Caring Light for Family Caregivers

项目简介：每66秒，美国就有一个人患上阿尔茨海默病，一种渐进性的疾病。 不可逆转的神经退行性疾病，不仅给痴呆症患者带来痛苦，也给护理人员带来痛苦 (15压力（60%）和抑郁（30%+）的发病率较高。 由于这一重大问题，需要有效，低成本和可获得的干预措施来帮助痴呆症 照顾者需要处理照顾需求、沉重的情感负担、生活变化和压倒性的经历。 一个有前途的交付机制是智能手机，因为：a）采用率非常高，并且在不断增长（例如， 我们在2019年的第二阶段，预计84%至95%的18-64岁成年人将拥有智能手机-根据我们的数据， CDC，大多数痴呆症照顾者（77%）年龄小于65岁，这是一个相当大的群体）;和B）98% 据白宫称，全国范围内有20%的美国人可以使用移动的宽带。 因此，我们提出了一个独特的干预措施，将我们的应对护理（CWC）课程， 正念（MBSR），自定进度的方法，和移动的应用程序交付，这是以前没有创造过的，称为 Caring Light应用程序（CLA）可增强护理人员的应对技能，减轻压力，缓解抑郁。 我们的项目将产生很大的影响，因为：1）CWC和正念的融合预计将非常 根据我们的初步研究和其他研究结果，该方案是有效的; 2）拟议的方案是低成本的 （每人每年4.99美元）; 3）CLA干预措施将作为一个移动的 该应用程序允许其广泛传播到无数与阿尔茨海默氏症和相关痴呆症作斗争的家庭。 CWC是由Gallagher-Thompson博士及其同事在循证程序中开发的， 许多随机临床试验（例如，作为NIH资助的国家研究项目REACH的组成部分， “资源，提高老年痴呆症护理人员的健康”），多年来不断加强，并成功地 转换成有效的自定进度的被动计划，如iCare和Webnovela。 基于正念的减压（MBSR）是由Kabat-Zinn博士开发的，并在许多环境中采用。 它包括正念、呼吸和冥想的练习;它被应用在无数的项目中 减轻压力，焦虑，抑郁，慢性疼痛和其他几种医疗条件的症状。 通过在新的移动的应用程序中将正念练习与我们经过验证的CWC课程相结合，我们将创建一个 护理人员的新计划，混合培训（应对技能，处理痴呆症的技术，实用技巧 困难的行为等）通过减压策略（例如，引导冥想，温和的伸展，以及其他 正念练习），这是预计将被很好地接受和易于使用的照顾者。 与阿尔茨海默氏症协会、斯坦福大学和护理人员合作，我们将开发和 在第一阶段评估原型。我们将评估完整的CLA（包括所有模块）的有效性， 改善幸福感，缓解压力的随机临床试验在第二阶段。

Project Summary: Every 66 seconds, someone in US develops Alzheimer’s Disease, a progressive irreversible neurodegenerative disease, causing distress not only to dementia patients, but also to caregivers (15+ million), who are the hidden patients with high incidence of stress (60%) and depression (30%+). Due to this significant problem, effective, low-cost, and accessible interventions are needed to help dementia caregivers to deal with the caring demands, heavy emotional toll, life changes, and overwhelming experiences. A promising delivery mechanism is the smartphone, because: a) adoption is very high and growing (e.g. during our Phase II in 2019, 84% to 95% of adults ages 18-64 are expected to own smartphones – and according to CDC, most of dementia caregivers (77%) are younger than 65 years, which is a fairly large group); and b) 98% of Americans nationwide have access to mobile broadband (according to the White House). Therefore, we propose a unique intervention by integrating our Coping with Caregiving (CWC) curriculum, mindfulness (MBSR), self-paced approach, and mobile app delivery, which has not been created before, called Caring Light App (CLA) to enhance caregiver coping skills, reduce stress, and alleviate depression. Our project will have a high impact because: 1) the blending of CWC and mindfulness is expected to be very effective, based on our preliminary studies and other research results; 2) the proposed program is low-cost ($4.99/year per person); and 3) CLA intervention will be accessible to a large group of caregivers as a mobile app, allowing its broad dissemination to innumerous families struggling with Alzheimer’s and related dementia. CWC was developed in evidence-based procedures by Dr. Gallagher-Thompson and associates, evaluated in many randomized clinical trials (e.g. as a component of the NIH-funded national research project REACH, “Resources for Enhancing Alzheimer’s Caregiver Health”), enhanced throughout the years, and successfully converted into effective self-paced passive programs, such as iCare and Webnovela. Mindfulness-based Stress Reduction (MBSR) was developed by Dr. Kabat-Zinn and adopted in many settings. It includes the practice of mindfulness, breathing, and meditation; and it was applied in innumerous programs to reduce stress, anxiety, depression, chronic pain, and other symptoms for several medical conditions. By integrating mindfulness practice with our proven CWC curriculum in a new mobile app, we will create a novel program for caregivers, blending training (coping skills, techniques to deal with dementia, practical tips on difficult behaviors, etc.) with stress reducing strategies (e.g. guided meditation, gentle stretches, and other mindfulness exercises), which is expected to be well accepted and easy to use by caregivers. In partnership with the Alzheimer’s Association, Stanford University, and caregivers, we will develop and evaluate a prototype in Phase I. We will assess the effectiveness of the complete CLA (with all modules) in improving well-being, and alleviating stress with a randomized clinical trial in Phase II.