Alzheimer's disease and related disorders (ADRD) constitute urgent challenges to U.S. Healthcare systems as well as enormous burdens on society as a whole. Nearly 75% of the care for persons with ADRD is delivered at home, and family caregivers need ongoing support to manage the daunting physical and psychological effects of care demands. As ADRD progresses, family caregivers are increasingly vulnerable to stress and depression, which may lead them to reluctantly place their relatives in nursing homes. PI Mittelman and colleagues, in a 20+ year randomized controlled trial, tested a psychosocial intervention for spouse caregivers, called the NYU Caregiver Intervention (NYUCI) and demonstrated long-term positive outcomes for people with ADRD and their family members. Most notably, the RCT 1) substantiated reduced depression and improved physical health for caregivers and 2) significantly extended the time persons with ADRD were able to remain at home-an average of 1.5 years longer than control group members (Mittelman et al., AG14634, formerly MH42216;See www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=122). This Phase I effort, """"""""Training for Providers of an Evidence-Based AD Family Caregiver Intervention,"""""""" proposes to create, develop, and test feasibility of a prototype of 4 of an eventual 12 modules of an innovative Internet-Based Multimedia Education (IBME) training program targeted to providers in community agencies seeking to learn how to implement the (NYUCI) model. Requests for NYUCI implementation training have become too numerous to satisfy in person, which led project investigators to conceive of this Phase I IBME. They hypothesize the proposed effort has the power to provide effective training with the aid of the Internet so that fidelity to the NYUCI content, protocols, and outcomes can be achieved efficiently. Moreover, in this form, it can be modified and kept up-to-date with new information and experiences of those implementing the intervention in different communities. Because the NYUCI assures support to family caregivers for the life of loved ones with ADRD, this proposed IBME has the potential to transform not only ADRD home care but also U.S. healthcare systems as it disseminates access to the 20+ years of clinical research validating the NYUCI model to many more agencies than would be possible without an IBME format. The project's innovation derives from a unique vision, multilevel intervention, and creative combination of the NYUCI itself, the professional experience of PI Hobday, PI Mittelman, and other key project personnel in the fields of family care, ADRD, and IBME development. In addition to its strong present commercial potential, this IBME may be also useful as a template for future training to support family caregivers of persons with chronic diseases other than ADRD.
This Phase I effort creates and develops an Internet-based training for social service providers implementing the evidence-based New York University Caregiver Intervention (NYUCI) model, a psychosocial intervention for families of those with Alzheimer's disease (AD). This effort is highly relevant to U.S. public health because the NYUCI has been shown to reduce depression in caregivers and delay nursing home placement by, on average, 1.5 years. Wider implementation of NYUCI model, to be facilitated by the proposed training intervention, could support the 9.8 million family caregivers delivering nearly 75% of the home care for those with AD (Alzheimer's Association, p. 15) as well as potentially saving the health care system hundreds of millions of dollars.
