Multisite Intervention Trial for Diverse Caregivers

描述(由申请人提供)：本提案的目的是 完善和测试多成分心理社会行为干预以 减轻家庭照顾者的负担和抑郁 阿尔茨海默病？S病或相关疾病。这种相互竞争的更新将建立 现有基础设施和从其母多站点获得的结果 可行性研究，增强阿尔茨海默病的资源？S照顾者健康 (伸展)。REACH，(由国家老龄研究所(NIA)和 国家护理研究所(NINR)U01-AG13305)探索了 不同干预措施对减轻老年人负担和痛苦的效果 六个参与地点的家庭照顾者。对这些数据的详细分析 建议可能有效的REACH干预措施的具体组成部分 在改善照顾者的结果方面。目前的研究整合了已确定的 REACH干预中的组件并测试单个多组件 干预。这项干预措施将在以下样本中进行评估 不同地理和种族/民族的照顾者群体。这个 研究设计为多点、两组随机临床试验。相同 两种情况：家庭多组件干预或标准化干预 将在五个地点实施仅限信息的控制条件 (伯明翰、孟菲斯、迈阿密、帕洛阿尔托和费城)， 匹兹堡的协调中心。招聘600人(每个地点120人) 护理者-护理接受者二人组将产生510人完成方案(15% 预计会出现自然减员)。同样数量的非裔美国人/黑人， 西班牙裔/拉丁裔和高加索/白人将被招募并分配给每个人 每个站点的情况。第一阶段涉及对干预措施的细化，以及 跨地点培训干预者；在第二阶段，随机 将进行临床试验。这一干预旨在使 照顾者赚取并使用认知和行为策略，以影响两者 护理接受者的行为(例如，游荡)和他们自己的行为(例如， 管理压力)。干预措施将包括10次由受训人员进行的家访 员工外加5个预先计划好的与训练有素的员工的联系 技术在六个月的时间内。这项技术还将提供 给正式的服务机构、家人和其他照顾者。一支统一的电池 预测指标和结果衡量标准将在基线、第三和第六阶段收集 月份。两种情况的成本-效果和临床意义 也将接受评估。

DESCRIPTION (provided by applicant): The objective of this proposal is to refine and test a multi-component psychosocial behavioral intervention to reduce burden and depression among family caregivers of persons with Alzheimer?s Disease or related disorders. This competing renewal will build on existing infrastructures and results obtained from its parent multi-site feasibility study, Resources for Enhancing Alzheimer?s Caregiver Health (REACH). REACH, (funded by the National Institute on Aging (NIA) and the National Institute for Nursing Research (NINR) U01-AG13305) explored the effectiveness of different interventions to reduce burden and distress of family caregivers in six participating sites. Detailed analyses of these data suggest specific components of the REACH interventions that may be efficacious in improving caregiver outcomes. The current study integrates identified components from the REACH interventions and tests a single multi-component intervention. This intervention will be evaluated among a sample of geographically and racially/ethnically diverse caregiver populations. The study design is a multi-site, two-group randomized clinical trial. The same two conditions: an in-home multi-component intervention or a standardized information only control condition will be implemented at five sites (Birmingham, Memphis, Miami, Palo Alto, and Philadelphia), with the Coordinating Center in Pittsburgh. Recruitment of 600 (120 per site) caregiver-care recipient dyads will yield 510 completing the protocol (15% attrition expected). Equal numbers of African Americans/Blacks, Hispanics/Latinos, and Caucasian/Whites will be recruited and assigned to each condition at each site. Phase 1 involves a refinement of the intervention and training of the interventionists across sites; in Phase 2, the randomized clinical trial will be conducted. The intervention is designed to enable caregivers to earn and use cognitive and behavioral strategies, to impact both care recipient behaviors (e.g. wandering) and their own behaviors (e.g., managing stress). The intervention will consist of 10 home visits by trained staff plus 5 preplanned contacts with trained staff through innovative technology over a six-month period. The technology will also provide access to formal services, family, and other caregivers. A uniform battery of predictor and outcome measures will be collected at baseline, three and six months. Cost effectiveness and clinical significance of the two conditions will also be evaluated.