Virtual Coaching to Maximize Dementia Caregivers' Respite Time-Use: A Stage 1 Pilot Test for Feasibility and Efficacy

虚拟辅导可最大限度地利用痴呆症护理人员的休息时间：第一阶段的可行性和有效性试点测试

• 批准号: 10451795
• 负责人: Rebecca Lynn Utz
• 金额: $ 34.03万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451795
• 关键词: Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Anxiety; Behavior Therapy; Caregiver Burden; Caregiver well-being; Caregivers; Caring; Client; Communities; Community Healthcare; Data; Dementia caregivers; Development; Effectiveness; Ensure; Experimental Designs; Exposure to; Family Caregiver; Family member; Feedback; Financial compensation; Goals; Health; Home; Home visitation; Hour; Individual; Intervention; Measures; Mediating; Mental Health; Modeling; Online Systems; Outcome; Participant; Patients; Personal Satisfaction; Persons; Phase; Pilot Projects; Population; Pre-Post Tests; Process; Provider; Randomized; Reporting; Research; Research Activity; Resources; Rewards; Risk; Role; Sampling; Self Administration; Services; Source; Spouses; Surveys; Telephone; Time; TimeLine; Training; Translations; Treatment Efficacy; United States; Visit; Waiting Lists; Work; base; caregiver interventions; caregiving; cohort; community engaged research; coping; cost efficient; design; dosage; economic value; feasibility testing; future implementation; implementation barriers; improved; insight; intervention effect; novel; online delivery; physical conditioning; pilot test; primary outcome; prototype; real world application; research study; satisfaction; success; therapy design; time use; tool; treatment group; usability; virtual coach; wasting; webinar

Respite, defined as time away from caregiving, has been identified as the most needed and desired service for family caregivers, especially the 16 million dementia caregivers who are faced with long term and demanding caregiving circumstances. Findings on the effectiveness of respite services have been mixed -- how caregivers spend their respite time seems to be a key factor behind these inconsistent findings. We have developed a novel intervention called “Time for Living & Caring” (TLC) that shows promise in improving respite time-use and maintaining caregiver wellbeing. However, it relies on trained facilitators and up to 15-20 individual home visits or phone calls with each caregiver, limiting its scalability to real world practice. The purpose of this study is to redevelop the TLC intervention, in which AD/ADRD caregivers are taught strategies to assess and identify ways to spend upcoming periods of respite time, to a fully online, self-administered virtual coaching format, and then to pilot-test the new TLC intervention for feasibility and efficacy. Aim 1 is to modify, adapt, and refine the existing intervention modules. This phase of the project utilizes a community- engaged design process where stakeholders (i.e., current or former caregivers, diverse community leaders, respite providers) will work alongside the research, technical, and creative teams to develop and provide feedback on the TLC design, features, and prototypes. Aim 2 is to conduct a pilot test with dementia caregivers who are currently using respite. This phase uses a full powered pilot sample (n=120) and a randomized waitlist control experimental design where participants are exposed to the redeveloped TLC intervention for 8 weeks and will provide assessments of daily respite use, respite time-use satisfaction, and wellbeing. These pilot data will be used to assess feasibility and to explore hypotheses regarding the potential efficacy of the intervention, as well as the mechanism (i.e., time-use satisfaction) underlying the intervention's effect on wellbeing. Wellbeing is measured with two primary outcome of anxiety and caregiver burden, both thought to be closely related and responsive to intervention's purpose. Aim 3 is intended to explore future implementation of the redeveloped TLC intervention with respite providers. This provides yet another layer of the tool's feasibility. We will host webinars to demonstrate the features and functionality of the TLC intervention as well as to preview pilot study results from Aim 2, then ask providers for feedback on their likelihood of implementation and barriers to using TLC with their clients. Together, these three aims represent a comprehensive approach to Stage 1 research activities, with the overall goal of developing an intervention that is scalable to real world applications. Throughout all stages of the proposed project, our team is committed to community-engaged research practices, where community partners will provide input and connect us with potential research participants. Given this pragmatic yet scientifically rigorous approach, the results have the potential to guide and accelerate the eventual implementation of the TLC intervention to community and health care practice.

喘息，定义为远离照看的时间，已被确定为最需要和期望的服务 家庭照顾者，特别是1600万痴呆症照顾者，他们面临长期和苛刻的 照顾他人的情况。关于暂缓服务的有效性的研究结果好坏参半--照顾者 在这些不一致的发现背后，花费他们的休息时间似乎是一个关键因素。我们已经开发出一种 一种名为“生活与关怀的时间”(TLC)的新型干预措施在改善休息时间利用方面显示出了希望 以及维护照顾者的健康。然而，它依赖于训练有素的辅导员和多达15-20个人的家庭 与每个护理人员进行访问或打电话，将其可伸缩性限制在现实世界的实践中。这项研究的目的 是重新开发TLC干预，在TLC干预中，AD/ADRD照顾者被教授评估和 确定如何利用即将到来的喘息时间，实现完全在线、自我管理的虚拟 指导模式，然后对新的TLC干预进行中试，以确定其可行性和有效性。目标1是 修改、调整和完善现有的干预模块。该项目的这一阶段利用了一个社区- 利益相关者(即，现任或前任照顾者、不同的社区领导人、 喘息提供商)将与研究、技术和创意团队合作开发和提供 对TLC设计、功能和原型的反馈。目标2是对痴呆症照顾者进行一项试点测试 目前正在使用缓释剂的患者。该阶段使用全功率试点样本(n=120)和随机等待名单 对照实验设计，参与者接受重新开发的TLC干预8周 并将提供对日常休息时间使用、休息时间使用满意度和幸福感的评估。这些试点数据 将被用来评估可行性并探索关于干预的潜在效果的假设， 以及干预对幸福感影响的机制(即时间使用满意度)。 幸福是通过焦虑和照顾者负担这两个主要结果来衡量的，两者被认为是密切相关的 与干预目的相关并对其作出反应。目标3旨在探讨如何在未来实施 重新开发了与喘息提供者的TLC干预。这为该工具的可行性提供了另一个层面。 我们将举办网络研讨会，展示TLC干预的特点和功能，以及 预览AIM 2的试点研究结果，然后要求提供商就其实施的可能性提供反馈 以及与客户使用TLC的障碍。这三个目标加在一起，代表了一种全面的方法 第一阶段研究活动，总体目标是开发可扩展到现实世界的干预措施 申请。在拟议项目的所有阶段，我们的团队致力于让社区参与 研究实践，社区合作伙伴将提供意见并将我们与潜在的研究联系起来 参与者。鉴于这种务实而又科学严谨的方法，这些结果有可能指导 并加快最终实施TLC对社区和医疗保健实践的干预。