Using design thinking approaches to tailor a dyadic behavioral sleep intervention for persons living with dementia and their caregivers

项目摘要 睡眠障碍在轻度认知障碍或早期阿尔茨海默病患者中普遍存在 疾病及相关痴呆症患者及其照顾者。这种流行率表明，睡眠 干扰是一个相互依赖的过程，它协同作用地影响照顾双方。 睡眠障碍与较差的健康结果有关，包括较高的抑郁症状和较低的 生活质量。失眠认知行为疗法(CBTI)对改善失眠患者睡眠障碍有效 在CBTI期间，许多人的支持和合作伙伴的支持会带来更成功的结果。这个 PLwCI-照顾者睡眠障碍的相互依赖表明有必要进行二元干预。然而， 在PLwCI和他们的患者中，没有结构完整的二元干预措施专注于管理睡眠障碍 此外，还没有制定有这些利益攸关方投入的二元性干预措施。 与国家老龄研究所的行为、社会科学和神经科学保持高度优先关系 痴呆症照顾者研究议程，建议以患者为导向的K23指导式职业发展 AWARD寻求在CBTI框架内使用设计思维、以人为中心的方法来量身定做 对PLwCI及其照顾者的干预(T-二分睡眠)。20个PLwCI-照顾者二人组和10个 医疗保健提供者将在定制阶段接受采访。然后我们将随机进行一份等候名单 对照试验(N=40对)，以测试可接受性、可行性和初步的即刻和持续 T-二元睡眠疗效(3个月)。完成这个有指导的研究项目将使我能够 掌握开展大规模干预试验的基础知识，满足有效干预需求 治疗PLwCI和照顾者二人组睡眠障碍的二元干预措施。跨学科培训计划 为这个K23奖项制定的目标将填补我目前技能套中的一个关键空白。在我作为一名 在睡眠和痴呆症护理方面有专业知识的临床医生，我将培养熟练的设计思维 途径，2)二元理论、概念和分析方法，3)痴呆的识别和诊断- 相关障碍，包括关注这些障碍与睡眠障碍的关系，以及4)科学写作， 口头陈述、手稿开发和同行评议。我已经组建了一支优秀的导师团队 (赫本、巴顿、里昂和拉博士)和合作者(格尔曼博士)。K23奖将为我提供 建立一个成功和独立的与睡眠相关的研究计划的必要基础， 痴呆症和照顾他人。我的研究计划与NIA的研究战略方向非常一致 了解并制定干预措施，以满足阿尔茨海默病患者的需求，并 与痴呆症相关的人及其照顾者的需要，并使痴呆症患者和 他们的照顾者作为研究团队的一部分。

Project Summary Sleep disturbance is prevalent in persons living with mild cognitive impairment or early-stage Alzheimer’s disease and related dementias (PLwCI) as well as their caregivers. This prevalence suggests that sleep disturbance is an interdependent process that synergistically affects both members of the caregiving dyad. Sleep disturbance is associated with poorer health outcomes, including higher depressive symptoms and lower quality of life. Cognitive behavioral therapy for insomnia (CBTI) is effective for improving sleep disturbance in many populations, and support from a partner during CBTI results in more successful outcomes. The interdependence of PLwCI-caregiver sleep disturbance suggests the need for a dyadic intervention. However, there are no structured fully dyadic interventions focused on managing sleep disturbance in PLwCI and their caregivers; moreover, no dyadic interventions have been developed with input from these stakeholders. Aligned with the National Institute of Aging’s Behavioral and Social Science and Neuroscience high-priority dementia caregiver research agenda, the proposed K23 Patient-Oriented Mentored Career Development Award seeks to use design thinking, human-centered approaches within the CBTI framework to tailor a dyadic intervention (T-Dyadic Sleep) for PLwCI and their caregivers. Twenty PLwCI-caregiver dyads and 10 healthcare providers will be interviewed during the tailoring phase. We will then conduct a waitlist randomized control trial (N = 40 dyads) to test the acceptability, feasibility, and preliminary immediate and sustained efficacy (3 months) of T-Dyadic Sleep. The completion of this mentored research project will enable me to acquire foundational knowledge for conducting large-scale intervention trials and fulfill the need for effective dyadic interventions to treat sleep disturbance in PLwCI and caregiver dyads. The interdisciplinary training plan and goals developed for this K23 award will fill a critical gap in my current skill set. Building on my training as a clinician with expertise in sleep and dementia caregiving, I will develop proficiency in 1) design thinking approaches, 2) dyadic theories, concepts, and analytic methods, 3) identification and diagnosis of dementia- related disorders, including a focus on how these disorders relate to sleep disturbance, and 4) scientific writing, oral presentations, manuscript development, and peer review. I have assembled an excellent team of mentors (Drs. Hepburn, Barton, Lyons and Lah) and a collaborator (Dr. Gehrman). The K23 award will provide me with the necessary foundation to build a successful and independent program of research related to sleep, dementia, and caregiving. My program of research aligns well with NIA’s Strategic Directions for Research to understand and develop interventions to address the needs of patients living with Alzheimer’s disease and related dementias as well as the needs of their caregivers, and to engage persons living with dementia and their caregivers as part of research teams.