Developing a Distance Education System to Train Savvy Caregiver Program Interventionists: Extending Access and Capacity in Community-Based Delivery of Evidence-Based Interventions

本申请是根据RFA-AG-18-030提交的，旨在寻求对为期四年的第一阶段干预的支持 发展项目。我们建议开发一个基于网络的系统，使用远程教育方法沿着 与手册和协议，以培训，认证，并监测性能的干预提供 Savvy Caregiver计划（Savvy）是一项基于证据的痴呆症家庭护理者心理教育计划。 Savvy采用基于社会认知理论的成熟的行动机制2 -5来促进 照顾者的解决方案为重点的应对行为，通过获得适当的知识，技能， 展望未来，提高学生的动手能力。训练有素的精明干预者，他们忠实地接受 该计划的核心原则和课程，并能够适应计划的条款，概念，甚至 满足护理参与者的文化和价值观的交付流程是将Savvy扩展到 使其广泛提供给越来越多的痴呆症家庭照顾者在美国的拟议系统 将取代昂贵且稀缺的亲自干预培训，并使组织- 大或小;以社区为基础的或全州范围内-提供精明，他们越来越多样化的选民。的 该系统将为管理Savvy提供指导方针和材料，Savvy是一个培训和认证员工的计划， 志愿者干预者领导和当地定制的Savvy，以及一个监控 干预者的表现。培训计划将使干预者掌握核心原则， Savvy的教学和辅导策略，并帮助他们与赞助商合作 组织和参与照顾者在适应的条款和概念的精明的方式， 对当地价值观和社区文化敏感并适合当地价值观和社区文化。一个调查小组， 护理专家，教育工作者和文化适应专家，由一个多元化的小组支持， 经验丰富的顾问，将进行一个三阶段的项目，其目标是建立准备， 该系统用于未来的第三阶段或第四阶段试验，可以为更广泛地使用和传播Savvy铺平道路。 使用先前工作中采用的过程，这些过程需要迭代开发、审查、改进、重新审查， 最后，我们将在目标1中开发一个基于网络的系统原型，用于精明的干预者培训， 认证和伴随的性能保真度监控过程。在目标2中，我们将进行 对基于网络的原型系统进行形成性评价。一旦系统被认为准备就绪，我们将在目标3中， 对在六个文化和/或组织上不同的赞助商中实施的系统进行实地测试 社.目标3测试主要评估该系统在培训干预人员方面的有效性， 保持对Savvy核心原则的忠诚，但它也将评估由 接受过系统培训的干预人员在护理参与者中产生预期结果的人数减少 抑郁和负担以及增强的运动控制。

This application, submitted in response to RFA-AG-18-030, seeks support for a four-year Stage I intervention development project. We propose to develop a web-based system that uses distance education methods along with manuals and protocols to train, certify, and monitor the performance of interventionists to deliver the Savvy Caregiver program (Savvy), an evidence-based dementia family caregiver psychoeducation program.1 Savvy employs a well-established mechanism of action based in Social Cognitive theory2-5 to promote caregivers' solution-focused coping behaviors through the acquisition of appropriate knowledge, skills, and outlook and the enhancement of caregiving mastery. Well-trained Savvy interventionists who faithfully embrace the program's core principles and its curriculum and are able to adapt program terms, concepts, and even delivery processes to fit the culture and values of caregiver participants are the key to scaling Savvy up to make it widely available to the growing number of dementia family caregivers in the U.S. The proposed system will replace the need for costly – and scarce – in-person interventionist training, and enable organizations – large or small; community-based or statewide – to offer Savvy to their ever more diverse constituents. The system will provide guidelines and materials for administering Savvy, a program to train and certify staff or volunteer interventionists to lead and locally tailor Savvy, and a process by which to monitor the fidelity of interventionists' performance. The training program will prepare interventionists in the core principles and teaching and coaching strategies of Savvy and also prepare them to collaborate with their sponsoring organization and participating caregivers in adapting the terms and concepts of Savvy in ways that are sensitive to and appropriate for the local values and culture of the community. An investigative team of caregiver specialists, educators, and cultural adaptation specialists, supported by a diverse panel of experienced advisors, will undertake a three-phase project, the goal of which is to establish the readiness of the system for a future Stage III or IV trial that can lead the way to broader use and dissemination of Savvy. Using processes employed in prior work that entail iterative development, review, refinement, re-review, and finalization, we will, in Aim 1, develop a prototype web-based system for Savvy interventionist training and certification and an accompanying performance fidelity monitoring process. In Aim 2, we will conduct a formative evaluation of the prototype web-based system. Once the system is deemed ready, we will, in Aim 3, conduct a field test of the system implemented in six culturally and/or organizationally diverse sponsoring agencies. The Aim 3 test will principally assess the effectiveness of the system in training interventionists who maintain fidelity to Savvy core principles but it will also assess the preliminary efficacy of programs led by system-trained interventionists in producing anticipated outcomes in caregiver participants – reduced depression and burden and enhanced caregiving mastery.