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 K01 期间，我将通过实现 6 个培训目标来填补培训中的关键空白：1）提高我的水平 了解阿尔茨海默病 (AD) 和 AD 相关痴呆症患者的经历 (ADRD)、他们的护理伙伴和老年人（共同导师：Edith Burns，医学博士）； 2）获得理论专业知识 孤独模型（团队成员：Louise Hawkley，博士）； 3）增进我对心理治疗的理解 （团队成员：Allison Applebaum 博士）； 4) 利用技术提供干预措施（主要导师： 迈克尔·迪芬巴赫博士）； 5) 学习高级研究设计、方法论和统计学（共同导师： 马丁·莱瑟博士）； 6) 参加维持研究计划成功所需的深入培训 （迪芬巴赫）。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 患者的护理伙伴表示感到孤独。 现有的证据表明，增加生活的意义和目的是减少生活的一个强有力的预测因素。 孤独感，可以通过纳入概念来加强减少该人群孤独感的干预措施 来自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 通过增强 AD/ADRD 患者的护理伙伴的意义和目的感来缓解他们的孤独感 在生活中使用 MCP 的概念，通过基于网络的平台 RELOAD-C（减少孤独感） 阿尔茨海默病护理伙伴）。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、利益相关者与 N=15 AD/ADRD 护理合作伙伴的参与以及适应 现有基于网络的平台）来制作 RELOAD-C，其中集中了：1）6 个简短的视频，描绘了我们的 MCP专家传递MCP理念； 2) 链接至 7 次虚拟小组会议（6 次每周会议 + 1 次加强会议）进行讨论 MCP 概念； 3) 对 MCP 视频材料进行扩展的书面内容。目标 2 评估 RELOAD-C 的可用性/可接受性（定义为任务成功率 ≥ 78%，系统得分 ≥ 68） 可用性量表），N=20 名 AD/ADRD 患者的护理伙伴。目标 3 提出了一项试点随机对照试验来评估 RELOAD-C 组件（MCP 视频与以 MCP 为中心的小组讨论）的初步功效 减少孤独感并提高未来进行大规模随机对照试验的可行性。 N=96 AD/ADRD 护理合作伙伴将 随机分为：常规护理，n=32；仅通过 RELOAD-C 的 MCP 视频，n=32；或 MCP 视频 + 每周小组 通过 RELOAD-C，n=32。护理伙伴的结果将在基线、治疗后 6 周和 3 个月进行评估 基线。我们预计效应大小将在中等范围内 (0.3)。可行性定义为：≥75% 同意，退出率≤ 30%，参与干预率为 80%。减少护理伙伴之间的孤独感 具有很高的公共卫生意义，将 MCP 纳入孤独干预措施具有高度创新性。