Improving health equities for Hispanic/Latino families living with dementia by validating a Spanish-language Caregiver-Enabled Care Program (CECP) in PACE participants

ABSTRACT Older Hispanic/Latino adults living with dementia face inadequate access to formal care and tend to rely heavily or solely on family members for dementia care and assistance. Access to evidence-based resources and support for family caregivers is critical to improving care and outcomes for a loved one living with dementia. However, these resources and support are lacking for Hispanic/Latino caregivers. To address these barriers to health equity in dementia care for the U.S. Hispanic/Latino population, Ceresti will develop an approach for deploying its proven Caregiver-Enabled Care Program (CECP) to Spanish-speaking caregivers of patients with dementia. CECP is a non-medical digital population health intervention that leverages data, predictive analytics, and artificial intelligence to engage and support unpaid/informal caregivers. This is accomplished via personalized education, proactive coaching, and remote monitoring, all delivered via a dedicated tablet shipped to the caregiver's home at no cost to the caregiver or person with dementia. In a previous clinical study of a 6-month version of CECP in a cohort of 164 English-speaking caregivers of persons with dementia, caregivers sustained longitudinal engagement in their CECP (96.7% month-to-month continue rate) and engaged in education, coaching and assessment for more than 40 min/week. After engaging at this level, caregivers improved their mental health, reduced their loneliness, and were highly satisfied with their CECP. For the proposed study, our central hypothesis is that Spanish-speaking caregivers will engaged at levels that are comparable to those of English-speaking caregivers of dementia patients who have enrolled in our English-language CECP. To test this hypothesis, we will enroll 135 Spanish-speaking caregivers of dementia patients participating in a Program for All-Inclusive Care for the Elderly (PACE) into a 6-month study of our Spanish-language CECP. At the end of this study, we expect to show that caregivers who enrolled in our Spanish CECP sustained comparable longitudinal and weekly engagement as English-speaking caregivers. These outcomes are important because sustained longitudinal and high-intensity engagement is a core pillar to effective population health; in this case, more engagement increases caregiver knowledge, skills, and confidence in caring for a loved one with dementia. Successful implementation of our Spanish-language CECP will be an important contribution towards achieving health equity for Spanish-speaking families living with dementia. Our findings will show that the highly scalable approach of using AI-plus-human validation to develop a Spanish-language CECP can deliver equivalent engagement to our proven English-language CECP. This crucial demonstration of the feasibility of our approach will position us favorably for future studies aimed to show the efficacy, scalability, and commercialization potential of our Spanish language CECP and our potential to implement our approach in other languages. Specific Aims Page 1