Mobile app delivered Mentalizing Imagery Therapy to augment remote family dementia caregiver skills training: a pilot randomized, controlled trial with outcomes assessment using digital phenotyping

项目摘要/摘要 超过1500万美国人担任阿尔茨海默病(AD)和AD患者亲属的家庭照顾者- 相关痴呆(ADRD)。家庭照顾者经常经历高水平的压力和负担，导致 精神健康状况不佳，身体疾病风险增加。国家老龄战略规划研究所 确定需要制定更好的干预措施以改善心理和身体状况，这是一个关键的优先领域 家庭ADRD照顾者的健康状况。本行政副刊的目的是支持这项研究 对哈佛医学院精神病学家Felipe Jain博士的培训。Jain博士是保罗·B奖的获得者。 Beeson K76老龄化研究中的新兴领导者职业发展奖，以表彰他的研究减少家庭 ADRD照顾者使用移动应用工具的压力和负担(意象化成像治疗实践， 正念练习和照顾者技能教育)。 照顾者使用教育和心理治疗移动应用程序(App)显示 在几周的过程中，参与度显著下降，这与移动心理治疗的模式相似 普通人群的应用程序使用情况。美国国立卫生研究院行为改变科学倡议旨在研究 促进长期养成健康行为的机制，如参与减压 和护理员技能工具。Jain博士用英语和西班牙语进行的焦点小组研究 护理者发现，护理者认为，在专家的指导下，与同龄人进行异步聊天 辅助者将显著改善护理者支持并提高移动应用参与度。 本补充提案将评估是否将新的便利聊天室功能集成到 带有护理者工具的移动应用程序改善了对家庭ADRD护理者的支持，并促进了长期 订婚。这项研究将描述优化移动应用聊天室使用的功能。基于 习惯养成和动机理论认为，聊天室的参与度将增加更长的时间。 与其他健康的移动应用程序工具互动。提高效率并减少与辅导员会面的时间 对紧急聊天帖子的响应(例如那些反映生活中的人的攻击的危险症状的帖子 患有痴呆症，或照顾者有严重的心理症状，如自残的想法)，自然 将开发语言处理算法，最终可能向协助者发送快速警报。这个 拟议的研究将测试一种新的行为改变策略，以改善对家庭的心理社会支持 ADRD照顾者，提供专家指导的机会，并促进压力减轻和照顾者 技能教育。

Project Summary / Abstract Over 15 million Americans serve as family caregivers of relatives with Alzheimer’s disease (AD) and AD- related dementias (ADRD). Family caregivers often experience high levels of stress and burden, resulting in poor mental health and increased risk of physical illness. The National Institute on Aging Strategic Plan identifies as a crucial priority area the need to develop better interventions to improve the mental and physical health of family ADRD caregivers. The purpose of this administrative supplement is to support the research training of Dr. Felipe Jain, a psychiatrist at Harvard Medical School. Dr. Jain is a recipient of the Paul B. Beeson K76 Emerging Leaders in Aging Research Career Development Award for his research to reduce family ADRD caregiver stress and burden using mobile application tools (mentalizing imagery therapy practices, mindfulness exercises and caregiver skills education). Usage of educational and psychotherapeutic mobile applications (Apps) by caregivers shows a significant drop-off in engagement over the course of weeks, a similar pattern to that of mobile psychotherapy App usage by the general population. The NIH Science of Behavior Change initiative aims to study mechanisms that promote long-term adoption of healthy behaviors, such as engagement with stress reduction and caregiver skills tools. A focus group study conducted by Dr. Jain with English and Spanish speaking caregivers found that caregivers believed that asynchronous chat groups with peers guided by an expert facilitator would substantially improve caregiver support and increase mobile App engagement. This supplement proposal will evaluate whether integration of a new facilitated chat room feature into a mobile App with caregiver tools improves family ADRD caregiver support and promotes long-term engagement. The study will characterize features that optimize usage of the mobile App chatroom. Based on habit formation and motivation theory, it is hypothesized that chatroom participation will increase long- engagement with other healthful mobile App tools. To improve efficiency and reduce time to facilitator response for urgent chat posts (such as those reflecting dangerous symptoms of aggression in the person living with dementia, or severe psychological symptoms in the caregiver such as thoughts of self-harm), a natural language processing algorithm will be developed that may ultimately send a rapid alert to the facilitator. The proposed research will test a novel strategy for behavior change that improves psychosocial support for family ADRD caregivers, provides opportunities for expert guidance, and promotes stress reduction and caregiver skills education.