SUPPLEMENT- 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很普遍 和相关痴呆（PLwCI）以及他们的照顾者。这种普遍性表明，睡眠障碍是 一个相互依赖的过程，协同影响两个成员的双胞胎。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。 失眠的认知行为疗法（CBTi）可有效改善许多人的睡眠障碍。 在CBTi期间，来自合作伙伴的支持可以带来更成功的结果。的相互依存关系 PLwCI-照顾者睡眠障碍提示需要进行二元干预。但没有 结构化的完全二元干预，重点是管理PLwCI及其照顾者的睡眠障碍; 此外，还没有根据这些利益攸关方的投入制定出二元干预措施。对准 国家老龄化研究所的行为和社会科学和神经科学高优先级痴呆症护理人员 研究议程，拟议的K23以患者为导向的指导职业发展奖旨在使用设计 在CBTi框架内以人为本的方法，为PLwCI量身定制二元干预， 他们的照顾者。20名PLwCI护理人员和10名医疗保健提供者将在 裁剪阶段。然后，我们将进行一项等待名单随机对照试验（N = 40对），以测试可接受性， 的可行性，以及初步的即时和持续的疗效（3个月）的二元干预。的 完成这一指导研究项目将使我获得基础知识进行 大规模干预试验并满足有效的二元干预措施来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 我目前技能的关键差距。在我作为一名睡眠和痴呆症专业临床医生的培训基础上， 通过学习，我将熟练掌握1）设计思维方法，2）二元理论，概念和分析 方法，3）痴呆相关疾病的识别和诊断，包括关注这些疾病如何 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 审查.我已经召集了一个优秀的导师团队（赫普本博士，巴顿，里昂和拉）和一个合作者 (Dr. Gehrman）。K23奖将为我提供必要的基础，以建立一个成功的， 与睡眠、痴呆和痴呆相关的独立研究项目。

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.