Developing a Screening Protocol for Family Caregivers of Older Persons with and without Dementia Seen in Primary Care

项目总结 在美国，近800万老年人依靠家人和其他无偿照顾者(邻居； 朋友)为他们的医疗保健提供帮助。这些照顾者总共提供了总护理的75%-80% 向居住在社区的老年人提供几个小时的时间，并填补医疗保健系统的多个空白：去看医生 探访，协调护理，并协助治疗方案。援助的可获得性和充分性 由家庭和无偿照顾者提供的服务对医疗成本和护理质量有直接影响 上了年纪的人。然而，在卫生保健提供系统中没有系统地确定照顾者，他们的能力 而且不会定期评估需求。初级保健实践处于有利地位，有助于识别和 解决高危家庭照顾者的需求--特别是与照看相关的人 对培训或支持有压力或有未得到满足的需求--通过系统的筛选和转介。这样做的目的是 该项目是为以下家庭照顾者开发、实施和试点测试筛查-转介系统 陪同老年人进行初级保健访问，明确考虑痴呆症的不同需求 以及非痴呆症照顾者。目标1将进行有史以来第一次全国范围内的照顾者筛查调查 美国初级卫生服务提供者(医生、护士、社会工作者、医生助理)的做法 关心。AIMS 2-4将利用与三家初级保健诊所的合作伙伴关系，为不同的患者群体提供服务 让关键利益相关者(护理人员、患者和医疗保健专业人员)参与开发、完善和 试点测试筛查转诊方案。凯瑟琳·里芬博士是这一系列研究的理想带头人 研究给予她在应用老年学方面的学术背景和富有成效的研究记录 家庭关系和健康。她的长期目标是领导一个社会科学研究项目， 在现实世界中为家庭照顾者设计、评估和传播循证干预措施。 为了实现这一目标，Riffin博士将在K01期间在四个关键领域进行额外的培训和指导 获奖期：实施科学、医疗政策制定、干预研究和独立资助 写作和职业发展。职业发展活动将包括正式的课程作业，应用 学习和研究机会，以及家庭领域领先专家的持续指导 护理、卫生服务研究和应用研究方法。里芬博士已经组建了一支强大的 由多学科导师和顾问组成的团队，具有家庭护理、临床试验设计、 医疗保健政策和实施科学，并在指导初级研究人员方面拥有丰富的经验 为独立干杯。如果得到资助，这一奖项将为里芬博士提供强化培训、研究经验、 而作为一名成功的独立调查员，她需要导师来开启她的职业生涯。

PROJECT SUMMARY In the United States, nearly 8 million older adults rely on family and other unpaid caregivers (neighbors; friends) for assistance with their health care. These caregivers collectively provide 75-80% of the total care hours to community-dwelling older persons, and fill multiple gaps in the health care system: attending doctor's visits, coordinating care, and assisting with treatment regimens. The availability and adequacy of assistance provided by family and unpaid caregivers has direct implications for health care costs and quality of care of older adults. Yet, caregivers are not systematically identified in health care delivery systems, and their abilities and needs are not routinely assessed. Primary care practices are well positioned to aid in identifying and addressing the needs of at-risk family caregivers – in particular, persons who suffer from caregiving-related stress or have unmet needs for training or support – through systematic screening and referral. The goal of this project is to develop, implement, and pilot test a screening-referral system for family caregivers who accompany older adults to their primary care visits, with explicit consideration of the distinct needs of dementia and non-dementia caregivers. Aim 1 will conduct the first ever nationwide survey of caregiver screening practices among US providers (physicians, nurses, social workers, physician assistants) working in primary care. Aims 2-4 will leverage partnerships with three primary care practices serving diverse patient populations to engage key stakeholders (caregivers, patients, and health care professionals) in developing, refining, and pilot testing the screening-referral protocol. Catherine Riffin, PhD is ideally situated to spearhead this line of research given her academic background in applied gerontology, and productive track-record of research on family relationships and health. Her long-term goal is to lead a program of social scientific research that designs, evaluates and disseminates evidence-based interventions for family caregivers in real-world contexts. To achieve this goal, Dr. Riffin will pursue additional training and mentorship in four key areas during the K01 award period: implementation science, healthcare policy-making, intervention research, and independent grant writing and professional development. Career development activities will consist of formal coursework, applied learning and research opportunities, and ongoing mentorship from leading experts in the fields of family caregiving, health services research, and applied research methods. Dr. Riffin has assembled a strong, multidisciplinary team of mentors and advisors with expertise in family caregiving, clinical trial design, healthcare policy, and implementation science, and with extensive experience in mentoring junior researchers to independence. If funded, this award will provide Dr. Riffin with the intensive training, research experience, and mentorship needed to launch her career as a successful independent investigator.