A Tailored Technology Intervention for Diverse Family Caregivers of AD Patients

描述（由申请人提供）：在美国，越来越多的成年人为50岁以上的阿尔茨海默病（AD）或痴呆症患者提供护理。为了满足护理人员的需求，已经开发了许多干预方案，并且有几项研究表明，在改善护理人员和患者的结果方面，有小到中等的效果。然而，这些项目的影响根据照顾者的特点而有所不同。此外，尽管有这些项目，但交通问题、他人支持不足、缺乏对现有服务的了解和文化信仰等障碍往往限制了护理人员，特别是少数民族护理人员参与干预项目和获取所需资源。计算机和通信技术可以帮助消除这些障碍，提高护理人员获得所需项目和服务的机会。然而，基于技术的干预方案的有效性需要与不同的照顾者群体进行严格的评估，因为越来越多的老年人来自少数民族人口，以及种族/文化对照顾情况的反应差异。该项目的目的是评估一种文化定制的基于技术的社会心理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，提高生活质量。干预的目的是解决护理人员已知的风险领域，并培养护理人员利用他们自己和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。我们将招募并随机分配240对夫妇（每个种族80人）到两个组：1)远程干预组或2)注意力控制营养组。干预将以家庭为基础，使用西班牙语或英语的笔记本技术，为期6个月。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。措施将包括痛苦、负担、健康和社会支持以及护理效力的指数。我们亦会收集有关三个族群对干预措施的反应差异及干预措施的成本效益的资料。此外，我们将进行适度分析，以检查其他照顾者特征（例如，年龄、与患者的关系、应对机制）对干预和调解分析的反应性的影响，以确定与结果相关的干预的具体组成部分。

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.