Increasing Meaning to Reduce Loneliness in Care Partners of Persons with AD/ADRD

减少 AD/ADRD 患者护理伙伴的孤独感越来越重要

• 批准号: 10624320
• 负责人: Allison Marziliano
• 金额: $ 12.35万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10624320
• 关键词: Address; Alzheimer' s Disease; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Anxiety; Burn injury; Caring; Consent; Disease; Distress; Doctor of Philosophy; Dropout; Education; Elderly; Evidence based intervention; Exercise; Feedback; Feeling; Focus Groups; Future; Genetic Transcription; Goals; Group Meetings; Group Psychotherapy; Health; Individual; Instruction; Intervention; Interview; Learning; Life; Link; Loneliness; Malignant Neoplasms; Malignant neoplasm of urinary bladder; Meaning and purpose; Mental Depression; Mentors; Mentorship; Methodology; Methods; Morbidity - disease rate; Myocardial Infarction; National Institute on Aging; Outcome; Pain; Participant; Patients; Persons; Phase; Population; Psyche structure; Psychotherapy; Public Health; Published Comment; Randomized; Reading; Reporting; Research; Research Design; Research Personnel; Social Workers; Stroke; Suggestion; System; Technology; Testing; Theoretical model; Thinking; Training; Vertebral column; Video Recording; Work; Writing; age related; cancer care; career; dementia care; design; effective intervention; experience; improved; innovation; intervention delivery; meetings; member; mortality risk; programs; statistics; success; treatment arm; treatment as usual; usability; virtual group; web platform; web-based intervention

During the K01 period, I will fill critical gaps in my training through meeting 6 training goals: 1) advance my understanding of the experiences of persons with Alzheimer’s Disease (AD) and AD-related dementias (ADRD), their care partners and older adults (co-mentor: Edith Burns, MD); 2) gain expertise in theoretical models of loneliness (team member: Louise Hawkley, PhD); 3) advance my understanding of psychotherapies (team member: Allison Applebaum, PhD); 4) leveraging technology to deliver interventions (primary mentor: Michael Diefenbach, PhD); 5) learning advanced study designs, methodologies, and statistics (co-mentor: Martin Lesser, PhD); and 6) engage in in-depth training needed to maintain a successful program of research (Diefenbach). These training goals and expert mentorship were designed in support of my overall career goal of becoming an independent investigator improving the lives of older adults and their care partners through reduction of loneliness. More than 60% of care partners of persons with AD/ADRD report feeling lonely. Building on the existing evidence that increasing meaning and purpose in life is a strong predictor of decreased loneliness, interventions to reduce loneliness in this population may be strengthened by incorporating concepts from Meaning-Centered Psychotherapy (MCP). Thus, the overall goal of the proposed project is to reduce loneliness in care partners of patients with AD/ADRD through increasing their sense of meaning and purpose in life using concepts from MCP, delivered via a web-based platform, RELOAD-C (REducing LOneliness in Alzeheimer’s Disease-Care Partners). This will be achieved through three Specific Aims. Aim 1 consists of three phases (preparatory work, stakeholder involvement with N=15 AD/ADRD care partners, and adaptation of the existing web-based platform) to produce RELOAD-C, which centralizes: 1) 6 brief videos portraying our MCP expert delivering MCP concepts; 2) links to 7 virtual group meetings (6 weekly + 1 booster) to discuss MCP concepts; and 3) written content expanding on the material from the MCP videos. Aim 2 evaluates usability/acceptability of RELOAD-C (defined as a task success rate ≥ 78%, and scores ≥ 68 on the System Usability Scale) with N=20 care partners of persons with AD/ADRD. Aim 3 proposes a pilot RCT to evaluate the preliminary efficacy of the RELOAD-C components (MCP videos vs. MCP-focused group discussions) in reducing loneliness and feasibility of conducting a future, large-scale RCT. N=96 AD/ADRD care partners will be randomized to: usual care, n=32; MCP videos alone via RELOAD-C, n=32; or MCP videos + weekly groups via RELOAD-C, n=32. Care partners’ outcomes will be assessed at baseline, and 6-weeks and 3-months post- baseline. We expect the effect sizes will be in the moderate range (.3). Feasibility is defined as: ≥ 75% consented, ≤ 30% drop-out, and 80% engagement with intervention. Reducing loneliness among care partners is of high public health significance and incorporating MCP in loneliness interventions is highly innovative.

在K01期间，我将通过实现6个培训目标来填补培训中的关键空白：1)提高我的 对阿尔茨海默病和阿尔茨海默病相关痴呆患者经历的理解 (ADRD)，他们的护理伙伴和老年人(共同导师：伊迪丝·伯恩斯，医学博士)；2)获得理论专业知识 孤独的模型(团队成员：路易丝·霍克利博士)；3)加深了我对心理疗法的理解 (团队成员：Allison Applebaum，博士)；4)利用技术提供干预措施(主要导师： Michael Diefenbach博士)；5)学习高级研究设计、方法和统计学(共同导师： 马丁·莱瑟，博士)；以及6)参与维持成功的研究计划所需的深入培训 (迪芬巴赫)。这些培训目标和专家指导是为了支持我的总体职业目标而设计的 成为一名独立调查员，通过以下方式改善老年人及其护理伙伴的生活 减少孤独感。超过60%的AD/ADRD患者的护理伙伴表示感到孤独。 现有证据表明，增加生活的意义和目标是减少的强烈预测因素 孤独感，在这一人群中减少孤独感的干预措施可能会通过纳入概念来加强 来自以意义为中心的心理治疗(MCP)。因此，拟议项目的总体目标是减少 增加AD/ADRD患者的意义和目的感的护理伙伴的孤独感 在生活中使用MCP的概念，通过基于网络的平台交付，ReLoad-C(在 阿尔泽海默氏症护理合作伙伴)。这将通过三个具体目标来实现。目标1由以下内容组成 三个阶段(准备工作、利益攸关方参与N=15个AD/ADRD护理伙伴和适应 现有的基于Web的平台)来制作ReLoad-C，它集中在：1)6个简短的视频描绘我们的 提供MCP概念的MCP专家；2)链接到7个虚拟小组会议(每周6次+1次助推器)以供讨论 MCP概念；以及3)在MCP视频材料上扩展的书面内容。AIM 2评估 ReLoad-C的可用性/可接受性(定义为任务成功率≥78%，系统得分≥68 可用性量表)，N=20个AD/ADRD患者的护理伙伴。目标3提出了一个试验性RCT来评估 ReLoad-C组件(MCP视频与以MCP为重点的小组讨论)在 减少孤独感和开展未来大规模随机对照试验的可行性。N=96 AD/ADRD关怀合作伙伴将 随机分为：常规护理，n=32；MCP视频单独通过ReLoad-C，n=32；或MCP视频+每周小组 通过重新加载-C，n=32。护理伙伴的结果将在基线、6周和3个月后进行评估 基线。我们预计影响大小将在中等范围内(0.3)。可行性定义为：≥75% 同意，≤30%退出，80%参与干预。减少护理伙伴的孤独感 具有很高的公共卫生意义，将MCP纳入孤独干预具有很高的创新性。