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特定挑战主题 15-MH-105 支持在临床和社区环境中采取干预措施的策略。该提案旨在增加照顾痴呆症患者的训练有素的辅助生活工作人员的数量和素质，以满足这个弱势且服务不足的社区的需求。华盛顿老龄化服务中心是代表华盛顿州非营利性长期护理和老年住房提供者的领先组织，与来自威斯康星大学的经验丰富的跨学科研究人员团队建立了良好的合作伙伴关系。护理学院西北老龄研究小组（NWRGA）将合作开发、评估和系统地翻译一项循证培训计划，旨在指导辅助生活住宅的护理人员改善对患有认知障碍的老年人的护理，提高其护理人员的技能水平，并推迟成本更高的住院治疗。在资助期结束时，将建立基础设施来确保该计划的有效和广泛翻译，从而为更广泛的社区维持有效的优质服务。随着该国需要护理的患有认知问题的老年人数量增加，对训练有素的工作人员的需求也在增加。据估计，辅助生活住宅目前为超过 200 万老年人提供护理，其中一半以上患有严重的认知、情感和行为问题，并且每年都有更多的老年人入住。尽管如此，接受培训和就业的人员数量不足，无法为这些弱势且服务不足的老年人提供优质护理。采用和转化有效的经经验评估的治疗方法来改善护理、减少情感和行为问题以及减少向更昂贵的长期护理选择的转移，将对公共卫生产生重大影响，影响现在数百万老年人和未来数百万老年人。具体目标是：(1) 通过系统化、标准化地传播循证干预措施，增加辅助生活领域合格培训师和直接护理人员的数量； (2) 使用最先进的治疗保真度方法来确定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接受者结果方面的计划有效性，包括情感和行为障碍、较低的医疗保健成本、培训师和护理人员对培训的满意度以及改善对居民的护理； (4) 开发基础设施，以便在当前计划期结束时继续开展培训。该提案解决了一个具有重大公共卫生意义的问题——减少生活辅助 (AL) 住所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) 是一项循证、最先进的治疗计划，在培训 AL 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合作伙伴关系，旨在将 STAR 转化为更广泛的全国用途。

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.