Development and pilot testing of a behavioral economics mobile health digital tool to improve adherence to non-pharmacologic strategies for behavioral and psychological symptoms of dementia

开发和试点测试行为经济学移动健康数字工具，以提高对痴呆症行为和心理症状的非药物策略的依从性

• 批准号: 10349954
• 负责人: Hayley Michelle Belli
• 金额: $ 13.05万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10349954
• 关键词: Address; Adherence; Adoption; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Antipsychotic Agents; Applications Grants; Area; Behavioral; Behavioral Symptoms; Caring; Chronic; Chronic Disease; Clinical; Collaborations; Data; Degenerative Disorder; Dementia; Development; Discipline; Disease Management; Drug Prescriptions; Economics; Educational workshop; Electronic Health Record; Emotional; Face; Family; Funding; Geriatrics; Goals; Guidelines; Guilt; Health; Health Technology; Health system; Healthcare; Human; Impaired cognition; Influenza vaccination; Intervention; Interview; Measures; Mental Depression; Mentors; Mentorship; Nature; New York; Outcome; Outcome Study; Patients; Peer Review; Persons; Pharmaceutical Preparations; Pilot Projects; Pragmatic clinical trial; Primary Health Care; Psychology; Publications; Recording of previous events; Reporting; Research; Research Methodology; Research Personnel; Resources; Review Literature; Risk; Role; Screening for cancer; Sedation procedure; Social Workers; Societies; Stress; Stroke; Structure; Tablet Computer; Technology; Telephone; Telephone Interviews; Testing; Text Messaging; Thinking; Training; Training Programs; United States National Institutes of Health; Universities; Visit; Work; acceptability and feasibility; arm; behavior test; behavioral economics; common symptom; communication device; dementia care; design; diabetes management; digital; digital health; evidence base; experience; falls; health care settings; human old age (65+); implementation science; improved; innovation; insight; mHealth; mortality; novel; patient population; pilot test; primary outcome; prototype; psychologic; psychological symptom; recruit; research study; secondary outcome; skills; sociodemographics; symposium; tool; wearable device

PROJECT SUMMARY / ABSTRACT: Background: There are currently more than five million Americans living with Alzheimer’s disease and related dementias, a number expected to increase to nearly 14 million by 2050. Among the most common symptoms of persons living with dementia (PLWD) are behavioral and psychological disturbances. PLWD require care partners who themselves face challenges including guilt, depression, and emotional and physical stress due to the behavioral and psychological symptoms of dementia (BPSD). Guidelines by the American Geriatrics Society currently discourage antipsychotic prescriptions to treat BPSD, instead encouraging non-pharmacological approaches. While some non-pharmacologic strategies for addressing BPSD have shown to be effective, adherence is challenging. Novel concepts from behavioral economics (BE), a field that combines insights from economics and psychology to recognize that humans often make predictable decision errors, has shown promise in promoting appropriate disease management in a variety of healthcare settings. Mobile health (mHealth) technology is one mechanism for delivering non-pharmacologic care; however, no strategies to date have incorporated BE principles to improve adherence to non-pharmacologic strategies for managing BPSD. Research: This study will leverage the power of BE with mHealth to develop, user-test, and pilot a digital health tool aimed at improving adherence to non-pharmacologic strategies for BPSD. A thorough review of the literature, stakeholder interviews, and a design-thinking workshop will aid in the development of the BE nudges. Visits with PLWD-care partner dyads and semi-structured telephone interviews will be conducted to user-test and refine the BE-mHealth digital tool prototype. The culmination of this work will be an intervention ready for testing via a single-arm, 6-month pilot study within the New York University Langone Health (NYULH) system. The primary study outcome will be adherence to the non-pharmacologic strategies, and secondary outcomes will include changes in BPSD, care partner burden, and prescriptions for anti-psychotic medications. Socio- demographic, clinical, and primary/secondary study outcomes will be measured using care partner reported outcomes and patient electronic health records embedded within the BE-mHealth tool for ease of data capture. Training: The candidate’s proposed training plan builds upon prior research in the design and testing of BE digital health interventions via embedded pragmatic clinical trials. The candidate will receive training in the fields of dementia, digital health innovation, implementation science, and mixed-methods research through one-on- one mentorship, coursework, seminars, workshops, and conferences in disciplines of high relevance to the proposed research. The mentorship team is composed of discipline-specific experts with a history of working together and with the candidate on NIH funded grant proposals and peer-reviewed publications. The candidate’s long-term goal is to become an independent investigator in the development and testing of BE-inspired digital health interventions for chronic disease management in persons living with dementia.

项目摘要 /摘要： 背景：目前有超过500万美国人患有阿尔茨海默氏病及相关的美国人 痴呆症，预计到2050年将增加到近1400万。 患有痴呆症（PLWD）的人是行为和心理灾难。 PLWD需要护理 伴侣自己面临挑战，包括内gui，沮丧以及情绪和身体压力 痴呆症（BPSD）的行为和心理症状。美国老年医学学会的指南 目前不鼓励抗精神病药处方治疗BPSD，而是鼓励非药物 方法。虽然某些针对BPSD的非药物策略已证明是有效的，但 依从性具有挑战性。行为经济学（BE）的新颖概念，该领域结合了见解 经济学和心理学认识到人类经常会犯有可预测的决策错误，这表明了诺言 在各种医疗机构中促进适当的疾病管理。移动健康（MHealth） 技术是提供非药物护理的一种机制；但是，迄今为止尚无策略 纳入的原则是提高对管理BPSD的非药物策略的遵守。 研究：这项研究将利用与MHealth一起开发，用户测试和进行数字健康的力量 旨在改善BPSD非药物策略的依从性的工具。对 文学，利益相关者的访谈和设计思维的研讨会将有助于推动Be Be Dudges的发展。 将与PLWD-Care合作伙伴二元组和半结构化电话采访进行访问 并完善Be-Mhealth数字工具原型。这项工作的高潮将是一项干预措施 通过纽约大学Langone Health（NYULH）系统中的单臂，6个月的试点研究进行测试。 主要的研究结果将是遵守非药物策略和次要结果 将包括BPSD的更改，护理伙伴Burnen和抗精神药物的处方。社会 人口统计，临床和初级/二级研究结果将使用报告的护理伙伴报告 结果和患者电子健康记录嵌入了BE-MHealth工具中，以便于数据捕获。 培训：候选人提议的培训计划是基于在设计和测试的先前研究基础的 通过嵌入式务实临床试验进行数字健康干预措施。候选人将接受田野培训 通过一对一的痴呆症，数字健康创新，实施科学和混合方法研究 与该学科相关的学科中的一项精神制，课程，半手，讲习班和会议 拟议的研究。 Mentalship团队由具有工作历史的特定学科专家组成 共同与NIH资助的赠款提案和同行评审的出版物一起。候选人的 长期目标是成为开发和测试BE启发数字的独立研究者 患有痴呆症患者的慢性疾病管理的健康干预措施。