Using Technology to Support Care Partners for Persons with Alzheimer's Disease: Tele-STELLA

项目总结 NIH 1B阶段混合方法研究的目的是测试可行性、可接受性、保真度和 以远程健康为基础的干预措施的有效性，旨在减轻家庭护理伙伴(CP)对 患有阿尔茨海默病和相关痴呆症(ADRD)。ADRD提取体力、精神和经济通行费 来自照顾受影响家庭成员的CPS。在疾病的后期，行为和心理 痴呆症状(BPSD)可增加CP负担，增加CPS和长期抑郁的风险。 ADRD患者的定期护理安置。帮助CPS管理BPSD的干预措施是可用的，但 获得这些服务受到成本、距离、护理需求和污名的限制。此外，大多数以技术为基础的 干预措施并不是针对疾病的后期阶段量身定做的，因为那时BPSD更常见。在建议的 研究我们的目标是提炼和优化多站点Tele-Stella(通过技术提供支持：生活和学习 随着ADRD的推进)干预。Tele-Stella是一种基于视频会议的干预措施，可提供 在ADRD的中后期阶段，为照顾家庭成员的CP提供教育和同伴支持。这个 CP从自己的家中进行干预，首先是与Tele-Stella进行一对一的培训 指导(护士或心理学家)，然后仿照回声进行基于同伴的教育和支持 (社区卫生保健成果的扩展)模板。干预是专门针对CPS的，不管- 患有ADRD的接受者将参加这项研究。然而，CP在Tele-Stella中培养的技能将被整合 进入ADRD患者的护理，从而减少行为症状。这项建议的基础是 进行了两项试点研究，评估了Tele-Stella的早期版本。这项混合方法的研究将 评估Tele-Stella的可行性、可接受性、治疗保真度和疗效。我们假设 Tele-Stella干预将是可行和可接受的，并将减少行为的频率 ADRD患者的症状，从而改善CP的情感症状(负担、抑郁、悲伤)和 CPS和ADRD患者的生活质量。我们将从农村、非洲裔美国人和白人CP(n=150)中招募 三个地点(俄勒冈州、肯塔基州和佐治亚州)。可行性将通过测量进行定量评估 出勤率和毕业率。来自焦点小组的定性数据将增强量化的可行性 调查结果并就消费者的可接受性提供反馈。内容专家将通过以下方式评估治疗保真度 回顾视频会议的子样本。我们将评估Tele-Tella在减少 ADRD患者行为和心理症状的频率 线性回归策略。我们的长期目标是通过以下方式减轻CPS的心理负担 为任何能够访问计算机和互联网连接的CP提供Tele-Stella干预。

PROJECT SUMMARY The purpose of this NIH Stage 1B mixed methods study is to test the feasibility, acceptability, fidelity and efficacy of a telehealth-based intervention designed to reduce stress for family care partners (CP) for those with Alzheimer's disease and related dementias (ADRD). ADRD extracts physical, mental and financial tolls from CPs caring for affected family members. In the later stages of disease, behavioral and psychological symptoms of dementia (BPSD) can contribute to CP burden, increasing the risk of depression in CPs and long- term care placement for those with ADRD. Interventions that help CPs manage BPSD are available, but access to them is limited by cost, distance, care demands and stigma. Further, most technology-based interventions are not tailored to the later stages of disease, when BPSD are more common. In the proposed study we aim to refine and optimize the multi-site Tele-STELLA (Support via TEchnology: Living and Learning with Advancing ADRD) intervention. Tele-STELLA is a video-conference-based intervention that provides education and peer support for CPs caring for family members in the moderate to late stages of ADRD. The intervention, which CPs access from their own homes, begins with one-to-one training with a Tele-STELLA Guide (a nurse or psychologist), then advances to peer-based education and support modeled on the ECHO (Extension of Community Healthcare Outcomes) template. The intervention is specifically for CPs, no care- recipients with ADRD will be in this study. However, the skills CPs develop in Tele-STELLA will be integrated into the care of the person with ADRD, thus reducing behavioral symptoms. The foundation of this proposal was laid with two pilot studies which assessed early versions of Tele-STELLA. This mixed-methods study will assess the feasibility, acceptability, treatment fidelity and efficacy of Tele-STELLA. We hypothesize that the Tele-STELLA intervention will be feasible and acceptable and will reduce the frequency of behavioral symptoms in persons with ADRD, thus improving CP affective symptoms (burden, depression, grief) and quality of life for CPs and those with ADRD. We will recruit rural, African American and white CPs (n=150) from three sites (Oregon, Kentucky and Georgia). Feasibility will be assessed quantitatively by measuring attendance and completion rates. Qualitative data from focus groups will augment the feasibility quantitative findings and provide feedback on consumer acceptability. Content experts will evaluate treatment fidelity by reviewing a subsample of video-taped sessions. We will measure efficacy of Tele-TELLA on reducing the frequency of behavioral and psychological symptoms in persons with ADRD using pre-post assessments and linear regression strategies. Our long term goal is to reduce the psychological burden CPs experience by providing the Tele-STELLA intervention for any CP who has access to a computer and an internet connection.