Advancing Alzheimer's family caregiving interventions and research capacity in Vietnam

摘要 低收入和中等收入国家(LMIC)正在进行的快速人口转型将 大幅增加患有阿尔茨海默病和相关疾病的老年人的数量 痴呆症(ADRD)，到2030年，全世界三分之二以上的ADRD患者 将居住在LMIC。因此，越南和其他LMIC越来越多地认识到 ADRD提出了一个重大的公共卫生问题，以及开发科学证据和 应对这一挑战的研究能力，包括以社区为基础的有效发展 为阿尔茨海默病患者的家庭照顾者提供支持的计划。建立在 在越南和两个HIC(美国和 澳大利亚)，该项目的总体目标是测试以社区为基础的计划的有效性 支持越南的阿尔茨海默病家庭照顾者，并通过以下方式加强研究能力 发展越南全国反兴奋剂机构研究网络。为了实现这些目标，我们将 直接建立在我们的规划拨款的成果之上。我们现在有一个强大的和 越南HIC(美国和澳大利亚)调查人员之间的有效合作关系 国家老年医院(NGH)和越南卫生部(MOH)。我们的研究 团队已经在文化上适应、实施并测试了 试点集群RCT中基于社区的家庭ADRD照顾者干预模式(REACH VN) 60名家庭照顾者。我们的试点集群RCT的初步结果显示，强有力的证据表明 具有可行性和初步疗效。我们现在建议测试REACH VN的有效性 在更大的集群中，RCT嵌入社区，使用耦合的III阶段临床试验设计 通过使用RE-AIM框架进行形成性评价，为今后的实施提供信息。我们 还将通过建立一个全国性的 研究人员网络，并创建关联的试点赠款计划，以提供指导和 资助有功绩的科学家进行家庭照料和其他方面的研究 与决策者高度相关的问题。这个项目的具体目标是：1)测试疗效 REACH VN在越南的32个组(350个家庭)的整群随机对照试验，2) 确定在社区环境中实施REACH VN的关键障碍和促进者 通过与分组区域工作队并行进行的形成性评价，以及3)加强和 建立越南在照料和其他ADRD研究方面的国家能力 一个研究人员网络以及一个指导和试点支持计划。

ABSTRACT A rapid demographic transition underway in low and middle-income countries (LMIC) will substantially increase the number of older adults suffering from Alzheimer’s disease and related dementias (ADRD) so that by 2030 more than 2/3 of all persons suffering from ADRD worldwide will reside in LMIC. Consequently, there is growing recognition in Vietnam and other LMIC that ADRD poses a major public health issue and the importance developing scientific evidence and research capacity to meet this challenge, including developing effective community-based support programs for family caregivers of persons with Alzheimer’s disease. Building on an established cross-national partnership between investigators in Vietnam and two HIC (US and Australia), the overall goals of this project are to test the efficacy of a community-based program to support Alzheimer’s family caregivers in Vietnam and to strengthen research capacity through development of a national Vietnam ADRD research network. To achieve these goals, we will build directly on the accomplishments of our planning grant. We now have in place a robust and effective collaborative relationship between investigators in HIC (US and Australia), the Vietnam National Geriatric Hospital (NGH), and the Vietnam Ministry of Health (MOH). Our research team has culturally adapted, implemented and tested the feasibility and preliminary efficacy of a community-based family ADRD caregiver intervention model (REACH VN) in a pilot cluster RCT of 60 family caregivers. Preliminary results of our pilot cluster RCT show strong evidence of both feasibility and preliminary efficacy. We now propose to test the efficacy of the REACH VN in a larger cluster RCT embedded in the community using a Stage III clinical trial design coupled with a formative evaluation using the RE-AIM framework to inform future implementation. We will also enhance ADRD research capacity more broadly in Vietnam by establishing a national network of researchers and creating a linked pilot grant program to provide mentoring and funding to meritorious scientists conducting ADRD research on family caregiving and other issues of high relevance to policy makers. Specific goals of this project are to 1) test the efficacy of REACH VN in Vietnam in cluster randomized controlled trial of 32 clusters (350 families), 2) identify key barriers and facilitators of REACH VN implementation in a community setting through a formative evaluation conducted in parallel with the cluster RCT, and 3) strengthen and build Vietnam national capacity in caregiving and other ADRD research through the creation of a network of researchers and a program of mentoring and pilot support.