A Scalable Model for Promoting Functioning and Well-Being among Older Adults with Mild Cognitive Impairment via Meaningful Social Interactions: Project SPEAK!

孤独和缺乏刺激的社会交往会增加轻度认知障碍（MCI）的风险， 而增加社会化可以防止MCI患者的情绪障碍，并防止进一步的 认知能力下降不幸的是，许多患有MCI的老年人缺乏与他人联系的机会， 在认识到自身不足的同时，利用自身优势的方法。在这项研究中，我们将完善和测试 干预“发言！”（老年人促进英语学习和知识）。请讲！被设计成接合 MCI的老年人作为志愿者帮助英语学习者（ELLs）提高他们的口语技能 通过使用视频会议的结构化对话。我们假设这些结构化的，目标导向的 谈话将增加老年人的心理健康和认知功能。该项目 密歇根大学老年痴呆症研究中心（University of Michigan Alzheimer's Research） 中心和代表ELL的多个组织。研究的目标1（NIA第0阶段）将进行 定性，以用户为中心的设计过程与10个老年人与MCI和ELLs的二人组，以完善 招募过程，定向协议，以及用于认知刺激和参与的材料 会话练习。定向材料将基于积极心理学，重点是 促进认知刺激的沟通策略，同时确保沟通是情感上的， 支持和增强老年人的感觉有效。在目标2和3（NIA阶段1-2）中，我们将 进行一项试点，等待名单对照随机试验，44个二人组，其中干预二人组将有12 每周由研究工作人员主持的网络摄像头对话。目标2的主要目标是评估我们的 招募、实施干预措施并保留足够数量的MCI参与者的能力 随后的随机对照试验评估了干预措施对参与者心理健康的影响， 存在、情绪和认知功能。老年人的情绪、健康状况和认知功能将受到影响。 在基线和随访时使用经验证的量表进行测量。二分体的两个成员都会报告满意度 以及沟通的障碍/促进因素。在目标3中，我们将使用混合方法， 评估老年人和ELL之间的沟通过程，包括有助于 参与有计划的接触，可能导致压力或不满，以及 老年人被欣赏和有效。我们还将估计关键结果变量的方差， 对参与者的健康、情绪和认知方面的干预-控制差异进行探索性分析 功能这项研究将评估一个高度可扩展的战略，以增加社会参与和预防 认知能力下降的患者。因为说话！利用了大量未被满足的语言需求， 在美国的英语学习者中，这种干预引起了多个组织的兴趣。 合作伙伴可以实现计划规模和经济可持续性。

Loneliness and a lack of stimulating social interactions increase the risk of Mild Cognitive Impairment (MCI), while increasing socialization may protect against mood disorders among MCI sufferers and prevent further cognitive decline. Unfortunately, many older adults with MCI lack opportunities for connecting with others in ways that draw on their strengths while recognizing their deficits. In this study we will refine and test the intervention “SPEAK!” (Seniors Promoting English Acquisition and Knowledge). SPEAK! is designed to engage older adults with MCI as volunteers helping English Language Learners (ELLs) improve their speaking skills via structured conversations using videoconferencing. We hypothesize that these structured, goal-oriented conversations will increase older adults' psychological well-being and cognitive functioning. The project has enthusiastic support from older adult wellness centers, the University of Michigan Alzheimer's Research Center, and multiple organizations representing ELLs. Aim 1 of the study (NIA Stage 0) will be to conduct a qualitative, user-centered design process with 10 dyads of older adults with MCI and ELLs in order to refine the recruitment processes, orientation protocols, and materials for use in cognitively stimulating and engaging conversation practice. Orientation materials will be based on Positive Psychology, with an emphasis on communication strategies that promote cognitive stimulation while ensuring that communication is emotionally supportive and enhances older adults' sense of feeling effective. In Aims 2 and 3 (NIA Stages 1-2), we will conduct a pilot, wait-list controlled randomized trial with 44 dyads in which intervention dyads will have 12 weekly webcam conversations facilitated by study staff. The primary goal of Aim 2 will be to evaluate our capacity to recruit, implement the intervention, and retain participants with MCI in sufficient numbers for a subsequent randomized-controlled trial evaluating the intervention's impact on participants' psychological well- being, mood, and cognitive functioning. Older adults' mood, health status, and cognitive functioning will be measured at baseline and follow-up using validated scales. Both members of a dyad will report satisfaction with the interaction as well as barriers/facilitators to communication. In Aim 3, we will use mixed methods to evaluate the communication process between older adults and ELLs including factors that contribute to engagement in planned contacts, possible contributors to stress or dissatisfaction, and perceptions among older adults of being appreciated and effective. We also will estimate variances for key outcome variables and conduct exploratory analyses of intervention-control differences in participants' wellbeing, mood, and cognitive functioning. This study will evaluate a highly-scalable strategy for increasing social engagement and preventing cognitive decline among older adults with MCI. Because SPEAK! taps the enormous unmet need for verbal English practice among ELLs in the US, the intervention has attracted interest from multiple organizational partners that could enable program scaling and economic sustainability.