Protocol for a program of research from the Aging, Community and Health Research Unit: Promoting optimal aging at home for older adults with multimorbidity.

Journal of comorbidity Pub Date : 2018-07-31 eCollection Date: 2018-01-01 DOI:10.1177/2235042X18789508
Maureen Markle-Reid, Jenny Ploeg, Ruta Valaitis, Wendy Duggleby, Kathryn Fisher, Kimberly Fraser, Rebecca Ganann, Lauren E Griffith, Andrea Gruneir, Carrie McAiney, Allison Williams
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引用次数: 12

Abstract

Background: The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program.

Objectives: The objectives of the ACHRU research program are (i) to codesign integrated and person-centered interventions with older adults, family/friend caregivers, and providers; (ii) to examine the feasibility of newly designed interventions; (iii) to determine the intervention effectiveness on Triple Aim outcomes: health, patient/caregiver experience, and cost; (iv) to examine intervention context and implementation barriers and facilitators; (v) to use diverse integrated knowledge translation (IKT) strategies to engage knowledge users to support scalability and sustainability of effective interventions; and (vi) to build patient-oriented research capacity.

Design: The research program was informed by the Knowledge-to-Action Framework and the Complexity Model. Six individual studies were conceptualized as integrated pieces of work. The results of the three initial descriptive studies will inform and be followed by three pragmatic randomized controlled trials. IKT and capacity building activities will be embedded in all six studies and tailored to the unique focus of each study.

Conclusions: This research program will inform the development of effective and scalable person-centered interventions that are sustainable through interagency and intersectoral partnerships with community-based agencies, policy makers, and other health and social service agencies. Implementation of these interventions has the potential to transform health-care services and systems and improve the quality of life for older adults with multimorbidity and their caregivers.

Trial registration: NCT02428387 (study 4), NCT02158741 (study 5), and NCT02209285 (study 6).

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老龄化、社区和健康研究单位的一个研究项目方案:促进患有多种疾病的老年人在家中实现最佳老龄化。
背景:老龄化、社区和健康研究单位(ACHRU)的目标是促进患有多种疾病(≥2种慢性病)的老年人在家中实现最佳老龄化,并支持他们的家人/朋友照顾者。本协议文件报告了这个以患者为导向的跨司法管辖区研究项目的基本原理和计划。目标:ACHRU研究项目的目标是:(i)与老年人、家人/朋友照顾者和提供者共同设计综合的、以人为中心的干预措施;(ii)研究新设计的干预措施的可行性;(iii)确定对“三重目标”结果的干预效果:健康、患者/护理者体验和成本;(iv)审查干预背景和实施障碍及促进因素;(v)使用多样化的综合知识转化(IKT)策略,吸引知识用户参与,以支持有效干预措施的可扩展性和可持续性;(六)建立以患者为中心的研究能力。设计:研究方案采用知识-行动框架和复杂性模型。六项单独的研究被概念化为综合的工作。三个初始描述性研究的结果将为三个实用的随机对照试验提供信息并随后进行。IKT和能力建设活动将纳入所有六项研究,并根据每项研究的独特重点进行调整。结论:本研究项目将通过与社区机构、政策制定者和其他卫生和社会服务机构的机构间和部门间伙伴关系,为有效和可扩展的以人为本的干预措施的发展提供信息。实施这些干预措施有可能改变卫生保健服务和系统,并改善患有多种疾病的老年人及其照顾者的生活质量。试验注册:NCT02428387(研究4)、NCT02158741(研究5)和NCT02209285(研究6)。
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