Tools for Distance Delivery of an Evidence-based AD Family Caregiver Intervention

基于证据的 AD 家庭护理人员干预的远程交付工具

• 批准号: 8709161
• 负责人: John V Hobday
• 金额: $ 60.83万
• 依托单位: HEALTHCARE INTERACTIVE, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8709161
• 关键词: Address; Age; Aging; Alzheimer' s Disease; Americas; Area; Caregivers; Caring; Communities; Confidentiality; Control Groups; Counseling; Country; Coupled; Data; Data Analyses; Dementia; Discipline; Disease; Disease Management; Effectiveness; Elderly; Emotional; Enrollment; Ensure; Evidence based intervention; Family; Family Caregiver; Family member; Feedback; Focus Groups; Funding; Geographic Locations; Healthcare; Healthcare Systems; Home environment; Internet; Intervention; Knowledge; Language; Left; Life; Link; Literature; Mental Depression; Modeling; New York; Nursing Homes; Participant; Persons; Phase; Play; Population; Population Heterogeneity; Problem behavior; Professional counselor; Provider; Public Health; Randomized Controlled Trials; Reaction; Recruitment Activity; Reporting; Research; Research Personnel; Reservations; Resources; Role; Rural; Schedule; Secure; Security; Services; Site; Social Work; Social support; Spouse Caregiver; Surveys; System; Technology; Telephone; Testing; Time; TimeLine; Training; Travel; United States Centers for Medicare and Medicaid Services; Universities; Veterans; Videoconferences; Videoconferencing; Writing; base; caregiving; cost; cost effective; depressive symptoms; design; evidence base; experience; health care delivery; improved; innovation; innovative technologies; member; patient home care; physical conditioning; prevent; programs; prototype; psychologic; psychosocial; satisfaction; skills; telehealth; tool

DESCRIPTION (provided by applicant): As the US population ages, Alzheimer's disease and related disorders (ADRD) will present an emotional and financial burden to an increasing number of families and the U.S. healthcare system. More than 75% of the care for persons with ADRD is provided by family members at home, who need ongoing support to manage the daunting physical and psychological demands of care. A 20+ year randomized controlled trial (RCT) demonstrated the many benefits of a counseling and support intervention for spouse caregivers, the NYU Caregiver Intervention (NYUCI). Most notably, the NYUCI substantially reduced caregiver's depressive symptoms, improved their physical health, and extended the time persons with ADRD remained at home by an average of 1.5 years (Mittelman et al., AG14634, formerly MH42216; See www.nrepp.samhsa.gov/programfulldetails.asp? PROGRAM_ID=122). The intervention is now being widely implemented, but there are barriers that prevent many caregivers from receiving its benefits, including geographic distance; impediments to older adults leaving their homes; and travel considerations for counselors which make it impossible to provide the NYUCI. This innovative Fast Track application has massive implications for social service delivery to older adults, because it will make it possible to delivr an in-person intervention which is already evidenced based to older adult caregivers who cannot currently be served. It will create the online reservation and management technology linking counselors with families as well as the evidence of effectiveness of providing such services via secure video teleconferencing vehicles. The proposed Telehealth Technology for Distance Counseling (TTDC) and related online educational training modules will connect skilled providers to the families of persons with dementia without regard to geographic location. Implications for rural healthcare delivery are particularly persuasive. To our knowledge, this will be the first large-scale TTDC to be developed and rigorously tested with a randomized controlled trial. We hypothesize that such a system, coupled with online training for providers and families on tele- counseling and distance caregiving, will have similar benefits to those achieved with in-person counseling during the original NYUCI RCT. The TTDC will include a scheduling system to link counselors to families at their mutual convenience and assure delivery in a cost-effective manner. The TTDC has the additional potential to transform ADRD care in ethnic and culturally diverse communities by connecting highly trained NYUCI counselors with specialized language and cultural skills to families who would not have access to these resources locally. This innovative technology has strong commercial potential not only for providing effective and efficient supportive services to rural and ethnically diverse populations, but also for a variety of other disease management areas.

描述(申请人提供)：随着美国人口老龄化，阿尔茨海默病及相关疾病(ADRD)将给越来越多的家庭和美国医疗体系带来情感和经济负担。对ADRD患者的护理超过75%是由在家的家庭成员提供的，他们需要持续的支持，以应对令人望而生畏的身体和心理护理需求。一项20多年的随机对照试验(RCT)展示了为配偶照顾者提供咨询和支持干预的许多好处，即纽约大学照顾者干预(NYUCI)。最值得注意的是，NYUCI显著减少了照顾者的抑郁症状，改善了他们的身体健康，并将患有ADRD的人在家中停留的时间平均延长了1.5年(Mittelman等人，AG14634，前身为MH42216；参见www.nrepp.samhsa.gov/ProgramfullDetails.asp？PROGRAM_ID=122)。这项干预措施现在正在广泛实施，但有一些障碍阻碍了许多照顾者获得其好处，包括地理距离；老年人离家出行的障碍；以及辅导员的旅行考虑，使其无法提供NYUCI。这一创新的快速通道应用程序对向老年人提供社会服务具有巨大的影响，因为它将使提供面对面干预成为可能，这一点已经被证明基于目前无法得到服务的老年人照顾者。它将创建在线预订和管理技术，将辅导员与家人联系起来，并通过安全的视频电话会议工具提供此类服务的有效性证据。拟议的远程咨询远程保健技术(TTDC)和相关的在线教育培训模块将把技术熟练的提供者与痴呆症患者的家庭联系起来，而不考虑地理位置。对农村医疗服务的影响尤其具有说服力。据我们所知，这将是 成为第一个通过随机对照试验开发和严格测试的大规模TTDC。我们假设，这样的系统，再加上对提供者和家庭进行的远程咨询和远程护理的在线培训，将产生与最初NYUCI RCT期间面对面咨询类似的好处。贸发局将设有时间安排系统，在方便的情况下将辅导员与家人联系，并确保以合乎成本效益的方式接生。TTDC通过将训练有素的NYUCI具有专门语言和文化技能的顾问与当地无法获得这些资源的家庭联系起来，具有更多的潜力来改变种族和文化多样性社区的ADRD护理。这项创新技术具有强大的商业潜力，不仅可以为农村和不同种族的人口提供有效和高效的支助服务，而且还可以用于各种其他疾病管理领域。