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号文件提交的，旨在为为期四年的第一阶段干预提供支持 开发项目。我们建议开发一个基于网络的系统，使用远程教育方法 使用手册和协议来培训、认证和监控干预者的表现，以交付 Savvy照顾者计划(Savvy)，一个基于证据的痴呆症家庭照顾者心理教育计划1 Savvy使用基于社会认知理论的成熟的行动机制2-5来促进 照顾者通过获得适当的知识、技能和 展望和加强照顾的掌握。训练有素、精明的干预者，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 符合照顾者参与者的文化和价值观的交付流程是将Snowvy扩展到 使其广泛适用于美国越来越多的痴呆症家庭照顾者。 将取代昂贵且缺乏人员参与的干预者培训，并使组织能够- 或大或小；以社区为基础或全州范围--为他们日益多样化的选民提供智慧。这个 系统将提供管理SAVY的指南和材料，培训和认证员工或 自愿干预者领导和了解当地的量身定做，并通过一个过程来监测 干预主义者的表现。培训计划将使干预者在核心原则和 精明的教学和指导策略，并为他们与赞助商合作做好准备 组织和参与照顾者以下列方式适应精明的术语和概念 对当地的价值观和社区文化敏感并适合他们。一支调查小组 护理专家、教育工作者和文化适应专家，由一个不同的小组提供支持 经验丰富的顾问将进行一个分三个阶段的项目，其目标是建立 该系统用于未来的III或IV阶段试验，可导致SAVEY的更广泛使用和传播。 使用先前工作中采用的过程，这些过程需要迭代开发、评审、改进、重新评审和 最后，我们将在目标1中开发一个基于网络的原型系统，用于精明的干预者培训和 认证和伴随的性能保真度监测过程。在目标2中，我们将进行 原型网络系统的形成性评价。一旦系统被认为是准备好的，我们将在目标3中， 对六个文化和/或组织不同的赞助商实施的系统进行实地测试 经纪公司。目标3测试将主要评估该系统在培训干预者方面的有效性 保持对精通核心原则的忠诚度，但它也将评估以下项目的初步效果 在照顾者参与者中产生预期结果的系统培训的干预者-减少 抑郁和负担，以及更强的照顾能力。

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.