Caring4Caregivers: A theory-driven mobile solution to promote self-care and well-being among caregivers of individuals with Alzheimer’s andrelated dementias

Caring4Caregivers：一种理论驱动的移动解决方案，旨在促进阿尔茨海默病和相关痴呆症患者的护理人员的自我护理和福祉

• 批准号: 10618164
• 负责人: Kerry Evers
• 金额: $ 60.03万
• 依托单位: PRO-CHANGE BEHAVIOR SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10618164
• 关键词: Absenteeism; Accident and Emergency department; Address; Adopted; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease caregiver; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Behavior; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Characteristics; Dementia; Dementia caregivers; Depressed mood; Development; Disease; Distress; Dose; Dropout; Drowning; Effectiveness; Electronic Mail; Emotional; Ensure; Expenditure; Family member; Fatigue; Feedback; Friends; Gender; General Population; Genes; Health; Hearing; Hour; Household; Income; Individual; Information Centers; Information Systems; Intervention; Interview; Learning; Life; Masks; Measurement; Measures; Medical; Memory; Mental Depression; Motivation; Oxygen; Parents; Participant; Patient Outcomes Assessments; Perception; Personal Satisfaction; Persons; Phase; Population; Productivity; Provider; Psyche structure; Quality of Care; Race; Randomized; Randomized, Controlled Trials; Readiness; Reporting; Research; Risk; Science; Self Care; Spouses; Techniques; Testing; Text; Text Messaging; Theoretical model; Time; Translating; Treatment Efficacy; Wife; Work; attentional control; behavior change; care giving burden; care recipients; caregiving; comparison intervention; cost; cost effective; design; digital; digital intervention; efficacy evaluation; emotional distress; evidence base; experience; follow-up; forgetting; grandparent; health care service utilization; improved; intervention effect; loved ones; phrases; pilot test; primary outcome; programs; prototype; secondary outcome; stress management; theories; therapy design; treatment group; web portal

7. Project Summary/Abstract Over 11 million Americans are currently providing unpaid care to a family member or friend with Alzheimer's disease or a related dementia (ADRD). While caregiving can be a positive experience that brings meaning and an increased sense of purpose, it can also take a toll. Nearly 60% of ADRD caregivers rate their emotional distress as high or very high, and over 30% suffer from depression. Caregivers with distress have higher healthcare utilization and costs and provide poorer quality care to their care recipient. Further, employed caregivers have decreased productivity and higher absenteeism due to their caregiving responsibilities. With the aging of the US population, the number of Americans living with ADRD is expected to triple in the next 30 years, which will lead to a drastic increase in the number of people who care for them. Thus, there is an urgent need for effective, easily disseminable interventions that promote the well-being of ADRD caregivers. As a part of our pilot development, Pro-Change conducted extensive formative qualitative and quantitative research to guide the development of a digital intervention prototype, Caring4Caregivers (C4C). Based on the Transtheoretical Model of Behavior Change (TTM), the program uses an approach to facilitate progress through the stages of change for using five self-care behaviors critical to the well-being of ADRD caregivers: 1) becoming educated about your family member or friend's stage of illness and needs; 2) figuring out your strengths and limits; 3) searching for and accepting outside help where needed; 4) taking time each day to care for yourself; and 5) getting emotional support. Intervention components, designed to fit into the lives of busy ADRD caregivers, include a brief assessment with immediate feedback and guidance; daily stage-matched text messages; and a web portal with an Information Center and stage-matched activities for each self-care behavior. In a 1-month pilot test involving 52 ADRD caregivers with low subjective well-being, C4C was well- received, and participants experienced statistically significant pre-post improvements in well-being and self- care behaviors. In the research we are proposing, the primary aims are to fully develop the C4C intervention, incorporating what was learned in the pilot, and to assess the intervention's efficacy in a 9-month trial involving 234 ADRD caregivers. Participants will be randomly assigned to the C4C condition or to an attention control condition. Efficacy of C4C will be assessed by comparing changes in subjective burden, emotional and physical well-being at 3, 6, and 9 month follow-up in those randomized to the treatment vs. control conditions. Secondary outcomes will include changes in depression, caregiver risk, and number of self-care behaviors. Analyses will assess whether intervention effects are moderated by intervention “dose” and key participant characteristics, including gender, race, age, who the caregiver is caring for, and number of self-care behaviors at baseline. The successful completion of Phase II will set the stage for disseminating an evidence-based caregiver well-being intervention to employers, wellness platform providers, and other organizations.

7. 项目总结/摘要 目前有超过 1100 万美国人正在为患有阿尔茨海默病的家人或朋友提供无偿护理 疾病或相关痴呆症 (ADRD)，而护理可以是一种积极的体验，带来意义和意义。 近 60% 的 ADRD 护理人员认为自己的情绪会受到影响。 痛苦程度为高或非常高，超过 30% 的照顾者患有抑郁症。 医疗保健利用率和成本，并为他们的护理接受者提供质量较差的护理。此外，就业。 护理人员由于承担护理责任而导致生产力下降和缺勤率增加。 随着美国人口老龄化，患有ADRD的美国人数量预计在未来30年将增加两倍 年，这将导致照顾他们的人数急剧增加，因此，这是一个紧迫的问题。 需要有效、易于传播的干预措施来促进 ADRD 护理人员的福祉。 在我们的试点开发过程中，Pro-Change 进行了广泛的形成性定性和定量研究， 指导开发基于 Caring4Caregivers (C4C) 的数字干预原型。 行为改变的跨理论模型 (TTM)，该计划使用一种促进进步的方法 通过使用对 ADRD 护理人员的福祉至关重要的五种自我护理行为的变革阶段：1) 了解您的家人或朋友的疾病阶段和需求 2) 弄清楚您的情况； 优点和局限性； 3） 在需要时寻求并接受外部帮助； 4） 每天花时间进行护理； 为自己；以及 5）获得旨在适应忙碌生活的情感支持。 ADRD 护理人员，包括带有即时反馈和指导的简短评估； 消息；以及一个门户网站，其中包含信息中心和针对每个自我护理的阶段匹配活动 在一项涉及 52 名主观幸福感较低的 ADRD 护理人员的为期 1 个月的试点测试中，C4C 的幸福感良好。 收到，参与者在工作前的幸福感和自我意识方面经历了显着的改善 在我们提出的研究中，主要目标是充分发展 C4C 干预， 结合试点中学到的知识，并在为期 9 个月的试验中评估干预措施的功效 234 名 ADRD 护理人员将被随机分配到 C4C 条件或涉及关注。 C4C 的效果将通过比较主观负担、情绪和情绪的变化来评估。 随机接受治疗组与对照组的受试者在 3、6 和 9 个月随访时的身体健康状况。 次要结果包括抑郁症的变化、照顾者风险和自我护理行为的数量。 分析将评估干预效果是否受到干预“剂量”和关键参与者的调节 特征，包括性别、种族、年龄、照顾者的照顾者以及自我照顾行为的数量 第二阶段的成功完成将为传播基于证据的研究奠定基础。 对雇主、健康平台提供商和其他组织的护理人员健康干预。