Peer-Led Problem-Solving Intervention for Family Caregivers

描述（由申请人提供）：该项目将开发和试点一个可访问的，可行的和可持续的一对一，同行领导的解决问题的干预家庭照顾者（CG）的体弱老年人。护理提供对CG的精神和身体健康，甚至寿命的负面影响，是有据可查的。尽管越来越多的支持性方案的CG，很少满足"真实的世界"的需要和限制。这项探索性/发展性研究通过开发和测试专门设计的干预措施来解决这一差距，以规避实施家庭CG支持计划的已知障碍。具体来说，我们将开发和试点的循证为基础，同侪支持干预，利用专业知识的人谁最了解的需求，前CG自己的家庭。"照顾者帮助解决问题"将培训以前照顾老年亲属但已脱离这一角色的人，向目前照顾残疾老年亲属的人提供半结构化干预。干预，解决问题的治疗和同伴支持的概念为基础，将明确解决的可及性，可行性和可持续性的问题，困扰着以前的家庭团体干预。重要的是，我们建议研究CHIPS对福利的有益影响，不仅是接受干预的现任CG，而且是将担任非专业干预者的前CG。拟议的工作通过界定CHIPS计划内容，确定和解决有效实施的障碍，以及测试该计划的可行性，为全面干预奠定了基础。具体目标是：（1）为家庭社区团体制定一个全面的、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册化的培训计划，以使前社区团体成为当前社区团体的同伴咨询师;（2）在一个小型现场试点中建立原型干预的可行性;（3）评估其对社区团体和个人电脑的积极影响。这些目标将在一个为期2年的项目中实现，最终将以循证心理教育干预为基础，培训前社区指导员为目前照顾残疾老年亲属的人实施半结构化、个性化的解决问题干预。本研究是迈向全面随机试验（RCT）的第一步，包括两项主要活动：（1）基于现有知识的干预措施开发，与CG和从业人员收集新数据，以及来自该领域专家小组的输入，以及（2）现场测试，以记录可行性和招募过程，并建立RCT的采样和人员配置参数。

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.