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Training the Long-Term Services and Supports Dementia Care Workforce in Provision of Care to Sexual and Gender Minority Residents

培训长期服务和支持痴呆症护理人员，为性少数群体居民提供护理

基本信息

批准号：
10523826
负责人：
B R Simon Rosser
金额：
$ 72.45万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10523826
关键词：
Address Adopted Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Area Assisted Living Facilities Attention Attitude Caring Client Control Groups Data Collection Discrimination E-learning Educational Curriculum Educational Intervention Effectiveness Elderly Environment Evidence based intervention Family member Fibrinogen Fright Funding Gender Identity Health Heterosexuals Hostility Human Resources Impaired cognition Individual Inferior Instruction Intake Intervention Knowledge Lesbian Gay Bisexual Long-Term Care Long-Term Effects Marketing Medicare/Medicaid Methods Minnesota Minority Modeling Nursing Homes Outcome Participant Persons Policies Policy Analysis Population Prevalence Quality of life Randomized Controlled Trials Regulation Religion and Spirituality Research Risk Rural Safety Service provision Services Sex Orientation Sexual and Gender Minorities Social Work Statutes and Laws Testing Time Training Training Programs Training Support United States National Institutes of Health Violence Waiting Lists aged arm base cisgender comparative effectiveness study dementia care design efficacy evaluation evidence base follow-up gender minority health disparity health care availability health disparity improved online course online intervention online version peer satisfaction skills sound transgender

项目摘要

SUMMARY In the US, sexual and gender minority (SGM) older adults are disproportionately at risk for Alzheimer’s disease and related dementias (AD/ADRD) and more likely to rely on long-term services and supports (LTSS) than their cisgender, heterosexual peers. Without training in culturally responsive care of the LTSS workforce, SGM residents are vulnerable to receiving inappropriate and/or inferior care contributing to poorer quality of life and health outcomes. To address this, some states have recently mandated training of the LTSS workforce in the culturally responsive care of SGM older adults. There are two major barriers to this approach being successful. First, we lack research on LTSS policies governing SGM with AD/ADRD care (in states where cultural care training is not mandated), which would inform whether such state legislation is needed. Second, there are no scalable, sustainable, evidence-based training programs to train the LTSS workforce in SGM with AD/ADRD culturally responsive care. This application is focused on the Training to Serve curriculum, which has trained over 12,000 LTSS workers in 12 states. This acceptable, feasible, and promising curriculum employs a multilevel approach to train management and frontline LTSS staff in culturally responsive care to SGM with AD/ADRD. But, it has not been rigorously evaluated and relies solely on in person instruction. This mixed methods and comparative effectiveness study has three specific aims. In Aim 1, we will conduct a comprehensive policy analysis of 362 nursing homes and 362 assisted living facilities in Minnesota to assess the number and proportion of agencies that have explicit SGM affirmative policies in human resources, marketing, training, governance; anti-discrimination policies guiding culturally responsive care, and resident sexual orientation and gender identity (SOGI) data collection. These findings will inform Aim 2 curriculum. In Aim 2, to make Training to Serve more scalable nationally and with high fidelity, we will design and develop an asynchronous online version and pilot it with 30 LTSS management and 30 staff. In Aim 3, to assess the effects of training, we will conduct a 3-arm, management/staff stratified, group randomized, controlled trial of the in-person training versus an online curriculum versus a waitlist control group (in 62 LTSS agencies, with 310 management and 450 staff per arm). At the individual level, we will assess management and staff knowledge, attitudes, and skills providing care to SGM clients. At the agency level, at six months follow-up, we predict agencies who receive training will have more SGM explicit policies, more SGM welcoming environments, SOGI data collection at intake, and staff with significantly greater knowledge, comfort, and skills in providing SGM with AD/ADRD culturally responsive care.

总结