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 老年华裔美国人是美国增长最快的人口之一，他们面临着许多 社会和经济障碍。超过 70% 的老年华裔美国人是第一代移民，近 20% 生活在贫困线以下（一般美国老年人为 9%），其中近一半的英语水平有限 熟练程度。老年华裔美国人所面临的这些社会经济劣势不仅会导致 患阿尔茨海默病和相关痴呆症 (ADRD) 的风险增加，而且获取机会不公平 促进认知健康的有效策略。认知训练是少数被证明有效的干预措施之一 有利于认知正常或轻度的老年人认知功能的维持或增强 认知障碍。移动电话的广泛使用提供了前所未有的机会 以相对较低的成本对大量人群进行远程认知培训干预。这一点特别相关 对于移民人口来说，因为他们通常居住在少数民族飞地并严重依赖智能手机和应用程序 建立社交网络并访问本地服务。尽管基于移动应用程序的认知训练前景广阔， 大多数先前的干预措施专门针对非西班牙裔白人进行了测试。目前，没有量身定制的认知训练 现有的计划可以适应独特的移民历史、文化价值观和语言特性 年长的华裔美国人。为了弥补这一差距，我们的目标是开发一种用于认知训练的移动健康干预措施 这在文化和语言上与年长的华裔美国人相关。我们将利用我们强大的合作伙伴关系 与当地华人社区组织、行业合作伙伴以及认知老龄化领域的跨学科专业知识合作， 民族老年学、实施科学和基于经验的协同设计。更具体地说，拟议的目标 目标 1：将经验支持的认知训练成分纳入文化和语言的培训体系中。 相关认知训练干预方案。目标 2：开展随机对照试验 提出认知训练干预措施，评估其可行性、可接受性，并取得初步效果 影响结果的大小，包括整体认知（初级）、心理健康、身体机能和生活质量。 这项研究将为多中心大规模随机对照试验提供科学基础，以测试 这种认知训练干预的现实效果。此外，这个项目将加深我们对以下方面的认识： 支持少数民族社区参与临床研究的方法。综合起来， 预计这些努力将最终促进实施有效、可持续和可扩展的 促进认知衰老的移动健康干预措施特别适合少数族裔老年人。