CommunityRx-Dementia

项目总结/摘要 超过1600万名无薪照顾者照顾着迅速增长的居家人口， 阿尔茨海默病和相关痴呆症（ADRD）在美国。ADRD照顾者的身体健康状况较差 比他们的同龄人和高比率的负担和抑郁症。耻辱和社会孤立是常见的。联邦法律 呼吁将护理人员与社区资源联系起来（例如ADRD教育、支持团体、临时护理）， 特别关注减少健康差距。与此同时，CMS正在测试常规评估和转诊 未得到满足的健康相关社会需求（HRSN）（如食物、住房、人际安全和社会支持）。 对生育的需求通常会产生财务压力，但HRSN在这一人群中仍然被忽视。低 需要高强度、可扩展的资源转诊解决方案来管理和促进 所有ADRD护理人员和痴呆症患者（PWD）。这项研究主要是在非洲进行的， 芝加哥南区的美国/黑人人口，将填补如何最好地干预， 支持ADRD护理人员。我们将进行一项随机、对照的疗效试验， 社区Rx-痴呆症（CRx-D）干预对照顾者和照顾接受者的结果超过12个月。CRx- D建立在CommunityRx的基础上，CommunityRx是一种基于信息的干预措施，系统地将人们与附近的人相匹配 社区资源，用于HRSN、康复和其他自我护理需求。护理人员将按未满足的 HRSN并随机分配至常规治疗或常规治疗+ CRx-D。在初级保健访问期间，指定的护理人员 CRx-D将收到：（a）关于ADRD护理人员共同资源需求的信息， （B）个性化资源“处方”（HealtheRx-D）;（c）使用在线 （d）就如何启动社区资源，包括如何接触 CRx-D社区资源专家CRx-D组还将收到超过8周的文本， 增加支持以激活资源。本研究的具体目的是：（1）在照顾者中， 未满足的HRSN，评价CRx-D与常规护理相比对护理者自我效能的影响， 心理和行为结果，以及健康和医疗保健利用;（2）评估 CRx-D与常规护理相比对医疗保健体验（包括满意度）的干预和影响 护理，在临床护理过程中的耻辱经历和共享社区资源信息的可能性 （3）质量评估：CRx-D干预的经验;耻辱在 披露需求和获取资源;与他人分享资源信息的经验。我们 目标是通过对照顾者进行干预，促进照顾者的健康和福祉。 初级保健。这项研究的长期目标是促进公众健康，减轻贫困人口的痛苦。 ADRD护理人员和PWD人口不断增加。这项工作通过产生新的信息来推进NIA的使命。 了解社区资源联系，促进ADRD的成果和支持。

PROJECT SUMMARY/ABSTRACT More than 16 million unpaid caregivers care for a rapidly growing population of home-dwelling people with Alzheimer’s disease and related dementias (ADRD) in the US. ADRD caregivers have poorer physical health than their peers and high rates of burden and depression. Stigma and social isolation are common. Federal law calls for connecting caregivers to community resources (e.g. ADRD education, support groups, respite care), with special concern for reducing health disparities. In parallel, CMS is testing routine assessment and referral for unmet health-related social needs (HRSNs) (e.g. food, housing, interpersonal safety and social support). Demands of caregiving commonly produce financial strain, yet HRSNs remain overlooked in this population. Low intensity, scalable resource referral solutions are needed to manage and promote the health and well-being of all ADRD caregivers and persons with dementia (PWD). The proposed research, in a predominantly African American/Black population on Chicago’s South Side, will fill a gap in knowledge about how to best intervene to support ADRD caregivers. We will conduct a randomized, controlled efficacy trial to test the effect of the CommunityRx-Dementia (CRx-D) intervention on caregiver and care recipient outcomes over 12 months. CRx- D builds on CommunityRx, an information-based intervention that systematically matches people to nearby community resources for HRSNs, caregiving and other self-care needs. Caregivers will be stratified by unmet HRSNs and randomized to usual care or usual care + CRx-D. During a primary care visit, caregivers assigned to CRx-D will receive: (a) information about common resource needs among ADRD caregivers, to normalize these needs; (b) a personalized resource "prescription" (HealtheRx-D); (c) demonstration on use of an online Community Resource Finder; and (d) coaching on how to activate community resources, including how to reach the CRx-D community resource specialist. The CRx-D group will also receive texts over 8 weeks offering additional support to activate resources. The specific aims of this research are to (1) Among caregivers with unmet HRSNs, evaluate the effects of CRx-D versus usual care on caregiver self-efficacy and secondary psychosocial and behavioral outcomes, as well as health and healthcare utilization; (2) Evaluate acceptability of the intervention and the effects of CRx-D versus usual care on the health care experience, including satisfaction with care, experiences of stigma during clinical care and likelihood of sharing community resource information with others; (3) Qualitatively assess caregivers’: experiences with the CRx-D intervention; the role of stigma in disclosing needs and accessing resources; and experiences sharing resource information with others. Our objective is to promote caregiver health and well-being by intervening with caregivers at the point of their own primary healthcare. The long-term goal of this research is to promote public health and alleviate suffering among a growing population of ADRD caregivers and PWD. This work advances the mission of NIA by generating new knowledge about community resource connections that promote ADRD caregiving outcomes and supports.