Diversity supplement to the U01 project-Care partner assisted intervention to improve oral health for person with mild dementia

家长赠款摘要(摘要)(1U01DE027512-01)： 在美国，近9%的65岁及以上的成年人患有痴呆症，而痴呆症患者 与认知正常的老年人相比，口腔健康明显更差。即使是轻度痴呆症患者也是如此 口腔健康不良的风险更高，有强有力的证据表明，不适当的口腔卫生做法是一种 主要的贡献因素。保持良好的口腔卫生是预防口腔恶化的关键一步 健康。在疗养院进行的一些研究表明，在常规的口腔卫生护理下，口腔 痴呆症患者的健康在短时间内显著改善。大多数轻度痴呆症患者 生活在家庭成员(即护理伙伴)提供日常活动监督或帮助的家里， 但往往忽视口腔卫生。因为护理伙伴在监督和护理方面发挥着重要作用 家居轻度痴呆症患者，对轻度痴呆症患者及其护理的干预 改善口腔自我护理的伴侣可能对患有轻度口腔疾病的个人有长期的口腔健康益处 痴呆症。然而，很少有干预措施解决一般老年人的口腔健康问题和 据我们所知，在轻度痴呆症患者中，没有任何口腔健康干预措施 在社区居住的轻度痴呆症患者中进行了这项研究。为了解决这一知识差距， 我们提出了一种新的干预方法，帮助护理伙伴学习如何调整指导个人的方法 有轻度痴呆症的人在进行口腔卫生。轻度痴呆症是干预的理想时机，因为个人 轻度痴呆症患者仍具有足够的认知能力，能够成功地完成口腔卫生任务 援助。使用我们进行的试点研究的结果，我们制定了干预方案并 建立了我们的多学科研究团队(NIDCR1R34DE023881)。我们初步研究的结果 提供强有力的迹象，表明我们的护理伙伴辅助干预将产生积极的口腔健康结果。 我们的团队准备在纽约市和北卡罗来纳州实施U01随机对照试验(RCT)。 干预措施包括定制的口腔护理计划和使用自适应 我们团队推出的慢性病领导框架，用于管理与 慢性疾病，如痴呆症。具体目标是：目标1：评估护理的有效性 伙伴辅助干预改善轻度口腔疾病患者的口腔卫生和口腔卫生行为 痴呆症。目标2：评估中介因素/进程结果的变化，包括 轻度痴呆症患者和护理伙伴的二元组、口腔健康知识和自我效能 了解干预的机制。这种创新的护理伙伴辅助的口腔护理行为 干预措施将帮助IMD和护理合作伙伴实施合作的口腔卫生护理计划，以预防 口腔健康恶化，这反过来将有助于我们的目标人群在#年保持独立性 在较长的一段时间内完成日常活动和生活质量。

Summary (Abstract) of Parent Grant (1U01DE027512-01) : Close to 9% of adults age 65 and older in the U.S. have dementia and individuals with dementia have significantly poorer oral health than cognitively intact older adults. Even individuals with mild dementia are at higher risk of poor oral health and evidence is strong to suggest that inadequate oral hygiene practices are a major contributing factor. Maintaining good oral hygiene is a critical step in preventing deterioration of oral health. A few studies conducted in nursing homes have shown that with routine oral hygiene care, the oral health of persons with dementia improves notably in a short period of time. Most individuals with mild dementia live at home where family members (i.e. care partners) provide supervision or assistance with daily activities, but often neglect oral hygiene. Because care partners play an essential role in supervising and caring for individuals with mild dementia at home, an intervention with both individuals with mild dementia and their care partners to improve oral self-care may have long term oral health benefits for the individuals with mild dementia. Yet, few interventions have addressed oral health problems among older adults in general and among individuals with mild dementia in particular, and to our knowledge, no oral health interventions have been conducted among community dwelling individuals with mild dementia. To address this gap in knowledge, we propose a novel intervention to help care partners learn how to adapt methods for guiding the individuals with mild dementia in carrying out oral hygiene. Mild dementia is an ideal time to intervene because individuals with mild dementia still retain sufficient cognitive ability to perform oral hygiene tasks successfully with minimal assistance. Using the results from a pilot study we conducted, we developed the intervention protocol and established our multidisciplinary research team (NIDCR 1R34DE023881). The results from our pilot study provide strong indication that our care partner-assisted intervention will generate positive oral health outcomes. Our team is ready to implement a U01 randomized control trial (RCT) in New York City and North Carolina. The intervention includes both a tailored oral care plan and a behavioral component using the Adaptive Leadership Framework for Chronic Disease that our team introduced to manage symptoms associated with chronic conditions, such as dementia. The specific aims are to: Aim 1: Evaluate the effectiveness of a care partner-assisted intervention to improve oral hygiene and oral hygiene behaviors in individuals with mild dementia. Aim 2: Assess changes in mediating factors/process outcomes, including communication between the dyads, oral health knowledge, and self-efficacy for both individuals with mild dementia and care partners to understand mechanisms of the intervention. This innovative care partner-assisted oral care behavior intervention will assist IMD and care partners in implementing a cooperative oral hygiene care plan to prevent deterioration of oral health, which in turn, will help our targeted population to maintain independence in completing daily activities and quality of life for an extended period of time.