Diversity supplement to the U01 project-Care partner assisted intervention to improve oral health for person with mild dementia

母公司补助金摘要（1U 01 DE 027512 -01）： 在美国，65岁及以上的成年人中有近9%患有痴呆症， 口腔健康明显比认知完好的老年人差。即使是轻度痴呆症患者， 口腔健康不良的风险更高，并且有强有力的证据表明，不适当的口腔卫生习惯 主要贡献因素。保持良好的口腔卫生是预防口腔疾病恶化的关键步骤。 健康在疗养院进行的一些研究表明，通过常规的口腔卫生护理， 痴呆症患者的健康状况在短时间内得到显著改善。大多数轻度痴呆症患者 住在家里，家庭成员（即护理伙伴）在日常活动中提供监督或帮助， 却常常忽视口腔卫生。因为护理伙伴在监督和照顾 轻度痴呆症患者在家中，对轻度痴呆症患者及其护理进行干预 改善口腔自我护理的合作伙伴可能对轻度口腔疾病患者的口腔健康有长期的益处。 痴呆然而，很少有干预措施解决了一般老年人的口腔健康问题， 特别是在轻度痴呆症患者中，据我们所知，没有口腔健康干预措施 在社区居住的轻度痴呆症患者中进行。为了弥补这一知识差距， 我们提出了一种新的干预措施，以帮助护理伙伴学习如何适应指导个人的方法， 患有轻度痴呆症的人进行口腔卫生。轻度痴呆症是进行干预的理想时机，因为 轻度痴呆患者仍然保持足够的认知能力，成功地执行口腔卫生任务， 援助.利用我们进行的一项试点研究的结果，我们制定了干预方案， 建立了我们的多学科研究团队（NIDCR 1 R34 DE 023881）。我们初步研究的结果 提供有力的证据表明，我们的护理伙伴协助干预将产生积极的口腔健康结果。 我们的团队准备在纽约市和北卡罗来纳州实施U 01随机对照试验（RCT）。 干预包括定制的口腔护理计划和使用自适应的行为组件。 我们的团队引入的慢性病领导框架，用于管理与 慢性疾病，如痴呆症。具体目标是：目标1：评估护理的有效性 伴侣辅助干预改善轻度牙周炎患者的口腔卫生和口腔卫生行为 痴呆目标2：评估中介因素/过程结果的变化，包括 轻度痴呆症患者和护理伙伴的二元关系、口腔健康知识和自我效能， 了解干预机制。这种创新的护理伙伴辅助口腔护理行为 干预将协助IMD和护理伙伴实施合作口腔卫生护理计划， 口腔健康恶化，这反过来将有助于我们的目标人群保持独立， 完成日常活动和生活质量延长一段时间。

Summary (Abstract) of Parent Grant (1U01DE027512-01) : Close to 9% of adults age 65 and older in the U.S. have dementia and individuals with dementia have significantly poorer oral health than cognitively intact older adults. Even individuals with mild dementia are at higher risk of poor oral health and evidence is strong to suggest that inadequate oral hygiene practices are a major contributing factor. Maintaining good oral hygiene is a critical step in preventing deterioration of oral health. A few studies conducted in nursing homes have shown that with routine oral hygiene care, the oral health of persons with dementia improves notably in a short period of time. Most individuals with mild dementia live at home where family members (i.e. care partners) provide supervision or assistance with daily activities, but often neglect oral hygiene. Because care partners play an essential role in supervising and caring for individuals with mild dementia at home, an intervention with both individuals with mild dementia and their care partners to improve oral self-care may have long term oral health benefits for the individuals with mild dementia. Yet, few interventions have addressed oral health problems among older adults in general and among individuals with mild dementia in particular, and to our knowledge, no oral health interventions have been conducted among community dwelling individuals with mild dementia. To address this gap in knowledge, we propose a novel intervention to help care partners learn how to adapt methods for guiding the individuals with mild dementia in carrying out oral hygiene. Mild dementia is an ideal time to intervene because individuals with mild dementia still retain sufficient cognitive ability to perform oral hygiene tasks successfully with minimal assistance. Using the results from a pilot study we conducted, we developed the intervention protocol and established our multidisciplinary research team (NIDCR 1R34DE023881). The results from our pilot study provide strong indication that our care partner-assisted intervention will generate positive oral health outcomes. Our team is ready to implement a U01 randomized control trial (RCT) in New York City and North Carolina. The intervention includes both a tailored oral care plan and a behavioral component using the Adaptive Leadership Framework for Chronic Disease that our team introduced to manage symptoms associated with chronic conditions, such as dementia. The specific aims are to: Aim 1: Evaluate the effectiveness of a care partner-assisted intervention to improve oral hygiene and oral hygiene behaviors in individuals with mild dementia. Aim 2: Assess changes in mediating factors/process outcomes, including communication between the dyads, oral health knowledge, and self-efficacy for both individuals with mild dementia and care partners to understand mechanisms of the intervention. This innovative care partner-assisted oral care behavior intervention will assist IMD and care partners in implementing a cooperative oral hygiene care plan to prevent deterioration of oral health, which in turn, will help our targeted population to maintain independence in completing daily activities and quality of life for an extended period of time.