Reducing COVID-19 Related Disability in Rural Community-Dwelling Older Adults Using Smart Technology

项目概要/摘要。 超过85%的密苏里州是农村和个人在这些地区是老年人，并已减少获得定期 与生活在密苏里州城市地区的个人相比，残疾人，特别是老年人 成年人感染COVID-19的风险更高。迫切需要减少残疾， 社区居住的残疾老年人的生活质量，以便在 2019冠状病毒病疫情。我们与我们的合作伙伴公司Foresite Healthcare一起开发了一种经过验证的传感器- 基于技术的解决方案，用于监测家庭中与健康相关的行为。在一项多中心随机 对照试验，我们证明，传感器系统与护理协调，防止下降， 为生活在辅助生活设施中的老年人提供服务。这项研究的长期目标是支持 让残疾老人尽可能长时间地独立生活。该项目的目的是 在农村社区居住的老年残疾人家中部署传感器系统， 传感器系统对减少残疾和改善健康相关生活质量的影响。使用两个- 手臂随机对照试验，传感器系统将安装在64名老年人的家中。 随机分配至研究组1的受试者将接受多学科（护理、职业治疗和 社会工作）自我管理干预与传感器系统配对。这种干预是基于 5作为自我管理的方法，是我们以前护理协调的直接翻译 research.随机分配至研究组2的受试者将接受与探头配对的标准健康教育 系统将利用以下方法编制一份执行指南，供不同伙伴机构今后使用： 使用RE-AIM框架从目标1、2和3收集的个人和环境层面数据。该项目将 实现三个目标。在目标1中，我们评估了传感器系统与 多学科自我管理干预相比，传感器系统与标准健康 一年后，提供关于残疾和健康相关生活质量的教育保健。在目标2中，我们将评估 传感器系统对次级健康结果（抑郁，焦虑，职业表现， 护理者负担）、福尔斯率和医疗保健使用。在目标3中，我们将收集个人参与者数据， 满意度和采用率以及利益相关者关于组织环境的数据。目标1、2和3的数据将 使用RE-AIM进行分析，以产生按组织设置的实施指导。为 生活在农村地区的老年残疾人，传感器系统有可能改变方法， 医疗保健和残疾管理。

Project Summary/Abstract. Over 85% of Missouri is rural and individuals in these areas are older and have reduced access to regular healthcare, compared to individuals living in urban areas of Missouri. Those with disabilities, particularly older adults, are at higher risk for contracting COVID-19. There is a critical need to reduce disability and improve quality of life for community-dwelling older adults with disabilities for successful aging-in-place during the COVID-19 pandemic. We have developed, with our partner company Foresite Healthcare, a proven sensor- based technology solution for monitoring health-related behaviors in the home. In a multi-site randomized controlled trial, we demonstrated that the sensor system with nursing care coordination prevents declines in function for older adults living in assisted living facilities. The long-term goal of this research is to support independent living for older adults with disabilities for as long as possible. The purpose of this project is to deploy the sensor system in the homes of rural community-dwelling older adults with disabilities and evaluate the effect of the sensor system on reducing disability and improving health-related quality of life. Using a two- arm randomized controlled trial, the sensor system will be installed in the homes of 64 older adults. Participants randomized to Study Arm 1 will receive a multidisciplinary (nursing, occupational therapy, and social work) self-management intervention paired with the sensor system. This intervention is based on the 5As self-management approach and is a direct translation of the nursing care coordination in our prior research. Participants randomized to Study Arm 2 will have standard health education paired with the sensor system. An implementation guide for future use with different partner agencies will be developed using individual and setting level data collected from Aims 1, 2 and 3 using the RE-AIM framework. The project will be accomplished in three aims. In Aim 1, we evaluate the effect of a sensor system paired with a multidisciplinary self-management intervention as compared to the sensor system paired with standard health education care on disability and health-related quality of life after 1 year. In Aim 2, we will evaluate the effect of the sensor system on secondary health outcomes (depression, anxiety, occupational performance, and caregiver burden), rates of falls, and healthcare usage. In Aim 3, we will collect individual participant data for satisfaction and adoption and stakeholder data about organizational setting. Data from Aims 1, 2 and 3 will be analyzed using RE-AIM to produce implementation guidance contextualized by organizational setting. For older adults with disabilities living in rural areas, the sensor system has the potential to change the approach to healthcare and disability management.