Caring for the Caregivers of Veterans: Planning a National Program Evaluation

照顾退伍军人的照顾者：规划国家计划评估

• 批准号: 8789675
• 负责人: Veronica Yank
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-11-01 至 2015-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8789675
• 关键词: Area; Blast Cell; Caregivers; Caring; Characteristics; Chronic; Data; Data Collection; Development; Enrollment; Evaluation; Evidence based program; Family; Future; Health; Health Professional; High Prevalence; Injury; Intervention; Interview; Knowledge; Mental Depression; Methods; Outcome; Output; Participant; Patients; Personal Satisfaction; Post-Traumatic Stress Disorders; Process; Program Evaluation; Recommendation; Recruitment Activity; Reporting; Rewards; Role; Self Efficacy; Services; Site; Social support; Structure; Sum; Surveys; Testing; Time; Training Support; Transcript; Traumatic Brain Injury; Variant; Veterans; Work; base; caregiver education; caregiving; design; falls; implementation science; informant; instrument; meetings; operation; patient home care; programs; research study; skills; statistics; success

PROJECT SUMMARY The daily task of "caring for those that have borne the battle" falls not only to health care professionals, but also to the well over 20,000 informal caregivers who provide critical in-home care for Veterans with serious chronic conditions. The VA Central Office Caregiver Support Program (CSP), which has worked closely with us to develop this proposal, is tasked with developing programs that support caregiving activities and caregiver health and, by extension, Veteran well-being. Building Better Caregivers (BBC) is an online, evidence-based program designed to boost caregiver skills and self-efficacy. The CSP began its national dissemination throughout the VA in January 2013. Early data indicate wide variation in caregiver enrollment across VA facilities (0 to >40 dyads/facility), indicating a need for implementation evaluation and improvement. We conducted preliminary interviews using the PARIHS framework of implementation sciences to build knowledge and develop data collection instruments that would distinguish implementation characteristics of high enrollment sites. These data strongly suggest that this national experiment in implementation of caregiver support will yield valuable lessons on how best to disseminate this important program. This proposal will generate the pilot data necessary to plan a comprehensive implementation evaluation and to design and test an intervention to boost BBC implementation in a subsequent Service Directed Project (SDP). The proposal will proceed with three specific aims: Aim 1: Identify national & regional characteristics of successful rollout of caregiver support program We will conduct semi-structured interviews with 5 national and 5 regional leaders regarding implementation characteristics considered important to BBC rollout success. Questions will derive from the revised PARIHS constructs of evidence, context, facilitation, and implementation success. We will apply qualitative analytic approaches to transcripts to identify key implementation characteristics at national and regional levels. Aim 2: Identify facility characteristics associated with high caregiver enrollment We will survey and interview VA staff and caregivers at local VA facilities-two with high and two low BBC enrollment. We will recruit staff involved in the BBC rollout (20 total, 5/facility) and caregivers who have and have not enrolled in the BBC (9 total, 2-3/facility). We will perform surveys and semi-structured interviews (also using PARIHS-derived questions) that probe regarding implementation topics. We will summarize survey findings with descriptive statistics and apply qualitative analytic approaches to interviews to identify implementation characteristics likely specific to high enrollment facilities. Aim 3: With partners, integrate findings, make recommendations, & plan targets for future evaluation This Aim will culminate in a full-day development meeting of the evaluation team, Advisory Group, and other project partners. Meeting discussion will generate a collaborative report that (a) integrates proposal findings, (b) recommends implementation characteristics amenable to immediate refinement, (c) describes draft implementation interventions and characteristics that require comprehensive targeting, and (d) designs the future SDP, all of which comprise the deliverables of the proposal. In sum, this proposal will identify key characteristics of successful implementation of the BBC program. Upon its completion, we and our project partners will be able to target some implementation characteristics for immediate refinement and others for further study and implementation intervention in a subsequent SDP. This collaborative, step-wise approach will inform, galvanize, and spread national dissemination of a signature VA program for Veteran caregivers.

项目摘要 “照顾那些承受了战斗”的日常任务福尔斯不仅落在卫生保健专业人员身上， 还有超过20，000名非正式护理人员，他们为患有严重疾病的退伍军人提供关键的家庭护理。 慢性病与我们密切合作的VA中央办公室护理人员支持计划（CSP） 为了制定这一提案，负责制定支持抚养活动和照顾者的计划。 健康，以及退伍军人的福利。 建立更好的照顾者（BBC）是一个在线的，以证据为基础的计划，旨在提高照顾者的技能 和自我效能。CSP于2013年1月开始在弗吉尼亚州全国范围内传播。早期数据 表明VA机构之间护理人员登记的差异很大（0至>40对/机构），表明需要 执行评估和改进。我们使用PARIHS进行了初步访谈 实施科学框架，以积累知识和开发数据收集工具， 区分高招生站点的实施特点.这些数据有力地表明， 实施照顾者支助的国家实验将产生宝贵的经验教训，说明如何最好地 传播这一重要方案。 这项建议将产生必要的试验数据，以规划全面的执行情况评价 并设计和测试干预措施，以促进BBC在随后的服务导向项目中的实施 （SDP）。该提案将围绕三个具体目标展开： 目标1：确定成功推出护理人员支持计划的国家和地区特征 我们将与5位国家和5位地区领导人就实施情况进行半结构化访谈 被认为是BBC成功推出的重要特征。问题将来自经修订的PARIHS 证据、背景、促进和实施成功的结构。我们将采用定性分析 采用记录的方法，以确定国家和区域两级的主要实施特点。 目标2：确定与高护理人员注册率相关的设施特征 我们将调查和采访VA工作人员和照顾者在当地VA设施-两个高和两个低BBC 招生我们将招募参与BBC推出的工作人员（共20人，5人/设施）和护理人员， 未在BBC注册（共9人，2-3人/机构）。我们将进行调查和半结构化访谈（也 使用PARIHS衍生的问题），探讨有关实施的主题。我们将总结调查 调查结果与描述性统计和应用定性分析方法，以确定 实施特征可能特定于高注册设施。 目标3：与合作伙伴一起，整合调查结果，提出建议，并规划未来评估的目标 该目标将在评估团队、咨询小组和其他人员的全天开发会议中达到高潮 项目合作伙伴。会议讨论将产生一份合作报告，该报告（a）整合提案结果， (b)建议可立即改进的执行特点，（c）说明草案 （d）制定执行措施和需要全面确定目标的特点， 未来的SDP，所有这些都包括该提案的可交付成果。 总之，这一建议将确定成功实施英国广播公司方案的主要特点。 完成后，我们和我们的项目合作伙伴将能够针对一些实施特点， 立即完善和其他供进一步研究和在随后的SDP中实施干预。这 一种协作的、逐步的方法将通知、激励和传播一个标志性的VA的全国传播 退伍军人护理人员计划。