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

NYUCI-ES：通过心理社会干预改善中国和韩国 ADRD 护理人员的健康状况

• 批准号: 10437459
• 负责人: Bei Wu
• 金额: $ 73.31万
• 依托单位: RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437459
• 关键词: Adult; Alzheimer' s disease related dementia; American; Area; Asian Americans; Asians; Belief; Biological; Biological Assay; Blood specimen; COVID-19; Cardiometabolic Disease; Caregivers; Caring; Chinese American; Chinese People; Chronic Disease; Collaborations; Conflict (Psychology); Control Groups; Counseling; Cultural Backgrounds; Cultural Diversity; Dementia caregivers; Diabetes Mellitus; Disease Management; Educational Materials; Elderly; Emotional; Enrollment; Evidence based intervention; Failure; Family; Family Caregiver; Glycosylated Hemoglobin; Health; Health Policy; Health Promotion; Hypertension; Individual; Inflammation; Intake; Intervention; Korean American; Koreans; Language; Lead; Linguistics; Mainstreaming; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Metabolic; Metabolism; Minority; Minority Groups; Modeling; Morbidity - disease rate; Multilingualism; New Jersey; New York; Nursing Homes; Outcome; Oxidative Stress; Patient Self-Report; Personal Satisfaction; Persons; Physiological; Policies; Population; Psychosocial Assessment and Care; Psychosocial Factor; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Research; Research Project Grants; Risk; Risk Factors; Sampling; Self Management; Services; Social Work; Social isolation; Social support; Stereotyping; Stress; Structure; Support Groups; Testing; Translating; arm; biological adaptation to stress; cardiometabolic risk; caregiver interventions; caregiving; caregiving outcomes; community organizations; cultural values; dementia care; dementia caregiving; depressive symptoms; efficacy testing; evidence base; follow-up; group intervention; health equity; health literacy; improved; lipid metabolism; metropolitan; multi-component intervention; peer support; physical conditioning; provider intervention; psychological outcomes; psychosocial; service providers; social; social media; social stigma; symptomatic improvement; underserved community

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.

研究项目 3 – NYUCI-ES – 摘要 痴呆症护理的身体和情感需求可能会对护理人员的健康产生巨大的负面影响 身体和心理健康。相比之下，痴呆症护理人员患高血压和糖尿病的风险增加 对于非照顾者，尤其是少数群体。本研究将进行一项双臂随机对照研究 试验旨在测试纽约大学护理人员干预 (NYUCI) 的文化定制版本以及增强版的功效 通过在线聊天组（NYUCI 加微信/Kakaotalk [人口社交媒体应用程序 中文/韩文]同行支持，我们称之为 NYUCI-ES，以降低心脏代谢疾病的健康风险 在照顾患有 ADRD 的亲戚的中国和韩裔美国老年人中。 NYUCI 已经证明 在减少 ADRD 患者护理人员以白人为主的样本中的心理结果方面的功效 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规模 NYUCI-ES 的潜在影响的规模测试，这是一种多成分干预措施，包括个人和 通过支持小组和在线聊天小组以及临时（按需）提供家庭咨询和持续支持 咨询。 与纽约和新泽西州北部的社区组织合作 在首都圈，我们将招募 300 名 ADRD 患者的护理人员（150 名中国人和 150 名韩国人）参加本次活动 学习。目标 1：开发适合文化的有关痴呆症和护理的信息和教育材料 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）将显着改善心理社会因素，例如 华裔和韩裔美国人的抑郁、压力自评健康与慢性病管理 ADRD 护理人员和这些变化将通过社会支持的改善来调节。 H1a：到第一个（6- 月）后续，中介因素（社会支持、压力反应的增加）将显着改善 干预组与对照组的基线值进行比较。 H1b：这些改进将 维持，并减少抑郁症状，改善自我报告的健康状况和慢性病 与对照组相比，通过 12 个月的随访观察疾病的自我管理情况。目标 3：检验假设， H2：NYUCI-ES 将减少生物危险因素，包括代谢健康（糖化血红蛋白）和 与基线和入组后 6 个月内相比，炎症（氧化应激、脂质代谢等） 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 个月的随访中维持。 这些发现的公共卫生意义可能会对 CG 的医疗保健政策产生影响 来自不同的服务不足的种族和文化背景，有可能降低发病率，并改善他们的 生活质量。