Multisite Intervention Trial for Diverse Caregivers

描述（由申请人提供）：本提案的目的是 完善和测试多成分的心理社会行为干预， 减轻残疾人家庭照料者的负担和抑郁 老年痴呆症？疾病或相关病症。这种竞争性的更新将建立 现有基础设施和从其父多站点获得的结果 可行性研究，提高阿尔茨海默病的资源？护理人员健康 （REACH）。REACH（由国家老龄化研究所（NIA）和 国家护理研究所（NINR）U 01-AG 13305）探索了 不同干预措施减轻儿童负担和痛苦的有效性 六个参与地点的家庭护理人员。这些数据的详细分析 建议REACH干预措施中可能有效的具体组成部分 改善护理人员的效果。目前的研究整合了确定的 组件从REACH干预和测试一个单一的多组件 干预这项干预措施将在以下样本中进行评估： 在地理和种族/族裔上多样化的照料者群体。的 研究设计为多中心、两组随机临床试验。相同的 两种情况：家庭多成分干预或标准化的 五个地盘将实施管制条件，只供参考 （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。招募600人（每个研究中心120人） 患者-护理接受者配对将产生510例完成方案（15% 预期损耗）。同等数量的非裔美国人/黑人， 西班牙裔/拉丁裔和高加索/白人将被招募并分配到每个 每个站点的条件。第一阶段涉及干预措施的完善， 对各研究中心的干预人员进行培训;在第2阶段， 将进行临床试验。干预措施旨在使 照顾者获得和使用认知和行为策略，以影响两者 护理接受者的行为（例如徘徊）和他们自己的行为（例如， 管理压力）。干预措施将包括10次家庭访问， 通过创新的方法， 在六个月的时间里，技术。这项技术还将提供 正式的服务，家庭和其他照顾者。一个统一的电池 将在基线、第三和第六天收集预测指标和结局指标 个月两种条件的成本效果和临床意义 也将进行评估。

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.