Resilient Together for Dementia: A live video resiliency dyadic intervention for persons with dementia and their care-partners early afterdiagnosis

Resilient Together for Dementia：针对痴呆症患者及其护理伙伴早期诊断后的实时视频弹性二元干预

• 批准号: 10689832
• 负责人: Sarah Bannon
• 金额: $ 19.6万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689832
• 关键词: Activities of Daily Living; Acute; Acute Brain Injuries; Address; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Behavioral; Benchmarking; Caregivers; Caring; Chronic; Clinical; Clinical Trials; Cognition; Cognitive; Collaborations; Communication; Dementia; Development; Diagnosis; Disease; Distress; Early Intervention; Education; Elements; Eligibility Determination; Emotional; Ensure; Environment; Family; Family member; Feedback; Focus Groups; Foundations; Future; General Hospitals; Geriatrics; Goals; Health; Home; Hybrids; Impairment; Individual; Institution; Intervention; Interview; Judgment; Language; Link; Long-Term Care; Manuals; Massachusetts; Medical; Memory impairment; Mentors; Mentorship; Methodology; Methods; Mission; Modeling; Morbidity - disease rate; Neurologic; Neurologist; Palliative Care; Pamphlets; Participant; Pathologist; Patient Self-Report; Patients; Personal Communication; Personal Satisfaction; Persons; Physicians; Population; Populations at Risk; Primary Care; Procedures; Process; Provider; Psychologist; Psychology; Publications; Quality of Care; Quality of life; Randomized; Research; Research Assistant; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Secure; Self Care; Self Efficacy; Social Workers; Social support; Speech; Spouses; Strategic Planning; Stress; Structure; Surveys; Symptoms; Testing; Training; Training Programs; Trauma; United States National Institutes of Health; Work; acceptability and feasibility; career; career development; clinical care; coping; dementia care; effective intervention; effectiveness trial; emotional distress; experience; feasibility testing; flexibility; improved; informal care; innovation; intervention refinement; loved ones; medical schools; medical specialties; meetings; member; mindfulness; mortality; novel; preference; preservation; prevent; primary care provider; programs; promote resilience; psychosocial; resilience; skills; skills training; social engagement; stressor; success; symposium; symptom management; therapy development; treatment as usual

PROJECT SUMMARY In this K23 proposal, I outline a comprehensive 5-year training program that will support my transition towards an independent investigator focused on the development and rigorous testing of interventions for dyads (i.e., pairs) of persons living with dementia (PWDs) and their informal care-partners, with an emphasis on early intervention. In this application, I propose a significant and innovative proposal that is directly tied with my proposed training and career development goals. Background: Alzheimer's disease and related dementias (ADRD) produce a host of stressors for PWDs and their spousal care-partners (SPs), who both experience substantial emotional distress after diagnosis. Emotional distress is interdependent within dyads and – without treatment—becomes chronic and negatively impacts both partners' health, quality of life, and their ability to navigate the short and long-term challenges associated with ADRDs. Addressing emotional distress early, when PWDs can still meaningfully participate, is an unexplored opportunity to prevent chronic emotional distress and preserve quality of life for both partners. Specific aims and research design: I aim to develop the first version of the live video Resilient Together for Dementia (RT-D) intervention and methodology via 1) interviews and quantitative surveys (N=20) of PWD-SP dyads, with additional feedback from 2) focus groups with ADRD medical stakeholders (N=4) (Aim 1). Next, I will explore, via an open pilot (N=5 dyads) with exit interviews and pre-post self- report assessments, the initial feasibility, acceptability, and credibility of the live video RT-D and procedures, and to further refine RT-D as needed (Aim 2). Finally, I will establish, via a pilot feasibility RCT of the RT-D versus control (N= up to 50 dyads), the feasibility, acceptability and credibility of RT-D following predetermined benchmarks (Aim 3). Findings will inform a hybrid efficacy-effectiveness trial through the R01 mechanisms and future studies extending this work to include additional family members and other care-partners. Training and mentoring: My aims are supported by 3 training goals to develop expertise in: 1) qualitative and mixed methods assessment to inform intervention adaptation; 2) specialty training in geriatrics and ADRD clinical care; 3) clinical trial methodology to facilitate dyadic intervention development and refinement. I will obtain mentorship from an exemplary team led by my primary mentor Dr. Ana-Maria Vranceanu, a clinical health psychologist with expertise in mixed-methods research and live video dyadic intervention development, and my co-mentor Dr. Christine Ritchie, a geriatrician and palliative care physician with decades of work improving the treatment of ADRD. My training goals are supported by 1) a team of expert mentors, 2) a rich institutional environment at Massachusetts General Hospital and Harvard Medical School, and 3) targeted coursework, scientific meetings, seminars and planned publications. Relevance to the NIA mission. This K23 is in line with NIAs priorities to develop interventions to the maintain health and wellbeing and reduce the burden of ADRDs. Impact: I am a clinical psychologist with expertise in couple and family interventions for neurological populations. The experience gained will serve as the foundation for an independent career in dyadic interventions for ADRDs, with a focus on early intervention.

项目总结