A Randomized Pilot Study of Behavioral Self-monitoring to Promote Mental Health among Spousally Bereaved Older Adults

应聘者描述：应聘者的长期目标是成为一名独立的临床调查员，进行健康的生活方式干预，影响与晚年丧偶有关的心理和身体健康结果。拟议的导师研究科学家发展奖(K01)将提供为期4年的专门培训计划，使候选人能够发展精神疾病预防干预研究方面的专业知识，并有效地过渡到独立干预者。 拟议的K01奖将确保候选人成功地过渡到独立干预者，提供三个关键领域的培训：(1)精神疾病预防干预研究的设计、开发和实施；(2)精神健康干预措施保护配偶失去亲人的老年人免受精神疾病影响的机制；以及(3)缓和和/或调节生物标记物对健康生活方式干预措施和精神健康结果之间关系的影响。这些培训目标得到了拟议研究计划的支持，该计划旨在测试健康生活方式干预的可行性和可接受性，这些老年人有可能在丧偶后患上严重的抑郁、焦虑和/或复杂的悲伤障碍(S)。本申请中概述的职业发展活动与NIMH战略目标2.3一致，即开发和测试创新的干预措施，以降低风险并积极改变疾病轨迹。大约10%-20%的丧偶老人经历了强烈和长期的情绪反应，这会导致精神健康问题，包括严重的抑郁、焦虑和/或复杂的悲伤障碍(S)。这项拟议的研究将评估健康生活方式干预的可行性和可接受性，该干预使用基于技术的行为自我监控协议，以鼓励配偶丧偶后参与体育活动、健康饮食和良好的睡眠实践。来自10名参与者的数据将用于编写预防干预手册(目标1)。将进行一项小型试点研究(目标2)，其中50名参与者将被随机分配到为期12周的(1)使用智能手机的行为自我监控(n=20)，(2)使用智能手机+基于激励性访谈的生活方式指导的行为自我监控(n=20)，或(3)加强日常护理(n=10)。将采集血液样本，以探索炎性细胞因子作为精神健康风险的潜在中介/调节因素。拟议的K01奖励将为候选人提供专业知识，使其能够转变为独立资助的干预者，并将使她能够收集以下方面的可行性证据 制定健康的生活方式干预措施，以防止老年丧偶的老年人出现或延缓精神健康问题的进展。拟议的K01将最终开发R01应用程序，以进行更大规模的预防试验，以促进配偶丧亲长者的精神健康。

DESCRIPTION (provided by applicant): The candidate's long-term goal is to become an independent clinical investigator who conducts healthy lifestyle interventions that will influence the mental and physical health outcomes associated with late-life spousal bereavement. The proposed Mentored Research Scientist Development Award (K01) will provide a specialized 4-year training program that will enable the candidate to develop expertise in mental illness prevention intervention research and to effectively transition into an independent interventionist. The proposed K01 Award will ensure the candidate's successful transition to an independent interventionist by providing training in three key areas: (1) the design, development, and conduct of mental illness prevention intervention research; (2) the mechanisms by which mental health interventions protect spousally bereaved elders from mental illness; and (3) moderating and/or mediating influences that biomarkers have on the relationship between healthy lifestyle interventions and mental health outcomes. These training aims are supported by the proposed research plan, which aims to test the feasibility and acceptability of a healthy lifestyle intervention among older adults who are at risk for developing major depression, anxiety, and/or complicated grief disorder(s) following spousal bereavement. The career development activities outlined in this application align with the NIMH strategic objective 2.3 - 'to develop and test innovative interventions to reduce risk and positively alter trajectories of illness.' Approximatel 10-20% of spousally bereaved elders experience intense and prolonged emotional responses that lead to mental health problems including major depression, anxiety, and/or complicated grief disorder(s). The proposed research will evaluate the feasibility and acceptability of a healthy lifestyle intervention that uses a technology-based behavioral self-monitoring protocol to encourage engagement in physical activity, healthy eating, and good sleep practices following spousal bereavement. Data from 10 participants will be used for the development of a prevention intervention manual (Aim 1). A small pilot study will be conducted (Aim 2) in which 50 participants will be randomly assigned to 12 weeks of (1) behavioral self- monitoring using a smartphone (n=20), (2) behavioral self-monitoring using a smartphone + motivational interviewing-based lifestyle coaching (n=20), or (3) enhanced usual care (n=10). Blood samples will be collected to explore inflammatory cytokines as a potential mediator/moderator of mental health risk. The proposed K01 award will provide the candidate with the expertise to transition into an independently funded interventionist, and will allow her to gather feasibility evidence for the development of a healthy lifestyle intervention to prevent the onset or delay the progression of mental health problems among older adults experiencing late-life spousal bereavement. The proposed K01 will culminate in the development of an R01 application to conduct a larger-scale prevention trial to promote the mental health of spousally bereaved elders.