Connecting Elders, Empowering Caregivers

描述(由申请人提供)：本提案是对通知编号(NOT-OD-09-058)和通知标题的回应：NIH宣布可为竞争性修订申请提供恢复法案资金。我们建议调整家庭联系系统(FCS)和数字邮箱技术以适应辅助生活环境，这些系统提供旨在增加家庭成员之间通信频率和类型的通信工具。脆弱和居住在辅助生活(AL)中与失去社会关系有关，增加了身心衰退和死亡的风险。FCS促进了AL居民之间的沟通，这些居民不太可能通过电子方式联系在一起，他们的社区网络成员依赖电子通信工具，如电子邮件和短信。最初的研究评估了FCS的使用对网络成员交流的频率和范围以及居民和家庭成员的心理社会健康的影响。在美国，90多万AL居民拥有非凡的潜力，可以从提高交流频率和参与者范围的干预措施中受益。拟议的竞争性修订以三种方式扩大了辅助生活中的FCS的现场试验：1)为AL人群中没有社区成员的社会网络中的亚群创建和试行网络建设干预。项目工作人员将帮助有兴趣的居民与失去联系的网络成员建立联系，邀请他们进入他们的FCS通信网络。FCS使沟通变得如此容易，以至于我们相信可以(重新)激活更广泛的网络来定期沟通。对社会贫困居民的定性访谈将确定网络建设的战略。项目工作人员将帮助居民参与他们新的(或重建的)网络，并测试我们是否可以发展网络，允许“孤儿”再次参与社区关系。2)开发将居民与外部社交网络联系起来的多项活动的活动模块指南。AL设施是如此多样化，需要广泛的潜在活动来最大限度地提高居民与其网络的沟通。将创建模块，为活动主管提供逐步说明，以实施一系列可能的活动事件，从而在居民的FCS网络内产生通信。外勤支助部工作人员将很容易获得基于网络的格式。3)创建用户指南，这是AL设置中部署的关键组件。用户指南(UG)可以根据用于在现有项目的三个AL试验场安装和操作FCS的程序来创建。UG将记录每个站点在AL内创建可操作的FCS时需要遵循的详细步骤。UG将被开发成可管理的小部分，通过专门为他们使用而建立的工作人员网站提供。 公共卫生相关性：辅助生活的居民具有从加强他们的社会网络和接触率的干预措施中受益的非凡潜力，因为他们的社会损失对身心健康有负面影响。该项目测试了一项创新技术的影响，该技术将老年人的纸和笔通信与网络成员的计算机化通信工具联系起来。修订后的项目增加了基础设施，以支持辅助生活设施的实施，方法是创建使用该技术的新活动、与基于网络的操作相结合的用户指南以支持工作人员用户，以及为设施外部缺乏联系的老年人建立社交网络的试点干预措施。

DESCRIPTION (provided by applicant): This proposal is in response to Notice Number (NOT-OD-09-058) and Notice Title: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications. We propose to adapt for an assisted living environment the Family Connections System (FCS) and Digital Mailbox technology which offer communication tools designed to increase the frequency and type of communications among family members. Frailty and residence within assisted living (AL) are associated with losing social connections, adding to the risk of physical and mental decline, and mortality. The FCS fosters communication between AL residents who are unlikely to be electronically linked, and their community-based network members who rely on electronic communication tools such as email and texting. The original study evaluates the impact of FCS use on communication frequency and range of network members communicating as well as the psychosocial wellbeing of residents and family members. Over 900,000 AL residents in the U.S. have extraordinary potential to benefit from interventions that enhance communication frequency and range of participants. The proposed competitive revision extends the field trial of the FCS within assisted living in three ways: 1) Creates and pilots a network building intervention for the subgroup of the AL population without community members in their social network. Project staff will help interested residents initiate contact with lost network members to invite them into their FCS communication network. The FCS makes communication so easy, that we believe broader networks can be (re-)activated to communicate regularly. Qualitative interviews with socially impoverished residents will identify strategies for network building. Project staff will assist residents with engaging their new (or re-built) network, and test whether we can grow networks that allow "orphans" to participate in community relationships again. 2) Develop an Activity Modules Guide of multiple activities linking residents to outside social networks. AL facilities are so diverse that a broad range of potential activities are needed to maximize residents' communication with their networks. Modules will be created that provide activity directors with step-by-step instructions for implementing a range of possible activity events that generate communication within residents' FCS networks. A web-based format will be easily accessible to AL staff. 3) Create a User's Guide, a critical component of deployment in AL settings. The User's Guide (UG) can be created from the procedures used to install and operate the FCS in the three AL test sites of the existing project. The UG will document the detailed steps that each site needs to follow in creating an operational FCS within AL. The UG will be developed to be delivered in small manageable sections through a staff website which will be built specifically for their use. PUBLIC HEALTH RELEVANCE: Residents of assisted living have extraordinary potential to benefit from interventions that enhance their social networks and rates of contact because their social losses have negative effects on physical and mental health. This project tests the impact of an innovative technology that links elders' paper and pencil communications with network members' computerized communication tools. The revised project adds infrastructure to support implementation in assisted living facilities by creating novel activities that use the technology, a User's Guide that is integrated with the web-based operation to support staff users, and a pilot intervention to build social networks for elders who lack connections external to the facility.