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CAMBRIDGE, MA, United States

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 140.00K | Year: 2009

DESCRIPTION (provided by applicant): The nation's workforce is aging, and the highest growth rate will be among persons aged 55 to 64 years old, with a projected 51% increase in labor force participation from 2002 to 2012. Given that older workers incur higher health care costs, the corporate sector has a strong incentive to develop successful risk reduction interventions that have the potential to both reduce older workers health care costs as well as enhance their productivity (USGAO, 2001). This Phase 1 SBIR application will establish the feasibility, acceptability, and short term effectiveness of a unique risk reduction intervention that integrates strategies for wellness, employee assistance, and work life, in order to best address the full spectrum of health and social needs of older workers, aged 55 to 64 years old. Specific study aims are to: 1) Modify Health Risk Appraisal (HRA) and tailored feedback for older workers aged 55-64 years old; 2) Implement the integrated risk reduction intervention in a randomized controlled trial at two worksites; 3) Evaluate the program using the RE-AIM conceptual model; and, 4) Develop and submit Phase II application, based on the Phase I evaluation results. Environment and Health Group is collaborating with Workplace Options (WPO), the world's largest provider of work-life employee benefits and ConvergenceHealth, an application software provider that currently delivers HRAs to 11 million health plan subscribers. Environment and Health and WPO will work with ConvergenceHealth to modify WPO's current Advantage Web HRA, along with its individualized report software and self-management software, specifically for individuals aged 55 to 64 years old. The integrated risk reduction intervention will be implemented in two worksites, with Workplace Options providing wellness coaching, employee assistance, and work-life services. Program evaluation will focus on program reach (including representativeness of participants and acceptability of program by participants); implementation fidelity; short-term effectiveness of the program in reducing behavioral risks; and, maintenance, specifically whether participants are retained in the program over the two month intervention period. The data obtained for the comparisons of behavioral change across treatment and control groups will be used to predict sample size for the Phase 2 application. Initial projections of intervention delivery costs will be obtained for a robust cost effectiveness analysis for the Phase 2 application. The product resulting from the Phase 1 study, and the subsequent Phase 2 application, will be an innovative new product that has the potential to be marketed to literally thousands of companies in the United States and abroad. PUBLIC HEALTH RELEVANCE: The purpose of this project is to develop a cost-effective worksite based health promotion/risk reduction program for older workers aged 55-64.

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 100.00K | Year: 2009

DESCRIPTION (provided by applicant): HIV infection is on the rise among older women in the U.S. There is an urgent need for culturally- sensitive, gender-specific, and age-appropriate HIV prevention interventions for older women, particularly minority older women who are most at-risk - a need that is disturbingly unmet. The need to overcome stigma and privacy barriers to HIV/AIDs and STD education in this group, combined with the explosive growth in the number of wired seniors, including minority seniors, makes an e-intervention an ideal delivery method for addressing this problem, and for addressing ethnic disparities in HIV infection rates among older women. Our overall goal is to develop a comprehensive (educational and behavioral), tailored, accessible, and innovative HIV/AIDs and STD prevention e-intervention for culturally-diverse older women age 50 and over. Specific Phase 1 Aims are to: 1) Develop a prototype website for a risk reduction e-intervention for culturally- diverse older women, incorporating a peer chatroom and ask the expert segment; 2) Collect pilot data to develop an individually tailored online coaching component to be incorporated into the Phase 2 site; 3) Evaluate the feasibility, acceptability, and immediate effectiveness of the Phase 1 site for increasing knowledge and perceived risks; and, 4) Prepare for the Phase 2 application with respect to functional expansion, evaluation, and commercialization of the website, to be developed in Phase I. Specific Aims for the Phase 2 application are to 1) Expand the peer chatroom to a fully-functional, interactive component of the website for users to meet peers, and share stories and experiences; 2) Expand the ask the expert segment to a fully-functional, interactive component in which user questions will be answered and posted on the website on an ongoing basis; 3) Incorporate scheduled, individually tailored, online behavioral coaching sessions with a health expert (nurse, gynecologist, or social worker); 4) Implement and evaluate the effectiveness of the enhanced risk reduction intervention in a randomized controlled trial, focusing on both proximal (e.g., increasing self-efficacy for safe sex practices, sexual negotiation skills, and physician communication skills), and distal outcomes (e.g., increase in consistent safe sex practices, successful sexual negotiation, and successful physician communication, including appropriate HIV/AID/STD testing); 5) Market the website through collaboration with national and local aging organizations, including CyberSeniors and the New England Association of HIV Over 50; and, 6) Commercialize the product(s) through individual subscription, advertising, and partnerships with other companies and nonprofits to ensure financial and administrative sustainability of the website. Environment and Health Inc. is well poised to successfully accomplish the proposed aims, given our highly qualified team, technical expertise, and infrastructure. PUBLIC HEALTH RELEVANCE: HIV infection rates are rising among older women, particularly African American women, creating public health and distributive justice imperatives for culturally-sensitive and gender-specific HIV and STD prevention interventions for older women. To date, no such interventions exist. We propose developing the first comprehensive (educational and behavioral), tailored, accessible, and innovative STD and HIV prevention e- intervention for culturally-diverse older women. The intervention will help prevent STD and HIV infection among older women, and reduce ethnic disparities in HIV/AIDS.

