Training for Providers of an Evidence-Based AD Family Caregiver Intervention

描述（由申请人提供）：阿尔茨海默病和相关疾病（ADRD）对美国医疗保健系统构成了紧迫的挑战，也给整个社会带来了巨大的负担。对ADRD患者的护理有近75%是在家中进行的，家庭护理人员需要持续的支持，以管理护理需求带来的令人生畏的生理和心理影响。随着ADRD的进展，家庭照顾者越来越容易受到压力和抑郁的影响，这可能导致他们不情愿地将亲人送到养老院。PI Mittelman和他的同事，在一项20多年的随机对照试验中，测试了一种针对配偶照顾者的心理社会干预，称为纽约大学照顾者干预（NYUCI），并证明了对患有ADRD的人及其家庭成员的长期积极效果。最值得注意的是，该随机对照试验1)证实了照顾者抑郁程度的降低和身体健康状况的改善，2)显著延长了ADRD患者能够留在家中的时间——平均比对照组成员长1.5年（Mittelman等人，AG14634，前身为MH42216；见www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=122）。第一阶段的工作是“基于证据的AD家庭照顾者干预提供者的培训”，建议创建、开发和测试最终12个创新的基于互联网的多媒体教育（IBME）培训计划模块中的4个原型的可行性，该培训计划的目标是社区机构的提供者寻求学习如何实施（NYUCI）模式。对NYUCI实施培训的要求太多了，无法亲自满足，这导致项目调查员构思了这个第一阶段的IBME。他们假设，拟议的努力有能力在互联网的帮助下提供有效的培训，从而有效地实现对NYUCI内容、协议和结果的忠诚。此外，在这种形式下，它可以根据在不同社区实施干预的人的新信息和经验进行修改和更新。由于NYUCI保证为患有ADRD的亲人的生活提供家庭照顾者的支持，这个拟议的IBME不仅有可能改变ADRD家庭护理，而且有可能改变美国的医疗保健系统，因为它将20多年的临床研究传播给更多的机构，验证NYUCI模型，而不是没有IBME格式。该项目的创新源于纽约大学自身独特的视角、多层次的干预和创造性的结合，以及PI Hobday、PI Mittelman和其他关键项目人员在家庭护理、ADRD和IBME发展领域的专业经验。除了目前具有强大的商业潜力外，该IBME还可作为未来培训的模板，以支持非慢性疾病患者的家庭照护者。

DESCRIPTION (provided by applicant): Alzheimer's disease and related disorders (ADRD) constitute urgent challenges to U.S. Healthcare systems as well as enormous burdens on society as a whole. Nearly 75% of the care for persons with ADRD is delivered at home, and family caregivers need ongoing support to manage the daunting physical and psychological effects of care demands. As ADRD progresses, family caregivers are increasingly vulnerable to stress and depression, which may lead them to reluctantly place their relatives in nursing homes. PI Mittelman and colleagues, in a 20+ year randomized controlled trial, tested a psychosocial intervention for spouse caregivers, called the NYU Caregiver Intervention (NYUCI) and demonstrated long-term positive outcomes for people with ADRD and their family members. Most notably, the RCT 1) substantiated reduced depression and improved physical health for caregivers and 2) significantly extended the time persons with ADRD were able to remain at home-an average of 1.5 years longer than control group members (Mittelman et al., AG14634, formerly MH42216; See www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=122). This Phase I effort, "Training for Providers of an Evidence-Based AD Family Caregiver Intervention," proposes to create, develop, and test feasibility of a prototype of 4 of an eventual 12 modules of an innovative Internet-Based Multimedia Education (IBME) training program targeted to providers in community agencies seeking to learn how to implement the (NYUCI) model. Requests for NYUCI implementation training have become too numerous to satisfy in person, which led project investigators to conceive of this Phase I IBME. They hypothesize the proposed effort has the power to provide effective training with the aid of the Internet so that fidelity to the NYUCI content, protocols, and outcomes can be achieved efficiently. Moreover, in this form, it can be modified and kept up-to-date with new information and experiences of those implementing the intervention in different communities. Because the NYUCI assures support to family caregivers for the life of loved ones with ADRD, this proposed IBME has the potential to transform not only ADRD home care but also U.S. healthcare systems as it disseminates access to the 20+ years of clinical research validating the NYUCI model to many more agencies than would be possible without an IBME format. The project's innovation derives from a unique vision, multilevel intervention, and creative combination of the NYUCI itself, the professional experience of PI Hobday, PI Mittelman, and other key project personnel in the fields of family care, ADRD, and IBME development. In addition to its strong present commercial potential, this IBME may be also useful as a template for future training to support family caregivers of persons with chronic diseases other than ADRD. PUBLIC HEALTH RELEVANCE: This Phase I effort creates and develops an Internet-based training for social service providers implementing the evidence-based New York University Caregiver Intervention (NYUCI) model, a psychosocial intervention for families of those with Alzheimer's disease (AD). This effort is highly relevant to U.S. public health because the NYUCI has been shown to reduce depression in caregivers and delay nursing home placement by, on average, 1.5 years. Wider implementation of NYUCI model, to be facilitated by the proposed training intervention, could support the 9.8 million family caregivers delivering nearly 75% of the home care for those with AD (Alzheimer's Association, p. 15) as well as potentially saving the health care system hundreds of millions of dollars.