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

项目总结 睡眠障碍在患有轻度认知障碍或早期阿尔茨海默病的人中很常见 和相关痴呆症患者以及他们的照顾者。这一流行率表明睡眠障碍是 这是一个相互依赖的过程，协同地影响照顾双方的两个成员。睡眠障碍 与较差的健康结果相关，包括较高的抑郁症状和较低的生活质量。 认知行为疗法对许多失眠患者的睡眠障碍有很好的改善作用 在CBTI期间，来自人群的支持和合作伙伴的支持会带来更多的成功结果。相互依存 PLwCI-照顾者睡眠障碍的发生表明有必要进行二元干预。然而，没有 结构化的、完全二元的干预措施，侧重于管理PLwCI及其照顾者的睡眠障碍； 此外，在这些利益攸关方的投入下，还没有制定出任何二元干预措施。与 国家老龄研究所的行为和社会科学及神经科学高优先级痴呆症照顾者 研究议程，拟议的K23以患者为导向的导师职业发展奖旨在利用设计 思考，在CBTI框架内以人为中心的方法，为PLWCI和 他们的照顾者。20名PLWCI照顾者和10名医疗保健提供者将在会议期间接受采访 裁剪阶段。然后我们将进行等待名单随机对照试验(N=40个二元)来测试可接受性， 二元干预的可行性、即刻和持续的初步疗效(3个月)。这个 完成这个有指导的研究项目将使我能够获得进行 大规模干预试验和满足有效的二元干预治疗睡眠障碍的需求 PLWCI和照顾者二人组。为K23奖项制定的跨学科培训计划和目标将填补 在我目前的技能组合中存在严重差距。作为一名具有睡眠和痴呆症专业知识的临床医生，我的培训是建立在我的基础上的 照顾，我将精通1)设计思维方法，2)二元理论，概念，和分析 方法，3)确定和诊断与痴呆症有关的疾病，包括重点关注这些疾病是如何 与睡眠障碍有关，以及4)科学写作、口头陈述、手稿开发和同行 复习一下。我已经组建了一支优秀的导师团队(赫本、巴顿、里昂和拉)和一名合作者 (格尔曼博士)。K23奖将为我提供必要的基础，以建立一个成功和 与睡眠、痴呆症和照顾有关的独立研究项目。

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 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 the dyadic intervention. 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.