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：
10703475
负责人：
B R Simon Rosser
金额：
$ 73.59万
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/10703475
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 Certification Client Control Groups Data Collection Discrimination E-learning Educational Curriculum Educational Intervention Effectiveness Elderly Environment Evidence based intervention Family member Fright Funding Gender Identity Health Heterosexuals Hostility Human Resources Impaired cognition Individual Inferior Instruction Intake Intervention Knowledge Lesbian Gay Bisexual Licensing 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 Research Risk Rural Safety Service provision Services Sex Orientation Sexual and Gender Minorities Social Work Statutes and Laws Testing Training Training Programs Training Support United States National Institutes of Health Violence Waiting Lists aged arm cisgender comparative effectiveness study dementia care design efficacy evaluation evidence base follow-up gender minority health disparity health care availability health care service 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.

概括在美国，性别和性别少数族裔（SGM）老年人患阿尔茨海默氏病的风险不成比例和相关的痴呆症（AD/ADRD），并且更有可能依靠长期服务和支持（LTSS）他们的传教士，异性恋同龄人。没有对LTSS劳动力的文化反应迅速护理培训，SGM 居民容易受到不适当和/或劣等护理的影响，导致生活质量较差和健康结果。为了解决这个问题，一些州最近要求对LTSS劳动力进行培训 SGM老年人对文化反应迅速的护理。这种方法成功有两个主要障碍。首先，我们缺乏有关使用广告/ADRD护理管理SGM的LTSS政策的研究（在文化护理的州不要求培训），这将告知是否需要此类州立法。第二，没有可扩展，可持续，基于证据的培训计划，以通过广告/ADRD培训SGM的LTSS劳动力文化反应迅速的护理。该应用程序专注于培训的培训，该课程已经培训了 12个州的12,000多名LTSS工人。这个可接受，可行和有前途的课程员工多级培训管理和前线LTSS员工在文化响应迅速护理SGM的情况下广告/adrd。但是，它并未经过严格的评估，并且仅依赖于亲自指导。这混合了方法和比较有效性研究具有三个具体目标。在AIM 1中，我们将进行对明尼苏达州的362套护士和362个辅助生活设施的全面政策分析以评估在人力资源中具有明确的SGM肯定政策的机构的数量和比例，营销，培训，治理；反歧视政策指导文化反应迅速护理，居民性取向和性别认同（SOGI）数据收集。这些发现将为AIM 2课程提供信息。在目标2，为了在全国范围内和高保真度上提供更可扩展的培训，我们将设计和开发一个异步在线版本，并使用30个LTSS管理和30名员工进行驾驶。在AIM 3中，评估培训的影响，我们将进行3臂，管理/人员分层，团体随机，对照试验的面对面培训与在线课程与候补列表对照组（在62个LTSS机构中， 310个管理人员和450名员工）。在个人层面，我们将评估管理和员工知识，吸引力和技能为SGM客户提供护理。在代理机构一级，在六个月的随访中，我们预测接受培训的机构将拥有更多的SGM明确政策，更多的SGM欢迎环境，摄入量的SOGI数据收集以及具有更大知识，舒适和技能的员工在提供AD/ADRD文化响应式护理中提供SGM。