Optimizing Mealtime (OPTIMAL): Development and Pilot Testing of a Person-Centered Mealtime Care Intervention for Nursing Home Residents with Alzheimer's Disease and Related Dementias (ADRD)

优化进餐时间 (OPTIMAL)：针对患有阿尔茨海默氏病和相关痴呆症 (ADRD) 的疗养院居民开发以人为本的进餐护理干预措施并进行试点测试

• 批准号: 10459521
• 负责人: Wen Liu
• 金额: $ 17.6万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10459521
• 关键词: Address; Adherence; Adult; Aging; Alzheimer' s disease related dementia; Area; Behavior; Behavior Therapy; Behavioral; Behavioral Research; Behavioral Symptoms; Body Weight decreased; Caring; Clinical; Clinical Research; Clinical Trials; Code; Cognition; Complement; Conduct Clinical Trials; Consent; Cues; Data; Dehydration; Dementia; Development; Eating; Evaluation; Exhibits; Experimental Designs; Food; Future; Goals; Health; Healthcare; Home Nursing Care; Hydration status; Individual; Infection; Intake; Intervention; Interview; Iowa; Joints; Knowledge; Life; Literature; Long-Term Care; Malnutrition; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methodology; Methods; Morbidity - disease rate; Neurobehavioral Manifestations; Nursing Homes; Outcome; Patient-Focused Outcomes; Perception; Personal Satisfaction; Persons; Population; Positioning Attribute; Procedures; Protocols documentation; Quality of Care; Quality of life; Research; Research Assistant; Research Personnel; Residential Treatment; Resolution; Resources; Risk; Risk Management; Scheme; Science; Social Interaction; Statistical Methods; Structure; Testing; Training; Training Activity; Treatment Efficacy; Universities; Videotape; Work; aging population; base; behavioral clinical trial; care outcomes; care providers; career; clinical care; design; efficacy evaluation; evidence base; experience; feasibility testing; improved; innovation; intervention refinement; mortality; nursing intervention; nutrition; patient oriented; person centered; pilot test; preference; programs; recruit; skills; systematic review; theories; therapy development; tool; treatment as usual

The overall goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to support the candidate, Dr. Wen Liu, in developing an independent clinical program of research to optimize mealtime care quality, function, and nutrition in aging and ADRD population. Her long-term career goal is to become an independent investigator and national leader conducting patient-centered, interdisciplinary clinical research to optimize mealtime care and patient outcomes across a broad range of care settings. Dr. Liu’s three training goals are: 1) Behavioral intervention science to develop knowledge and skills on the development, delivery, evaluation, and refinement of behavioral interventions for dementia mealtime care in clinical care settings; 2) Advanced methodologies in clinical trials to develop knowledge and skills in a) design and conduct of clinical trials, and b) the use of qualitative and mixed methods to inform feasibility of the intervention and guide refinement of the intervention; and 3) Advanced quantitative statistical methods to analyze large clustered data coded from video-taped mealtime observations that are collected from behavioral clinical trials. Under the mentorship of an accomplished team of investigators, Dr. Liu will achieve the training goals through completion of systematically planned formal and informal training activities at the University of Iowa, a research-intensive organization with significant and long-standing resources for early career investigators. The training plan will provide her with knowledge and skills necessary to address two significant and intertwined dementia mealtime care problems - mealtime difficulties and insufficient intake - both requiring immediate and joint resolution. Emerging evidence supports the negative association of full assistance provision and the positive association of person-centered care with resident mealtime difficulties and intake. Current interventions on the use of person-centered care is lacking, and fail to address care providers’ needs for knowledge and skills to provide optimal mealtime care. To address this gap, the proposed research aims to complete the development and feasibility testing of a theory-based person-centered mealtime care intervention, Optimizing Mealtime Care (OPTIMAL), to effectively engage residents in eating and maintain their highest level of function possible. The three specific aims are: 1) Develop the OPTIMAL intervention and training materials; 2) Determine the feasibility of successfully delivering the OPTIMAL intervention; and 3) Determine the treatment fidelity of delivering OPTIMAL. This study will use a mixed methods approach integrating qualitative interviews and a one-group pre-post design. Data from this study will be used to refine the OPTIMAL intervention, training materials, and study procedures, all of which will be used in future larger trials. Dr. Liu will develop and submit an R01 application to evaluate the efficacy of the refined OPTIMAL using an RCT design. This study is a critical first step to achieve Dr. Liu’s long-term career goal, and complements the NIA strategic focus to support and conduct behavioral research to improve health, well-being, and function in aging and ADRD population.

该指导的以患者为导向的研究职业发展奖（K23）的总体目标是支持 候选人刘文博士，在开发一个独立的临床研究计划，以优化用餐时间 老年人和ADRD人群的护理质量、功能和营养。她的长期职业目标是成为一名 独立研究者和国家领导人开展以患者为中心的跨学科临床研究， 在广泛的护理环境中优化餐时护理和患者结果。刘医生的三项训练 目标是：1）行为干预科学，以发展关于发展，交付， 评估和改进临床护理环境中痴呆症餐时护理的行为干预; 2） 临床试验中的先进方法，以发展a）临床试验设计和实施方面的知识和技能 试验，和B）使用定性和混合方法，以告知干预和指导的可行性 改进干预措施; 3）先进的定量统计方法， 从行为临床试验中收集的进餐时间观察录像编码的数据。下 在一个有成就的研究者团队的指导下，刘博士将通过完成 在爱荷华州大学系统规划的正式和非正式培训活动，一个研究密集型 该组织为早期职业调查员提供了大量长期资源。培训计划将 为她提供必要的知识和技能，以解决两个重要的和相互交织的痴呆症用餐时间 护理问题-进餐困难和摄入量不足-都需要立即和共同解决。 新出现的证据支持提供全面援助的负面关联和提供全面援助的正面关联。 以人为本的护理与居民用餐时间的困难和摄入量。目前关于使用 缺乏以人为本的护理，未能满足护理提供者对知识和技能的需求， 最佳的用餐时间护理。为了解决这一差距，拟议的研究旨在完成开发， 基于理论的以人为中心的餐时护理干预的可行性测试，优化餐时护理 （最佳），以有效地参与居民的饮食和保持其最高水平的功能可能。的 三个具体目标是：1）开发最佳干预和培训材料; 2）确定 成功提供最佳干预的可行性;以及3）确定治疗保真度 传递最优。本研究将采用定性访谈和 一组前后设计。本研究的数据将用于优化最佳干预、培训 材料和研究程序，所有这些都将用于未来更大的试验。刘博士将开发并提交 R 01应用程序，用于使用RCT设计评价改良OPTIMAL的有效性。这项研究是一个关键的 这是实现刘博士长期职业目标的第一步，也是对NIA战略重点的补充， 进行行为研究，以改善老年人和ADRD人群的健康，福祉和功能。