Caring4Caregivers: A theory-driven mobile solution to promote self-care and well-being among caregivers of individuals with Alzheimer’s andrelated dementias

Caring4Caregivers：一种理论驱动的移动解决方案，旨在促进阿尔茨海默病和相关痴呆症患者的护理人员的自我护理和福祉

• 批准号: 10395174
• 负责人: Kerry Evers
• 金额: $ 127.82万
• 依托单位: PRO-CHANGE BEHAVIOR SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10395174
• 关键词: Absenteeism; Accident and Emergency department; Address; Adopted; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease caregiver; American; Behavior; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Characteristics; Custom; Dementia; Dementia caregivers; Depressed mood; Development; Disease; Distress; Dose; Dropout; Drowning; Effectiveness; Electronic Mail; Emotional; Ensure; Expenditure; Family member; Fatigue; Feedback; Friends; Gender; General Population; Genes; Health; Health Care Costs; Hearing; Hour; Household; Income; Individual; Information Centers; Information Systems; Intervention; Life; Masks; Measurement; Measures; Medical; Memory; Mental Depression; Modeling; Motivation; Oxygen; Parents; Participant; Patient Outcomes Assessments; Perception; Personal Satisfaction; Persons; Phase; Population; Productivity; Provider; Psyche structure; Quality of Care; Race; Randomized; Randomized Controlled Trials; Readiness; Reporting; Research; Risk; Science; Self Care; Spouses; Techniques; Testing; Text; Text Messaging; Time; Translating; Treatment Efficacy; Wife; Work; attentional control; base; behavior change; care giving burden; care recipients; caregiving; comparison intervention; cost effective; design; digital; digital intervention; emotional distress; evidence base; experience; follow-up; grandparent; health care service utilization; intervention effect; loved ones; phrases; pilot test; primary outcome; programs; prototype; secondary outcome; stress management; theories; therapy design; treatment group; web portal

7. Project Summary/Abstract Over 11 million Americans are currently providing unpaid care to a family member or friend with Alzheimer's disease or a related dementia (ADRD). While caregiving can be a positive experience that brings meaning and an increased sense of purpose, it can also take a toll. Nearly 60% of ADRD caregivers rate their emotional distress as high or very high, and over 30% suffer from depression. Caregivers with distress have higher healthcare utilization and costs and provide poorer quality care to their care recipient. Further, employed caregivers have decreased productivity and higher absenteeism due to their caregiving responsibilities. With the aging of the US population, the number of Americans living with ADRD is expected to triple in the next 30 years, which will lead to a drastic increase in the number of people who care for them. Thus, there is an urgent need for effective, easily disseminable interventions that promote the well-being of ADRD caregivers. As a part of our pilot development, Pro-Change conducted extensive formative qualitative and quantitative research to guide the development of a digital intervention prototype, Caring4Caregivers (C4C). Based on the Transtheoretical Model of Behavior Change (TTM), the program uses an approach to facilitate progress through the stages of change for using five self-care behaviors critical to the well-being of ADRD caregivers: 1) becoming educated about your family member or friend's stage of illness and needs; 2) figuring out your strengths and limits; 3) searching for and accepting outside help where needed; 4) taking time each day to care for yourself; and 5) getting emotional support. Intervention components, designed to fit into the lives of busy ADRD caregivers, include a brief assessment with immediate feedback and guidance; daily stage-matched text messages; and a web portal with an Information Center and stage-matched activities for each self-care behavior. In a 1-month pilot test involving 52 ADRD caregivers with low subjective well-being, C4C was well- received, and participants experienced statistically significant pre-post improvements in well-being and self- care behaviors. In the research we are proposing, the primary aims are to fully develop the C4C intervention, incorporating what was learned in the pilot, and to assess the intervention's efficacy in a 9-month trial involving 234 ADRD caregivers. Participants will be randomly assigned to the C4C condition or to an attention control condition. Efficacy of C4C will be assessed by comparing changes in subjective burden, emotional and physical well-being at 3, 6, and 9 month follow-up in those randomized to the treatment vs. control conditions. Secondary outcomes will include changes in depression, caregiver risk, and number of self-care behaviors. Analyses will assess whether intervention effects are moderated by intervention “dose” and key participant characteristics, including gender, race, age, who the caregiver is caring for, and number of self-care behaviors at baseline. The successful completion of Phase II will set the stage for disseminating an evidence-based caregiver well-being intervention to employers, wellness platform providers, and other organizations.

7。项目摘要/摘要 目前，超过1100万美国人向家庭成员或朋友提供无偿护理 疾病或相关痴呆症（ADRD）。虽然照顾可以是带来意义和的积极经历 一种越来越多的目的感，它也会造成巨大的损失。几乎60％的ADRD护理人员对他们的情感评价 遇到高或很高的困扰，超过30％的人患有抑郁症。遇险的护理人员更高 医疗保健利用和成本，并为其护理人员提供较差的质量护理。此外，受雇 由于护理人员的责任，护理人员的生产率和更高的缺勤率提高了。和 美国人口的老龄化，预计在接下来的30次 多年，这将导致关心他们的人数急剧增加。那是紧急的 需要有效，易于分发的干预措施，以促进ADRD护理人员的福祉。作为一部分 在我们的飞行员开发中，亲转换进行了广泛的形成性定性和定量研究 指导数字干预原型的开发，即Caring4Carevers（C4C）。基于 行为改变（TTM）的跨理论模型，该程序使用一种方法来促进进步 通过变革阶段，使用五种自我保健行为对ADRD护理人员的福祉至关重要：1） 对您的家人或朋友的疾病和需求进行教育； 2）弄清楚你的 优势和极限； 3）在需要时搜索并接受外部帮助； 4）每天花时间照顾 为自己5）获得情感支持。干预组件，旨在适应忙碌的生活 ADRD护理人员，包括立即反馈和指导的简短评估；每日舞台匹配的文字 消息；以及一个具有信息中心和阶段匹配活动的网络门户网站 行为。在1个月的试点测试中，涉及52名主观福祉低的ADRD护理人员，C4C是良好的 收到的，参与者在幸福感和自我方面经历了统计学上显着的前验证前改善 护理行为。在我们提出的研究中，主要目的是完全开发C4C干预措施， 在飞行员中纳入学到的知识，并在9个月的试验中评估干预效率 涉及234名ADRD护理人员。参与者将被随机分配到C4C条件或注意力 控制条件。 C4C的功效将通过比较主观燃烧，情感和 在3、6和9个月的随访中，在治疗条件与对照条件的情况下进行了身体健康。 次要结果将包括抑郁症，照料者风险和自我保健行为的数量的变化。 分析将评估干预效果是否通过“剂量”和关键参与者进行调节 特征，包括性别，种族，年龄，照料者所携带的特征和自我保健行为的数量 基线。第二阶段的成功完成将为传播基于证据的阶段奠定 照顾者福祉干预雇主，健康平台提供者和其他组织。