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，以及预防和特定挑战主题15-MH-105支持在临床和社区环境中采用干预措施的战略。这项提议旨在增加受过训练的照顾痴呆症患者的辅助生活工作人员的数量和能力，以满足这一脆弱和服务不足的社区的需要。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华盛顿州老龄服务机构与来自护理学院西北老龄研究小组(NWRGA)的一群经验丰富的跨学科研究人员将合作开发、评估和系统地翻译一项基于证据的培训计划，旨在指导辅助生活公寓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，并推迟成本更高的机构化。在资助期结束时，将有一个基础设施来确保本计划的有效和广泛的翻译，以保持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。据估计，辅助生活之家目前为200多万老年人提供护理，其中超过一半的人经历了严重的认知、情感和行为问题，而且每年都有更多的人进入。尽管如此，没有足够数量的人接受培训和就业，为这些弱势和服务不足的老年人提供优质护理。采用和转化一种有效的经验性评估的治疗方法，以改善护理，减少情感和行为问题，并减少向成本更高的长期护理方案的转移，将对公共健康产生重大影响，现在影响数百万老年人，未来影响数百万人。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者和直接护理人员的数量；(2)使用治疗保真度的最新科学方法，建立和评估这一传播的成功；(3)评估关于培训者、直接护理人员和护理接受者结果的计划有效性，包括情感和行为障碍，更低的医疗保健成本，培训者和照顾者对培训的满意度，以及改善对住院医生的护理；(4)发展基础设施，以便在当前计划期结束时继续进行这种培训。这项建议解决了一个重大的公共卫生问题--减少辅助生活(AL)住所中痴呆症患者的情感和行为障碍。辅助生活之家的员工培训(STAR)是一项以证据为基础的最先进的治疗计划，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表现出了有效性。拟议的项目是大学研究人员和一个社区组织之间的合作伙伴关系，以将STAR翻译成更广泛的全国性使用。

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.