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 741.47K | Year: 2006

DESCRIPTION (provided by applicant): Latino family members are often the caregivers for their loved ones with Alzheimer's disease and related disorders (ADRD), but they face many barriers in accessing and utilizing services. To address these barriers to care, we implemented a Phase I SBIR project, in which we developed a culturally competent, prototype website for Latino caregivers. In this Phase II SBIR project, we will expand the Phase I prototype bilingual website into a fully functioning, content-rich, culturally relevant, accessible, interactive and sustainable on-line community, CareHub.org. The CareHub project is designed as a working system for engaging Latino caregivers and providing ADRD information, and as a culturally-compatible online virtual community that can support its members. The website will provide real time, online education and support for Latino family caregivers including culturally competent information about Alzheimer's disease and related disorders, practical "how-to" instructions about managing dementia-related behaviors, and information on taking care of oneself. New technologies will include a discussion forum for caregivers, an "ask an expert" resource, links to other national resources, and a series of interactive mini-tutorials on using the website. The Phase II aims are to: (1) Expand website information available to Latino caregivers about the symptoms and course of ADRD, caregiving skills, and tools and information for maintaining their own health and well-being; (2) Build additional features and infrastructure (e.g., bulletin board, chat room) for online peer support and interaction among caregivers using the website; (3) Add an expert advice feature to the website; (4) Evaluate the website, with a focus on the effectiveness of the website in increasing knowledge of ADRD, improving caregiver's competence, enhancing perceived social support, improving attitude towards service use, and reducing caregiver burden and emotional distress; and (5) Market and commercialize the website through collaboration with health, elder care, Latino and Alzheimer organizations to ensure financial and administrative sustainability of the website.

Agency: Department of Health and Human Services | Branch: National Institutes of Health | Program: SBIR | Phase: Phase II | Award Amount: 397.89K | Year: 2016

