An Upstream Palliative Care Intervention for Rural Family Caregivers

描述（由申请人提供）：这份K99/R00申请表描述了申请人J. Nicholas Dionne- Odom，博士，注册护士的背景和经验，以及他计划获得必要的知识和培训，成为一名领先的独立临床研究者，开发和测试远程医疗姑息治疗干预措施，优化晚期癌症患者的农村家庭照顾者（FCGs）的结果。K99阶段的总体目标是在制定干预措施、进行随机对照试验（rct）和健康指导/动机访谈方面获得高级研究培训，以便为生活在美国南部的晚期癌症患者的农村FCGs开发和测试远程医疗计划。基于Pearlin的家庭护理模式，这项新干预的目标将是通过指导家庭护理人员如何管理照顾对象的护理需求和需求，以及他们自己的需求，来提高家庭护理人员的自我效能感、能力和决策技能。K99阶段的具体培训目标是：(1)制定和定制干预措施；(1)深入了解使用混合方法进行研究的社区参与；1b)在开发、操作和评估干预的保真度方面发展先进的理解和技能；1c)更好地了解尖端远程医疗和其他移动医疗发展；加深对以精神和信仰为导向的干预措施的理解；(2)培养技能

DESCRIPTION (provided by applicant): This K99/R00 application describes the background and experience of the applicant, J. Nicholas Dionne- Odom, PhD, RN, and his plan to acquire the knowledge and training necessary to become a leading independent clinical investigator in developing and testing telehealth palliative care interventions that optimize the outcomes of rural family caregivers (FCGs) of persons with advanced cancer. The overall goal during the K99 phase is to gain advanced research training in developing interventions, conducting randomized controlled trials (RCTs), and health coaching/motivational interviewing in order to develop and test a telehealth program for rural FCGs of persons with advanced cancer living in the Southern US. Based on Pearlin's Model of Family Caregiving, the goal of this new intervention will be to promote FCGs' self-efficacy, competence, and decision- making skills by coaching them about how to manage not only the care demands and needs of their care recipients but also their own needs. The specific training objectives during the K99 phase are to: (1) develop and tailor interventions, to: 1a) gain advanced understanding of community engagement in research using mixed methods; 1b) develop advanced understanding and skills in developing, manualizing, and assessing fidelity of an intervention; 1c) gain greater understanding of cutting edge telehealth and other m-health developments; and 1d) develop greater understanding of spiritually- and faith-based-oriented interventions; (2) develop skills to design and lead RCTs relevant to family caregiving; 3) augment knowledge and skills in health coaching; and (4) continue training in research ethics. The research specific aim during the K99 phase is: through interviews with a) rural dwelling persons with advanced cancer, b) their primary FCGs, and c) lay healthcare navigators, develop and tailor the content, format and delivery of a telehealth intervention for FCGs of persons with advanced cancer in the rural South. To meet the K99 training objectives, a comprehensive training plan has been developed in concert with an interdisciplinary mentorship and consultant team of senior research experts. The plan includes intensive one-on-one mentorship, formal coursework/workshops, clinical trial research observerships, and conference attendance. The overall goal during the R00 phase is to conduct a pilot RCT with 60 rural Southern advanced cancer FCGs to assess acceptability, feasibility, and potential efficacy of the newly tailored FCG intervention resulting from the K99 phase. The research specific aims during the R00 phase are to: 1) evaluate the acceptability of a newly tailored FCG intervention and the feasibility of enrolling and retaining 60 participants into a RCT of the FCG intervention for 24 weeks and 2) evaluate the efficacy of the intervention in improving caregiver outcomes (quality of life, burden, and mood [depression/anxiety]) compared to usual care. The results will directly support an R-01 application to conduct an efficacy RCT of an early, telehealth PC intervention for rural Southern FCGs of advanced cancer patients.