Mindfulness-based Cognitive Coping Mobile App Intervention for caregivers of individuals with Alzheimer’s Disease

项目摘要： 阿尔茨海默病（AD）是一种对患者、家庭和社会都具有毁灭性的疾病。AD的大部分护理 病人靠在非正式护理人员的肩膀上，这些人基本上没有受过承担护理角色的训练， 高度痛苦，身体健康和心理健康状况恶化。 有超过1500万美国人为痴呆症患者提供护理， (60%），抑郁症（33%），心血管疾病的相关风险，以及许多其他不良健康影响。 例如，在单独的研究中，住院和急诊室就诊更有可能是 痴呆症照顾者比任何其他类型的照顾者。 研究表明，非药物干预对痴呆症照顾者有益。然而，在这方面， 许多项目依赖于以设施为基础的方法或小团体干预，这限制了可行性，成本， 有效性和部署。缺乏传播是由于成本、地点（即外部环境、团体 会议等）或时间因素（具体会议时间）。为了解决这些问题，我们建议 开发新的基于正念的认知应对（MCC）移动的应用程序干预，不仅 使护理人员能够使用移动的应用程序（在任何地点和任何时间）访问，而且还提供有效的 采取干预措施，以具有成本效益的方式减轻大量照顾者的压力和抑郁。 MCC干预将改编自基于正念的认知疗法（MBCT），该疗法已被 有效治疗重度抑郁症患者，并将痴呆症与应对相结合 策略，以帮助照顾者克服压力的情况下，他们的照顾者的角色。 我们的目标是加强非常有效的MBCT协议与核心痴呆症的组成部分， 在一个名为Caring Mind App（CMA）的移动的应用程序中实现它，该应用程序具有互动和吸引人的功能，以便 制定一项干预措施，以减少压力，减少抑郁，并改善心理健康， 痴呆症护理人员，可以传播到数百万与痴呆症作斗争的家庭。 创新：这是MBCT方案与痴呆症预防应对相结合的首次实施 策略在移动的应用程序.据我们所知，市场上没有类似的产品. 与阿尔茨海默氏症协会、斯坦福大学和护理人员合作，我们将确定 新干预的课程。包括护理人员在内的焦点小组将为项目提供信息，并探讨 护理人员对MCC计划的态度、移动的应用程序使用情况和整体干预方案。一个原型 将与痴呆症护理人员一起开发和测试，以确定该方法在第一阶段的可行性。 研究结果将指导第二阶段全面干预措施的制定。 商业机会：MCC计划将提供给痴呆症护理人员（美国1500多万人）， 一个移动的应用程序订阅。这种模式在我们目前的应用商店中的移动的应用程序中非常成功。

Project Summary: Alzheimer’s Disease (AD) is a devastating illness for patients, families, and society. Most of the care of AD patients rests on shoulders of informal caregivers, largely untrained to undertake the caregiving role, bearing a high level of distress, and suffering deterioration in physical health and psychological well-being. There are over 15 million Americans providing care to dementia patients, experiencing high rates of stress (60%), depression (33%), associated risks for cardiovascular diseases, and many other adverse health effects. For example, in separate studies, hospitalization and emergency department visits were more likely for dementia caregivers than any other types of caregivers. Research suggests that non-pharmacological interventions are beneficial to dementia caregivers. However, many programs depend on facility-based approaches or small group interventions, which limit feasibility, cost- effectiveness, and deployment. The lack of dissemination is due to cost, location (i.e. outside settings, group meetings, etc.) or temporal factors (specific meeting times). In order to address these limitations, we propose the development of a new Mindfulness-based Cognitive Coping (MCC) Mobile App intervention, not only to enable access to caregivers with the mobile app (at any place, and any time), but also to provide an effective intervention to reduce stress and depression in a cost-effective manner to a large number of caregivers. The MCC intervention will be adapted from the Mindfulness-Based Cognitive Therapy (MBCT), which has been effective to treat individuals with major depressive disorder, with the integration of dementia caregiving coping strategies from our past studies, to help caregivers to overcome stressful situations in their caregiver role. Our goal is to enhance the very effective MBCT protocol with core dementia caregiving components and implement it in a mobile app, called Caring Mind App (CMA), with interactive and engaging features, in order to develop an intervention to decrease stress, reduce depression, and improve the psychological well-being of dementia caregivers, which could be disseminated to millions of families struggling with dementia. Innovation: this is the first implementation of the MBCT protocol combined with dementia caregiving coping strategies in a mobile app. As far as we know, there are no similar products in the market place. In partnership with the Alzheimer’s Association, Stanford University, and caregivers, we will determine the curriculum of the new intervention. Focus groups involving caregivers will inform the project and explore caregiver attitudes towards the MCC program, mobile app usage, and overall intervention protocol. A prototype will be developed and tested with dementia caregivers to establish the feasibility of the approach in Phase I. The results will guide the development of the full intervention in Phase II. Commercial Opportunity: MCC program will be available to dementia caregivers (15+ Million people in US) as a mobile app subscription. This model has been very successful with our current mobile apps in App Stores.