计划：针对可能患有痴呆症的韩国老年人及其护理人员的痴呆症识字教育和导航 (PLAN)
研究表明，与白人同行相比，少数民族老年人更容易被及时忽视适当的痴呆症护理。 在少数族裔群体中，韩裔美国人 (KAs) 是亚洲第四大亚群，也是增长最快的亚群之一，被认为是痴呆症护理资源不足和服务不足的人群。 正在进行这项研究，以了解由训练有素的社区卫生工作者 (CHW) 领导的教育和导航支持计划如何帮助可能患有痴呆症的韩裔美国老人和韩裔美国老人的护理人员。 在一项有 288 对的双臂随机对照试验 (RCT) 中，研究人员的目的是 (1) 测试由受过训练的 CHWs 对可能患有痴呆症的未确诊 KA 老人和 KA 老人的护理人员提供的基于社区的干预的效果，（2）评估与常规护理相比，PLAN 在提高护理人员的痴呆症知识、痴呆症护理和服务使用中的自我效能、社会支持、抑郁和 6 个月时的生活质量方面的效果，以及（3）检查是否PLAN 的影响因年龄、性别、英语熟练程度和教育照顾者子群体而异。 探索性目的是测试 PLAN 对可能患有痴呆症的韩国老年人的影响，以及与常规护理相比，护理人员制定 6 个月痴呆症护理计划的效果。
目标 1 和探索性目标检验以下假设：(1) 与对照组（目标 1）相比，接受 PLAN 的可能患有痴呆症的韩国老年人与痴呆症医疗服务的联系率更高，以及 (2) 患有痴呆症的韩国老年人可能患有痴呆症和接受 PLAN 的 KA 长者的照顾者拥有痴呆症护理计划的比例高于对照组（探索性目标）。 目标 2 检验以下假设：与对照组相比，PLAN 组的护理人员在痴呆症知识、痴呆症护理和服务使用、社会支持和生活质量方面的自我效能感更高，抑郁症更低。
研究概览
详细说明
Studies have shown that ethnic-racial minority elders are more likely to be neglected from appropriate dementia care in time than the white counterparts. Among minorities group, Korean Americans (KAs) are the 4th largest and one of the most rapidly growing Asian subpopulations and have been characterized as under-resourced and underserved population of dementia care. This research is being done to understand how an education and navigation support program led by trained community health workers (CHWs) helps Korean American elders with probable dementia and the Korean American elders' caregivers. In a 2-arm randomized controlled trial (RCT) with 288 dyads, the investigators' aims are to (1) test the effect of a community-based intervention delivered by trained CHWs for undiagnosed KA elders with probable dementia and the KA elders' caregivers, (2) evaluate the effect of the PLAN on improving caregiver's dementia literacy, self-efficacy in dementia care and service use, social support, depression, and quality of life at 6 months in comparison to usual care, and (3) examine whether the effect of PLAN differs across age, sex, English proficiency and education caregiver subgroups. Exploratory Aim 1 is to explore the effect of PLAN on Korean elders with probable dementia and caregiver development of a plan regarding dementia care at 6 months in comparison to usual care. The other two Exploratory Aims are to test the applicability of this study in another environment: Exploratory Aim 2: Using an equity-informed human-centered design framework, scale PLAN for implementation in ethnic daycare and Exploratory Aim 3: Pilot test the feasibility and acceptability of PLAN in ethnic adult daycare.
Aim 1 tests the following hypothesis: (1) Korean elders with probable dementia who receive the PLAN will have higher rates of linkage to medical service for dementia than those in the control group. Aim 2 tests the following hypothesis: Caregivers in the PLAN group will have higher dementia literacy, self-efficacy in dementia care and service use, social support, and quality of life, and lower depression than those in the control group.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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New York
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Bayside、New York、美国、11361
- Korean Community Services of Metropolitan New York
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Virginia
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Annandale、Virginia、美国、22003
- Korean Community Service Center of Greater Washington
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
描述
患者纳入标准：
- 自我认定为第一代KA
- 65岁或以上
- 话单 1.0+
- 有一个住在同一家庭或至少每周有一次互动的看护人
- 能够同意或有代理可用于同意
- 书面同意参与研究
看护者纳入标准：
- 年满 18 岁
- 能够阅读和说韩语
- 与老人同住或至少每周有一次互动
- 书面同意参与研究并允许团队审核医疗记录以与痴呆症医疗服务相关联
患者排除标准：
- 先前的痴呆诊断
- 除抑郁症以外的所有 Axis I 诊断（例如，精神分裂症、双相情感障碍或物质使用障碍）
- 除阿尔茨海默氏病外可能影响认知的神经系统疾病（例如中风）
- 使用精神药物，包括抗精神病药，
照顾者排除标准：
- 计划在 6 个月内搬离该地区
- 积极治疗绝症或临终关怀
学习计划
研究是如何设计的？
设计细节
- 主要用途：放映
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：计划（干预）
第 1 组将在第一个基线问卷调查后的 6 个月研究期间接受研究干预。
干预如下：参与者将被要求在参与者家中或任何对参与者最方便的社区地点参加由训练有素的社区卫生工作者进行的一次性、一小时的教育。
教育课程结束时，将提供参与者可以在家阅读的教育资源。
参与者的社区卫生工作者将每月给参与者打电话，以确定痴呆症护理的障碍，并在参与者请求帮助时帮助参与者和参与者的长者预约或运送到医疗机构。
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研究干预 PLAN 是由训练有素的 CHW 领导的多方面干预。
它包括两个主要部分：痴呆症识字教育和带导航辅助的电话咨询，通过（1）1 小时的痴呆症识字教育访问和（2）每月带导航辅助的咨询
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有源比较器：护理标准（对照）
第 2 组将收到阿尔茨海默氏症协会提供的痴呆症症状和治疗手册，并将转诊给老人的主治医生。
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研究人员会将对照组参与者转介给参与者的主治医生进行随访，并提供阿尔茨海默氏症协会关于痴呆症和痴呆症治疗迹象的小册子，该手册以韩语公开。
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Number of Participants Linked to Medical Service for Dementia Measured by Medical Record Verification
大体时间：6 months
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Linkage to medical service for dementia is defined as the completion of a medical clinic visit by a Korean older adult with probable dementia.
