Low Literacy Elder Caregiver Support for Callcenters

识字率低的老年护理人员对呼叫中心的支持

• 批准号: 7670533
• 负责人: AMELIA J BIRNEY
• 金额: $ 19.94万
• 依托单位: OREGON CENTER FOR APPLIED SCIENCE, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-15 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7670533
• 关键词: Accident and Emergency department; Address; Adherence; African American; Anxiety; Area; Arts; Asians; Attitude; Blue Cross; Blue Shield; Caregivers; Caring; Caucasians; Caucasoid Race; Chronic; Chronic Obstructive Airway Disease; Clinical Trials Design; Collection; Computer software; Congestive Heart Failure; Coping Skills; Cost Savings; Country; Data; Development; Disease; Disease Management; Educational Intervention; Educational Materials; Elderly; Electronic Mail; Emergency Situation; Evaluation; Experimental Designs; Family Caregiver; Florida; Foundations; Foxes; Friends; Funding; Generic Drugs; Health; Health Planning; Health Status; Healthcare; Hispanics; Home environment; Hospitalization; Hospitals; Impact evaluation; Independent Living; Individual; Industry; Institute of Medicine (U.S.); Intention; Internet; Intervention; Knowledge; Length of Stay; Lung diseases; Mails; Maintenance; Managed Care; Measures; Medical Care Team; Medicare; Modeling; Morbidity - disease rate; Motivation; Online Systems; Outcome; Outcome Measure; Pamphlets; Patient Care; Patients; Pattern; Performance; Persons; Phase; Physicians; Population; Printed Media; Printing; Private Sector; Process; Production; Psychological reinforcement; Public Health; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Reading; Recommendation; Reporting; Research; Research Infrastructure; Research Personnel; Risk; Role; Self Care; Self Efficacy; Services; Siblings; Spouses; Stress and Coping; Support System; Surveys; System; Telephone; Telephone Interviews; Training; Treatment Protocols; United States Centers for Medicare and Medicaid Services; Vertebral column; Visit; Work; Writing; base; caregiving; compliance behavior; coping; cost; depression; design; digital; follow-up; handbook; health care service utilization; health literacy; innovation; instrument; literacy; member; mortality; multidisciplinary; neglect; patient home care; peer; programs; public health relevance; response; skills; sound; usability

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.

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进入医疗保险人群的护理协调角色，需要材料来帮助教练协助老年护理人员履行和维持他们作为患者依从性促进者的角色。此外，老年照顾者本身往往患有慢性病，他们为了照顾患病配偶的需要而忽视了这些疾病。呼叫中心低识字率老年护理人员支持是一个多层次的网络应用程序，旨在培训呼叫中心教练在护理人员的问题，以及促进后续媒体的申请，以各种低识字率格式发送给护理人员（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）。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护理人员在疾病管理，护理计划依从性，个人应对护理人员角色以及护理人员自己在自我护理方面的努力等领域的需求。根据护理人员对调查的反应，教练将获得与该呼叫者相关的谈话要点和电话脚本的个性化菜单。教练也将有能力申请量身定制的教育材料发送给照顾者的基础上，呼叫特定的项目。由于59%的老年人的健康知识水平处于基本或低于基本水平，所有材料都将按照医学研究所为健康知识水平低的个人提出的建议编写。第一阶段将涉及与充血性心力衰竭患者的老年家庭护理人员进行形成性评估，以及呼叫中心专业人员和健康素养和老年护理研究领域领导人的咨询理事会。将编制一张低识字率DVD和一本小册子，其中载有低识字率文章汇编，内容涉及与老年照料者有关的选定专题。这种干预的理论基础是Lazarus和Folkman压力和应对模式。所有总结性评价工具都将基于这些结构。DVD和小册子的有效性将在准实验性前后设计中进行评价，36名符合Medicare资格的非裔美国人、西班牙裔、白人和亚裔老年护理人员为符合Medicare资格的充血性心力衰竭护理接受者提供帮助。在这项研究中测量的结果包括照顾者自我效能，知识，并打算改变的领域的照顾技能和照顾者应对。第二阶段将扩大护理人员材料，以涵盖所有领域，增加有关慢性阻塞性肺疾病的信息和呼叫中心教练所需的人员模块，包括培训，调查，谈话要点，以及DVD视频，打印和电子邮件支持材料的申请。在第二阶段，完整的计划将进行一项涉及老年护理人员的大规模随机临床试验，并对参与呼叫中心的工作人员进行过程和影响评估。公共卫生关系：老年护理人员是医疗保健团队的一个组成部分，促进护理计划的遵守和独立生活。此外，作为老年人本身，他们也有自己的健康挑战，而这些挑战往往因他们的抚养角色而加剧。该计划旨在协助疾病管理呼叫中心教练提供国家的最先进的支持，老年护理人员在疾病管理技能，护理计划的遵守，护理人员应对和护理人员自我护理领域，包括低识字的后续材料DVD视频，或作为硬拷贝或电子邮件文章。