A Randomized Pilot Study of Behavioral Self-monitoring to Promote Mental Health among Spousally Bereaved Older Adults

行为自我监测促进失去配偶的老年人心理健康的随机试点研究

• 批准号: 9205262
• 负责人: Sarah T Stahl
• 金额: $ 14.81万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2019-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9205262
• 关键词: Address; Adherence; Age; Anxiety; Area; Behavior; Behavioral; Bereavement; Biological Markers; Blood specimen; Case Series; Cellular Phone; Clinical Investigator; Clinical Trials; Cognitive; Complex; Cytokine Signaling; Data; Development; Disease; Education; Elderly; Emotional; Enrollment; Ensure; Event; Exercise; Funding; Goals; Grief reaction; Guidelines; Health; Healthy Eating; Immune system; Individual; Inflammatory; Intervention; Intervention Studies; Intervention Trial; Lead; Life; Life Style; Literature; Major Depressive Disorder; Manuals; Measures; Mediating; Mediator of activation protein; Medical Research; Mental Depression; Mental Health; Mental Tests; Mental disorders; Mentored Research Scientist Development Award; Monitor; Mood Disorders; National Institute of Mental Health; Nature; Outcome; Participant; Pattern; Physical activity; Pilot Projects; Prevention; Prevention trial; Preventive Intervention; Production; Protocols documentation; Psyche structure; Randomized; Recruitment Activity; Research; Risk; Safety; Signaling Molecule; Sleep; Spouses; Standardization; Survivors; Symptoms; Technology; Testing; Time; Training; Training Programs; Widow; Widower; Work; adverse outcome; aged; anxiety symptoms; arm; base; behavioral study; career development; cytokine; depressive symptoms; design; experience; healthy lifestyle; indicated prevention; innovation; intrinsic motivation; lifestyle intervention; mortality; motivational enhancement therapy; physical conditioning; physical symptom; prevent; public health relevance; randomized trial; resilience; response; selective prevention; systematic review; theories; tool; treatment as usual; uptake

DESCRIPTION (provided by applicant): The candidate's long-term goal is to become an independent clinical investigator who conducts healthy lifestyle interventions that will influence the mental and physical health outcomes associated with late-life spousal bereavement. The proposed Mentored Research Scientist Development Award (K01) will provide a specialized 4-year training program that will enable the candidate to develop expertise in mental illness prevention intervention research and to effectively transition into an independent interventionist. The proposed K01 Award will ensure the candidate's successful transition to an independent interventionist by providing training in three key areas: (1) the design, development, and conduct of mental illness prevention intervention research; (2) the mechanisms by which mental health interventions protect spousally bereaved elders from mental illness; and (3) moderating and/or mediating influences that biomarkers have on the relationship between healthy lifestyle interventions and mental health outcomes. These training aims are supported by the proposed research plan, which aims to test the feasibility and acceptability of a healthy lifestyle intervention among older adults who are at risk for developing major depression, anxiety, and/or complicated grief disorder(s) following spousal bereavement. The career development activities outlined in this application align with the NIMH strategic objective 2.3 - 'to develop and test innovative interventions to reduce risk and positively alter trajectories of illness.' Approximatel 10-20% of spousally bereaved elders experience intense and prolonged emotional responses that lead to mental health problems including major depression, anxiety, and/or complicated grief disorder(s). The proposed research will evaluate the feasibility and acceptability of a healthy lifestyle intervention that uses a technology-based behavioral self-monitoring protocol to encourage engagement in physical activity, healthy eating, and good sleep practices following spousal bereavement. Data from 10 participants will be used for the development of a prevention intervention manual (Aim 1). A small pilot study will be conducted (Aim 2) in which 50 participants will be randomly assigned to 12 weeks of (1) behavioral self- monitoring using a smartphone (n=20), (2) behavioral self-monitoring using a smartphone + motivational interviewing-based lifestyle coaching (n=20), or (3) enhanced usual care (n=10). Blood samples will be collected to explore inflammatory cytokines as a potential mediator/moderator of mental health risk. The proposed K01 award will provide the candidate with the expertise to transition into an independently funded interventionist, and will allow her to gather feasibility evidence for the development of a healthy lifestyle intervention to prevent the onset or delay the progression of mental health problems among older adults experiencing late-life spousal bereavement. The proposed K01 will culminate in the development of an R01 application to conduct a larger-scale prevention trial to promote the mental health of spousally bereaved elders.

描述（由申请人提供）：候选人的长期目标是成为一名独立的临床研究者，进行健康的生活方式干预，这将影响与晚年配偶丧亲相关的精神和身体健康结果。拟议的指导研究科学家发展奖（K 01）将提供一个专门的4年培训计划，使候选人能够发展精神疾病预防干预研究的专业知识，并有效地过渡到独立的干预者。 拟议的K 01奖将通过提供三个关键领域的培训，确保候选人成功过渡到独立的干预者：（1）设计，开发和进行精神疾病预防干预研究;（2）精神健康干预措施保护丧偶老人免受精神疾病影响的机制;以及（3）生物标志物对健康生活方式干预和心理健康结果之间的关系的调节和/或介导影响。这些培训目标得到了拟议的研究计划的支持，该计划旨在测试健康生活方式干预在老年人中的可行性和可接受性，这些老年人有可能在配偶丧亲后患上严重抑郁症，焦虑症和/或复杂的悲伤障碍。本申请中概述的职业发展活动与NIMH战略目标2.3 -"开发和测试创新干预措施以降低风险并积极改变疾病轨迹“相一致。“大约10-20%的丧偶老人经历了强烈和长期的情绪反应，导致心理健康问题，包括严重抑郁症，焦虑症和/或复杂的悲伤障碍。拟议的研究将评估健康生活方式干预的可行性和可接受性，该干预使用基于技术的行为自我监测协议，以鼓励在配偶丧亲后参与体育活动，健康饮食和良好的睡眠习惯。来自10名参与者的数据将用于编写预防干预手册（目标1）。将进行一项小型试点研究（目标2），其中50名参与者将被随机分配接受为期12周的（1）使用智能手机的行为自我监测（n=20），（2）使用智能手机的行为自我监测+基于动机访谈的生活方式辅导（n=20），或（3）加强日常护理（n=10）。将采集血液样本，以探索炎症细胞因子作为心理健康风险的潜在介质/调节剂。拟议的K 01奖将为候选人提供过渡到独立资助干预者的专业知识，并将使她能够收集可行性证据， 制定健康的生活方式干预措施，以防止经历晚年配偶丧亲的老年人出现心理健康问题或延缓其进展。建议的K 01将最终发展为R 01应用程序，以进行更大规模的预防试验，促进丧偶长者的精神健康。