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 目前有1100多万美国人为阿尔茨海默氏症的家人或朋友提供无偿护理 疾病或相关痴呆症(ADRD)。虽然照料可以是一种积极的经历，带来意义和 在使命感增强的同时，这也可能带来损失。近60%的ADRD照顾者将他们的情感 痛苦程度高或非常高，超过30%的人患有抑郁症。有痛苦的照顾者有更高的 卫生保健利用率和成本，并为其护理对象提供质量较差的护理。此外，受雇于 照顾者由于他们的照看责任，工作效率降低，缺勤率增加。使用 随着美国人口老龄化，ADRD携带者的美国人数预计将在未来30年增加两倍 这将导致照顾他们的人的数量急剧增加。因此，有一个紧急的 需要有效、易于传播的干预措施，以增进ADRD照顾者的福祉。作为一部分 在我们的试点开发中，Pro-Change进行了广泛的形成性定性和定量研究，以 指导数字干预原型Caring4Caregiver(C4C)的开发。基于 跨理论行为改变模型(TTM)，该计划使用一种方法来促进进展 通过改变使用对ADRD照顾者福祉至关重要的五种自我照顾行为的阶段：1) 了解你的家人或朋友的病情和需求；2)了解你的 长处和局限；3)在需要的地方寻找和接受外界的帮助；4)每天花时间去关心 为你自己；5)获得情感上的支持。干预组件，旨在适应忙碌的生活 ADRD照顾者，包括具有即时反馈和指导的简短评估；每日阶段匹配文本 消息；以及一个具有信息中心和每个自助服务的阶段匹配活动的Web门户 行为。在一项涉及52名主观幸福感较低的ADRD照顾者的为期1个月的试点测试中，C4C- 接受调查，受试者在上岗前幸福感和自我感觉有显著改善 关爱行为。在我们提出的研究中，主要目标是充分发展C4C干预， 纳入在试点中学到的东西，并在9个月的试验中评估干预的效果 涉及234名ADRD照顾者。参与者将被随机分配到C4C状态或受到关注 控制条件。C4C的疗效将通过比较主观负担、情感和 那些随机接受治疗的患者在3个月、6个月和9个月时的身体健康状况与对照条件相比。 次要结果将包括抑郁症、照顾者风险和自我护理行为数量的变化。 分析将评估干预效果是否受到干预“剂量”和关键参与者的影响 特征，包括性别、种族、年龄、照顾者正在照顾的人以及自我照顾行为的数量 在基线上。第二阶段的成功完成将为传播以证据为基础的 照顾者对雇主、健康平台提供商和其他组织的福祉干预。