Impact of Adult Day Services on Psychosocial and Physiological Measures of Stress among African American Dementia Family Caregivers

成人日间服务对非裔美国痴呆症家庭护理人员的社会心理和生理压力测量的影响

• 批准号: 10328955
• 负责人: Lauren Parker
• 金额: $ 12.93万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10328955
• 关键词: Address; Adult; African American; African American population; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Award; Biological Markers; Biological Products; Caregiver well-being; Caregivers; Caring; Collection; Communities; Coping Behavior; Coping Skills; Dehydroepiandrosterone Sulfate; Dementia; Dementia caregivers; Development; Disease; Family Caregiver; Family member; Goals; Health; Home; Hour; Hydrocortisone; Intervention; Interview; Length; Measures; Mental Health; Mentored Research Scientist Development Award; Mentors; Methods; Modeling; National Institute on Aging; Outcome; Pattern; Persons; Physiological; Psychosocial Assessment and Care; Psychosocial Stress; Reporting; Research; Research Personnel; Resources; Salivary; Sampling; Security; Services; Site; Social support; Source; Stress; Stressful Event; Structure; Supervision; Survey Methodology; Telomere Shortening; Time; Training; Training Programs; Transportation; United States National Institutes of Health; age related; alpha-amylase; base; biopsychosocial; caregiver stress; caregiving; dehydroepiandrosterone; dementia caregiving; depressive symptoms; design; diaries; expectation; experience; health disparity; implementation science; improved; multilevel analysis; perceived stress; psychosocial; respite care; response; service programs; service utilization; social stigma; stress management; stress reduction; stressor; telomere; therapy development

PROJECT ABSTRACT The rate of Alzheimer’s Disease and related dementias (AD/ADRD) is nearly twice as high among African Americans when compared to Whites. African Americans are more likely than others to age with ADRD in the community and rely heavily on family members or other informal sources for support. African American caregivers spend more time providing care than their White counterparts, and report need for daytime respite care. The greater time spent providing care to relatives and unmet need for respite services may accelerate aging and the negative health effects of stress associated with caregiving among African Americans. Adult day services (ADS) may offer respite to alleviate caregiving-related stressors among African American dementia caregivers. Adult day services offer community-based, out-of-home, supervised support for persons with dementia. Guided by the NIH-Stage Model, this NIA-K01 award will allow completion of the initial stage of the model to identify the mechanisms which ADS influence caregiving-related stressors and needs for African American ADRD caregivers. A convergent parallel mixed methods design will be used. The aims will employ quantitative methods of survey assessment of psychosocial stress (caregiver stress, perceived stress), the collection of salivary biologics (Alpha-Amylase, dehydroepiandrosterone sulfate, cortisol and telomere length) to assess physiological stress, and descriptive interviews and daily diaries to explore African American caregivers’ daily stressors, health seeking and coping behaviors. Over a 5-day period, 50 African American caregivers’ will be asked to keep a daily diary of stressful events they encounter during the day, and strategies used to manage stress. During this period, the caregivers will also be asked to self-collect salivary biomarkers four times a day (upon waking, 30-minutes are waking, before dinner, and bedtime) for five consecutive days (20 samples per caregiver), to include at least two days of ADS use and a weekend day. Descriptive interviews will also be used to elicit caregivers’ experiences with daily stressors and coping behaviors. The specific research aims of this study are focused on African American ADRD caregivers, who utilize ADS at least twice a week for a person with dementia. The three specific aims are to: 1) Identify daily stressors, health seeking and coping behaviors among African American dementia caregivers, 2) Identify the association between caregiver stress and physiological stress, and 3) Evaluate diurnal patterns in physiological stress on ADS vs non-ADS day usage. Outcomes of this proposed project will inform a R01 award to develop a culturally-tailored stress reduction intervention for African American dementia-caregivers at the ADS site, to be submitted during year 4. The candidate’s training plan capitalizes on the expertise of a diverse mentoring team, and lays out a comprehensive plan to gain training in mixed-methods, intervention development, and the integration of physiological indicators of stress into dementia-related research.

项目摘要 在非洲，阿尔茨海默病和相关痴呆症（AD/ADRD）的发病率几乎是非洲人的两倍。 美国人与白人相比非裔美国人比其他人更有可能在ADRD中老化， 社区和严重依赖家庭成员或其他非正式来源的支持。非裔美国人 护理人员比白色同行花费更多的时间提供护理，并报告需要白天休息 在乎更多的时间用于照顾亲属和未满足的喘息服务需求可能会加速 老龄化和与非洲裔美国人中的生育相关的压力对健康的负面影响。成人日间 ADS服务可能会缓解非裔美国人痴呆症患者与痴呆症相关的压力 照顾者成人日间服务为患有精神分裂症的人提供基于社区的、家庭外的、有监督的支持。 痴呆在NIH阶段模型的指导下，该NIA-K 01奖项将允许完成 模型，以确定ADS影响非洲人与工作有关的压力源和需求的机制 美国ADRD护理人员。将使用收敛并行混合方法设计。目标将采用 心理社会压力（照顾者压力，感知压力）调查评估的定量方法， 收集唾液生物制剂（α-淀粉酶、硫酸脱氢表雄酮、皮质醇和端粒长度） 评估生理压力，描述性访谈和每日日记，以探索非洲裔美国人 照顾者的日常压力源、健康寻求与因应行为。在5天的时间里，50名非洲裔美国人 护理人员将被要求每天记录他们在白天遇到的压力事件， 用来管理压力在此期间，护理人员还将被要求自行收集唾液生物标志物 一天四次（醒来时，30分钟醒来，晚餐前，睡前），连续五天 (20每个护理人员的样本），包括至少两天的ADS使用和一个周末。描述性访谈 也将被用来引出照顾者的日常压力和应对行为的经验。具体 本研究的研究目的是集中在非裔美国人ADRD照顾者，他们至少使用两次ADS 一周的时间三个具体目标是：1）确定日常压力源，寻求健康 非裔美国人痴呆症照顾者的应对行为，2）确定 护理人员压力和生理压力，以及3）评估ADS与 非ADS日使用。这个拟议项目的成果将告知R 01奖，以开发一个文化定制的 在ADS网站为非裔美国人痴呆症照顾者提供减压干预，将在 第四年。候选人的培训计划利用了多元化辅导团队的专业知识，并制定了 综合计划，以获得培训的混合方法，干预发展，并整合 压力生理指标纳入痴呆症相关研究。