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6 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Caregiver's Dementia Literacy Measured by Dementia Literacy Test
大体时间：Baseline, 3 months, and 6 months
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Dementia literacy test is a 11-item instrument (true or false).
Scoring of the dementia literacy instrument is in such a way that each correct response will be coded as 1 whereas incorrect response will be coded as 0. Total scores can range from 0 to 11 with higher scores indicating higher health literacy.
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Baseline, 3 months, and 6 months
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Self-efficacy in Dementia Care Measured by Dementia Self-efficacy Scale
大体时间：Baseline, 3 months, and 6 months
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Dementia self-efficacy scale is a 10-item instrument.
Scoring of the dementia self-efficacy scale ranges from "not at all certain" coded as 1 to "very certain" coded as 10 for each item.
Total scores will range from 10 to 100 with higher scores indicating higher self-efficacy.
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Baseline, 3 months, and 6 months
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Social Support Status as Assessed by Medical Outcomes Study Scale
大体时间：Baseline, 3 months, and 6 months
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The 8-item scale of medical outcomes study scoring ranges from "none of the time" coded as 1 to "all of the time" coded as 5 for each item.
Mean scores will range from 1 to 5, with higher scores indicating greater social support.
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Baseline, 3 months, and 6 months
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Depression Status as Assessed by Patient Health Questionnaire-9
大体时间：Baseline, 3 months, and 6 months
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Patient health questionnaire-9 is a 9-item instrument and scoring ranges from "not at all" coded as 0 to "nearly every day" coded as 3. Total scores will range from 0 to 27 with higher score indicating higher depression.
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Baseline, 3 months, and 6 months
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Quality of Life (QoL) Measured by QoL-dementia Caregiver Instrument
大体时间：Baseline, 3 months, 6 months
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QoL-dementia caregiver is a 13-item instrument and scoring ranges from "poor" coded as 1 to "excellent" coded as 4 for each item.
Total scores will range from 13 to 52 with higher scores indicating higher quality of life.
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Baseline, 3 months, 6 months
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合作者和调查者
调查人员
- 首席研究员：Hae-Ra Han, PhD, RN、Johns Hopkins University
出版物和有用的链接
一般刊物
- Min D, Yun JY, Parslow C, Jajodia A, Han HR. Online-Based Recruitment Methods for Community-Dwelling Older Adults: Scoping Review and Lessons Learned From the PLAN Trial. J Med Internet Res. 2025 Feb 25;27:e55082. doi: 10.2196/55082.
- Han HR, Perrin N, Kwon SC, Joo J, Yun JY, Min D, Lee HB. PLAN-Dementia literacy education and navigation for Korean elders with probable dementia and their caregivers: Rationale, methods, and design of a community-based, randomized, controlled, multi-site clinical trial. Contemp Clin Trials. 2025 Jan;148:107771. doi: 10.1016/j.cct.2024.107771. Epub 2024 Nov 30.
- Han HR, Yun JY, Min D, Razaz M. Health literacy demand and attitudes toward COVID-19 prevention measures among Korean American older adults and their caregivers. BMC Public Health. 2024 Oct 23;24(1):2941. doi: 10.1186/s12889-024-20427-7.
- Baumeister A, Aldin A, Chakraverty D, Hubner C, Adams A, Monsef I, Skoetz N, Kalbe E, Woopen C. Interventions for improving health literacy in migrants. Cochrane Database Syst Rev. 2023 Nov 14;11(11):CD013303. doi: 10.1002/14651858.CD013303.pub2.
- Han HR, Min D, Yun JY, Joo JH, Lee HB, Kwon S. The impact of anti-Asian racism on routine activities and mental health among Korean American older adults and their caregivers. Front Public Health. 2023 Feb 22;11:958657. doi: 10.3389/fpubh.2023.958657. eCollection 2023.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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