SAGE LEAF: Reducing Burden in Alzheimer's Disease Caregivers through Positive Emotion Regulation and Virtual Support

项目总结 阿尔茨海默病(AD)和其他痴呆症的患病率正在稳步攀升，预计将影响 到2050年，将有多达1600万美国人。2016年，59%的痴呆症照顾者报告经历了兴奋 情绪和身体压力的水平，以及痴呆症护理的慢性压力带来的风险 为养成一系列身体和精神健康问题的照顾者被广泛记录在案。 与照顾有关的压力会导致社交孤立、孤独和身体疾病，并增加风险 看护人的死亡。对痴呆症照顾者的干预主要集中在减少负面影响上 情绪和负担。然而，在过去的几十年里，积极的情绪显然是 独特地与更好的心理和身体健康有关，独立于负面影响 情绪表明，专门针对积极情绪的干预有望改善 照顾者的幸福感，以及最终对AD患者的护理质量。我们最近随机化的 由训练有素的辅导员通过网络在N=170个家庭中进行的积极情绪技能干预试验 痴呆症患者的照顾者在照顾者的心理健康方面有显著的改善。 然而，由促进者提供的干预措施成本高昂，难以大规模忠实地实施。 此外，推进由训练有素的促进者提供的行为干预的一个主要挑战是 保证忠诚度。我们已经开发了一个自我指导的在线干预版本，已经显示出可行性 和几个样本的可接受性，但这个版本没有捕捉到关键的社会关系方面 由促进者提供的干预。我们建议采取下一步行动，结束科学到- 自制网络版积极情绪调节干预的实践差距 特别适用于痴呆症照顾者，它结合了社交联系的成分，以对抗 许多阿尔茨海默氏症照顾者经历的孤独和孤立。这种干预被称为鼠尾草叶 (家庭照顾者生活改善活动的自我引导电子交付的社会强化) 是对美国国家老龄研究所的PAR-18-588“个人辅助技术”的回应 阿尔茨海默氏症和相关痴呆症及其照顾者。鼠尾草干预杠杆作用 从最初的LEAFE项目中吸取的教训，并将其积极情绪干预适应AD 以自我指导的形式提供照顾者，同时纳入社会联系组件和适应性系统 促进干预坚持的反馈机制。

PROJECT SUMMARY The prevalence of Alzheimer’s Disease (AD) and other dementias is steadily climbing and predicted to affect as many as 16 million Americans by 2050. In 2016, 59% of dementia caregivers reported experiencing high levels of emotional and physical stress, and the risk that the chronic stress of dementia caregiving places on caregivers for developing a range of physical and mental health issues is extensively documented. Caregiving-related stress contributes to social isolation, loneliness, and physical illness and increases the risk of caregiver death. Interventions for dementia caregivers have primarily focused on reducing negative emotions and burden. However, over the past few decades, it has become clear that positive emotions are uniquely related to better psychological and physical well-being, independent of the effects of negative emotion suggesting that an intervention that specifically targets positive emotion holds promise for improving caregiver well-being and, ultimately, quality of care for the individual living with AD. Our recent randomized trial of the positive emotion skills intervention, delivered by trained facilitators via the web in N = 170 family caregivers of people with dementia resulted in significant improvements in caregiver psychological well being. However, facilitator-delivered interventions are costly and difficult to implement with fidelity on a large scale. Furthermore, a major challenge to advancing behavioral interventions delivered by trained facilitators is assuring fidelity. We have developed a self-guided online version of the intervention that has shown feasibility and acceptability in several samples, but this version does not capture the critical social connection aspects of the facilitator-delivered intervention. We propose to take the next step toward closing the science-to- practice gap for the positive emotion regulation intervention by tailoring the self-guided online version specifically for dementia caregivers that incorporates the social connection components to combat the loneliness and isolation experienced by many Alzheimer’s caregivers. The intervention, called SAGE LEAF (Social Augmentation of self-Guided Electronic delivery of the Life Enhancing Activities for Family caregivers) is in response to the National Institute on Aging’s PAR-18-588 “Assistive Technology for Person’s with Alzheimer’s Disease and Related Dementias and Their Caregivers.” The SAGE LEAF intervention leverages the lessons learned from the original LEAF project and adapts its positive emotion intervention to AD caregivers in a self-guided format while incorporating social connection components and adaptive system feedback mechanisms to promote intervention adherence.