Recharge Behavioral Therapy for caregivers of individuals with Alzheimer's Disease

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Project Summary Caring for individuals with Alzheimer's Disease (AD) is associated with depressive symptoms and “burden” because dealing with AD patient's cognitive, behavioral and personality changes is very challenging and stressful for caregivers. There are over 11 million AD caregivers in the US, providing informal care services to family members, with high incidences of stress (59%) and depressive symptoms (30%). Clinical trials and other academic research demonstrated the benefits of non-pharmacological interventions to improve the psychological well-being of AD caregivers, however there is a recognized need to translate these programs to accessible products/services and deliver them widely at minimum cost. To address these needs, we propose the new Recharge Behavioral Therapy (RBT), derived from an evidence- based protocol to treat depression (Behavioral Activation) and a proven program to train coping skills (Coping With Caregiving). We will translate prior research, combine powerful behavioral activation methods, and tailor the integrated curriculum for AD caregivers into a new intervention to reduce stress and depressive symptoms. Besides being an effective treatment for depression (efficacy stablished by multiple clinical trials), Behavioral Activation (BA) was selected because it motivates individuals to engage in healthy behaviors to improve their wellness. AD caregivers usually sacrifice their own physical and emotional needs, when providing care. The BA component will encourage caregivers to take care of their own well-being and “Recharge their energy” in their caregiving journey, so that they can fulfil their caregiver role at their best and improve their quality of life. Coping With Caregiving (CWC) is a psychoeducational training program for AD caregivers, evaluated in several clinical trials with demonstrated effectiveness in decreasing caregiver distress, burden of care, stress, and depression. By integrating CWC in RBT, we will provide the necessary consideration to the AD caregiving context and the resulting intervention will contain beneficial coping strategies for AD caregivers. Furthermore, the implementation mechanism for the RBT intervention will be the new Recharge Mobile App (RMA), an interactive, easy to use, and engaging mobile app that can be deployed to millions of people on demand (app install from app stores) and at very low cost (small subscription fee). RMA will be tailored for AD caregivers with training, practices, and content for RBT, which is not available in the market. Creative use of app features (interactivity, compliance, and notifications) will engage caregivers. Phase I will determine the initial RBT curriculum, develop the RMA prototype, and evaluate the feasibility. Phase II will fully develop RBT/RMA and evaluate the intervention effectiveness with a randomized clinical trial. RMA will help to reduce caregiver stress and depressive symptoms related to AD caregiving with a non- pharmacological approach; offering an effective, low-cost, and accessible mobile app to be disseminated to innumerous families struggling with Alzheimer's Disease through Apple and Google Play app stores.