Health Services Use: Analysis of ACTIVE Data

描述(由申请人提供)：R03的具体目的是对1998-2001年间进行的独立和有活力的老年人高级认知培训(积极)试验的数据进行二次分析。这项研究是由国家老龄研究所(NIA)和国家护理研究所(NINR)资助的一项临床试验，在六个现场站点和一个数据协调中心进行。ACTIVE的主要目标是测试三种不同的认知干预措施在改善老年人在基本认知测量和认知需求日常活动测量方面的表现的有效性和持久性(《美国医学会杂志》，2002年报道)。这项倡议的最终目标是减少与老年人丧失独立性有关的公共健康问题，特别是减少对正规保健服务的需要。这项建议的主要目的是评估积极的认知干预措施在减少对正规保健服务的需求和使用方面的有效性。拟议项目的具体目的是分析数据，以：1)调查认知培训对参与者健康相关生活质量的影响；2)评估干预组分配与正规医疗服务利用的关系；3)评估近端干预有效性(训练后的认知能力的改善程度)和远端健康服务使用结果的中介作用；4)通过比较自我报告的(Medicare可报销)服务的使用情况和Medicare索赔数据，评估自我报告的健康服务利用的有效性。Active是最大的纯行为治疗试验之一。由于其规模和精心开发的严谨性，其数据集为调查人员提供了大量进行二次分析的机会。积极试验的资金于2002年12月31日结束。正在申请资金，以支持研究调查人员的工作，以分析以前由于初始裁决资金不足而没有调查的次要结果。审判数据目前正在存档供公众使用，只有现役调查人员才能获得。

DESCRIPTION (provided by applicant): The Specific Aim of this R03 is to conduct secondary analyses of data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, which was conducted from 1998-2001. The study was a clinical trial funded by the National Institute of Aging (NIA) and National Institute on Nursing Research (NINR) and conducted at six field sites with a data-coordinating center. The primary objective of ACTIVE was to test the effectiveness and durability of three distinct cognitive interventions in improving older adults' performance on basic measures of cognition and on measures of cognitively demanding daily activities (reported in JAMA, 2002). The ultimate goal of this initiative was to reduce the public health problems related to loss of independence in the elderly, specifically the need for formal health care services. The Primary Aim of this proposal is to evaluate the effectiveness of the ACTIVE cognitive interventions in reducing demand for and use of formal health care services. The Specific Aims of the proposed project are to analyze data to: 1) investigate the effect of cognitive training on participants' health-related quality of life; 2) evaluate the relationship of intervention group assignment and formal health care services utilization; 3) evaluate the mediating role of proximal intervention effectiveness (degree of improvement in trained cognitive abilities) and distal health services use outcomes; and 4) assess the validity of self-reported health services utilization by comparing self-reported use of (Medicare reimbursable) services to Medicare claims data. ACTIVE is one of the largest purely behavioral treatment trials. Because of its size and the carefully developed rigor, its datasets offer to investigators a wealth of opportunities for secondary analyses. Funding for the ACTIVE trial ended on 12/31/02. Funds are being requested to support the work of the study investigators to analyze secondary outcomes not previously investigated due to insufficiency of funds in the initial award. The trial data currently are being archived for public use and are available only to the ACTIVE investigators.