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

项目摘要/摘要 丧偶的老年成年人患严重抑郁障碍(MDD)的风险非常高。在…的时代 新冠肺炎，无法参加支持哀悼过程的仪式将使其更加困难 应对配偶的死亡。本建议的行政副刊充分利用了我们资助的R01“功效” 健康的生活方式干预以预防丧偶的老年成年人的抑郁“(Well) 提高我们现有行为健康干预的覆盖面、接受度和可持续性，以适应 新冠肺炎失去的年长配偶正在寻求预防和自我管理策略来管理 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 以及受新冠肺炎大流行严重影响的地理位置的访问。促进遵守 和持续使用油井，我们将使用现有数据(K01 MH103467)来识别个体和干预- 与停止使用数字心理干预与持续使用数字干预相关的水平特征 健康支持。死亡、垂死和丧亲的其他衡量标准(死亡准备，缺乏 关闭，社会孤立，失去哀悼仪式)将获得100名参与者在 增刊的两年时间框架。这些数据将被用来检验新冠肺炎死亡对 抑郁症状(通过本附录收集)和抑郁症状的轨迹超过一 年(在油井跟踪期间通过本补充资料收集)。建议的目标是 研究将检查丧偶的老年成年人患MDD的高风险(由于阈值以下的症状 (1)新冠肺炎丧亲的年长配偶的抑郁症状负担是否高于 因其他死因丧失的；(2)新冠肺炎丧亲是否与其他死亡原因有关 精神病理状况，包括焦虑、创伤后应激、自杀念头和长期悲伤 无序(S)。总之，Well提供了一个独特的机会来审视新冠肺炎死亡与 社区居住的老年配偶的大型纵向研究中的死亡配偶的精神症状 由于配偶丧亲，特别容易患上MDD。

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.