Defining a Culturally Tailored Crisis Intervention Model Targeting African American Dementia Caregivers in Socially Disadvantaged Neighborhoods

定义针对社会弱势社区的非裔美国痴呆症护理人员的文化定制危机干预模型

• 批准号: 10396092
• 负责人: Quinton Cotton
• 金额: $ 6.32万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10396092
• 关键词: Acute; Address; African American; African American population; Aging; Alzheimer' s disease related dementia; American; Belief System; Caregivers; Caring; Clinical Services; Communities; Complex; Consequentialism; Crisis Intervention; Data; Decision Making; Dementia; Dementia caregivers; Diagnosis; Disease; Economically Deprived Population; Emergency department visit; Environment; Environmental Risk Factor; Ethnic group; Event; Family; Fibrinogen; Foundations; Friends; Funding; Goals; Health; Health Services Accessibility; Hospitalization; Infrastructure; Intervention; Interview; Investigation; Knowledge; Medical; Modeling; National Institute on Aging; Neighborhoods; Outcome; Pathway interactions; Personal Satisfaction; Phase; Population; Precipitating Factors; Prevalence; Principal Investigator; Procedures; Process; Provider; Race; Reporting; Research; Research Personnel; Research Priority; Resources; Role; Sampling; Severities; Shapes; Time; Trust; United States National Institutes of Health; Validation; Variant; Work; age related; care giving burden; care outcomes; care recipients; career; caregiving; contextual factors; cultural values; dementia caregiving; design; dimensional analysis; disability; effective intervention; experience; first responder; health disparity; health economics; health equity; help-seeking behavior; high risk; intervention delivery; member; mortality; neighborhood disadvantage; prevent; prospective; racial and ethnic; service providers; service utilization; social; social disadvantage; social metrics; theories

PROJECT ABSTRACT Health disparities in Alzheimer’s disease and related dementia (ADRD) persist among African Americans who are two-fold more likely to develop dementias. African Americans also rely more heavily on unpaid family or friend caregivers to meet the complex needs of care recipients with ADRD than other racial/ethnic groups. Disproportionately high caregiving burden is experienced within African American communities, as many African American caregivers reside in socially disadvantaged neighborhoods—environments with fewer health, economic, and social resources. African American caregivers also report high levels of unmet needs, which often escalate to the point of crisis. Emerging evidence suggests that crisis events, defined as unplanned stressful situations requiring immediate action, are frequently experienced by African American caregivers. Yet, effective strategies for addressing African American ADRD needs and crisis in the context of social disadvantage are lacking. Although addressing caregiving needs and disparities are national research priorities, efforts to address crisis events have been hindered by under-inclusion of African Americans in research. Consequentially, it is not known how African American caregivers perceive and manage crisis events in socially disadvantaged environments, limiting identification of interventions to prevent, mitigate, and manage crisis in this context. The proposed prospective qualitative will utilize a validated metric of social disadvantage to guide sampling and Grounded Dimensional Analysis (GDA), a variant of Grounded Theory, to examine ADRD crisis. Aim 1 will identify precipitating, mitigating, and modifiable features of crisis among African American caregivers in socially disadvantaged environments and generate crisis intervention model. Sub-Aim 1A will examine the role of environmental factors in shaping decision-making surrounding crisis events. Finally, Aim 2 will validate a culturally tailored crisis intervention model for African Americans ADRD caregivers in the context of social disadvantage. The proposed research will provide the urgently needed foundational knowledge to better understand and ultimately shape interventions for crisis events in a high-risk and understudied ADRD population, African American caregivers—and is directly responsive to priorities of the National Institute on Aging (NIA) framework “Aging Well in the 21st Century: Strategic Directions for Research on Aging.” The study addresses Goal C of the framework: “develop effective interventions to maintain health, well-being, and function and prevent or reduce the burden of age-related diseases, disorders, and disabilities.” Findings from this research will establish preliminary design components for mode of intervention delivery building on identified intervention targets.

项目摘要 非洲裔美国人中阿尔茨海默病和相关痴呆症 (ADRD) 的健康差异仍然存在 患痴呆症的可能性增加两倍。非裔美国人也更严重地依赖无报酬的家庭或 与其他种族/族裔群体相比，照顾者朋友可以满足 ADRD 照顾者的复杂需求。 非裔美国人社区中承受着不成比例的高照护负担，因为许多非洲人 美国护理人员居住在社会弱势社区——健康状况较差的环境， 经济、社会资源。非裔美国护理人员也报告了大量未满足的需求，这往往 升级到危机的地步。新出现的证据表明，危机事件（定义为计划外的压力事件） 非裔美国护理人员经常遇到需要立即采取行动的情况。然而，有效 在社会弱势背景下解决非裔美国人 ADRD 需求和危机的战略是 缺乏。尽管解决护理需求和差异是国家研究的重点，但解决护理需求和差异的努力 由于研究中非裔美国人的参与不足，危机事件受到阻碍。因而，它不是 了解非裔美国护理人员如何看待和处理社会弱势群体的危机事件 环境，限制了在此背景下预防、减轻和管理危机的干预措施的确定。这 拟议的前瞻性定性将利用经过验证的社会劣势指标来指导抽样和 扎根维度分析 (GDA) 是扎根理论的一种变体，用于检查 ADRD 危机。目标1将 识别非裔美国护理人员在社会方面的危机的诱发、缓解和可改变的特征 弱势环境并生成危机干预模型。子目标 1A 将研究以下角色的作用： 影响危机事件决策的环境因素。最后，目标 2 将验证 在社会背景下为非裔美国人 ADRD 护理人员量身定制的危机干预模型 劣势。拟议的研究将为更好地提供迫切需要的基础知识 了解并最终制定针对高风险和未充分研究的 ADRD 人群中的危机事件的干预措施， 非裔美国护理人员 - 直接响应国家老龄化研究所 (NIA) 的优先事项 框架“21 世纪的老龄化：老龄化研究的战略方向”。研究地址 该框架的目标 C：“制定有效的干预措施以维持健康、福祉和功能，并预防 或减轻与年龄相关的疾病、失调和残疾的负担。”这项研究的结果将 基于已确定的干预措施，建立干预实施模式的初步设计组件 目标。