Roybal Translational Research Center to Promote Context-Specific Caregiving of Community-Dwelling Persons Living with Alzheimer's Disease or Related Disorders

抽象的。拟议中的罗伊巴尔翻译研究中心的目标是为西班牙提供支持， 全国各地的教师进行NIH阶段I-III干预研究，这将提高特定环境的 老年痴呆症和类似疾病患者的非正式护理者的角色掌握。我们展望 未来：到2050年，多达2000万美国人将患有这些疾病， 非正规护理人员将增加到4 000万至5 000万人。非正式就业是生活质量的关键， 老年痴呆症和类似疾病患者的持续社区生活;这也是防止 不断上涨的医疗费用。我们中心的前提是，非正式协商不是一个同质的实体 而是上下文特定的。随着美国继续经历社会和经济结构的重大调整， 人口组成（例如，到2043年，我们将成为一个“少数民族占多数”的国家），我们预计， 发生在一个不断增加的异构环境中。这些背景是由各种疾病 条件、家庭、文化或社会背景、地理位置和接受护理者的 通过护理环境过渡，特别是急性环境。本申请中提出的两个试点 由异质背景形成的主题：一个侧重于小学生的学习 进行性失语症，另一个是关于性取向少数群体的照顾者的情况。我们 中心的第二个主张是，为解决这些问题而制定的干预措施必须与 在这些背景下，照顾者/消费者的参与。我们的中心建立在大量的贡献 我们机构的支持以及与阿尔茨海默氏症主要国家网络的一系列现有关系， 从事老年医学和老年学研究的护理人员研究人员、中心和调查人员，以及中心 以及致力于促进多样性和消费者声音的组织。我们中心将提供一套 集成过程和“设计思维”方法（以产品为中心的促进多视角 话语）嵌入我们的设计工作室，创建一个管道，导致越来越复杂的 照顾者的干预。该中心具有外联职能，以吸引和吸引调查人员， 消费者讨论和设计干预措施。它包括一个功能，指导感兴趣的 调查人员在制定有效的试点建议和严格的方法，特别是选择 有价值的建议。在支持试点的实施阶段，中心的试点核心假设 指导和监督作用，以确保试点成功，行政核心提供结构， 确保飞行员的行为负责。试点核心和设计工作室与试点调查员合作， 制定并遵循一个单独的计划，通过该计划为试点的下一阶段开发创建建议 寻求我们或其他来源的支持。该中心的相互关联的活动将使其能够追求 第二个总体目标是继续推进干预发展科学。

Abstract. The goal of the proposed Roybal Translational Research Center is to provide support to investiga- tors across the nation to conduct NIH Stage I-III intervention research that will enhance the context-specific role-mastery of informal caregivers of persons living with Alzheimer’s disease and similar illnesses. We look to the future: by 2050, as many as 20 million Americans will be living with these illnesses, and the number of informal caregivers will expand to 40-50 million. Informal caregiving is the key to the quality of life and continued community living of persons living with Alzheimer’s and similar illnesses; it is also a bulwark against rising health care costs. Our Center rests on the premise that informal caregiving is not one homogenous entity but is context-specific. As the U.S. continues to experience major reconfigurations in its social and demographic composition (we will, for instance, be a “minority majority” country by 2043), we expect caregiving to occur in an ever-increasing set of heterogeneous contexts. These contexts are framed by various illness conditions, family, cultural, or social caregiving situations, geographical location, and care recipients’ transitions through care settings, especially the acute setting. The two pilots proposed in this application exemplify topics shaped by heterogeneous contexts: one focuses on caregiving for persons with Primary Progressive Aphasia, the other on the situation of caregivers from a sexual-orientation minority group. Our Center’s second assertion is that interventions developed to address these contexts must be designed with the involvement of caregivers/consumers from within these contexts. Our Center builds on substantial contributed support from our institution and a set of existing relationships with key national networks of Alzheimer’s and caregiver researchers, centers and investigators engaged in geriatrics and gerontology research, and centers and organizations focused on promoting diversity and the voice of the consumer. Our Center will provide a set of integrated processes and a method of “design thinking” (product-focused facilitated multi-perspective discourse) embedded in our Design Studio that creates a pipeline leading to increasingly sophisticated caregiver interventions. The Center incorporates an outreach function to attract and engage investigators and consumers in discussions about and design of interventions. It includes a function for mentoring interested investigators in the development of effective pilot proposals and a rigorous method for selecting especially meritorious proposals. In the implementation phase of supported pilots, the Center’s Pilot Core assumes a mentoring and monitoring role to ensure pilot success, and the Administrative Core provides structure to ensure the responsible conduct of the pilots. The Pilot Core and Design Studio work with pilot investigators to craft and follow an individual plan by which a proposal for the next stage of development for the pilot is created to seek support from us or other sources. The inter-related activities of the Center will enable it to pursue a second overall aim, the continued advancement of the science of intervention development.