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.项目总结/摘要 目前，超过1100万美国人正在为患有阿尔茨海默氏症的家庭成员或朋友提供无偿护理 疾病或相关痴呆（ADRD）。虽然庆祝可以是一种积极的体验，带来意义， 目标感的增强，也会造成损失。近60%的ADRD照顾者认为他们的情绪 抑郁程度高或非常高，超过30%的人患有抑郁症。有痛苦的照顾者 并向其护理接受者提供较差质量护理。此外，就业 由于照料者的双重责任，他们的生产力下降，缺勤率增加。与 随着美国人口的老龄化，预计未来30年，美国ADRD患者的数量将增加两倍。 这将导致照顾他们的人数急剧增加。因此，迫切需要 需要有效、易于传播的干预措施来促进ADRD护理人员的福祉。一部分 在我们的试点开发中，Pro-Change进行了广泛的定性和定量研究， 指导数字干预原型Caring 4Caregivers（C4 C）的开发。基于 行为改变的跨理论模型（TTM），该计划使用的方法，以促进进步 通过使用对ADRD护理人员的福祉至关重要的五种自我护理行为的变化阶段：1） 了解你的家人或朋友的病情和需求; 2）弄清楚你的 优点和局限性; 3）在需要时寻求和接受外部帮助; 4）每天花时间照顾 （5）获得情感支持。干预组件，旨在适应忙碌忙碌的生活 ADRD护理人员，包括一个简短的评估与即时反馈和指导;每日阶段匹配的文本 信息;以及一个带有信息中心和与每个自我护理阶段相匹配的活动的Web门户 行为在一项为期1个月的试点测试中，涉及52名主观幸福感较低的ADRD照顾者，C4 C良好， 收到，参与者经历了统计上显着的改善后，幸福和自我， 关怀行为在我们提议的研究中，主要目标是充分发展C4 C干预， 结合试点中学到的知识，并在9个月的试验中评估干预措施的有效性 涉及234名ADRD护理人员。参与者将被随机分配到C4 C条件或注意 控制条件C4 C的疗效将通过比较主观负担、情绪和 随机分配至治疗组与对照组的患者在3、6和9个月随访时的身体健康状况。 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干预“剂量”和关键参与者的调节 特征，包括性别、种族、年龄、照顾者所照顾的人以及自我照顾行为的数量 在基线。第二阶段的成功完成将为传播一个以证据为基础的 向雇主、健康平台提供者和其他组织提供照顾者健康干预。