NYUCI-ES: Psychosocial Intervention to Improve Health Outcomes for Chinese and Korean ADRD Caregivers

研究项目3-NYUCI-ES-摘要 痴呆症照顾者的身体和情感需求可能会对照顾者的 身心健康。痴呆症照顾者患高血压和糖尿病的风险增加 提供给非照顾者，特别是在少数群体中。本研究将进行双臂随机对照研究 纽约大学护理人员干预(NYUCI)加增强型文化定制版的有效性试验 通过在线聊天组(NYUCI+微信/KakaoTalk[Popular Social Media App for 中国/韩国]在降低心脏代谢性疾病健康风险方面的同伴支持，我们称之为NYUCI-ES 在年长的中国人和韩裔美国人中，照顾患有ADRD的亲属。NYUCI已经证明 在ADRD患者照顾者中以白人为主的样本中减少心理结果的有效性 并在美国和其他地方被广泛复制和翻译。这项研究将提供第一个大型- NYUCI-ES潜在影响的量表测试，这是一种多成分干预，包括个人和 通过支持小组、在线聊天组和临时(按需)提供家庭咨询和持续支持 心理咨询。 与纽约和新泽西北部的社区组织合作 大都会地区，我们将招募300名ADRD患者的照顾者(150名中国人和150名韩国人) 学习。目标1：编写适应文化的关于痴呆症和照看的信息和教育材料 对干预的社会服务提供者和家庭照顾者的问题。目标2：检验假设，h1： 咨询和支持干预(NYUCI-ES)将显著改善心理社会因素，如 中国人和韩裔美国人的抑郁、压力自评健康和慢性病管理 ADRD照顾者和这些变化将通过改善社会支持来实现。H1a：第一次(6- 月)随访，中介人(增加社会支持、压力反应)在 干预组与对照组比较基线值。H1B：这些改进将是 保持，并导致抑郁症状的减少，以及自我报告的健康和慢性疾病的改善 通过对疾病自我管理进行12个月的随访，与对照组进行比较。目标3：检验假设， H2：NYUCI-ES将降低生物风险因素，包括代谢健康(糖化血红蛋白)和 炎症(氧化应激、脂类代谢等)在注册后6个月内与基线相比，以及 对照组；这些变化将通过增加社会支持和减少抑郁来调节 症状，并将在12个月的随访中保持。 这些发现的公共卫生意义可能会对CGs的医疗保健政策产生影响 来自不同的未得到充分服务的种族和文化背景，潜在地降低发病率，并改善他们的 生活质量。

Research Project 3 – NYUCI-ES – Abstract The physical and emotional demands of dementia caregiving can have enormous negative effects on caregivers’ physical and mental health. Dementia caregivers have increased risk of hypertension and diabetes, compared to non-caregivers, especially in minority populations. This study will conduct a two-arm randomized controlled trial to test the efficacy of a culturally tailored version of the NYU Caregiver Intervention (NYUCI) plus enhanced support (ES) through online chat groups (the NYUCI plus WeChat/Kakaotalk [population social media app for Chinese/Korean] peer support which we call the NYUCI-ES in reducing health risks for cardiometabolic disease among older Chinese and Korean-American adults caring for relatives with ADRD. The NYUCI has proven efficacy in reducing psychological outcomes among largely White samples of caregivers of persons with ADRD and has been widely replicated and translated in the USA and elsewhere. This study will provide the first large- scale test of the potential effects of the NYUCI-ES, a multicomponent intervention that includes individual and family counseling and ongoing support via support group and online chat groups and ad hoc (on demand) counseling. In collaboration with community organizations across the New York and northern New Jersey metropolitan area, we will enroll 300 caregivers of people with ADRD (150 Chinese and 150 Korean) in this study. Aim 1: Develop culturally adapted informational and educational materials about dementia and caregiving issues for social service providers of the intervention and for family caregivers. Aim 2: Test the hypothesis, H1: A counseling and support intervention (the NYUCI-ES) will significantly improve psychosocial factors such as depression, stress self-rated health and chronic disease management among Chinese and Korean-American ADRD caregivers and these changes will be mediated by improvement in social support. H1a: By the first (6- month) follow-up, the mediators (increases in social support, stress reaction) will improve significantly in the intervention group compared to baseline values and the control group. H1b: These improvements will be maintained, and lead to reduction in depressive symptoms, and improvement in self-reported health and chronic disease self-management by the 12-month follow-up compared to the control group. Aim 3: Test the hypothesis, H2: the NYUCI-ES will reduce biologic risk factors, including metabolic health (glycosylated hemoglobin) and inflammation (Oxidative stress, lipid metabolism, etc.) within 6 months of enrollment compared to baseline and a control group; these changes will be mediated through increases in social support and decreases in depressive symptoms and will be maintained at the 12-month follow-up. The public health significance of these findings will likely have an impact on health care policy for CGs from diverse underserved ethnic and cultural backgrounds, potentially reducing morbidity, and improving their quality of life.