A Tailored Technology Intervention for Diverse Family Caregivers of AD Patients

为 AD 患者的多元化家庭护理人员量身定制的技术干预措施

• 批准号: 9034456
• 负责人: SARA J CZAJA
• 金额: $ 45.95万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9034456
• 关键词: Address; Adult; Adverse event; Affect; African American; Age; Alzheimer' s Disease; American; Anxiety; Area; Attention; Belief; Caregiver Burden; Caregiver support; Caregivers; Caring; Characteristics; Clinical; Communication; Communities; Computer Interface; Computers; Data; Dementia; Demographic Factors; Disease; Distress; Economic Burden; Effectiveness; Effectiveness of Interventions; Elderly; Emotional; Employment; Ethnic Origin; Ethnic group; Evaluation; Family Caregiver; Family Relationship; Family member; Fostering; Friends; Future; Goals; Health; Hispanics; Home environment; Hour; Individual; Intervention; Knowledge; Link; Measures; Mediation; Mental Depression; Minority; Minority Groups; Modification; Not Hispanic or Latino; Outcome; Participant; Patient-Focused Outcomes; Patients; Personal Satisfaction; Persons; Population; Prevalence; Quality of life; Randomized; Recruitment Activity; Resources; Risk; Role; Services; Shapes; Social support; Societies; Specific qualifier value; Stress; Target Populations; Technology; Testing; Transportation; Treatment Efficacy; United States; aged; base; caregiving; coping mechanism; cost; cost effectiveness; design; ethnic minority population; evidence base; experience; flexibility; improved; indexing; information gathering; innovation; intervention program; loved ones; meetings; mortality; multi-site trial; nutrition; physical conditioning; post intervention; preference; programs; psychosocial; response; social; telecare; usability

DESCRIPTION (provided by applicant): An increasing number of adults in the U.S. provide care to someone aged 50+ years with Alzheimer's Disease (AD) or dementia. Numerous intervention programs have been developed to address the needs of caregivers and several studies have demonstrated small to moderate effects in improving both caregiver and patient outcomes. However, the impact of these programs has been shown to vary according to the characteristic of the caregiver. In addition, despite the availability of these programs, barriers such as transportation problems, insufficient support from others, lack of knowledge about available services, and cultural beliefs often limit caregivers, especially minority caregivers, frm participating in intervention programs and accessing needed resources. Computer and communication technologies may help remove these barriers and enhance caregiver access to needed programs and services. However, the effectiveness of technology-based intervention programs needs to be rigorously evaluated with diverse caregiver groups given the increasing numbers of elders from minority populations, and ethnic/cultural differences in response to the caregiving situation. The aims of this project are to evaluate the acceptability and efficacy of a culturally tailored technology-based psychosocial intervention for reducing the stress and burden and enhancing quality of life of diverse family caregivers of AD patients. The intervention is designed to address known areas of caregiver risk and to foster the ability of caregivers to leverage the type of supports they need for themselves and the AD patient. The target population is Black/African American, Hispanic, and White non-Hispanic family caregivers of AD patients. These diverse cultural groups are predominant in the greater Miami community and in the larger United States older adult population. We will recruit and randomly assign 240 dyads (80 from each ethnic group) to one of two groups: 1) The Telecare Intervention Condition or 2) An Attention Control Nutrition Condition. The intervention will be home-based and delivered over 6 months using notebook technology in Spanish or English. Participants will be assessed at baseline, post-intervention (6 months after baseline), and six months later (12 months after baseline). Measures will include indices of distress, burden, health and social support and caregiving efficacy. We will also gather information on differences in response to the intervention among the three ethnic groups and the cost-effectiveness of the intervention. In addition, we will conduct moderation analyses to examine the influence of other caregiver characteristics (e.g., age~ relationship to the patient~ coping mechanisms) on responsiveness to the intervention and mediation analyses to identify specify components of the intervention that are linked to outcomes.

描述（由申请人提供）：在美国，越来越多的成年人为50岁以上的阿尔茨海默病（AD）或痴呆症患者提供护理。已经开发了许多干预计划来满足护理人员的需求，一些研究已经证明了在改善护理人员和患者结局方面的小到中等效果。然而，这些方案的影响已被证明是根据照顾者的特点而有所不同。此外，尽管这些方案是可行的，但诸如交通问题、来自他人的支持不足、缺乏对现有服务的了解以及文化信仰等障碍往往限制照顾者，特别是少数民族照顾者参与干预方案和获得所需资源。计算机和通信技术可能有助于消除这些障碍，并提高护理人员获得所需的计划和服务。然而，基于技术的干预方案的有效性，需要严格评估不同的照顾者群体，考虑到越来越多的老年人来自少数民族人口，和种族/文化差异，以应对老年人的情况。该项目的目的是评估一个文化定制的技术为基础的心理社会干预的可接受性和有效性，以减少压力和负担，提高生活质量的不同的家庭照顾者的AD患者。该干预措施旨在解决已知的护理人员风险领域，并培养护理人员利用他们自己和AD患者所需的支持类型的能力。目标人群为AD患者的黑人/非裔美国人、西班牙裔和白色非西班牙裔家庭护理者。这些不同的文化群体在更大的迈阿密社区和更大的美国老年人口中占主导地位。 我们将招募并随机分配240对（每个种族80人）到两组中的一组：1）运动干预条件或2）注意力控制营养条件。干预措施将以家庭为基础，并在6个月内使用西班牙语或英语的笔记本技术进行。 参与者将在基线、干预后（基线后6个月）和6个月后（基线后12个月）进行评估。衡量标准将包括痛苦指数、负担指数、健康和社会支持指数以及康复功效指数。我们还将收集有关三个种族群体对干预措施的反应差异以及干预措施的成本效益的信息。此外，我们将进行适度分析，以检查其他照顾者特征的影响（例如，年龄~与患者的关系~应对机制）对干预和中介分析的反应，以确定与结果相关的干预的具体组成部分。