A5062443502- Dementia and Cognitive Impairment Research
- Geriatric Care and Nursing Homes
- Intergenerational Family Dynamics and Caregiving
- Migration, Health and Trauma
- Posttraumatic Stress Disorder Research
- Blood Pressure and Hypertension Studies
- Family Support in Illness
- Family Caregiving in Mental Illness
- Resilience and Mental Health
- Health disparities and outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Frailty in Older Adults
- Cardiac Arrest and Resuscitation
- Family and Patient Care in Intensive Care Units
- Trauma and Emergency Care Studies
- Interprofessional Education and Collaboration
- Health Policy Implementation Science
- Anthropology: Ethics, History, Culture
- Health and Wellbeing Research
- Empathy and Medical Education
- Chronic Disease Management Strategies
- Traumatic Brain Injury Research
- Telemedicine and Telehealth Implementation
- Cerebrovascular and Carotid Artery Diseases
- Primary Care and Health Outcomes
University of Tennessee Health Science Center
2014-2024
Memphis VA Medical Center
2002-2024
Veterans Health Administration
2013-2024
University of Warwick
2022
Sprint (United States)
2021
SPRINT
2021
VA North Texas Health Care System
2019
University of Michigan–Ann Arbor
1988-2009
Thomas Jefferson University
2005-2009
University of Pittsburgh
2009
There are currently no proven treatments to reduce the risk of mild cognitive impairment and dementia.To evaluate effect intensive blood pressure control on dementia.Randomized clinical trial conducted at 102 sites in United States Puerto Rico among adults aged 50 years or older with hypertension but without diabetes history stroke. Randomization began November 8, 2010. The was stopped early for benefit its primary outcome (a composite cardiovascular events) all-cause mortality August 20,...
The effect of intensive blood pressure lowering on brain health remains uncertain.To evaluate the association treatment with cerebral white matter lesion and volumes.A substudy a multicenter randomized clinical trial hypertensive adults 50 years or older without history diabetes stroke at 27 sites in United States. Randomization began November 8, 2010. overall was stopped early because benefit for its primary outcome (a composite cardiovascular events) all-cause mortality August 20, 2015....
In successfully reducing healthcare expenditures, patient goals must be met and savings differentiated from cost shifting. Although the Department of Veterans Affairs ( VA ) Home Based Primary Care HBPC program for chronically ill individuals has resulted in reduction , it is unknown whether results restricting services or shifting costs to Medicare meets goals. Cost projection using a hierarchical condition category HCC model adapted was used determine plus projected 9,425 newly enrolled...
We examined differences in positive aspects of caregiving (PAC) among 275 African American and 343 Caucasian caregivers individuals with Alzheimer's disease from the National Institutes Health Resources for Enhancing Care (REACH) study sites Birmingham, Memphis, Philadelphia. Americans reported higher scores on PAC than did Caucasians. Americans' religiosity partially mediated relationship between race PAC. Additional variables that contributed to their were lower anxiety, feelings bother by...
Purpose: This study developed and tested two 24-month primary care interventions to alleviate the psychological distress suffered by caregivers of those with Alzheimer's disease. The interventions, using targeted educational materials, were patient behavior management only, plus caregiver stress–coping management. We hypothesized that addition component would improve outcomes. Design Methods: A randomized clinical trial 167 caregiver–care recipient dyads was run, whom 76 completed without...
for Enhancing Alzheimer's Caregiver Health (REACH) randomized controlled trial (REACH II), REACH VA (Department of Veterans Affairs) was the first national clinical translation a proven behavioral intervention
BACKGROUND: The long‐term efficacy of interdisciplinary outpatient primary care Geriatric Evaluation and Management (GEM) has not been proven. This article focuses on results obtained during the 2 years study. METHODS: In this 2‐year randomized clinical trial, at Veterans Affairs Medical Center, Memphis, TN, 128 veterans, age 65 older, were to GEM or usual (UC). Two‐year follow‐up analyses are based 98 surviving individuals. Study outcome measurements included health status, function,...
OBJECTIVES: To examine the cost‐effectiveness of a randomized, clinical trial home‐based intervention for caregivers people with dementia. DESIGN: This analysis examined Resources Enhancing Alzheimer's Caregivers Health (REACH II), multisite, trial, from June 2002 through December 2004, funded by National Institute on Aging and Nursing Research, behavioral to decrease caregivers' stress improve management care recipient problems. SETTING: Community‐dwelling dementia caregiving dyads Memphis...
