Mindfulness-based Cognitive Coping Mobile App Intervention for caregivers of individuals with Alzheimer's Disease

项目摘要 阿尔茨海默病（AD）是一种对患者、家庭和社会都具有毁灭性的疾病。AD的大部分护理 病人靠在非正式护理人员的肩膀上，这些人基本上没有受过承担护理角色的训练， 高度痛苦，身体健康和心理健康状况恶化。 有超过1600万美国人为AD患者提供护理， 症状（30%），压力（59%），心血管疾病的相关风险，以及许多其他不良健康 方面的影响.例如，在单独的研究中，住院和急诊室就诊更有可能是 痴呆症照顾者比任何其他类型的照顾者。 AD的严重程度受多种因素的影响，如AD中痴呆症状的强度 患者，护理人员如何感知具有挑战性的痛苦情况，以及可用的资源。虽然 关于阿尔茨海默病的信息和程序是向公众提供的，一个重要的缺失工具是 如何以有效的方式处理抑郁症状，因为它们非常常见且要求很高。 因此，在这个第二阶段的项目中，我们建议完成新的正念认知应对 (MCC)我们的移动的应用程序名为Caring Mind App（CMA）， 为照顾者提供有效的成本效益干预，以减轻他们的压力和抑郁症状。 MCC干预是建立在正念认知疗法（MBCT）的基础上，该疗法已被 有效治疗重度抑郁症患者，并结合多种应对策略 从我们过去的研究，以帮助照顾者克服压力的情况下，他们的照顾者的角色。 创新：（1）在移动的应用程序中集成MBCT和隐藏应对;（2）匿名分享真实的 护理人员使用的响应和技术;以及（3）通过高级 （在项目人员“整理”之后）“众包”知识，以推广最佳做法。 第一阶段证明了可行性，达到了所有里程碑，并提供了支持这一概念的证据（MCC 应用程序格式）。AD护理人员能够使用Caring Mind移动的应用程序，并且接受得非常好。事实上， 除了展示可用性，接受度和感知的好处外，第一阶段的研究还显示了显著的积极意义， 照顾者的结果，减少他们的抑郁症状和心理压力。 在第二阶段，我们将最终确定MCC课程，开发完整的应用程序，并评估其有效性， 随机临床试验;导致一种新的干预措施，整合MCC内容，聚集 社区分享经验，提供有效的培训，以减少抑郁症状和心理压力，以及 一个移动的应用程序将被部署到数百万与阿尔茨海默病作斗争的家庭。 商业机会：MCC计划将提供给AD护理人员（美国1600多万人）， 移动的应用程序订阅。这种模式在我们目前的应用商店中的移动的应用程序中非常成功。

Project Summary Alzheimer's Disease (AD) is a devastating illness for patients, families, and society. Most of the care of AD patients rests on shoulders of informal caregivers, largely untrained to undertake the caregiving role, bearing a high level of distress, and suffering deterioration in physical health and psychological well-being. There are over 16 million Americans providing care to AD patients, experiencing high rates of depressive symptoms (30%), stress (59%), associated risks for cardiovascular diseases, and many other adverse health effects. For example, in separate studies, hospitalization and emergency department visits were more likely for dementia caregivers than any other types of caregivers. The severity of AD caregiving is influenced by several factors, such as intensity of dementia symptoms in AD patients, how challenging distressful situations are perceived by caregivers, and available resources. Although information and programs about Alzheimer's Disease are available to the public, an essential missing tool is how to deal with depressive symptoms in an effective manner, as they are very common and demanding. Therefore, in this Phase II project, we propose to complete the new Mindfulness-based Cognitive Coping (MCC) intervention, and enable easy access with our mobile app, called Caring Mind App (CMA), providing an effective cost-effective intervention for caregivers to reduce their stress and depressive symptoms. The MCC intervention is built upon the Mindfulness-Based Cognitive Therapy (MBCT), which has been effective to treat individuals with major depressive disorder, with the integration of caregiving coping strategies from our past studies to help caregivers to overcome stressful situations in their caregiver role. Innovation: (1) integration of MBCT with caregiving coping in a mobile app; (2) anonymous sharing of real responses and techniques used by caregivers; and (3) automated content update through an advanced “crowdsourcing” of caregiving knowledge (after “curation” by project personnel) to promote best practices. Phase I demonstrated the feasibility, met all milestones, and provided evidence to support the concept (MCC in app format). AD caregivers were able to use the Caring Mind mobile App and accepted it very well. In fact, besides demonstrating usability, acceptance and perceived benefits, Phase I study showed significant positive outcomes for caregivers on reducing their depressive symptoms and psychological stress. In Phase II, we will finalize the MCC curriculum, develop the complete app, and evaluate its effectiveness in a randomized clinical trial; resulting in a novel intervention that integrates MCC content, aggregation of community shared experience, effective training to reduce depressive symptoms and psychological stress, and a mobile app to be deployed to millions of families struggling with Alzheimer's Disease. Commercial Opportunity: MCC program will be available to AD caregivers (16+ Million people in US) as a mobile app subscription. This model has been very successful with our current mobile apps in App Stores.