Efficacy of a Healthy Lifestyle Intervention to Prevent Depression in Older Spousally-bereaved Adults-Supplement

项目总结/摘要 失去配偶的老年人患重度抑郁症（MDD）的风险很高。时代的 COVID-19，无法参与支持悲伤过程的仪式将使人们更难 面对配偶的死亡。这一拟议的行政补充利用了我们资助的R01 "功效 健康的生活方式干预，以防止抑郁症在老年配偶丧失成年人"（好）， 增加我们现有的行为健康干预措施的覆盖面、吸收率和可持续性， 因COVID-19而失去亲人的老年配偶，他们正在寻求预防和自我管理策略， 大流行期间和之后的精神症状。我们将使用数字广告来优化覆盖范围 以及在受COVID-19疫情严重影响的地理位置的访问。促进遵守 以及WELL的持续使用，我们将使用现有数据（K01 MH103467）来确定个体和干预措施- 与中止与持续使用数字干预措施相关的水平特征， 保健支助。对死亡、垂死和丧亲之痛的额外测量（对死亡的准备，缺乏 封闭，社会隔离，和哀悼仪式的损失）将获得100名参与者招募超过 补编的两年时限。这些数据将用于研究COVID-19死亡对 抑郁症状（通过本补充收集）和抑郁症状的轨迹超过一个 年（在WELL随访期间通过本补充资料收集）。建议的目标 一项研究将调查那些有抑郁症高风险的丧偶老人（由于阈下症状 （1）因COVID-19而失去配偶的老年人的抑郁症状负担是否高于 因其他死因而丧失亲人的人;及（2）COVID-19丧亲之痛是否与其他 精神病理状况，包括焦虑、创伤后应激、自杀意念和长期悲伤 disorder（s）.总之，WELL提供了一个独特的机会来研究COVID-19死亡与 和幸存配偶的精神症状在一个大型的纵向研究社区居住的老年配偶 尤其容易因丧偶而患抑郁症

PROJECT SUMMARY/ABSTRACT Older spousally-bereaved adults are at very high risk for major depressive disorder (MDD). In the age of COVID-19, the inability to engage in rituals that support the grieving process will make it much more difficult to cope with the death of a spouse. This proposed Administrative Supplement leverages our funded R01 “Efficacy of a Healthy Lifestyle Intervention to Prevent Depression in Older Spousally-bereaved Adults” (WELL) to increase the reach, uptake, and sustainability of our existing behavioral-health intervention to accommodate older spouses bereaved by COVID-19 who are seeking prevention and self-management strategies to manage psychiatric symptoms both during and following the pandemic. We will use digital advertising to optimize reach and access in geographic locations heavily impacted by the COVID-19 pandemic. To promote adherence to and sustained use of WELL, we will use existing data (K01 MH103467) to identify individual and intervention- level characteristics that are associated with discontinuation vs sustained use of digital interventions for mental health support. Additional measurements of death, dying, and bereavement (preparedness for death, lack of closure, social isolation, and loss of mourning rituals) will be obtained for the 100 participants recruited over the Supplement’s two-year time frame. The data will be used to examine both the impact of COVID-19 death on depression symptoms (collected through this supplement) and trajectories of depression symptoms over one year (collected through this supplement during the WELL follow-up time period). The aims of the proposed research will examine in older spousally-bereaved adults at high risk for MDD (due to subthreshold symptoms of depression) (1) whether depression symptom burden is higher in older spouses bereaved by COVID-19 than those bereaved by other causes of death; and (2) whether COVID-19 bereavement is associated with other psychopathological conditions including anxiety, post-traumatic stress, suicidal ideation, and prolonged grief disorder(s). In sum, WELL provides a unique opportunity to examine the relationship between COVID-19 death and surviving spouses’ psychiatric symptoms in a large longitudinal study of community-dwelling older spouses particularly vulnerable to MDD due to spousal bereavement.