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。近75%的ADRD患者的护理是在家中提供的，家庭护理人员需要持续的支持，以管理令人生畏的身体和心理护理需求。一项为期20多年的随机对照试验测试了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ADRD患者及其家庭成员的长期积极结果。最值得注意的是，随机对照试验表明，NYUCI大大减少了护理人员的抑郁症状和他们对疾病引起的行为反应的严重程度，改善了他们的身体健康，并延长了ADRD患者能够留在家里的时间--平均比那些接受常规护理的护理人员多1.5年（Mittelman等人，AG 14634，以前称为MH 42216;见www.nrepp.samhsa.gov/programfulldetails.asp? ID=122）。第二阶段的工作建议完成和评估一个创新的基于互联网的多媒体教育（IBME）培训计划，为社区机构和私人执业的提供者提供培训，以学习如何实施NYUCI或更熟练地为痴呆症患者的家庭护理人员提供咨询。认证和继续教育学分将是产品的一部分。培训要求太多，无法亲自及时满足。我们假设所提出的努力可以提供有效的培训与互联网的帮助，使保真度的NYUCI的内容，协议和成果，可以有效地实现。我们将在第二年通过一项随机对照试验来检验这一假设，该试验将包括定量分析和定性评估，比较使用完整产品的亲自培训和在线培训的结果。由于NYUCI确保为ADRD患者的家庭护理人员提供支持，因此拟议的IBME有可能改变ADRD家庭护理，也有可能改变美国的医疗保健系统，因为它将循证NYUCI模型传播给更多的机构，而不是没有IBME格式。该项目的创新源于独特的愿景，多层次的干预，以及NYUCI本身的创造性结合，调查人员和家庭护理，ADRD和IBME发展领域的其他关键人员的专业经验。除了其强大的商业潜力，这IBME也可能是有用的模板，为未来的培训提供者提供支持，以慢性疾病的人，而不是ADRD。

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 percent of the care for persons with ADRD is delivered at home, and family caregivers need ongoing support to manage the daunting physical and psychological demands of care. 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 showed that the NYUCI substantially reduced caregiver's depressive symptoms and the severity of their reaction to the behaviors caused by the illness, improved their physical health, and extended the time persons with ADRD were able to remain at home-an average of 1.5 years longer than those whose caregivers received usual care (Mittelman et al., AG14634, formerly MH42216; See www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=122). This Phase II effort proposes to complete and evaluate an innovative Internet-Based Multimedia Education (IBME) training program for providers in community agencies and private practice seeking to learn how to implement the NYUCI or become more proficient in counseling family caregivers of people with dementia. Certification and continuing education credits will be part of the product. Requests for training have become too numerous to satisfy in a timely manner in person. We hypothesize the proposed effort can provide effective training with the aid of the Internet so that fidelity to the NYUCI content, protocols, and outcomes can be achieved efficiently. We will test this hypothesis in YR2 with a randomized controlled trial that will inclue both quantitative analyses and qualitative evaluations, comparing the results of in person training and on-line training using the completed product. Because NYUCI assures support to family caregivers for the life of those with ADRD, the proposed IBME has the potential to transform ADRD home care but also U.S. healthcare systems as it disseminates access to the evidence-based 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 the Investigators and other key 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 of providers of caregiving support to persons with chronic diseases other than ADRD.