Enhancing American Indian Caregiver Mastery through a Savvy Caregiver Peer Program

通过精明的照顾者计划增强美国印第安人照顾者的掌握-Peer解决 越来越多对痴呆症了解有限的美国印第安人照顾者。高水平的负担 与为痴呆症患者提供护理有关，以及对疾病管理的不确定性 条件、护理的不同心理社会方面的问题、缺乏适应文化的培训和 教育材料导致照顾者报告孤独和抑郁的感觉。尽管有独特的需求 在美国印第安人照顾者中，很少有资源以文化上合适的方式支持这一群体。精明的人 护理者计划是一个由多个组成部分组成的心理教育计划，包括每周6次，每次2小时 居家照顾痴呆症患者的家庭照顾者。压力调节与社会认知 理论上，精明的照顾者计划是为了缓解照看压力和加强知识， 通过课堂、互动练习和家庭作业，培养学生的技能和视野。 这项研究将使用以社区为基础的参与式研究框架来提高精明的照顾者 计划通过添加基于同伴的教育和支持组件，称为Savvy Caregiver Peer 项目，它结合了压力调节和生成性理论。将举行六个连续的谈话圈 有5-8名以前的美国印第安人痴呆症照顾者，他们是白人地球国家(AIM)的登记成员 1)开发了精明的Caregiver Peer Program原型。参与者将回顾精明的照顾者计划 课程设置并讨论同伴导师在项目中的角色和期望，包括同伴选择、 培训，以及监督同伴导师和照顾者参与度的管理结构。6规划和 设计讨论圈将收集战略上、文化上合适的信息，以(1)为同行导师提供 有机会直接定义他们的角色和期望，作为明智的照顾者同行计划的一部分；(2) 教育同龄人了解精明的照顾者计划的核心要素及其在支持材料方面的作用；以及(3) 收集有关同伴指导材料的见解，以提供给照顾者。在完成顺序操作后 讨论圈和发展明智的照顾者计划-同伴培训材料和基础设施，a 将对30名照顾者(20名干预组，10名对照组)进行平行ARM随机临床试验 为期12周(每两周6次)(目标2)。来自同伴导师和照顾者的定性和定量数据 将收集以评估招募的可行性和可接受性、随机化、干预坚持、 和照顾者措施的管理。在第四年(目标3)，我们将主持谈话圈，以吸引照顾者 和同伴导师在完善和改进明智的照顾者计划-同行在准备 在随后的更大规模的随机临床试验中进行测试。这项研究将有助于文化和语境 为最终制定基于文化价值观的照顾者干预措施提供信息的知识 美国印第安人痴呆症照顾者的生活质量和结果。

Enhancing American Indian Caregiver Mastery through a Savvy Caregiver Program-Peer addresses the growing number of American Indian caregivers with limited knowledge of dementia. The high level of burden associated with providing care for those with dementia, along with uncertainty about managing disease conditions, problems with different psychosocial aspects of care, lack of culturally responsive training and education materials results in caregivers reporting feelings of isolation and depression. Despite the unique needs of American Indian caregivers, few resources support this group in a culturally appropriate way. The Savvy Caregiver Program is a multi-component, psychoeducational program consisting of 6 weekly 2-hour sessions for family caregivers of people living with dementia at home. Informed by Stress Mediation and Social Cognitive Theories, the Savvy Caregiver Program was developed to alleviate caregiving strains and strengthen knowledge, skills, and outlook through classes, interactive exercises, and home assignments. This study will use a community-based participatory research framework to enhance the Savvy Caregiver Program by adding a peer-based educational and support component, referred to as the Savvy Caregiver Peer Program, that incorporates Stress Mediation and Generativity Theories. Six sequential talking circles will be held with 5-8 previous American Indian dementia caregivers who are enrolled members of White Earth Nation (Aim 1) to develop the Savvy Caregiver Peer Program prototype. Participants will review the Savvy Caregiver Program curriculum and discuss the roles and expectations of peer mentors in the program, including peer selection, training, and a management structure to oversee peer mentors and caregiver engagement. The 6 planning and design talking circles will gather strategic, culturally appropriate information to (1) provide the peer mentors with an opportunity to directly define their role and expectations as part of the Savvy Caregiver Peer Program; (2) educate peers on the Savvy Caregiver Program core elements and their role in supporting the materials; and (3) gather insights about the peer mentor material to be provided to the caregiver. Upon completion of the sequential talking circles and development of the Savvy Caregiver Program-Peer training materials and infrastructure, a parallel arm randomized clinical trial of 30 caregivers (20 to intervention, 10 to control group) will be conducted for 12 weeks (6 biweekly sessions) (Aim 2). Qualitative and quantitative data from peer mentors and caregivers will be collected to assess the feasibility and acceptability of recruitment, randomization, intervention adherence, and administration of caregiver measures. During Year 4 (Aim 3), we will host talking circles to engage caregivers and peer mentors in the refinement and improvement of the Savvy Caregiver Program-Peer in preparation for testing in a larger, subsequent randomized clinical trial. This study will contribute cultural and contextual knowledge to inform the eventual development of caregiver interventions grounded in cultural values to improve the quality of life and outcomes for American Indian dementia caregivers.