Uptake of STAR: Increasing Qualified Staff to improve care of older adults in Ass

描述（由申请人提供）：本申请涉及广泛的挑战领域（01）行为、行为改变和预防，以及具体的挑战主题15-MH-105，以支持在临床和社区环境中采取干预措施。这项建议旨在增加训练有素的辅助生活人员的数量和水平，以照顾痴呆症患者，以满足这个脆弱和服务不足的社区的需求。华盛顿老年服务机构是华盛顿州非营利长期护理和老年住房提供者的领导组织，来自华盛顿大学护理学院西北老龄化研究小组（NWRGA）的一组经验丰富的跨学科研究人员将合作开发，评估，系统地翻译一项以证据为基础的培训计划，旨在指导辅助生活住宅的护理人员改善对有认知障碍的老年人的护理，提高护理人员的技能水平，并推迟成本更高的机构化。在资助期结束时，将建立一个基础设施，以确保该计划的有效和广泛的翻译，从而为更广泛的社区提供有效的优质服务。随着这个国家有认知问题需要护理的老年人数量的增加，对训练有素的工作人员的需求也在增加。目前，辅助生活住宅估计为200多万老年人提供护理，其中一半以上的老年人患有严重的认知、情感和行为问题，并且每年都有更多的老年人进入。尽管如此，培训和雇用的人员数量不足，无法为这些脆弱和得不到充分服务的老年人提供优质护理。采用和转化经经验评估的有效治疗方法，以改善护理，减少情感和行为问题，并减少向更昂贵的长期护理选择的转移，将对现在和未来数百万老年人产生重大的公共卫生影响。具体目标是：(1)通过系统和标准化的循证干预传播，增加辅助生活方面合格的培训师和直接护理人员的数量；(2)利用最先进的治疗保真方法建立和评估这种传播的成功；(3)评估培训师、直接护理人员和护理对象的效果，包括情感和行为障碍，降低医疗保健成本，培训师和护理人员对培训的满意度，以及对住院患者的护理改善；(4)发展基础设施，以便在当前项目期结束后继续进行培训。该提案解决了一个具有重大公共卫生利益的问题——减少生活辅助（AL）院中痴呆症患者的情感和行为障碍。辅助生活住宅员工培训（STAR）是一项以证据为基础的、最先进的治疗项目，在培训人工智能员工利用行为问题解决技术来减少情感和行为障碍并改善痴呆症患者的生活方面已被证明有效。拟议的项目是大学研究人员和社区组织之间的伙伴关系，将STAR转化为更广泛的全国使用。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (01) Behavior, Behavioral Change, and Prevention and specific Challenge Topic 15-MH-105 Strategies to support uptake of interventions within clinical and community settings. This proposal seeks to increase the number and caliber of trained Assisted Living staff caring for persons with dementia, in order to meet the needs of this vulnerable and underserved community. A well-established partnership of Aging Services of Washington, the leading organization representing not-for- profit long-term care and senior housing providers in the state of Washington and an experienced group of interdisciplinary researchers from the U.W. School of Nursing's NorthWest Research Group on Aging (NWRGA) will collaborate to develop, evaluate, and systematically translate an evidence-based training program designed to direct care staff in Assisted Living Residences to improve the care of older adults with cognitive impairments, increase the level of skill of their caregivers, and delay more costly institutionalization. At the end of the funding period, an infrastructure will exist to insure effective and wide-spread translation of this program to sustain effective quality services for the wider community. As the numbers of older adults with cognitive problems requiring care in this country increase, so does the need for well trained staff. Assisted living residences are currently estimated to provide care for over two million older adults, with over half experiencing significant cognitive, affective, and behavioral problems, and more entering every year. Despite this, there are insufficient numbers of individuals trained and employed to provide quality care to these vulnerable and underserved older adults. The uptake and translation of an effective empirically evaluated treatment to improve care, reduce affective and behavioral problems, and reduce transfer to more costly long-term care options will have a significant public health impact affecting millions of older adults now and millions more in the future. The specific aims are to: (1) increase the number of qualified trainers and direct care staff in Assisted living through the systematic and standardized dissemination of an evidence-based intervention; (2) establish and evaluate success of this dissemination using state-of-the- science methods for treatment fidelity; (3) evaluate program effectiveness in regards to trainer, direct care staff, and care-recipient outcomes including affective and behavioral disturbance, lower health care costs, satisfaction with training among trainers and caregivers, and improved care for residents; (4) develop the infrastructure to continue this training when the current program period is concluded. This proposal addresses an issue of significant public health interest - the reduction of affective and behavioral disturbances in persons with dementia in Assisted-living (AL) residences. Staff Training in Assisted-living Residences (STAR) is an evidenced-based, state-of-the-art treatment program with demonstrated efficacy in training AL staff to utilize behavioral problem solving techniques to reduce affective and behavioral disturbances and improve the lives of persons with dementia. The proposed project is a partnership between university researchers and a community organization to translate STAR for broader, national use.