Aging with Pride: Innovations in Dementia Empowerment and Action (IDEA).
Aging with Pride: Innovations in Dementia Empowerment and Action (IDEA).
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DOI：
10.1016/j.conctc.2023.101169
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发表时间：
2023-10
影响因子：
1.5
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中科院分区：
文献类型：
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与一般人群相比，性少数和性别少数 (SGM) 老年人及其护理伙伴面临着独特的脆弱性，这些脆弱性加剧了痴呆症的生活，包括合并症差异加大、社会孤立和结构性不平等，例如歧视和缺乏支持。本文描述了有史以来第一个随机对照临床试验干预措施的虚拟适应过程，“自豪地老龄化：痴呆症赋权和行动的创新”(IDEA)，该试验是为 SGM 痴呆症老年人及其护理伙伴设计的，建立在 RDAD 和 NHAS 的基础上。 IDEA 的虚拟改编以可访问性、质量、易于交付、可持续性和文化相关性等目标为指导。该实施需要开发符合 HIPPA 标准的在线虚拟平台、教练和参与者虚拟培训，并根据需要修改必要的干预元素和材料。根据初步结果，参与者和干预教练对 IDEA 的虚拟改编反应良好。与面对面交付相比，虚拟交付减少了干预参与者和教练的流失。 IDEA 干预措施的虚拟适应带来了初步的、意想不到的、但潜在重要的好处，包括扩大干预范围和减少人员流失的能力。对于痴呆症患者及其护理伙伴来说，虚拟干预是一个新兴领域，需要进行额外的系统研究来充分评估其益处和局限性，并评估不同的交付方式是否可以更好地为特定亚群提供服务。
Sexual and gender minority (SGM) older adults and their care partners, compared to the general population, face unique vulnerabilities that exacerbate living with dementia, including elevated disparities in comorbidities, social isolation, and structural inequities, such as discrimination and lack of access to supports. This paper describes the virtual adaptation process of the first-ever randomized controlled clinical trial intervention, Aging with Pride: Innovations in Dementia Empowerment and Action (IDEA), that was designed for SGM older adults living with dementia and their care partners and built upon the foundation of RDAD and NHAS. The virtual adaptation of IDEA was guided by the goals of accessibility, quality, ease of delivery, sustainability, and cultural relevance. The implementation required the development of a HIPPA-compliant online virtual platform, coach and participant virtual training, and modification of necessary intervention elements and materials, as needed. Based on the preliminary findings, the participants and intervention coaches responded well to the virtual adaptation of IDEA. When comparing to in-person delivery, the virtual delivery decreased attrition among both intervention participants and coaches. The virtual adaptation of the IDEA intervention resulted in preliminary, unexpected, yet potentially important benefits, including the ability to expand the reach of the intervention and decreased attrition. Virtual interventions are an emerging field for people living with dementia and their care partners and additional systematic research is needed to fully assess the benefits and limitations as well as to evaluate if specific subgroups are better served by differing delivery modalities.