Peer-Led Problem-Solving Intervention for Family Caregivers

描述（由申请人提供）：本项目将为体弱老年人的家庭照护者（CGs）开发和试点一种可获取、可行和可持续的一对一、同伴主导的问题解决干预措施。护理提供对老年人身心健康，甚至寿命的负面影响已得到充分证明。尽管支持cg的项目越来越多，但很少能满足“现实世界”的需求和限制。这项探索性/发展性研究通过开发和测试一种专门设计的干预措施来解决这一差距，该干预措施旨在绕过实施家庭CGs支持计划的已知障碍。具体而言，我们将开发和试点一种基于证据的同伴支持干预措施，利用最了解家庭护理需求的人的专业知识，即前家庭护理人员本身。“照顾者帮助解决问题”（CHIPS）将培训以前照顾年长亲属但已过渡到该角色的人，为目前照顾受损年长亲属的人提供半结构化干预。该干预措施以问题解决疗法和同伴支持的概念为基础，将明确设计用于解决困扰以往家庭CGs干预措施的可及性、可行性和可持续性问题。重要的是，我们建议检查CHIPS对健康的有益影响，不仅是目前接受干预的cg，还有将作为非专业干预者的前cg。拟议的工作通过描述CHIPS计划内容，识别和解决有效实施的障碍，以及测试计划的可行性，为全面干预奠定了基础。具体目标是：(1)为家庭心理咨询师制定一个全面的、解决问题的干预措施，包括基于利益相关者投入的干预材料和一个手动培训计划，使前家庭心理咨询师成为当前家庭心理咨询师的同伴辅导员；(2)在小型现场试验中建立原型干预的可行性；(3)评估其对CGs和pc的积极影响。这些目标将在一个为期两年的项目中实现，最终将以一项基于证据的心理教育干预为目标，该干预将培训前心理咨询师为目前照顾受损老年亲属的人实施半结构化、个性化的问题解决干预。本研究是全面随机试验（RCT）的第一步，包括两个主要活动：(1)基于现有知识开发干预措施，与CGs和从业人员一起收集新数据，并从该领域的专家小组中输入；(2)现场测试，以记录可行性和招募过程，并为RCT建立抽样和人员配置参数。

DESCRIPTION (provided by applicant): This project will develop and pilot an accessible, feasible and sustainable one-on-one, peer-led problem-solving intervention for family caregivers (CGs) of frail older adults. Negative effects of care provision on CGs' mental and physical well-being, and even longevity, are well documented. Despite a growing number of supportive programs for CGs, few meet "real world" needs and limitations. This exploratory/developmental research addresses this gap by developing and testing an intervention designed specifically to circumvent known barriers to implementing supportive programs for family CGs. Specifically, we shall develop and pilot an evidence-based, peer support intervention that capitalizes on the expertise of persons who best know the demands of family caregiving-former CGs themselves. "Caregivers Help in Problem Solving" (CHIPS) will train persons who previously cared for an elder relative but have transitioned out of that role to deliver a semi-structured intervention to persons currently caring for an impaired elder relative. The intervention, based in concepts of problem-solving therapy and peer support, will be designed expressly to address problems of accessibility, feasibility and sustainability that have plagued previous interventions for family CGs. Importantly, we proposed to examine the beneficial impact of CHIPS upon well- being not just of current CGs receiving the intervention, but also of the former CGs who will serve as lay interventionists. The proposed work sets the stage for full-scale intervention by delineating CHIPS program content, identifying and resolving barriers to effective implementation, and testing feasibility of the program. Specific aims are: (1) to develop a comprehensive, problem-solving intervention for family CGs, including intervention materials based on stakeholder input and a manualized training program to prepare former CGs to be- come peer counselors for current CGs; (2) to establish feasibility of the prototype intervention in a small field pilot, and(3) to estimate its positive impact on CGs and PCs. These aims will be pursued in a 2-year project culminating in an evidence-based psychoeducational intervention that will train former CGs to implement a semi-structured, individualized problem-solving intervention for persons currently caring for an impaired elder relative. This research, a first step toward a full-scale randomized trial (RCT), comprises two primary activities: (1) intervention development based on existing knowledge, new data collection with CGs and practitioners, and input from a panel of experts in the field, and (2) a field test to document feasibility and recruitment process, and establish sampling and staffing pa- rameters for the RCT.