Low Literacy Elder Caregiver Support for Callcenters

描述（由申请人提供）：随着私营部门疾病管理组织的呼叫中心转变为医疗保险人口的护理协调角色，需要材料来帮助教练协助老年护理人员履行和维持他们作为患者依从性促进者的角色。此外，老年人照顾者本身往往也患有慢性病，他们为了照顾患病配偶的需要而忽视了这一点。呼叫中心低文化长者照顾者支持是一个多层次的网络应用程序，旨在培训呼叫中心教练照顾者问题，以及方便申请后续媒体，以各种低文化格式发送给照顾者（dvd视频，四年级阅读水平的印刷媒体，通过电子邮件或邮寄发送）。拟议的系统将与现有的呼叫中心软件集成，以帮助教练评估老年护理人员在疾病管理、护理计划依从性、个人应对护理角色以及护理人员自我护理方面的需求。根据护理者对调查的回应，教练将获得一份个性化的谈话要点菜单，以及与来电者相关的电话脚本。教练也将有能力申请量身定制的教育材料，根据呼叫者特定的项目发送给照顾者。由于59%的老年人的健康知识水平处于基本或低于基本水平，因此将按照医学研究所针对低健康知识水平个人的建议编写所有材料。第一阶段将涉及对充血性心力衰竭患者的老年家庭护理人员进行形成性评估，并成立一个由呼叫中心专业人员和健康知识和老年护理研究领域的领导者组成的咨询委员会。将编制一份低识字率DVD和一本载有低识字率文章的小册子，内容涉及与老年人照顾者有关的选定主题。这种干预的理论基础是Lazarus和Folkman压力和应对模型。所有总结性评估工具都将基于这些结构。DVD和小册子的有效性将在准实验的前后设计中进行评估，36名非裔美国人、西班牙人、白种人和符合医疗保险资格的亚洲老年人护理人员为符合医疗保险资格的充血性心力衰竭患者提供帮助。本研究测量的结果包括照顾者自我效能感、知识和照顾者在照顾技能和照顾者应对方面的改变意图。第二阶段将扩展护理人员材料以覆盖所有领域，增加关于慢性阻塞性肺疾病的信息和呼叫中心教练所需的工作人员模块，包括培训、调查、谈话要点以及订购dvd视频、印刷和电子邮件支持材料。在第二阶段，整个项目将进行一项涉及老年护理人员的大规模随机临床试验，并对参与呼叫中心的工作人员进行流程和影响评估。公共卫生相关性：老年护理人员是卫生保健团队不可分割的一部分，促进护理计划的遵守并使其能够独立生活。此外，作为老年人本身，他们也有自己的健康挑战，而他们的照顾角色往往会加剧这些挑战。该项目旨在帮助疾病管理呼叫中心教练在疾病管理技能、护理计划依从性、护理人员应对和护理人员自我护理等领域为老年护理人员提供最先进的支持，包括以dvd视频、硬拷贝或电子邮件形式提供的低文化水平后续材料。

DESCRIPTION (provided by applicant): As call centers for private sector disease management organizations move into a care coordination role with the Medicare population, materials are needed to help coaches assist elder caregivers in fulfilling and maintaining their roles as adherence facilitators for the patient. Furthermore, elder caregivers themselves often have chronic conditions, which they neglect in deference to the needs of their ill spouse. Low Literacy Elder Caregivers Support for Call Centers is a multi-level web application designed to train call center coaches in caregiver issues, as well as facilitate the requisition of follow-up media to be sent to the caregiver in a variety of low literacy formats (DVD-video, 4th grade reading level print media to be sent via email or post). The proposed system will integrate with existing call center software to help coaches assess the needs of elder caregivers in the domains of disease management, care plan adherence, personal coping with the caregiver role, and the caregiver's own efforts at self-care. Based on caregiver responses to surveys, coaches will be presented with an individualized menu of talking points and phone scripts pertinent to that caller. Coaches will also have the ability to requisition tailored educational materials to be sent to the caregiver based on caller-specific items. Since 59% of seniors function at Basic or Below Basic levels of health literacy, all materials will be developed following the Institute of Medicine's recommendations for individuals with low health literacy. Phase I will involve formative evaluation with elder family caregivers of persons with congestive heart failure, and an advisory council of call center professionals and leaders in the field of health literacy and eldercare research. A low literacy DVD and a booklet containing a collection of low-literacy articles will be prepared concerning select topics relevant to elder caregivers. The theoretical basis of this intervention is the Lazarus and Folkman stress and coping model. All summative evaluation instruments will be based on these constructs. The efficacy of the DVD and booklet will be evaluated in a quasi-experimental pre-post design with 36 African-American, Hispanic, Caucasian, and Asian Medicare-eligible elder caregivers providing assistance to a Medicare-eligible care- receiver with congestive heart failure. Outcomes measured in this study include caregiver self-efficacy, knowledge, and intention to change in the domains of caregiving skills and caregiver coping. Phase II will expand the caregiver materials to cover all domains, adding information on chronic obstructive pulmonary disorder and the staff modules needed for call center coaches, including training, surveys, talking points, and the requisitioning of DVD-video, print, and email support materials. In Phase II, the complete program will undergo a large scale randomized clinical trial involving elder caregivers, and a process and impact evaluation of the staff of participating call centers. PUBLIC HEALTH RELEVANCE: Elder caregivers are an integral part of the health care team, facilitating care plan adherence and enabling independent living. In addition, as seniors themselves, they have their own health challenges, which are often exacerbated by their caregiving role. This program is designed to assist disease management call center coaches in offering state-of-the-art support to elder caregivers in the domains of disease management skills, care plan adherence, caregiver coping, and caregiver self-care, including low literacy follow-up materials available on DVD-video, or as hard copy or e-mail articles.