LEAD IT! An App to Enable Persons with Early Stage Dementia to Lead Group Activities for Their Peers

项目总结 约有100万痴呆症(PWD)患者居住在长期护理(LTC)中，这一数字预计将 在未来20年内翻一番(Gaugler等人，2019年)。痴呆症还与各种反应行为有关。 (卡明斯，1997)。早期痴呆症(PESD)患者也经常经历生存危机，因为他们感到失落 人生目标(Cohen&Eisdorfer，2001)。虽然PESD的剩余优势已经知道有一段时间了，但很少有人 扮演有意义的社会角色的机会是存在的。因此，迫切需要并具有很强的商业化潜力 使PESD能够在驻地领导的活动中担任小组组长的产品。由于高速互联网、平板电脑和应用程序 已经变得无处不在，部署这样的产品的一个有希望的方式是通过基于平板电脑的应用程序。考虑到这一点，在一个 在第一阶段SBIR中，Skrajner[Pi]开发并评估了一款基于平板电脑的应用程序的Alpha版本，名为Lead IT！，它 使PESD能够实施由居民主导的活动。第一阶段项目证明(1)PESD能够使用 促进活动的应用程序，(2)参加此类活动的残疾人--即常驻玩家(RP)--表现出较高的水平 (3)驻地领导(RLS)和驻地领导(RPS)都对这款应用程序表示非常满意。建议数 第二阶段项目将使我们能够进一步开发和评估Lead IT！，以及检查 RLS和RPS都长期使用该应用程序。拟议的第二阶段项目的具体目标是：(1)开发 改进了Lead IT！的Beta 1(B1)和Beta 2(B2)版本！有足够的内容来促进每年两次的六次活动 每周4.5个月；(2)检查RLS在使用Lead IT时能够在多大程度上充当领导者！(3)检查 居民主导的领先IT的影响！RPS上的编程；以及(4)检查PWD和员工对Lead IT的满意度！ 为了达到这些目标，将进行两个准实验。实验1，它将测试铅的B1版本 它！，将使用预贴式设计。将通过检查RP的参与度/影响程度来评估近期(即时)影响 在基准(标准)活动期间和在领导IT期间！活动。我们假设它是领头的！将导致 比基线活动更高质量的参与度。实验2将测试该应用程序的B2版本，它将是一个集群 随机试验(CRT)，包括治疗组(TG)干预前和干预后的测量 将由接受干预的PWD和由PWD Who组成的对照组(CG)组成 接受标准的规划/护理。由于实验#2将在应用程序的所有调整完成后进行，它将 代表领导IT的最终审判！APP对PWD的影响。对于近期(即时)措施，我们预计 检测一组x时间交互效应，其中TG参与者表现出显著更大的正性增加 与CG参与者相比，参与者的参与形式。对于远端测量，我们预计检测到一组x次 相互作用的影响，TG参与者在治疗时DEMQOL得分显著增加，AS 与CG参与者相比。在全面开发和评估Lead-IT！之后，该应用程序将处于有利地位，可以做出 对许多残障人士的生活有意义的改变。

PROJECT SUMMARY Approximately one million persons with dementia (PWD) reside in long term care (LTC), and this figure is expected to double over the next 20 years (Gaugler et al., 2019). Dementia is also associated with a variety of responsive behaviors (Cummings, 1997). Persons with early stage dementia (PESD) also often experience an existential crisis, as they feel a loss of purpose in life (Cohen & Eisdorfer, 2001). While the remaining strengths of PESD have been known for some time, few opportunities for meaningful social roles exist. So, there is an urgent need and strong commercialization potential for a product that enables PESD to serve as group leaders in resident-led activities. Since high-speed internet, tablets, and apps have become ubiquitous, one promising way to deploy such a product is through a tablet-based app. With this in mind, in a Phase 1 SBIR, Mr. Skrajner [PI] developed and evaluated an Alpha Version of a tablet-based app called LEAD IT!, which enables PESD to implement resident-led activities. The Phase 1 project demonstrated that (1) PESD were capable of using the app to facilitate activities, (2) PWD participating in such activities—i.e., resident-players (RPs)—exhibited high levels of positive engagement, and (3) both Resident-Leaders (RLs) and RPs reported high satisfaction with the app. The proposed Phase 2 project will allow us to further develop and evaluate LEAD IT!, as well as an examine the clinical outcomes of long-term use of the app by both RLs and RPs. The Specific Aims of the proposed Phase 2 project are to: (1) develop improved Beta 1 (B1) and Beta 2 (B2) Versions of LEAD IT! with sufficient content to facilitate six activities twice per week for 4.5 months; (2) examine the extent to which RLs are able to serve as leaders while using LEAD IT! (3) examine the effects of resident-led LEAD IT! programming on RPs; and (4) examine PWD and staff satisfaction with LEAD IT! To meet these aims, two quasi-experiments will be conducted. Experiment #1, which will test the B1 version of LEAD IT!, will use a pre-post design. Proximal (immediate) effects will be assessed by examining RP’s levels of engagement/affect during baseline (standard) activities and again during LEAD IT! activities. We hypothesize that LEAD IT! will result in higher quality engagement than baseline activities. Experiment #2, which will test the B2 version of the app, will be a cluster randomized trial (CRT), consisting of pre- and post-intervention measurements of a TREATMENT GROUP (TG)—which will consist of PWD who receive the intervention – and a CONTROL GROUP (CG) – which will consist of PWD who receive standard programming / care. Since Experiment #2 will occur after all tweaking of the app is completed, it will represent the definitive trial of the LEAD IT! app’s impact on PWD. For proximal (immediate) measures, we anticipate detecting a GROUP x TIME interaction effect, with TG participants exhibiting significantly greater increases in positive forms of engagement, as compared to CG participants. For distal measures, we anticipate detecting a GROUP x TIME interaction effect, with TG participants exhibiting significantly greater increases in DEMQOL scores at treatment, as compared to CG participants. After full development and evaluation of LEAD-IT!, the app will be well-positioned to make a meaningful difference in the lives of many PWD.