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个培训目标来填补训练中的关键空白：1） 了解阿尔茨海默氏病（AD）和广告相关痴呆症患者的经历 （ADRD），他们的护理伙伴和老年人（联合学：伊迪丝·伯恩斯，医学博士）； 2）获得理论方面的专业知识 孤独模式（团队成员：路易丝·霍克利（Louise Hawkley），博士）； 3）提高我对心理治疗的理解 （团队成员：Allison Applebaum，博士）； 4）利用技术提供干预措施（主要导师： 迈克尔·迪芬巴赫（Michael Diefenbach），博士）； 5）学习高级研究设计，方法和统计学（同事： 马丁·莱斯（Martin Lesser），博士）； 6）进行深入的培训，以维持成功的研究计划 （Diefenbach）。这些培训目标和专家精神旨在支持我的整体职业目标 成为一名独立调查员，改善老年人及其护理伙伴的生活 减少孤独感。有60％以上的广告/ADRD报告的护理伙伴感到孤独。 基于现有证据，表明人生中的意义和目的是有力的预测指标 孤独，减少该人群中孤独的干预措施可以通过纳入概念来加强 来自以意义为中心的心理治疗（MCP）。这是拟议项目的总体目标是减少 通过增加其意义和目的的意识，对患有AD/ADRD患者的护理伙伴的孤独感 在生活中使用MCP的概念，通过基于Web的平台ReloAd-C提供的概念（减少了孤独感 Alzeheimer的病态伴侣）。这将通过三个特定目标来实现。目标1包括 三个阶段（预备工作，利益相关者参与n = 15 AD/ADRD护理伙伴以及适应 现有的基于Web的平台）生产重新加载-C，该c集中：1）6个简短的视频描绘了我们的 MCP专家提供MCP概念； 2）链接到7次虚拟小组会议（6个每周 + 1个助推器）进行讨论 MCP概念； 3）书面内容扩展了MCP视频的材料。 AIM 2评估 重新加载-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个有AD/ADRD的人的护理伙伴。 AIM 3提案提出试点RCT来评估 重新加载-C组件的初步效率（MCP视频与以MCP为重点的小组讨论） 降低了进行未来大规模RCT的孤独和可行性。 n = 96 AD/ADRD护理合作伙伴将 随机分配为：通常的护理，n = 32;单独通过Reload-C单独进行MCP视频，n = 32;或MCP视频 +每周小组 通过Reload-C，n = 32。护理伙伴的成果将在基线时进行评估，并在6周和3个月后进行评估。 基线。我们预计效果大小将在中等范围内（.3）。可行性定义为：≥75％ 同意，≤30％的辍学和80％的干预措施。减少护理伙伴之间的孤独 具有很高的公共健康意义，并且在孤独干预措施中纳入MCP具有很高的创新性。