DESCRIPTION provided by applicant Environment and Health Group EHG Inc in collaboration with a number of Boston MA and Columbia SC based organizations seeks to enhance test and commercialize an individually tailored culturally sensitive positive psychology and behavioral economics based mobile health intervention to promote ART adherence increase ART self efficacy and reduce feelings of stress burden among HIV positive African Americans age and older African Americans represent a growing portion of people living with HIV CDC by those age will account for half of all cases of HIV AIDS in the U S NIDA Poor ART adherence contributes to disparities in HIV AIDS outcomes among older African Americans The proposed project is based on EHGandapos s previous research with HIV age years and older African American adults That research revealed personalized pill reminder text messages with positive psychology based motivational and educational messages are effective at addressing two major barriers to ART adherence in this group memory deficits resulting from the combined effects of HIV cognitive aging and increased allostatic load and low motivation due to lack of ART self efficacy and negative affect Findings showed significant improvement in ART adherence scores and marginally significant improvement in ART self efficacy scores While affect scores did not change qualitative findings showed the intervention helped reduce feelings of stress burden Supporting ART adherence is key to reducing health disparities among HIV African Americans Doing so for those age and older who are most vulnerable to cumulative age accelerating effects of HIV infection and allostatic load is urgent which is why we are lowering the age cut off from to in Phase II To date no ART adherence support intervention has been developed for this highly vulnerable group The Phase II project will enhance the existing mobile intervention by offering a two way communication capability through which participants can i indicate andquot pill takenandquot in response to pill reminders and ii receive a positive visual icon as behavioral economics based reinforcement for andquot pill takenandquot responses live real time pharmacist counseling and medication support and the addition of opt in smoking cessation educational and motivational texts Overall aims are to expand mhealth intervention to incorporate new Phase II features evaluate effectiveness in an RCT of HIV African Americans age and older and prepare marketing and commercialization plans Our long term goal is to increase ART adherence thus decreasing health disparities among HIV African Americans age PUBLIC HEALTH RELEVANCE According to the CDC there are approximately African Americans in the age group of and older who are living with an HIV diagnosis Unfortunately many African Americans will die earlier from HIV AIDS than their white non Hispanic counterparts due in large part to lack of adherence to Antiretroviral therapy ART The proposed mhealth intervention seeks to increase ART adherence among HIV African Americans who are over the age of thus improving health outcomes and reducing disparities in this group

Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 292.49K | Year: 2011

DESCRIPTION (provided by applicant): The growing prevalence of dementia, the health and mental health consequences for family caregivers, the lack of ethno-cultural and linguistic training programs for ethnic minority family caregivers, and the increasingpenetration of the internet in ethnic minority communities underscore the need for an online training program for ethnic minority dementia caregivers. In response to the National Institute on Aging PA-06-049, we propose to develop and test the feasibilityand preliminary effectiveness of an online self-directed, skill training intervention for Chinese and Hispanic adults providing care to individuals with Alzheimer's disease and related dementia. The overall goal of this project is to use internet-based technology to develop a self-directed training intervention that is designed to enhance caregiver management skills to improve self-efficacy, which we hypothesize will lead to reduced caregiver burden and emotional distress; and increase caregiver self-care skills, which we hypothesize will result in enhanced overall health and quality of life. Specifically, Phase I will develop a prototype for two internet-based SDL training programs, one for Chinese caregivers, and the other for Hispanic caregivers, to improve caregiving management skills and self care skills. An iterative formative evaluation will be performed to inform the process of designing the intervention components in order to ensure the usability, content validity, motivational design, and ethno-cultural and linguistic competency of the intervention. A randomized controlled trial will be conducted to assess preliminary effectiveness of the training intervention with regard to its impact on both caregivers and care recipients. The findings of this Phase I application will be used to develop a Phase II SBIR, in which we will conduct a large-scale randomized trial of the full scale SDL intervention. Phase 1 study results will provide the effect size necessary to determine the sample size needed for the Phase 2 application. Evidence of the effectiveness of the SDL training program will be a valuable contribution to the developing evidence-base of online caregiver training programs for ethnic minority caregivers. Successful accomplishment of the Phase II application will result in an innovative, online caregiver training service model with high commercialization potential. First, the use of the proposed technology will facilitate the delivery of competence-based training services, which can be offered eitherstanding alone or in combination with other support-based services available for dementia caregivers. Second, the proposed training model can be applied not only for ethnic minority caregivers with dementia, but also for caregivers caring for older adultswith other chronic conditions. PUBLIC HEALTH RELEVANCE: The proposed Phase I effort focuses on developing a self-directed skill training intervention program for ethnic Chinese and Hispanic dementia caregivers. This is highly relevant to the nation's public health not only because there is a persistent lack of ethno-cultural and linguistically competent education, support, and assistance programs for these ethnic minority groups, but also because Hispanic and Asian Americans are two fastest growing groups of the nation, increasing by 43% in the past decade, according to the Census Bureau report released in early 2011.

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