Using Technology to Support Care Partners for Persons with Alzheimer's Disease: Tele-STELLA

利用技术支持阿尔茨海默病患者的护理合作伙伴：Tele-STELLA

• 批准号: 10598002
• 负责人: Allison Lindauer
• 金额: $ 59.2万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-15 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598002
• 关键词: Address; Affect; Affective Symptoms; African American; Alzheimer' s Disease; Alzheimer' s disease related dementia; Anxiety; Behavioral; Behavioral Symptoms; Binding; Caring; Cognitive; Communication; Community Healthcare; Computers; Coupled; Cultural Backgrounds; Data; Dementia; Development; Disease; Disease Progression; Distress; Education; Educational Intervention; Educational process of instructing; Family; Family member; Feedback; Focus Groups; Foundations; Frequencies; Goals; Grief reaction; Health; Home; Incentives; Individual; Internet; Intervention; Kentucky; Learning; Life; Linear Regressions; Link; Long-Term Care; Measures; Mental Depression; Methods; Modeling; Nurses; Oregon; Participant; Persons; Pharmaceutical Preparations; Pilot Projects; Planet Earth; Positioning Attribute; Process; Protocols documentation; Psyche structure; Psychologist; Quality of life; Randomized, Controlled Trials; Recommendation; Research Personnel; Risk; Rural; Science; Scientist; Site; Stress; Symptoms; Techniques; Technology; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Videoconferencing; Videotape; Work; acceptability and feasibility; barrier to care; care burden; care outcomes; care recipients; cost; design; experience; family caregiving; feasibility testing; improved; novel; peer; peer support; personalized approach; programs; psychoeducational intervention; psychologic; psychological symptom; public health priorities; recruit; skills; social stigma; stress reduction; telehealth; therapy design; videoconference; web-based intervention

PROJECT SUMMARY The purpose of this NIH Stage 1B mixed methods study is to test the feasibility, acceptability, fidelity and efficacy of a telehealth-based intervention designed to reduce stress for family care partners (CP) for those with Alzheimer's disease and related dementias (ADRD). ADRD extracts physical, mental and financial tolls from CPs caring for affected family members. In the later stages of disease, behavioral and psychological symptoms of dementia (BPSD) can contribute to CP burden, increasing the risk of depression in CPs and long- term care placement for those with ADRD. Interventions that help CPs manage BPSD are available, but access to them is limited by cost, distance, care demands and stigma. Further, most technology-based interventions are not tailored to the later stages of disease, when BPSD are more common. In the proposed study we aim to refine and optimize the multi-site Tele-STELLA (Support via TEchnology: Living and Learning with Advancing ADRD) intervention. Tele-STELLA is a video-conference-based intervention that provides education and peer support for CPs caring for family members in the moderate to late stages of ADRD. The intervention, which CPs access from their own homes, begins with one-to-one training with a Tele-STELLA Guide (a nurse or psychologist), then advances to peer-based education and support modeled on the ECHO (Extension of Community Healthcare Outcomes) template. The intervention is specifically for CPs, no care- recipients with ADRD will be in this study. However, the skills CPs develop in Tele-STELLA will be integrated into the care of the person with ADRD, thus reducing behavioral symptoms. The foundation of this proposal was laid with two pilot studies which assessed early versions of Tele-STELLA. This mixed-methods study will assess the feasibility, acceptability, treatment fidelity and efficacy of Tele-STELLA. We hypothesize that the Tele-STELLA intervention will be feasible and acceptable and will reduce the frequency of behavioral symptoms in persons with ADRD, thus improving CP affective symptoms (burden, depression, grief) and quality of life for CPs and those with ADRD. We will recruit rural, African American and white CPs (n=150) from three sites (Oregon, Kentucky and Georgia). Feasibility will be assessed quantitatively by measuring attendance and completion rates. Qualitative data from focus groups will augment the feasibility quantitative findings and provide feedback on consumer acceptability. Content experts will evaluate treatment fidelity by reviewing a subsample of video-taped sessions. We will measure efficacy of Tele-TELLA on reducing the frequency of behavioral and psychological symptoms in persons with ADRD using pre-post assessments and linear regression strategies. Our long term goal is to reduce the psychological burden CPs experience by providing the Tele-STELLA intervention for any CP who has access to a computer and an internet connection.

项目摘要 这项NIH Stage 1B混合方法研究的目的是测试 旨在减轻家庭护理伙伴（CP）压力的远程保健干预措施的有效性 阿尔茨海默病和相关痴呆症（ADRD）。ADRD提取身体，精神和财务费用 照顾受影响家庭成员的CP。在疾病的后期，行为和心理 痴呆症状（BPSD）可能会导致CP负担，增加CP和长期抑郁症的风险。 长期护理安置与ADRD。有帮助CP管理BPSD的干预措施，但 由于费用、距离、护理需求和耻辱，获得这些服务的机会受到限制。此外，大多数基于技术 干预措施不适合疾病的后期阶段，BPSD更常见。拟议 我们的研究旨在完善和优化多站点Tele-STELLA（通过技术支持：生活和学习 ADRD）干预。Tele-STELLA是一种基于视频会议的干预， 为照顾中晚期ADRD家庭成员的CP提供教育和同伴支持。的 干预，其中CP从自己的家中访问，开始与Tele-STELLA一对一的培训 指导（护士或心理学家），然后推进到以ECHO为模型的同伴教育和支持 （社区卫生保健成果扩展）模板。干预是专门为CP，没有照顾- 患有ADRD的受试者将参与本研究。然而，CP在Tele-STELLA中培养的技能将被整合到 对ADRD患者进行护理，从而减少行为症状。这项建议的基础是 两项试验性研究评估了Tele-STELLA的早期版本。这种混合方法的研究将 评估Tele-STELLA的可行性、可接受性、治疗保真度和疗效。我们假设 远程STELLA干预将是可行的和可接受的，并将减少行为的频率， ADRD患者的症状，从而改善CP情感症状（负担，抑郁，悲伤）， CP和ADRD患者的生活质量。我们将招募农村、非裔美国人和白色CP（n=150）， 三个地点（俄勒冈州、肯塔基州和格鲁吉亚）。可行性将通过测量进行定量评估 出勤率和毕业率。来自焦点小组的定性数据将增加定量的可行性 调查结果，并就消费者的接受程度提供反馈。内容专家将通过以下方式评估治疗保真度： 回顾一个录像会议的子样本。我们将衡量Tele-TELLA在减少 使用前后评估的ADRD患者的行为和心理症状频率， 线性回归策略我们的长期目标是通过以下方式减轻CP的心理负担： 为任何能够访问计算机和互联网连接的CP提供Tele-STELLA干预。