barriers. Over 70% of older Chinese Americans are first generation immigrants, nearly 20% are living below the poverty line (9% in general US older adults), and close to half of them have limited English proficiency. These socioeconomic disadvantages shared by older Chinese Americans will not only contribute to an increased risk of developing Alzheimer's disease and related dementias (ADRD), but also inequitable access to effective strategies to promote cognitive health. Cognitive training is one of the few interventions shown to be beneficial to the maintenance or enhancement of cognitive function in older adults with normal cognition or mild cognitive impairment. The widespread use of mobile phones offers an unprecedented opportunity to deliver cognitive training interventions remotely to a large population at relatively low cost. This is particularly relevant to the immigrant populations as they often reside in ethnic enclaves and rely heavily on smartphones and apps to build social networks and to access local services. Despite the promise of mobile app-based cognitive training, most prior interventions were tested exclusively in non-Hispanic Whites. Currently, no tailored cognitive training program exists that can accommodate the unique immigration history, cultural values, and linguistic properties of older Chinese Americans. To address this gap, we aim to develop a mHealth intervention for cognitive training that is culturally and linguistically relevant to older Chinese Americans. We will leverage our strong partnership with a local Chinese community organization, industry partner, and interdisciplinary expertise in cognitive aging, ethnogeriatrics, implementation science, and experience-based codesign. More specifically, the proposed aims are: Aim 1: To adapt empirically supported cognitive training components into a culturally and linguistically relevant cognitive training intervention protocol. Aim 2: To conduct a pilot randomized controlled trial of the proposed cognitive training intervention to evaluate the feasibility, acceptability, and obtain preliminary effect sizes on outcomes including global cognition (primary), mental health, physical functioning, and quality of life. This study will provide the scientific groundwork for a multi-site large scale randomized control trial to test the real-world efficacy of this cognitive training intervention. In addition, this project will further our knowledge of methods to support engagement of ethnic minority communities in clinical research studies. Taken together, these efforts are expected to ultimately facilitate the implementation of effective, sustainable, and scalable mHealth interventions to promoting cognitive aging specifically suited for ethnic minority older adults.

抽象的 中国美国人是美国增长最快的人口之一，他们面对许多人 社会和经济障碍。超过70％的中国美国人是第一代移民，近20％ 生活在贫困线以下（美国一般年轻人9％），近一半的英语 熟练程度。这些老年美国人共享的这些社会经济劣势不仅会促成 患阿尔茨海默氏病和相关痴呆症（ADRD）的风险增加，但也无法获得 有效促进认知健康的策略。认知训练是显示的少数几次干预措施之一 有益于正常认知或轻度的老年人的认知功能的维持或增强 认知障碍。手机的广泛使用提供了空前的机会 认知培训干预措施以相对较低的成本遥控人群。这特别重要 对于移民人口，他们经常居住在民族飞地，并严重依赖智能手机和应用 建立社交网络并访问本地服务。尽管有基于移动应用程序的认知培训的承诺，但 大多数先前的干预措施仅在非西班牙裔白人中进行测试。目前，没有量身定制的认知培训 存在可以适应独特的移民历史，文化价值和语言特性的程序 中国美国人。为了解决这一差距，我们旨在开发用于认知培训的MHealth干预措施 这在文化和语言上与中年美国人有关。我们将利用我们的牢固伙伴关系 与当地的中国社区组织，行业合作伙伴和认知衰老方面的跨学科专业知识， 民族病理学，实施科学和基于经验的代码。更具体地说，拟议的目的 是：目标1：将经验支持的认知训练组成适应文化和语言上 相关的认知训练干预方案。目的2：进行试点随机对照试验 提出的认知训练干预措施以评估可行性，可接受性并获得初步效果 大小，包括全球认知（主要），心理健康，身体功能和生活质量的大小。 这项研究将为多站点的大规模随机控制试验提供科学基础，以测试 这种认知训练干预的现实世界疗效。此外，这个项目将进一步了解我们的知识 支持少数民族社区参与临床研究的方法。在一起， 这些努力有望最终促进实施有效，可持续和可扩展的 MHealth的干预措施促进专门适合少数民族老年人的认知衰老。