Mobile Media Intervention for Family Caregivers of Veterans with Dementia

描述(由申请人提供)： 这是由Blake K.Scanlon博士提交的VA康复研究与开发(RR&D)小项目康复研究(SPIRE)奖的申请。他目前是斯坦福大学/VA老龄临床研究中心的临床研究助理(相当于助理教授)，在收到RR&D CDA-2(痴呆症照顾者康复：加强退伍军人和以家庭为中心的护理，1 ik2 RX001240-01A1；JIT流程完成，开始日期待定)后，有一个悬而未决的8/8 VA任命。斯坎伦博士正在确立自己作为临床医生兼科学家的地位，开展以患者和家庭为中心的痴呆症和神经退行性疾病的临床研究。这项奖励将为斯坎伦博士和他的团队提供开发一个新项目所需的资源，该项目旨在通过利用移动媒体设备(即平板电脑)为更多患有痴呆症的退伍军人的家庭照顾者提供舒适的家中服务，从而扩大CDA-2干预研究的覆盖范围。为了实现这一目标，他聚集了一个团队，其成员包括三名共同研究人员：Jerome Yesavage博士(老年精神病学家，也是终身认知和精神功能方面的著名专家)；喜悦·泰勒博士(认知心理学家，认知衰退轨迹专家)；Lisa Kinoshita博士(专门研究痴呆症认知和行为症状的评估和治疗方面的临床神经心理学家)；高级研究员：Mary Mittelman博士(国际知名的痴呆症照顾者干预专家)及顾问：Booil Jo博士(具有临床试验设计/分析、纵向数据分析及缺失数据分析方面的专业知识)。拟议的项目研究了教育和技能培养康复(ESBR)干预对患有痴呆症的退伍军人家庭照顾者的影响，该干预旨在使用移动媒体设备进行低成本和临床可扩展的干预。总共40名照顾患有痴呆症的退伍军人的照顾者将被随机分配到移动媒体ESBR干预(ESBR-m；n=20)或常规护理加纸质教育材料(UC；n=20)。干预效果将在干预后三个月进行检查。这项研究的主要目的是确定通过移动媒体设备(例如，iPad等平板电脑)向退伍军人家庭照顾者提供基于群体的干预的可行性。斯坎伦博士还将使用先进的统计技术(例如，混合效应建模)来评估干预对以下方面的影响：生活质量(特定目标1)；感知压力和抑郁症状(特定目标2)；社交和参与愉快活动(特定目标3)。这一奖项将创造一个理想的环境，使斯坎伦博士和他的团队能够建立必要的试点数据，率先开发低成本、实用和临床可翻译的方法，以改进VHA内神经退行性疾病和痴呆症的康复和管理。

DESCRIPTION (provided by applicant): This is an application for a VA Rehabilitation Research and Development (RR&D) Small Projects in Rehabilitation Research (SPiRE) Award submitted by Blake K. Scanlon, Ph.D. He is currently a Clinical Research Associate (Assistant Professor equivalent) at the Stanford/VA Aging Clinical Research Center with a pending 8/8ths VA appointment subsequent to receipt of a RR&D CDA-2 (Dementia caregiver rehabilitation: enhancing Veteran and family-centered care, 1 IK2 RX001240-01A1; JIT process complete, start date pending). Dr. Scanlon is establishing himself as a clinician-scientist who conducts patient- and family-centered clinical research on dementia and neurodegenerative disease. This award will provide Dr. Scanlon and his team with the resources necessary to develop a novel project aiming to expand the reach of the CDA-2 intervention study by utilizing mobile media devices (i.e., tablets) to serve additional family caregivers of Veterans with dementia in the comfort of their own homes. To accomplish this goal, he has gathered a team that includes three Co-Investigators: Dr. Jerome Yesavage (a geriatric psychiatrist and renowned expert in cognitive and psychiatric functioning across the lifespan); Dr. Joy Taylor (a cognitive psychologist and expert in the trajectory of cognitive decline); and Dr. Lisa Kinoshita (a clinical neuropsychologist with expertise in the assessment and treatment of cognitive and behavioral symptoms in dementia); a Senior Researcher: Dr. Mary Mittelman (an internationally renowned expert in dementia caregiver intervention) and a consultant: Dr. Booil Jo (a biostatistician with expertise in design/analysis of clinical trials, longitudinal data analysis, and missing data analysis). The proposed project studies the effects of an education and skill-building rehabilitation (ESBR) intervention, designed to be low-cost and clinically scalable using mobile media devices, on family caregivers of Veterans with dementia. A total of 40 caregivers caring for a Veteran with dementia will be randomized to mobile media ESBR intervention (ESBR-m; n=20) or to usual care plus paper educational materials (UC; n=20). Intervention effects will be examined at three months post-intervention. The Primary Aim of this study is to establish the feasibility of delivering a group-based intervention to family caregivers of Veterans through mobile media devices (e.g., tablets such as the iPad). Dr. Scanlon will also use advanced statistical techniques (e.g., mixed-effects modeling) to evaluate the impact of the intervention on: quality of life (Specific Aim 1); perceive stress and depressive symptoms (Specific Aim 2); and socialization and engagement in pleasant activities (Specific Aim 3) in caregivers of Veterans with dementia. This award will create an ideal environment where Dr. Scanlon and his team can establish the necessary pilot data to pioneer the development of low-cost, pragmatic and clinically translatable methods for improving rehabilitation and management of neurodegenerative disease and dementia within VHA.