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: 10352286
• 负责人: Hanzhang Xu
• 金额: $ 21.41万
• 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 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10352286
• 关键词: Accounting; Address; Adherence; Adult Children; Alzheimer' s disease related dementia; Asian; Asian Americans; Asian population; Behavior Therapy; Car Phone; Chinese; Chinese American; Clinical Research; Cognition; Cognitive; Cognitive aging; Communities; Complex; Country; Cues; Dementia; Development; Economics; Educational Intervention; Educational workshop; Elderly; Elements; Face; Focus Groups; Friendships; Future; Generations; Health; Health Services Accessibility; Immigrant; Immigration; Impaired cognition; 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; base; 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; mHealth; member; mild cognitive impairment; minority communities; mobile application; novel; prevent; prevention service; remote intervention; research study; service programs; skills training; smartphone Application; 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.

摘要 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(9%的美国老年人)，其中近一半的人英语水平有限 熟练程度。年长的华裔美国人的这些社会经济劣势不仅将有助于 罹患阿尔茨海默病和相关痴呆(ADRD)的风险增加，但机会不平等 到促进认知健康的有效策略。认知训练是为数不多的干预措施之一。 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 以相对较低的成本远程向大量人口提供认知培训干预。这一点特别相关 对于移民人口来说，因为他们经常居住在种族飞地，严重依赖智能手机和应用程序 建立社交网络和使用当地服务。尽管基于移动应用的认知训练前景看好， 之前的大多数干预措施都是专门在非西班牙裔白人中进行测试的。目前，没有量身定制的认知培训 存在能够适应独特的移民历史、文化价值和语言特性的计划 年长的华裔美国人。为了解决这一差距，我们的目标是开发一种用于认知训练的mHealth干预 这在文化和语言上都与年长的华裔美国人有关。我们将充分利用我们牢固的伙伴关系 与当地的华人社区组织、行业合作伙伴和认知老龄化方面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，拟议的目标是 目标1：将经验支持的认知训练内容调整为文化和语言上的 相关认知训练干预方案。目的2：进行一项先导性随机对照试验 建议进行认知训练干预，评估其可行性、可接受性，并取得初步效果 结果的大小包括全球认知(主要)、心理健康、身体功能和生活质量。 这项研究将为多点大规模随机对照试验提供科学基础 这种认知训练干预的真实效果。此外，这个项目将进一步加深我们对 支持少数民族社区参与临床研究的方法。加在一起， 预计这些努力最终将促进有效、可持续和可扩展的 特别适合少数民族老年人的促进认知老化的移动健康干预措施。