Increasing Meaning to Reduce Loneliness in Care Partners of Persons with AD/ADRD

减少 AD/ADRD 患者护理伙伴的孤独感越来越重要

• 批准号: 10427648
• 负责人: Allison Marziliano
• 金额: $ 12.35万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10427648
• 关键词: Address; Alzheimer' s Disease; Alzheimer' s disease related dementia; Anxiety; Burn injury; Caring; Consent; Dementia; Disease; Distress; Doctor of Philosophy; Dropout; Education; Elderly; Evidence based intervention; Exercise; Feedback; Feeling; Focus Groups; Future; Goals; Group Meetings; Group Psychotherapy; Health; Individual; Instruction; Intervention; Interview; Learning; Life; Link; Loneliness; Malignant Neoplasms; Malignant neoplasm of urinary bladder; Mental Depression; Mentors; Mentorship; Methodology; Methods; Morbidity - disease rate; Myocardial Infarction; National Institute on Aging; Online Systems; Outcome; Pain; Participant; Patients; Persons; Phase; Population; Psyche structure; Psychotherapy; Public Health; Published Comment; Randomized; Reading; Reporting; Research; Research Design; Research Personnel; Social Workers; Stroke; Suggestion; System; Technology; Testing; Theoretical model; Thinking; Training; Vertebral column; Work; age related; cancer care; career; dementia care; design; effective intervention; experience; improved; innovation; intervention delivery; meetings; member; mortality risk; programs; statistics; success; treatment arm; treatment as usual; usability; virtual; web-based intervention

During the K01 period, I will fill critical gaps in my training through meeting 6 training goals: 1) advance my understanding of the experiences of persons with Alzheimer’s Disease (AD) and AD-related dementias (ADRD), their care partners and older adults (co-mentor: Edith Burns, MD); 2) gain expertise in theoretical models of loneliness (team member: Louise Hawkley, PhD); 3) advance my understanding of psychotherapies (team member: Allison Applebaum, PhD); 4) leveraging technology to deliver interventions (primary mentor: Michael Diefenbach, PhD); 5) learning advanced study designs, methodologies, and statistics (co-mentor: Martin Lesser, PhD); and 6) engage in in-depth training needed to maintain a successful program of research (Diefenbach). These training goals and expert mentorship were designed in support of my overall career goal of becoming an independent investigator improving the lives of older adults and their care partners through reduction of loneliness. More than 60% of care partners of persons with AD/ADRD report feeling lonely. Building on the existing evidence that increasing meaning and purpose in life is a strong predictor of decreased loneliness, interventions to reduce loneliness in this population may be strengthened by incorporating concepts from Meaning-Centered Psychotherapy (MCP). Thus, the overall goal of the proposed project is to reduce loneliness in care partners of patients with AD/ADRD through increasing their sense of meaning and purpose in life using concepts from MCP, delivered via a web-based platform, RELOAD-C (REducing LOneliness in Alzeheimer’s Disease-Care Partners). This will be achieved through three Specific Aims. Aim 1 consists of three phases (preparatory work, stakeholder involvement with N=15 AD/ADRD care partners, and adaptation of the existing web-based platform) to produce RELOAD-C, which centralizes: 1) 6 brief videos portraying our MCP expert delivering MCP concepts; 2) links to 7 virtual group meetings (6 weekly + 1 booster) to discuss MCP concepts; and 3) written content expanding on the material from the MCP videos. Aim 2 evaluates usability/acceptability of RELOAD-C (defined as a task success rate ≥ 78%, and scores ≥ 68 on the System Usability Scale) with N=20 care partners of persons with AD/ADRD. Aim 3 proposes a pilot RCT to evaluate the preliminary efficacy of the RELOAD-C components (MCP videos vs. MCP-focused group discussions) in reducing loneliness and feasibility of conducting a future, large-scale RCT. N=96 AD/ADRD care partners will be randomized to: usual care, n=32; MCP videos alone via RELOAD-C, n=32; or MCP videos + weekly groups via RELOAD-C, n=32. Care partners’ outcomes will be assessed at baseline, and 6-weeks and 3-months post- baseline. We expect the effect sizes will be in the moderate range (.3). Feasibility is defined as: ≥ 75% consented, ≤ 30% drop-out, and 80% engagement with intervention. Reducing loneliness among care partners is of high public health significance and incorporating MCP in loneliness interventions is highly innovative.

在K 01期间，我将通过实现以下6个培训目标来填补培训中的关键空白：1）提高我的 了解阿尔茨海默病（AD）和AD相关痴呆患者的经历 （ADRD），他们的护理伙伴和老年人（共同导师：伊迪丝伯恩斯，医学博士）; 2）获得理论方面的专业知识 孤独模型（团队成员：Louise Hawkley，博士）; 3）促进我对心理治疗的理解 (team成员：Allison Applebaum博士）; 4）利用技术提供干预措施（主要导师： Michael Diefenbach博士）; 5）学习先进的研究设计，方法和统计学（共同导师： Martin Lesser博士）;以及6）参与维持成功的研究计划所需的深入培训 （Diefenbach）.这些培训目标和专家指导旨在支持我的总体职业目标 成为一名独立的调查员，通过以下方式改善老年人及其护理伙伴的生活： 减少孤独感。超过60%的AD/ADRD患者的护理伙伴报告感到孤独。 根据现有证据，生活意义和目的的增加是生活质量下降的一个强有力的预测因素。 孤独，干预措施，以减少孤独在这一人群中可能会加强纳入概念， 以意义为中心的心理治疗（MCP）因此，拟议项目的总体目标是减少 通过增加AD/ADRD患者护理伙伴的意义感和目的感来改善其孤独感 在生活中使用MCP的概念，通过基于网络的平台RELOAD-C（减少 Alzeheimer's Disease-Care Partners）。这将通过三个具体目标来实现。目标1包括 三个阶段（准备工作，利益相关者参与N=15 AD/ADRD护理伙伴，以及适应 （现有的基于网络的平台）制作RELOAD-C，其中集中：1）6个简短的视频，描述我们的 MCP专家提供MCP概念; 2）链接到7个虚拟小组会议（6个每周会议+1个助推器），讨论 MCP概念;和3）书面内容扩展的材料从MCP视频。目标2评价 RELOAD-C的可用性/可接受性（定义为任务成功率≥ 78%，系统评分≥ 68 可用性量表），其中N=20名AD/ADRD患者的护理伙伴。目标3提出了一项试点RCT，以评估 RELOAD-C组件（MCP视频与以MCP为重点的小组讨论）在以下方面的初步疗效： 减少孤独感，以及进行未来大规模RCT的可行性。N=96例AD/ADRD护理伙伴将 随机分配至：常规护理组，n=32;通过RELOAD-C单独进行MCP视频，n=32;或MCP视频+每周一次组 通过RELOAD-C，n=32。将在基线、治疗后6周和3个月评估护理伙伴的结局。 基线。我们预计效应量将在中等范围内（.3）。可行性定义为：≥ 75% 知情同意，≤ 30%脱落，80%参与干预。减少护理伙伴的孤独感 具有很高的公共卫生意义，将MCP纳入孤独干预措施具有很高的创新性。