Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
基本信息
- 批准号:10610439
- 负责人:
- 金额:$ 66.52万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-06-15 至 2026-03-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdherenceAdrenal GlandsAdultAdvocateAftercareAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAmyloid beta-ProteinAnxietyAreaArousalBehavior TherapyBehavioralBiological MarkersC-reactive proteinCaregiversCatchment AreaCentral Nervous SystemChronic InsomniaCognitionCognitiveCognitive TherapyCommunitiesCountyDementiaDementia caregiversDevelopmentEducationElderlyEnsureFaceFamilyFutureGeographyGoalsHealthHealth OccupationsHypothalamic structureImmuneImpaired cognitionInflammationInterleukin-6InternetInterventionLow incomeMediatorMedical ResearchMedicineMental DepressionMethodsModelingMoodsNeurodegenerative DisordersOnline SystemsOutcomePatient Self-ReportPeripheralPersonal SatisfactionPersonsPituitary GlandPolicy MakerPopulationProblem SolvingProcessProtocols documentationProviderPublic HealthQuestionnairesRecommendationResearchResearch PriorityRiskRuralRural PopulationScheduleScienceSeveritiesSleepSleeplessnessStressSurveysTechniquesTechnologyTest ResultTestingTimeTrainingTranslationsUnited States National Institutes of HealthValidationWorkacceptability and feasibilityarmbehavior changecaregivingcognitive performancecurrent pandemicdementia careexperienceflexibilityimprovedimproved outcomeimprovement on sleepinterestlifestyle factorsmulti-site trialnovelpeerprimary caregiverprimary outcomeprogramsrural arearural familiessatisfactionsecondary outcomesleep healthsleep onsetstress managementtau Proteinstelehealththeoriestherapy developmenttreatment optimizationunderserved area
项目摘要
PROJECT SUMMARY
Compared to their urban counterparts, rural family dementia caregivers (CGs) face increased vulnerability to insomnia and
related health concerns (stress, inflammation, depression, anxiety, cognitive disturbance). Cognitive behavioral treatment
for insomnia (CBT-I) holds promise for improving insomnia and these related concerns, but is difficult to access in rural
areas. Our team developed brief telehealth CBT-I (tele bCBT-I) tailored for CGs (e.g., includes stress management/problem
solving) that improved sleep, arousal, mood, cognition and inflammation (small to large effects). While telehealth improves
accessibility, it is still burdensome for CGs due to inflexible scheduling and scarcity of trained therapists. Thus, more
research is needed. Web delivery would increase access and web CBT-I is efficacious in non-CG adults, but has not been
tested in rural CGs. Using the NIH Stage Model flexible framework and Medical Research Council recommendations, we
developed NiteCAPP (web translation of our tele bCBT-I protocol). Stage IA/B validation and testing show high feasibility
and acceptability, and improvements in sleep, arousal, mood, burden and cognition in a single arm pilot in rural CGs (n=5).
The proposed trial is the next logical step - Stage II testing in an RCT (n=100) to establish efficacy and further evaluate
feasibility and acceptability. The Cognitive Activation Theory of Stress provides a framework for our basic premise that
CGs experience insomnia, arousal and inflammation that prompt sympathetic activation and hypothalamic-pituitary-adrenal
(HPA) disruption that have downstream negative effects on health. The proposed trial tests the novel hypothesis that
NiteCAPP will improve CG health, mood, burden and cognition by targeting their shared underlying mechanisms – sleep,
arousal and inflammation – thereby, returning sympathetic and HPA functioning to normal. Another novel aspect of the
proposed trial is inclusion of behavioral strategies to target the person with dementia’s (PWD) sleep. Outcomes will be
assessed at baseline, post-treatment and two follow-ups (6 and 12 months) and include CG sleep, arousal, inflammation,
health, mood, burden and cognition, and PWD sleep.
The proposed study has four specific aims. Aim 1 focuses on the feasibility and acceptability of NiteCAPP and
WebSHE (sleep hygiene education – active web comparator). Aims 2 and 3 examine NiteCAPP’s effects (versus WebSHE)
on CG primary/mechanistic (sleep, arousal, inflammation) and secondary outcomes (health, mood, burden, cognition),
respectively. Because the PWD’s sleep impacts CG sleep, Aim 4 examines NiteCAPP’s secondary effects on PWD sleep
(objectively assessed). An Exploratory Aim examines the relationships between changes in CG primary and secondary
outcomes, and their potential mediators/ moderators.
Public Health Implications: Demonstration that rural CGs can use NiteCAPP to target sleep, arousal/stress, inflammation
and related health concerns has important implications for multiple stakeholders, including rural CGs, rural PWDs, their
families, clinicians and policymakers.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Christina S McCrae其他文献
Christina S McCrae的其他文献
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{{ truncateString('Christina S McCrae', 18)}}的其他基金
Improving Sleep and Reducing Opioid Use in Individuals with Chronic Pain
改善慢性疼痛患者的睡眠并减少阿片类药物的使用
- 批准号:
10587972 - 财政年份:2023
- 资助金额:
$ 66.52万 - 项目类别:
Contributions of Sleep and Pain to Alzheimer's Disease Related Biomarkers: Identifying Modifiable Risk Factors in Women with Normal to Mildly Impaired Cognitive Function
睡眠和疼痛对阿尔茨海默病相关生物标志物的影响:识别认知功能正常至轻度受损女性的可改变危险因素
- 批准号:
10289504 - 财政年份:2021
- 资助金额:
$ 66.52万 - 项目类别:
Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
- 批准号:
10739134 - 财政年份:2021
- 资助金额:
$ 66.52万 - 项目类别:
Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
- 批准号:
10428576 - 财政年份:2021
- 资助金额:
$ 66.52万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
10163918 - 财政年份:2018
- 资助金额:
$ 66.52万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
10414802 - 财政年份:2018
- 资助金额:
$ 66.52万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
9769887 - 财政年份:2018
- 资助金额:
$ 66.52万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
9927672 - 财政年份:2018
- 资助金额:
$ 66.52万 - 项目类别:
Sleep and Pain Interventions in Fibromyalgia: Hyperalgesia and Central Sensitizat
纤维肌痛的睡眠和疼痛干预:痛觉过敏和中枢敏化
- 批准号:
7941684 - 财政年份:2009
- 资助金额:
$ 66.52万 - 项目类别:
Sleep in Cardiac patients with Implantable Cardioverter Defibrillators (ICD)
使用植入式心脏复律除颤器 (ICD) 的心脏病患者的睡眠
- 批准号:
7839764 - 财政年份:2009
- 资助金额:
$ 66.52万 - 项目类别:
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