Defining a Culturally Tailored Crisis Intervention Model Targeting African American Dementia Caregivers in Socially Disadvantaged Neighborhoods

项目摘要 阿尔茨海默病和相关痴呆症(ADRD)在非洲裔美国人中的健康差异仍然存在 患痴呆症的可能性是普通人的两倍。非裔美国人也更严重地依赖于无偿家庭或 与其他种族/民族群体相比，朋友照顾者能够满足ADRD患者的复杂需求。 在非洲裔美国人社区中，护理负担过高，就像许多非洲人一样 美国照顾者生活在社会弱势社区--健康状况较差的环境中， 经济和社会资源。非洲裔美国人的照顾者也报告了高水平的未得到满足的需求，这通常 升级到危机的地步。新出现的证据表明，被定义为计划外压力的危机事件 需要立即采取行动的情况，经常是非裔美国人照顾者经历的。然而，有效的 在社会不利的背景下处理非裔美国人的ADRD需求和危机的战略是 缺乏。尽管解决护理需求和差距是国家研究的优先事项，但努力解决 危机事件因非洲裔美国人未被纳入研究而受到阻碍。因此，它不是 了解非裔美国照顾者如何看待和管理社会弱势群体中的危机事件 环境，限制了在这种情况下预防、缓解和管理危机的干预措施的确定。这个 建议的前瞻性定性将利用经过验证的社会劣势度量来指导抽样和 扎根的维度分析(GDA)，扎根理论的变体，以检查ADRD危机。目标1将 确定非裔美国人照顾者在社会中的危机的诱发、缓解和可改变的特征 弱势环境和危机干预模式的产生。次级目标1A将审查以下方面的作用 影响危机事件决策的环境因素。最后，AIM 2将验证一个 社会背景下为非裔美国人ADRD照顾者量身定做的危机干预模式 劣势。拟议的研究将提供急需的基础知识，以更好地 了解并最终形成对高风险和未得到充分研究的ADRD人群中的危机事件的干预， 非裔美国人照顾者-直接响应国家老龄研究所(NIA)的优先事项 框架：21世纪的老龄化：老龄化研究的战略方向。这项研究解决了 框架的目标C：“制定有效的干预措施，以维持健康、福祉和功能，并预防 或减轻与年龄相关的疾病、障碍和残疾的负担。这项研究的发现将 在已确定干预措施的基础上建立干预措施交付模式的初步设计组件 目标。

PROJECT ABSTRACT Health disparities in Alzheimer’s disease and related dementia (ADRD) persist among African Americans who are two-fold more likely to develop dementias. African Americans also rely more heavily on unpaid family or friend caregivers to meet the complex needs of care recipients with ADRD than other racial/ethnic groups. Disproportionately high caregiving burden is experienced within African American communities, as many African American caregivers reside in socially disadvantaged neighborhoods—environments with fewer health, economic, and social resources. African American caregivers also report high levels of unmet needs, which often escalate to the point of crisis. Emerging evidence suggests that crisis events, defined as unplanned stressful situations requiring immediate action, are frequently experienced by African American caregivers. Yet, effective strategies for addressing African American ADRD needs and crisis in the context of social disadvantage are lacking. Although addressing caregiving needs and disparities are national research priorities, efforts to address crisis events have been hindered by under-inclusion of African Americans in research. Consequentially, it is not known how African American caregivers perceive and manage crisis events in socially disadvantaged environments, limiting identification of interventions to prevent, mitigate, and manage crisis in this context. The proposed prospective qualitative will utilize a validated metric of social disadvantage to guide sampling and Grounded Dimensional Analysis (GDA), a variant of Grounded Theory, to examine ADRD crisis. Aim 1 will identify precipitating, mitigating, and modifiable features of crisis among African American caregivers in socially disadvantaged environments and generate crisis intervention model. Sub-Aim 1A will examine the role of environmental factors in shaping decision-making surrounding crisis events. Finally, Aim 2 will validate a culturally tailored crisis intervention model for African Americans ADRD caregivers in the context of social disadvantage. The proposed research will provide the urgently needed foundational knowledge to better understand and ultimately shape interventions for crisis events in a high-risk and understudied ADRD population, African American caregivers—and is directly responsive to priorities of the National Institute on Aging (NIA) framework “Aging Well in the 21st Century: Strategic Directions for Research on Aging.” The study addresses Goal C of the framework: “develop effective interventions to maintain health, well-being, and function and prevent or reduce the burden of age-related diseases, disorders, and disabilities.” Findings from this research will establish preliminary design components for mode of intervention delivery building on identified intervention targets.