To develop and validate a brief screening measure for use in research, healthcare, community settings to systematically assess well-being identify needed areas of support caregivers patients with dementia.This study used data from Resources Enhancing Alzheimer's Caregiver Health (REACH II), multisite randomized clinical trial behavioral intervention designed improve the quality life multiple domains.REACH II.Two hundred twelve Hispanic, 211 black, 219 white family providing in-home care...
Purpose: In published dementia caregiver intervention research, there is widespread failure to measure the level at which treatment was implemented as intended, thereby introducing threats internal and external validity. The purpose of this article discuss importance inducing assessing implementation (TI) strategies in caregiving trials propose Lichstein's TI model a potential guide. Design Methods: efforts large cooperative research study interventions, Resources for Enhancing Alzheimer's...
To evaluate psychometric properties and response patterns of the Care-giver Assessment Function Upset (CAFU), a 15-item multidimensional measure dependence in dementia patients caregiver reaction.640 families were administered CAFU (53% White, 43% African American, 4% mixed race ethnicity). We created random split sample conducted exploratory factor analyses on Sample 1 confirmatory 2. Convergent discriminant validity evaluated using Spearman rank correlation coefficients.A two-factor...
This primary-care-based study was designed to determine needs as identified by the informal caregiver. A total of 165 caregivers selected topics concern. Depressed requested more information about depression, adult day care, grief, caregiver feelings, and relaxation. Caregivers individuals with mild dementia on confusion, driving, patient shadowing, telling others, depression. Behavioral (activities, combativeness, communication, confusion) stress (healthy lifestyle, relaxation, depression)...
Health care and social services such as physician visits support groups used by dementia caregivers for themselves were examined. Caregivers (N = 642) from the Resources Enhancing Alzheimer's (REACH II) study. Caregiver predisposing, enabling, need variables examined using chi-squared t-tests to characterize service users. Stagewise linear regression was explain numbers of used. Predisposing, significantly related caregivers' use. In regression, who older, more educated, married, not...
Background and ObjectivesTo investigate the reproducibility validity of latent class analysis (LCA) hierarchical cluster (HCA), multiple correspondence followed by k-means (MCA-kmeans) (kmeans) for multimorbidity clustering.MethodsWe first investigated clustering algorithms in simulated datasets with 26 diseases varying prevalence predetermined clusters, comparing derived clusters to known using adjusted Rand Index (aRI). We then them medical records male patients, aged 65 84 years from 50...
Objective Examine caregiver and care recipient healthcare costs associated with caregivers’ participation in Resources for Enhancing Alzheimer's Caregivers Health ( REACH II or VA ) behavioral interventions to improve coping skills management. Design RCT ); propensity‐score matched, retrospective cohort study ). Setting Five community sites 24 facilities Participants Care recipients disease related dementias ADRD their caregivers who participated (analysis sample of 110 197 recipients);...
The Resources for Enhancing Alzheimer's Caregivers Health in the VA (REACH VA) dementia caregiving intervention has been implemented VA, community agencies, and internationally. As identified 2013 2015 National Plan to Address Disease, REACH is being made available American Indian Alaska Native communities. Implementation activities are carried out by local Public Nursing programs operated Service Tribal programs, Administration Community Living/Administration on Aging funded program staff...
Recruitment is often the most challenging aspect of research with older persons. Social marketing--applying marketing techniques to influence behavior target audiences improve their welfare--can help researchers identify factors that recruitment.
This study used a geographically diverse sample to estimate the total cost of informal care and formal services for community-residing Alzheimer's disease (AD) recipients. Baseline data were 1200 family caregivers from Resources Enhancing Caregiver Health (REACH) study, multisite intervention trial. The replacement-wage-rate approach estimated cost. Formal assigned based on secondary sources. Annual per recipient amounted $23,436 $8,064 services. Variation in was almost entirely due...
In 1995, the John A. Hartford Foundation launched an initiative to strengthen geriatric interdisciplinary team training (GITT) for advanced practice nursing and masters‐level social work students residents in internal medicine family practice. As part of national evaluation initiative, case‐study cross‐case designs were employed using quantitative qualitative data examine influence cultures, regulations, attitudes individual disciplines on efforts at first eight GITT programs. This found...
The purpose of this study was to determine if telephone support groups for dementia caregivers have an effect on bother with patient behaviours, burden, depression, and general well-being. randomized controlled trial compared (15 5 or 6 caregivers) control (print materials). Groups met 14 times over 1 year. 1-hour sessions included content education, coping skills, support. Data were collected at baseline 12 months. sample comprised 154 caregivers, 77 per arm, providing care veterans a...