Virtual Coaching to Maximize Dementia Caregivers' Respite Time-Use: A Stage 1 Pilot Test for Feasibility and Efficacy

住院，定义为离开住院的时间，已被确定为最需要和最希望的服务， 家庭照顾者，特别是1600万痴呆症照顾者，他们面临着长期和苛刻的 在这种情况下。关于喘息服务有效性的调查结果喜忧参半-护理人员如何 花费喘息时间似乎是这些不一致的调查结果背后的一个关键因素。我们已经开发出一种 一种名为“生活和关怀的时间”（TLC）的新干预措施显示出改善喘息时间使用的希望 并保持护理人员的健康。然而，它依赖于训练有素的调解人和多达15-20个家庭， 与每个护理者的访问或电话，限制了其对真实的世界实践的可扩展性。本研究的目的 是重新开发TLC干预，其中AD/ADRD护理人员被教导评估和 确定如何度过即将到来的喘息时间，以完全在线，自我管理的虚拟 教练的形式，然后试点测试新的TLC干预的可行性和有效性。目标1： 修改、调整和完善现有干预模块。该项目的这一阶段利用社区- 参与设计过程，其中利益相关者（即，现任或前任护理人员，不同的社区领导人， 喘息提供者）将与研究，技术和创意团队一起开发和提供 关于TLC设计、功能和原型的反馈。目的2是与痴呆症照顾者进行试点测试 正在使用缓刑该阶段使用全功率试验样本（n=120）和随机等待列表 对照实验设计，其中参与者暴露于重新开发的TLC干预8周 并将提供日常休息使用、休息时间使用满意度和健康状况的评估。这些试点数据 将用于评估可行性，并探讨有关干预措施潜在疗效的假设， 以及该机制（即，时间使用满意度）是干预对幸福感的影响的基础。 幸福感是用焦虑和照顾者负担这两个主要结果来衡量的，两者都被认为是密切相关的。 与干预的目的相关并作出反应。目标3旨在探讨未来实施 重新制定了与缓刑提供者的TLC干预措施。这提供了该工具可行性的另一层。 我们将举办网络研讨会，展示TLC干预的特点和功能， 预览目标2的试点研究结果，然后询问提供者对其实施可能性的反馈 和使用TLC的障碍。这三个目标合在一起， 阶段1研究活动，总体目标是开发一种可扩展到真实的世界的干预措施 应用.在整个项目的各个阶段，我们的团队致力于社区参与 研究实践，社区合作伙伴将提供投入，并将我们与潜在的研究联系起来 参与者鉴于这种务实而又科学严谨的方法， 加速TLC干预在社区和卫生保健实践中的最终实施。

Respite, defined as time away from caregiving, has been identified as the most needed and desired service for family caregivers, especially the 16 million dementia caregivers who are faced with long term and demanding caregiving circumstances. Findings on the effectiveness of respite services have been mixed -- how caregivers spend their respite time seems to be a key factor behind these inconsistent findings. We have developed a novel intervention called “Time for Living & Caring” (TLC) that shows promise in improving respite time-use and maintaining caregiver wellbeing. However, it relies on trained facilitators and up to 15-20 individual home visits or phone calls with each caregiver, limiting its scalability to real world practice. The purpose of this study is to redevelop the TLC intervention, in which AD/ADRD caregivers are taught strategies to assess and identify ways to spend upcoming periods of respite time, to a fully online, self-administered virtual coaching format, and then to pilot-test the new TLC intervention for feasibility and efficacy. Aim 1 is to modify, adapt, and refine the existing intervention modules. This phase of the project utilizes a community- engaged design process where stakeholders (i.e., current or former caregivers, diverse community leaders, respite providers) will work alongside the research, technical, and creative teams to develop and provide feedback on the TLC design, features, and prototypes. Aim 2 is to conduct a pilot test with dementia caregivers who are currently using respite. This phase uses a full powered pilot sample (n=120) and a randomized waitlist control experimental design where participants are exposed to the redeveloped TLC intervention for 8 weeks and will provide assessments of daily respite use, respite time-use satisfaction, and wellbeing. These pilot data will be used to assess feasibility and to explore hypotheses regarding the potential efficacy of the intervention, as well as the mechanism (i.e., time-use satisfaction) underlying the intervention's effect on wellbeing. Wellbeing is measured with two primary outcome of anxiety and caregiver burden, both thought to be closely related and responsive to intervention's purpose. Aim 3 is intended to explore future implementation of the redeveloped TLC intervention with respite providers. This provides yet another layer of the tool's feasibility. We will host webinars to demonstrate the features and functionality of the TLC intervention as well as to preview pilot study results from Aim 2, then ask providers for feedback on their likelihood of implementation and barriers to using TLC with their clients. Together, these three aims represent a comprehensive approach to Stage 1 research activities, with the overall goal of developing an intervention that is scalable to real world applications. Throughout all stages of the proposed project, our team is committed to community-engaged research practices, where community partners will provide input and connect us with potential research participants. Given this pragmatic yet scientifically rigorous approach, the results have the potential to guide and accelerate the eventual implementation of the TLC intervention to community and health care practice.