SBIR-STTR Award

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. , ,

Public Health Relevance:
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.

Thesaurus Terms:
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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 percent of the care for persons with ADRD is delivered at home, and family caregivers need ongoing support to manage the daunting physical and psychological demands of care. 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 showed that the NYUCI substantially reduced caregiver's depressive symptoms and the severity of their reaction to the behaviors caused by the illness, improved their physical health, and extended the time persons with ADRD were able to remain at home-an average of 1.5 years longer than those whose caregivers received usual care (Mittelman et al., AG14634, formerly MH42216;See www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=122). This Phase II effort proposes to complete and evaluate an innovative Internet-Based Multimedia Education (IBME) training program for providers in community agencies and private practice seeking to learn how to implement the NYUCI or become more proficient in counseling family caregivers of people with dementia. Certification and continuing education credits will be part of the product. Requests for training have become too numerous to satisfy in a timely manner in person. We hypothesize the proposed effort can provide effective training with the aid of the Internet so that fidelity to the NYUCI content, protocols, and outcomes can be achieved efficiently. We will test this hypothesis in YR2 with a randomized controlled trial that will inclue both quantitative analyses and qualitative evaluations, comparing the results of in person training and on-line training using the completed product. Because NYUCI assures support to family caregivers for the life of those with ADRD, the proposed IBME has the potential to transform ADRD home care but also U.S. healthcare systems as it disseminates access to the evidence-based 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 the Investigators and other key 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 of providers of caregiving support to persons with chronic diseases other than ADRD.

Public Health Relevance:
This Phase II effort completes and evaluates 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 1.5 years, on average. Widespread implementation of the NYUCI model, to be facilitated by the proposed training and certification program, could support the 10.9 million family caregivers delivering nearly 75 percent of the home care for those with AD (Alzheimer's Association: 2010 Alzheimer's Disease Facts and Figures) as well as potentially saving the health care system hundreds of millions of dollars.