Adult Day Service Utilization and Outcomes: A Mixed Methods Approach

描述(由申请人提供)：这一K02奖项有两个发展目标：1)获得定性和混合方法设计方面的专业知识，以推进首席研究员关于非正式和正式长期护理的研究计划；2)获得基于混合方法设计创新的大规模协作研究计划的开发和管理方面的知识和经验。为实现这两个目标，提出了一项详细的职业发展计划，该计划将通过阅读教科书、大学课程、参加研究所以及与一些资深同事合作，在定性和混合方法研究方法方面提供广泛的培训。这些活动将允许候选人整合方法论观点，并将在他过渡到依赖于多个R01级项目和对初级研究人员的有效指导的研究计划的管理时提供有价值的指导。基于这些培训目标的研究活动将为候选人提供在长期护理中进行复杂、混合方法研究的丰富经验。利用互补的定量和定性方法，拟议的试点研究将：确定成人日间服务(ADS)计划的各个方案方面如何促进牢固的客户-家庭-工作人员关系的发展；确定ADS计划环境和客户-家庭-工作人员关系如何独立和协调地运作，以影响关键利益相关者(即客户、家庭和ADS工作人员)的结果；以及测试和完善ADS利用的概念模型。定量试点数据将从20个ADS项目和200名老年ADS客户(65岁或以上)以及与每个客户的监督和照顾最密切相关的主要家庭照顾者和ADS工作人员中随机抽样收集。定性部分将涉及对两个ADS地点和嵌入定量部分的20个客户-家庭-工作人员星座进行深入的人种学研究。案例研究和专题分析将有助于将定性调查结果与定量议定书的调查结果结合起来。这项研究是对ADS方案和社会背景过程的创新分析，将有助于开发新的概念模型，以帮助评估ADS和其他基于社区的长期护理服务。此外，综合培训和研究活动将为今后的大规模举措奠定坚实的基础，这些举措围绕综合研究长期护理利用的过程和结果轨迹的多种方法展开。

DESCRIPTION (provided by applicant): There are two developmental objectives in this proposed K02 award: 1) to obtain expertise in qualitative and mixed-methods design to advance the principal investigator's (Pi's) research program on informal and formal long-term care, and 2) to gain knowledge and experience in the development and administration of large-scale, collaborative research initiatives based on the innovation of mixed methods designs. To achieve both objectives, a detailed career development plan is proposed that will offer extensive training in qualitative and mixed-methods research approaches via textbook reading, university-based courses, attendance at institutes, and collaboration with a number of senior colleagues. These activities will allow the candidate to integrate methodological viewpoints and will also provide valuable guidance as he transitions to the administration of research initiatives that rely on multiple R01-level projects and effective mentorship of junior researchers. Research activities based on these training aims will offer the candidate extensive experience in the conduct of complex, mixed methods research in long-term care. Using complementary quantitative and qualitative approaches, the proposed pilot study will: ascertain how various programmatic aspects of adult day service (ADS) programs facilitate the development of strong client-family-staff relationships; determine how ADS program environment and client-family-staff relationships operate independently and in concert to influence outcomes across key stakeholders (i.e., clients, families, and ADS staff); and test and refine a conceptual model of ADS utilization. Quantitative pilot data will be collected from a random sample of 20 ADS programs and 200 elderly ADS clients (65 years of age or over) as well as primary family caregivers and ADS staff persons most closely involved in the supervision and care of each client. The qualitative component will involve in-depth ethnographic research at two ADS sites and 20 client-family-staff constellations embedded in the quantitative component. Case study and thematic analyses will facilitate integration of the qualitative findings with those from the quantitative protocol. This study, an innovative analysis of the process of ADS programmatic and social contexts, will help to develop new conceptual models to aid in the evaluation of ADS and other community-based long-term care services. Moreover, the integrated training and research activities will provide a strong foundation for future, large-scale initiatives revolving around the integration of multiple methodologies in the study of process and outcome trajectories of long-term care utilization.