Joint Patient and Caregiver Intervention for Older African Americans with Poorly Controlled Type 2 Diabetes (Joint Home-DM-BAT)

针对 2 型糖尿病控制不佳的老年非裔美国人的患者和护理人员联合干预 (Joint Home-DM-BAT)

• 批准号: 10644727
• 负责人: Aprill Dawson
• 金额: $ 59.7万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-11 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644727
• 关键词: Address; Adherence; Adult; African American population; Age; Behavior; Behavioral; Blood Pressure; Caregiver Burden; Caregivers; Caring; Chronic; Clinical; Cognitive Therapy; Complex; Complications of Diabetes Mellitus; Control Groups; Data; Diabetes Mellitus; Elderly; Feedback; Focus Groups; Funding; Glycosylated hemoglobin A; High Prevalence; Home; Hour; Housing; Impaired cognition; Individual; Intervention; Joints; LDL Cholesterol Lipoproteins; Learning Module; Life Style; Literature; Low income; Manuals; Mediator; Medical; Mental Depression; Mental Health; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nursing Faculty; Outcome; Participant; Patient-Focused Outcomes; Patients; Pilot Projects; Quality of life; Randomized; Recommendation; Resources; Risk Factors; SF-12; Schedule; Self Care; Shapes; Social isolation; Social support; Stress; Stress and Coping; Telephone; Testing; Training; Treatment Protocols; United States National Institutes of Health; care coordination; care costs; caregiver interventions; comparison control; cost effectiveness; diabetes education; diabetes management; diabetes mellitus nursing; diabetes risk; disability; efficacy evaluation; efficacy trial; ethnic minority; experience; follow-up; food insecurity; health determinants; impaired functional status; improved; informal caregiver; informal support; intervention effect; intervention mapping; loved ones; mortality; multiple chronic conditions; perceived stress; physical conditioning; pressure; psychosocial; social; social health determinants; telephone delivery; therapy development; treatment as usual

Older African Americans (AAs) have higher prevalence of type 2 diabetes (T2DM) and increased risk of diabetes related complications and mortality. In addition, older AAs are more likely to require help from caregivers to manage their diabetes and caregivers provide numerous hours of costly care daily providing physical and social support, and care coordination. However, informal/unpaid caregivers frequently have little or no formal training on managing diabetes or addressing the social risk factors associated with patient outcomes. Therefore, there is an urgent need to provide informal caregivers with appropriate training and strategies for diabetes management to reduce caregiver burden and improve their quality of life, so they can continue to care for older AAs with T2DM. Behavioral activation is a cognitive behavior therapy, originally developed to address depression, that has shown promise in individuals with chronic medical conditions, including T2DM. We are currently completing an NIH funded RCT (R01DK118038) to evaluate the efficacy and cost-effectiveness of 8 sessions of in-home, telephone-delivered, behavioral activation treatment for older adults with diabetes (Home DM-BAT). 40% of AAs in the study have informal caregivers. Caregivers have requested formal training on managing diabetes in the form of joint training sessions with participants. We conducted focus groups with participant-caregiver dyads and their feedback has guided the decision to conduct this R21 study and shaped the proposed intervention. The proposed study will test the preliminary efficacy of home-based, joint patient and caregiver intervention (Joint Home-DM-BAT) on patient clinical outcomes (hemoglobin A1c, blood pressure, and LDL-Cholesterol) and quality of life and caregiver quality of life and caregiver burden. This study fills a gap in the literature by combining diabetes education with brief behavioral activation treatment, addressing social determinants of health, and incorporating training and support for informal caregivers. Finally, this study is responsive to patient and caregiver feedback and allows incorporation of the lived experience into intervention development for older AAs with T2DM.

老年非洲裔美国人（AAs）有较高的2型糖尿病（T2DM）患病率和更高的风险