"Safety in Dementia": An Online Caregiver Intervention.

“痴呆症的安全”：在线护理人员干预。

• 批准号: 10398633
• 负责人: Marian Elizabeth Betz
• 金额: $ 171.89万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10398633
• 关键词: Accidental Injury; Address; Adult; Affect; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Area; Attention; Behavior; Behavioral; Caregiver research; Caregiver support; Caregiver well-being; Caregivers; Cessation of life; Characteristics; Cognitive; Communities; Confusion; Counseling; Data; Data Collection; Daughter; Decision Aid; Decision Making; Dementia; Dementia caregivers; Development; Elderly; Electronic Mail; Emotional; Evaluation; Face; Facebook; Firearms; Foundations; Future; Gender; Geography; Goals; Guilt; Gun injury; Guns; Home; Individual; Injury; Intentional injury; International; Internet; Intervention; Interview; Left; Methods; Mind; Modeling; Paranoia; Participant; Patients; Persons; Population; Preparation; Prevalence; Qualitative Research; Recommendation; Research; Rights; Risk; Safety; Sampling; Self Efficacy; Suicide; Testing; Text; Time; Trust; United States; United States National Institutes of Health; Work; aging in place; base; behavioral outcome; caregiver interventions; cost; dementia caregiving; demographics; efficacy testing; efficacy trial; experience; follow-up; health belief; healthy aging; improved; informal caregiver; injury prevention; innovation; insight; multidisciplinary; outreach; person centered; pilot trial; preference; prevent; primary outcome; prospective; randomized trial; recruit; relative cost; retention rate; safety testing; secondary outcome; service providers; social media; theories; therapy development; tool

PROJECT SUMMARY Cognitive and behavioral changes that come with Alzheimer's Disease and related dementias (ADRD) can increase the risk of injury or death, including from firearms. Suicide is the primary injury risk from firearms for people with ADRD, but ADRD-related confusion or paranoia can put others at risk. In the United States, an estimated 33-60% of people with ADRD have a firearm in the home, and 38% of ADRD caregivers identify firearms as an issue to address. Yet firearm safety is rarely discussed with ADRD patients or caregivers, leaving some ADRD caregivers without guidance about when and how to address the sensitive topic. To address this gap, we developed “Safety in Dementia” (SiD) for informal caregivers to address firearm safety (R34MH113539-NIA suppl). Based on theory and international standards for development, SiD is an online decision aid that helps caregivers clarify values and preferences and then commit to implementing their preferred options. SiD had high acceptability in a small pilot trial, and we hypothesize SiD will increase informal caregivers' preparation and self-efficacy to make and implement decisions that effectively address firearm access, thereby reducing injury risk. Overa three-year period,our multi-disciplinary, established study team will conduct an online randomized trial of SiD with national recruitment and longitudinal follow-up, with recruitment of informal caregivers of community-dwelling adults with ADRD who have firearm access. Through this trial and qualitative interviews with stakeholders, we aim to: (1) test the efficacy of SiD on firearm safety decision quality and behaviors among a national sample of informal caregivers; (2) compare varied methods (social media/internet versus via relevant organizations) in reaching informal caregivers; and (3) explore stakeholder longitudinal experiences with SiD and firearm-related decisions, including recommendations for optimal SiD use. Our underlying hypotheses are that SiD will be significantly associated with higher immediate decision quality and subsequent action to reduce firearm access, and that caregiver populations will vary by method of contact (social media/internet versus relevant organizations). The proposed research will meet a critical need for effective, acceptable tools to help caregivers address firearm access in the context of ADRD, thereby helping reduce firearm injuries and deaths while respecting and promoting older adult independence, autonomy, and rights. The aging of the U.S. population underscores the urgency of these issues, and our proposed work will provide the scientific foundation for future implementation and evaluation of person- centered tools in real-world settings, including through enhanced understanding of methods for reaching and engaging caregivers.

项目摘要 阿尔茨海默病和相关痴呆症（ADRD）带来的认知和行为变化可以 增加受伤或死亡的风险，包括火器造成的伤害或死亡。自杀是枪支的主要伤害风险， 但与ADRD相关的混乱或偏执可能会使其他人处于危险之中。在美国， 估计33-60%的ADRD患者家中有枪支，38%的ADRD护理人员认为 枪支是一个需要解决的问题。然而，枪支安全很少与ADRD患者或护理人员讨论， 这使得一些ADRD护理人员没有关于何时以及如何处理敏感话题的指导。到 为了解决这一差距，我们为非正式护理人员开发了“痴呆症安全”（SiD），以解决枪支安全问题 （R34 MH 113539-NIA补充）。基于理论和国际标准的发展，小岛屿发展中国家是一个在线 帮助护理人员澄清价值观和偏好的决策辅助工具，然后致力于实施他们的 首选选项在一个小规模的试点试验中，SiD具有较高的可接受性，我们假设SiD将增加非正式的 照顾者的准备和自我效能，以作出和执行有效处理枪支问题的决定 从而降低受伤风险。在三年的时间里，我们的多学科，建立研究团队 将进行一项在线随机试验，包括全国招募和纵向随访， 招募社区居住的ADRD成年人的非正式护理人员，他们可以获得枪支。通过 本试验和定性访谈的利益相关者，我们的目标是：（1）测试的有效性，SiD对枪支安全 非正式照顾者的决策质量和行为的全国样本;（2）比较各种方法 （社交媒体/互联网与通过相关组织）接触非正式护理人员;以及（3）探索 利益攸关方在小岛屿发展中国家和枪支相关决策方面的纵向经验，包括以下方面的建议 最佳的SiD使用。我们的基本假设是，SiD将显着相关的较高的即时 决策质量和随后的行动，以减少枪支的访问，照顾人口将因 联系方式（社交媒体/互联网与相关组织）。该研究将满足A 迫切需要有效的、可接受的工具，以帮助护理人员解决在ADRD背景下获得枪支的问题， 从而有助于减少火器伤害和死亡，同时尊重和促进老年人的独立性， 自主权和权利。美国人口的老龄化凸显了这些问题的紧迫性， 建议的工作将为今后实施和评价人- 在现实世界的设置为中心的工具，包括通过加强对方法的理解， 吸引护理人员。