Examining the clinical workflow and outcomes of integrating health information technology to educate and support dementia caregivers

项目摘要。拟议的项目，“检查临床工作流程和成果， 整合健康信息技术，教育和支持痴呆症护理人员，”是一个 一项全面的研究，将评估CareHeroes的整合，一个网络和智能手机， 基于健康信息技术（HIT）应用程序的临床护理，同时支持和 增强老年痴呆症和其他形式痴呆症（AD）成年人的护理人员的能力。 AD是全球残疾的主要原因，管理AD的压力和挑战 症状通常导致AD护理者的抑郁、负担和健康受损。AD 也不成比例地影响非裔美国人和西班牙裔的患者和护理人员。 同时，提供者在收集患者相关信息以供使用方面存在障碍 对于AD临床决策和AD护理人员报告的挑战，以共同决策。 HIT已被建议作为一种方法来解决与AD临床相关的挑战， 尽管人们对如何利用移动的技术来连接 护理人员和临床护理提供者。为了解决这些问题，研究小组 开发的CareHeroes是一款多功能应用程序，用于：教育AD护理人员， AD护理人员，并为AD护理人员提供一个安全的平台，以分享患者相关的 从家庭或社区环境中实时与提供者的信息。后 成功的可行性研究，该项目建议将CareHeroes整合到临床 两个记忆诊所的工作流程，为大部分AD患者和护理人员提供服务， 弱势背景（西班牙裔，非裔美国人，农村居住）。作为研究的一部分， 护理人员将使用该应用程序为期12个月，作为对康复的支持， 他们作为护理团队沿着提供者的一部分的角色。该项目的具体目标是： (1)评估将CareHeroes整合到临床工作流程中的可行性及其 在提供者和护理人员之间进行临床和共享决策的使用;以及（2） 研究应用程序的使用对照顾者的自我效能和健康素养的影响。 这些发现将具有很高的公共卫生重要性，因为它将为未来的努力提供信息。 实施HIT作为AD临床护理的辅助手段，这可能会改善反应 为AD护理人员和患者提供更好的身心健康结果。的 多学科小组已经制定了一个可行的干预和评估计划，由PI领导，博士。 亚拉巴马大学社会工作系副教授Nicole Ruggiano和Dr. 佛罗里达国际大学（FIU）护理学副教授埃伦·布朗说。

PROJECT SUMMARY. The proposed project, “Examining the clinical workflow and outcomes of integrating health information technology to educate and support dementia caregivers,” is a comprehensive study that will evaluate the integration of CareHeroes, a web- and smartphone- based health information technology (HIT) app into clinical care while supporting and empowering caregivers of adults with Alzheimer's disease and other forms of dementia (AD). AD is a leading cause of disability worldwide and the stress and challenges of managing AD symptoms often results in depression, burden, and compromised health for AD caregivers. AD also disproportionately affects patients and caregivers who are African American and Hispanic. Simultaneously, there are barriers for providers in collecting patient-related information to use for AD clinical decision making and AD caregivers report challenges to shared decision making. HIT has been suggested as a way to address the challenges associated with AD clinical care and caregiving, though little is known about how to utilize mobile technologies to link caregivers and providers for clinical care. To address these issues, the research team has developed CareHeroes, a multi-functional app that: educates AD caregivers, provides support to AD caregivers, and provides a secure platform for AD caregivers to share patient-related information with providers from the home or community setting in real-time. Following the success of its feasibility study, this project proposes to integrate CareHeroes into the clinical workflow of two memory clinics that serve large proportions of AD patients and caregivers from disadvantaged backgrounds (Hispanic, African American, rural dwelling). As part of the study, caregivers will use the app for a period of 12 months as a support for caregiving and to elevate their role as part of the care team along with providers. The specific aims of this project are to: (1) evaluate the feasibility of integrating CareHeroes into clinical workflow and the effects of its usage on clinical and shared decision making between providers and caregivers; and (2) examine the effects of usage of the app on caregivers' self-efficacy and health literacy. The findings will have high public health importance, because it will inform future efforts on implementing HIT as an adjunct to AD clinical care, which may result in improved responses to AD care and better physical and mental health outcomes for AD caregivers and patients. The multi-disciplinary team has devised a feasible intervention and evaluation plan, led by PIs, Dr. Nicole Ruggiano, Associate Professor of Social Work at the University of Alabama, and Dr. Ellen Brown, Associate Professor of Nursing at Florida International University (FIU).