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

项目总结/文摘

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.