Defining a Culturally Tailored Crisis Intervention Model Targeting African American Dementia Caregivers in Socially Disadvantaged Neighborhoods

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PROJECT ABSTRACT Health disparities in Alzheimer’s disease and related dementia (ADRD) persist among African Americans who are two-fold more likely to develop dementias. African Americans also rely more heavily on unpaid family or friend caregivers to meet the complex needs of care recipients with ADRD than other racial/ethnic groups. Disproportionately high caregiving burden is experienced within African American communities, as many African American caregivers reside in socially disadvantaged neighborhoods—environments with fewer health, economic, and social resources. African American caregivers also report high levels of unmet needs, which often escalate to the point of crisis. Emerging evidence suggests that crisis events, defined as unplanned stressful situations requiring immediate action, are frequently experienced by African American caregivers. Yet, effective strategies for addressing African American ADRD needs and crisis in the context of social disadvantage are lacking. Although addressing caregiving needs and disparities are national research priorities, efforts to address crisis events have been hindered by under-inclusion of African Americans in research. Consequentially, it is not known how African American caregivers perceive and manage crisis events in socially disadvantaged environments, limiting identification of interventions to prevent, mitigate, and manage crisis in this context. The proposed prospective qualitative will utilize a validated metric of social disadvantage to guide sampling and Grounded Dimensional Analysis (GDA), a variant of Grounded Theory, to examine ADRD crisis. Aim 1 will identify precipitating, mitigating, and modifiable features of crisis among African American caregivers in socially disadvantaged environments and generate crisis intervention model. Sub-Aim 1A will examine the role of environmental factors in shaping decision-making surrounding crisis events. Finally, Aim 2 will validate a culturally tailored crisis intervention model for African Americans ADRD caregivers in the context of social disadvantage. The proposed research will provide the urgently needed foundational knowledge to better understand and ultimately shape interventions for crisis events in a high-risk and understudied ADRD population, African American caregivers—and is directly responsive to priorities of the National Institute on Aging (NIA) framework “Aging Well in the 21st Century: Strategic Directions for Research on Aging.” The study addresses Goal C of the framework: “develop effective interventions to maintain health, well-being, and function and prevent or reduce the burden of age-related diseases, disorders, and disabilities.” Findings from this research will establish preliminary design components for mode of intervention delivery building on identified intervention targets.