Low Literacy Elder Caregiver Support for Callcenters

描述(由申请人提供)：随着私营部门疾病管理组织的呼叫中心转变为与联邦医疗保险人口的护理协调角色，需要材料来帮助教练帮助老年照顾者履行和保持他们作为患者依从性促进者的角色。此外，年长的照顾者本身也经常患有慢性病，出于对患病配偶的需求的考虑，他们忽视了这些疾病。呼叫中心的低识字率老年人照顾者支持是一个多层次的Web应用程序，旨在培训呼叫中心教练有关照顾者问题的知识，以及促进以各种低识字率格式(DVD-视频、4年级阅读水平的印刷媒体通过电子邮件或邮寄发送)向照顾者发送后续媒体的要求。拟议的系统将与现有的呼叫中心软件集成，以帮助教练评估老年照顾者在疾病管理、护理计划遵守、个人对照顾者角色的处理以及照顾者自身在自我护理方面的努力方面的需求。根据护理者对调查的回应，教练将获得与呼叫者相关的谈话要点和电话脚本的个性化菜单。教练还可以根据呼叫者的具体物品申请定制的教材，并将其发送给护理者。由于59%的老年人处于基本或低于基本健康素养水平，所有材料都将按照医学研究所为健康素养较低的个人提出的建议编写。第一阶段将包括与充血性心力衰竭患者的老年家庭照顾者一起进行形成性评估，以及由呼叫中心专业人员和健康素养和老年护理研究领域的领导人组成的咨询委员会。将编写一张低识字率DVD和一本载有低识字率文章集的小册子，内容涉及与老年照顾者有关的选定主题。这种干预的理论基础是Lazarus和Folkman的压力和应对模型。所有总结性评价工具都将以这些结构为基础。DVD和小册子的效果将以准试验性的事后设计进行评估，36名符合联邦医疗保险资格的老年照顾者将为患有充血性心力衰竭的符合联邦医疗保险资格的护理接受者提供帮助。本研究测量的结果包括照顾者的自我效能感、知识以及在照顾者技能和照顾者应对领域的改变意向。第二阶段将把护理者材料扩展到所有领域，增加关于慢性阻塞性肺疾病和呼叫中心教练所需的工作人员模块的信息，包括培训、调查、谈话要点和DVD-视频、印刷和电子邮件支持材料的征用。在第二阶段，完整的计划将接受一项涉及老年照顾者的大规模随机临床试验，并对参与的呼叫中心的工作人员进行流程和影响评估。公共卫生相关性：老年护理员是卫生保健团队不可或缺的一部分，促进护理计划的遵守并使其能够独立生活。此外，作为老年人本身，他们也面临着自己的健康挑战，而他们的照看角色往往加剧了这一挑战。该计划旨在帮助疾病管理呼叫中心教练在疾病管理技能、护理计划遵从性、照顾者应对和照顾者自我护理方面为老年照顾者提供最先进的支持，包括通过DVD视频、硬拷贝或电子邮件文章提供的低识字率跟踪材料。

DESCRIPTION (provided by applicant): As call centers for private sector disease management organizations move into a care coordination role with the Medicare population, materials are needed to help coaches assist elder caregivers in fulfilling and maintaining their roles as adherence facilitators for the patient. Furthermore, elder caregivers themselves often have chronic conditions, which they neglect in deference to the needs of their ill spouse. Low Literacy Elder Caregivers Support for Call Centers is a multi-level web application designed to train call center coaches in caregiver issues, as well as facilitate the requisition of follow-up media to be sent to the caregiver in a variety of low literacy formats (DVD-video, 4th grade reading level print media to be sent via email or post). The proposed system will integrate with existing call center software to help coaches assess the needs of elder caregivers in the domains of disease management, care plan adherence, personal coping with the caregiver role, and the caregiver's own efforts at self-care. Based on caregiver responses to surveys, coaches will be presented with an individualized menu of talking points and phone scripts pertinent to that caller. Coaches will also have the ability to requisition tailored educational materials to be sent to the caregiver based on caller-specific items. Since 59% of seniors function at Basic or Below Basic levels of health literacy, all materials will be developed following the Institute of Medicine's recommendations for individuals with low health literacy. Phase I will involve formative evaluation with elder family caregivers of persons with congestive heart failure, and an advisory council of call center professionals and leaders in the field of health literacy and eldercare research. A low literacy DVD and a booklet containing a collection of low-literacy articles will be prepared concerning select topics relevant to elder caregivers. The theoretical basis of this intervention is the Lazarus and Folkman stress and coping model. All summative evaluation instruments will be based on these constructs. The efficacy of the DVD and booklet will be evaluated in a quasi-experimental pre-post design with 36 African-American, Hispanic, Caucasian, and Asian Medicare-eligible elder caregivers providing assistance to a Medicare-eligible care- receiver with congestive heart failure. Outcomes measured in this study include caregiver self-efficacy, knowledge, and intention to change in the domains of caregiving skills and caregiver coping. Phase II will expand the caregiver materials to cover all domains, adding information on chronic obstructive pulmonary disorder and the staff modules needed for call center coaches, including training, surveys, talking points, and the requisitioning of DVD-video, print, and email support materials. In Phase II, the complete program will undergo a large scale randomized clinical trial involving elder caregivers, and a process and impact evaluation of the staff of participating call centers. PUBLIC HEALTH RELEVANCE: Elder caregivers are an integral part of the health care team, facilitating care plan adherence and enabling independent living. In addition, as seniors themselves, they have their own health challenges, which are often exacerbated by their caregiving role. This program is designed to assist disease management call center coaches in offering state-of-the-art support to elder caregivers in the domains of disease management skills, care plan adherence, caregiver coping, and caregiver self-care, including low literacy follow-up materials available on DVD-video, or as hard copy or e-mail articles.