A Tailored Technology Intervention for Diverse Family Caregivers of AD Patients

描述(申请人提供)：在美国，越来越多的成年人为患有阿尔茨海默病(AD)或痴呆症的50岁以上的人提供护理。已经制定了许多干预计划来满足照顾者的需求，几项研究表明，在改善照顾者和患者结果方面，有轻微到中等的效果。然而，这些方案的影响已被证明根据照顾者的特征而有所不同。此外，尽管提供了这些方案，但交通问题、其他人的支持不足、缺乏对现有服务的了解以及文化信仰等障碍往往限制了照顾者，特别是少数族裔照顾者参与干预方案和获得所需资源的能力。计算机和通信技术可能有助于消除这些障碍，并加强护理者获得所需程序和服务的机会。然而，鉴于少数族裔老年人的数量不断增加，以及针对照顾情况的种族/文化差异，需要与不同的照顾者群体严格评估以技术为基础的干预计划的有效性。本项目的目的是评估一种基于技术的心理社会干预的可接受性和有效性，以减轻AD患者不同家庭照顾者的压力和负担，并提高其生活质量。该干预措施旨在解决照顾者风险的已知领域，并培养照顾者利用他们自己和AD患者所需的支持类型的能力。目标人群是AD患者的黑人/非裔美国人、西班牙裔和白人非西班牙裔家庭照顾者。这些不同的文化群体在大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240名双胞胎(每个种族80名)，并随机分配到两组中的一组：1)电信干预条件或2)注意力控制营养条件。干预将以家庭为基础，使用西班牙语或英语的笔记本技术在6个月内交付。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照料效率指数。我们还将收集关于应对三个族裔群体干预的差异以及干预的成本效益的信息。此外，我们将进行缓和分析，以研究其他照顾者特征(例如，年龄、与患者的关系、应对机制)对干预反应的影响，并进行调解分析，以确定干预的具体组成部分与结果相关。

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.