Adapting and testing an Alzheimer’s family caregiver intervention in Vietnam

摘要 低收入和中等收入国家(如越南)正在经历戏剧性的 将导致老年人数量大幅增加的人口结构转变， 包括那些患有阿尔茨海默氏症和相关痴呆症的人，在接下来的几年里 几十年。阿尔茨海默氏症是困扰老年人的最昂贵和最致残的疾病之一 对成年人来说，这给家庭带来了相当大的压力。加强LMIC能力以支持 痴呆症患者的家庭照顾者通过低成本和可持续的非 药理学方法，如教育和技能培养，以应对困难 行为，对于避免昂贵和无效的替代药物，如精神药物至关重要 或制度化，并减轻照顾者的负担和抑郁。虽然以证据为基础 高收入国家(HIC)存在非药物治疗模式，这些 干预措施尚未翻译和改编用于越南和其他低收入国家。这 应用程序直接解决了我们知识中的这一重要差距。拟议的项目将 加强在美资深调查人员与高级调查人员之间的合作 在国家老年医院，一家领先的国家老年政策、培训和 在越南的研究。与痴呆症相关的服务和计划几乎不存在于 越南，一个正在经历老年人口快速增长的LMIC。这 申请源于国家老年医院和越南领导人的要求 以社区为基础的发展的技术专长和援助国民大会 为痴呆症护理人员提供的服务。在这项计划的第一年，我们建议把 REACH-VA模型在越南使用。为了调整模型，我们将使用系统的方法来 吸引关键利益相关者的意见，并关注文化因素和当地资源。在 第二年，我们建议测试调整后的模式的可行性和可接受性，并 使用结果进一步优化模型。在项目的两年中，我们将进行 在越南加强和建设适应和评估基于社区的能力的活动 痴呆症护理干预。在项目结束时，我们还将发布项目成果 并促进与越南其他感兴趣的团体建立联系。此应用程序将生成 初步数据和促进能力建设，为更大规模的R01应用程序做准备，以测试 文化适应模式在越南的有效性。生成的知识 还将作为适应循证的典范，向更广泛的领域提供信息 LMIC对痴呆症和其他神经退行性脑疾病的干预。

ABSTRACT Low and middle income countries (LMIC) such as Vietnam are undergoing a dramatic demographic transition that will result in a substantial increase in the number of older adults, including those afflicted with Alzheimer's disease and related dementias, over the next several decades. Alzheimer's disease is among the most costly and disabling conditions to afflict older adults and places considerable stress on families. Strengthening LMIC capacity to support family caregivers of persons with dementia through low-cost and sustainable non- pharmacological approaches, such as education and skill-building to deal with difficult behaviors, is vital to avoid costly and ineffective alternatives such as psychotropic medications or institutionalization and to reduce caregiver burden and depression. While evidence-based models of non-pharmacological treatments exist in high income countries (HIC), these interventions have not been translated and adapted for use in Vietnam and other LMIC. This application directly addresses this important gap in our knowledge. The proposed project will strengthen collaboration between experienced investigators in the US and senior investigators at the National Geriatric Hospital, a leading institution for national geriatric policy, training and research in Vietnam. Dementia-related services and programs are virtually non-existent in Vietnam, a LMIC that is experiencing a rapid increase in its older adult population. This application arose from a request by leaders at the National Geriatric Hospital and Vietnam National Assembly for technical expertise and assistance in developing community based services for dementia caregivers. In the first year of this project, we propose to adapt the REACH-VA model for use in Vietnam. To adapt the model we will use a systematic approach to elicit input from key stakeholders and to attend to cultural factor and local resources. In the second year, we propose to test the feasibility and acceptability of the adapted model and to use the results to further refine the model. Throughout both years of the project, we will conduct activities to strengthen and build capacity in Vietnam to adapt and evaluate community-based dementia care interventions. At the end of the project, we will also disseminate project results and promote networking with other interested groups in Vietnam. This application will generate preliminary data and promote capacity-building to prepare for a larger R01 application to test the effectiveness of the culturally adapted model's effectiveness in Vietnam. Knowledge generated will also inform the broader field by serving as a model for adaptation of evidence-based interventions for dementia and other neurodegenerative brain diseases in LMIC.