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

摘要 低收入和中等收入国家（LMIC）正在发生的快速人口结构转型将使 大大增加老年人患有阿尔茨海默病和相关疾病的人数 因此，到2030年，全球超过2/3的ADRD患者 将留在LMIC。因此，越南和其他低收入国家越来越认识到， ADRD是一个重大的公共卫生问题，开发科学证据和 应对这一挑战的研究能力，包括发展有效的社区基础 为老年痴呆症患者的家庭照顾者提供的支助方案。建立在 在越南的调查人员和两个HIC（美国和 澳大利亚），这个项目的总体目标是测试一个以社区为基础的项目的功效 支持越南的阿尔茨海默氏症家庭护理人员，并通过以下方式加强研究能力： 建立越南ADRD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补助金的成就上。我们现在有一个强大的， HIC（美国和澳大利亚）、越南 国家老年医院（NGH）和越南卫生部（MOH）。我们的研究 团队已经在文化上进行了调整，实施并测试了 一项试点随机对照试验中基于社区的家庭ADRD照顾者干预模式（REACH VN） 60个家庭护理员我们的试点集群RCT的初步结果显示， 既有可行性，又有初步功效。我们现在建议测试REACH VN的有效性 在一个更大的集群RCT中，使用III期临床试验设计， 使用RE-AIM框架进行形成性评估，为未来的实施提供信息。我们 还将通过建立一个全国性的研究中心， 研究人员网络，并建立一个联系试点赠款计划，以提供指导和 资助杰出科学家进行关于家庭生育和其他方面的ADRD研究 与决策者高度相关的问题。该项目的具体目标是：1）测试功效 越南REACH VN在32个聚类（350个家庭）的聚类随机对照试验中，2） 确定在社区环境中实施REACH VN的主要障碍和促进因素 通过与分组RCT同时进行的形成性评估，以及3）加强和 通过建立以下机构，建设越南在农业和其他农业发展与农村发展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方案。

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.