Low Literacy Elder Caregiver Support for Call Centers

识字率低的老年护理人员对呼叫中心的支持

• 批准号: 7814378
• 负责人: AMELIA J BIRNEY
• 金额: $ 19.99万
• 依托单位: OREGON CENTER FOR APPLIED SCIENCE, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7814378
• 关键词: Address; Adherence; Anxiety; Arts; Blue Cross; Blue Shield; Caregivers; Caring; Chronic; Chronic Disease; Chronic Obstructive Airway Disease; Chronically Ill; Computer software; Congestive Heart Failure; Cost Savings; Country; Databases; Development; Disease Management; Documentation; Education; Educational Intervention; Educational Materials; Elderly; Emergency Situation; Evaluation; Evaluation Studies; Expenditure; Family Caregiver; Florida; Flowcharts; Foxes; Friends; Funding; Goals; Health; Health Planning; Health Status; Healthcare; Home environment; Hospitalization; Hospitals; Human Resources; Independent Living; Individual; Industry; Insurance; Integrated Delivery Systems; Internet; Intervention; Interview; Knowledge; Learning; Length of Stay; Lung diseases; Mails; Maintenance; Managed Care; Medical Care Team; Medicare; Mental Depression; Morbidity - disease rate; Motivation; Online Systems; Outcome; Pamphlets; Parents; Patient Care; Patients; Pattern; Phase; Physicians; Population; Pre-Post Tests; Principal Investigator; Printed Media; Printing; Private Sector; Process; Production; Protocols documentation; Public Health; Published Comment; Randomized Clinical Trials; Reading; Recommendation; Recovery; Research; Research Infrastructure; Research Personnel; Resources; Risk; Role; Self Care; Self Efficacy; Services; Siblings; Spouses; Statutes and Laws; Support System; Surveys; System; Telephone; Testing; Time; TimeLine; Training; Training Support; Treatment Protocols; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Vertebral column; Visit; Voice; Work; base; caregiving; compliance behavior; coping; cost; design; evidence base; follow-up; health care service utilization; health literacy; improved; innovation; literacy; loved ones; member; mortality; multidisciplinary; neglect; parent grant; patient home care; peer; programs; prototype; public health relevance; response; satisfaction; skills; success; treatment adherence

DESCRIPTION (provided by applicant): Because the majority of Medicare expenditures involve repeated and often preventable hospitalizations for chronic conditions like CHF and COPD, private-sector disease management organizations are increasingly offering telephonic support to seniors with these conditions. In order to improve care coordination, call center coaches need materials to help elder caregivers in their roles as adherence facilitators for both the patient and themselves. This project will develop and evaluate a multi-level Web-based content delivery system to: (a) train call center coaches on caregiver issues, (b) facilitate coaches' assessment of caregiver-specific needs, and (c) requisition tailored low-literacy follow-up media for the caregiver in a variety of formats (DVD-video, 4th grade reading level print and PDF). The system will integrate with existing call center applications to help coaches address the domains of disease management, care plan adherence, personal coping with the caregiver role, and caregiver self-care. In Phase I, this project will focus on caregivers of individuals with Congestive Heart Failure (CHF); in Phase II the focus will be expanded to include caregivers of individuals with Chronic Obstructive Pulmonary Disorder (COPD). This revision application is submitted in response to NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (NOT-OD-09-058). It directly addresses: (a) the goals of the ARRA legislation, and (b) the primary concern of the parent Phase I application reviewers: " "The most salient limitation is that the evaluation study does not really assess the main and most promising component of the intervention - the call center interactions and coaching." The parent Phase I application involves the production and evaluation of caregiver educational materials on CHF. In response to reviewer concerns, this revision Phase I application will create and evaluate a prototype of the system's complementary training and coaching components. Thus, this project will accelerate the research by testing the feasibility of both program components, allowing reviewers of the Phase II application to more clearly assess the feasibility of the overall program. In addition, this revision will provide considerable ARRA funding to support part-time/under-supported research personnel. The efficacy of the prototype call center component will be evaluated with 40 call center coaches using a within-subject pre-post test design. Outcomes include knowledge self-efficacy, motivation, perceived utility, and user satisfaction. Lessons learned in Phase I of both the parent and revision projects will be applied in Phase II, improving the quality of the program. Phase II will expand the caregiver materials to cover all domains, adding caregiver and call center materials on COPD and caregiver self-care/coping, as well as product promotional materials. In Phase II, the complete program will undergo a large-scale randomized clinical trial involving elder caregivers, and a process and outcome evaluation of the call center staff. PUBLIC HEALTH RELEVANCE: Elder caregivers are an integral part of the health care team, facilitating care plan adherence and enabling independent living. In addition, as seniors themselves, they have their own health challenges, which are often exacerbated by their caregiving role. This program is designed to assist disease management call center coaches in offering state-of-the-art support to elder caregivers in the domains of disease management skills, care plan adherence, caregiver coping, and caregiver self-care, including low literacy follow-up materials available on DVD-video, or as hard copy or e-mail articles.

描述（由申请人提供）：由于大部分医疗保险支出涉及慢性疾病（如慢性心力衰竭和慢性阻塞性肺病）的反复且通常可预防的住院治疗，私营部门疾病管理组织越来越多地为患有这些疾病的老年人提供电话支持。为了改善护理协调，呼叫中心教练需要材料来帮助老年护理人员发挥他们作为患者和他们自己的依从性促进者的作用。该项目将开发和评估一个多层次的基于网络的内容交付系统，以：(a)对呼叫中心教练进行护理人员问题培训，(b)促进教练对护理人员特定需求的评估，以及(c)为护理人员定制各种格式的低文化水平后续媒体（dvd视频、四年级阅读水平的印刷品和PDF）。该系统将与现有的呼叫中心应用程序集成，以帮助教练解决疾病管理、护理计划遵守、个人应对照顾者角色和照顾者自我照顾等领域的问题。在第一阶段，该项目将重点关注充血性心力衰竭（CHF）患者的护理人员；在第二阶段，重点将扩大到包括慢性阻塞性肺疾病（COPD）患者的护理人员。本修订申请是为了响应NIH宣布竞争性修订申请恢复法案基金的可用性（NOT-OD-09-058）而提交的。它直接解决了：(a) ARRA立法的目标，以及(b)母公司第一阶段应用审稿人的主要关注点：“最显著的限制是，评估研究并没有真正评估干预的主要和最有希望的组成部分——呼叫中心的互动和指导。”家长第一阶段的申请包括制作和评估照顾者关于CHF的教育材料。为了回应审稿人的关注，这个修订阶段I的应用程序将创建并评估系统的补充培训和指导组件的原型。因此，该项目将通过测试两个项目组成部分的可行性来加速研究，使第二阶段申请的审稿人能够更清楚地评估整个项目的可行性。此外，这一修订将提供相当多的ARRA资金来支持兼职/资助不足的研究人员。原型呼叫中心组件的功效将由40名呼叫中心教练使用受试者前-后测试设计进行评估。结果包括知识自我效能、动机、感知效用和用户满意度。在第一阶段的家长和修订项目中吸取的经验教训将应用于第二阶段，提高项目的质量。二期将扩大护理人员材料覆盖所有领域，增加护理人员和呼叫中心关于COPD和护理人员自我护理/应对的材料，以及产品宣传材料。在第二阶段，整个项目将进行一项涉及老年护理人员的大规模随机临床试验，并对呼叫中心工作人员进行过程和结果评估。