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

摘要 低收入和中等收入国家（LMIC），如越南，正在经历一场戏剧性的 人口结构转型将导致老年人数量大幅增加， 包括那些患有阿尔茨海默病和相关痴呆症的人， 几十年阿尔茨海默氏病是折磨老年人的最昂贵和致残的疾病之一， 成年人，给家庭带来相当大的压力。加强低收入国家的能力， 通过低成本和可持续的非政府组织， 药理学方法，如教育和技能建设，以处理困难 行为，是至关重要的，以避免昂贵和无效的替代品，如精神药物 或机构化，并减少照顾者的负担和抑郁症。虽然基于证据 非药物治疗模式存在于高收入国家（HIC），这些 干预措施尚未翻译和调整，以在越南和其他低收入国家使用。这 应用程序直接解决了我们知识中的这一重要空白。拟议项目将 加强美国经验丰富的调查人员与高级调查人员之间的合作 国家老年医院是国家老年政策、培训和 越南的研究。与痴呆症相关的服务和项目在美国几乎不存在。 越南，一个老年人口迅速增加的低收入国家。这 申请是应国家老年医院和越南领导的要求提出的， 发展社区基础技术专门知识和援助国民议会 为痴呆症护理人员提供服务。在这个项目的第一年，我们建议调整 REACH-VA模型用于越南。为了调整模型，我们将使用一种系统的方法， 征求主要利益攸关方意见，并注意文化因素和当地资源。在 第二年，我们建议测试适应模型的可行性和可接受性， 使用结果进一步完善模型。在这两年的项目中，我们将 加强和建设越南适应和评估基于社区的 痴呆症护理干预措施。在项目结束时，我们还将传播项目成果 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，并促进能力建设，为更大规模的R 01应用做好准备， 文化适应模式在越南的有效性。产生的知识 还将通过作为适应循证医学的模式，为更广泛的领域提供信息。 LMIC中的痴呆症和其他神经退行性脑疾病的干预措施。

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.