Resilient Together for Dementia: A live video resiliency dyadic intervention for persons with dementia and their care-partners early after diagnosis

Resilient Together for Dementia：针对痴呆症患者及其护理伙伴在诊断后早期进行的实时视频弹性二元干预

• 批准号: 10524823
• 负责人: Sarah Bannon
• 金额: $ 7.4万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10524823
• 关键词: Activities of Daily Living; Acute; Acute Brain Injuries; Address; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Behavioral; Benchmarking; Caregivers; Caring; Chronic; Clinical; Clinical Trials; Cognition; Cognitive; Communication; Dementia; Development; Diagnosis; Disease; Distress; Early Intervention; Elements; Eligibility Determination; Emotional; Ensure; Environment; Family; Family member; Feedback; Focus Groups; Foundations; Future; General Hospitals; Geriatrics; Goals; Health; Home; Hybrids; Impairment; Individual; Intervention; Intervention Studies; Interview; Judgment; Language; Link; Long-Term Care; Manuals; Massachusetts; Medical; Memory impairment; Mentors; Mentorship; Methodological Studies; Methodology; Methods; Mission; Modeling; Morbidity - disease rate; Neurologic; Neurologist; Palliative Care; Pamphlets; Participant; Pathologist; Patient Self-Report; Patients; Personal Communication; Personal Satisfaction; Persons; Physicians; Population; Populations at Risk; Primary Health Care; Procedures; Process; Provider; Psychologist; Psychology; Publications; Quality of Care; Quality of life; Randomized; Research; Research Assistant; Research Design; Research Methodology; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Secure; Self Care; Self Efficacy; Social Workers; Social support; Speech; Spouses; Strategic Planning; Stress; Structure; Surveys; Symptoms; Testing; Training; Training Programs; Trauma; United States National Institutes of Health; Work; acceptability and feasibility; base; care providers; career; career development; clinical care; coping; dementia care; effectiveness trial; emotional distress; experience; feasibility testing; flexibility; improved; informal care; innovation; intervention refinement; loved ones; medical schools; medical specialties; meetings; member; mindfulness; mortality; novel; preference; preservation; prevent; programs; psychosocial; resilience; skills; skills training; social; stressor; success; symposium; symptom management; therapy development; treatment as usual

PROJECT SUMMARY In this K23 proposal, I outline a comprehensive 5-year training program that will support my transition towards an independent investigator focused on the development and rigorous testing of interventions for dyads (i.e., pairs) of persons living with dementia (PWDs) and their informal care-partners, with an emphasis on early intervention. In this application, I propose a significant and innovative proposal that is directly tied with my proposed training and career development goals. Background: Alzheimer's disease and related dementias (ADRD) produce a host of stressors for PWDs and their spousal care-partners (SPs), who both experience substantial emotional distress after diagnosis. Emotional distress is interdependent within dyads and – without treatment—becomes chronic and negatively impacts both partners' health, quality of life, and their ability to navigate the short and long-term challenges associated with ADRDs. Addressing emotional distress early, when PWDs can still meaningfully participate, is an unexplored opportunity to prevent chronic emotional distress and preserve quality of life for both partners. Specific aims and research design: I aim to develop the first version of the live video Resilient Together for Dementia (RT-D) intervention and methodology via 1) interviews and quantitative surveys (N=20) of PWD-SP dyads, with additional feedback from 2) focus groups with ADRD medical stakeholders (N=4) (Aim 1). Next, I will explore, via an open pilot (N=5 dyads) with exit interviews and pre-post self- report assessments, the initial feasibility, acceptability, and credibility of the live video RT-D and procedures, and to further refine RT-D as needed (Aim 2). Finally, I will establish, via a pilot feasibility RCT of the RT-D versus control (N= up to 50 dyads), the feasibility, acceptability and credibility of RT-D following predetermined benchmarks (Aim 3). Findings will inform a hybrid efficacy-effectiveness trial through the R01 mechanisms and future studies extending this work to include additional family members and other care-partners. Training and mentoring: My aims are supported by 3 training goals to develop expertise in: 1) qualitative and mixed methods assessment to inform intervention adaptation; 2) specialty training in geriatrics and ADRD clinical care; 3) clinical trial methodology to facilitate dyadic intervention development and refinement. I will obtain mentorship from an exemplary team led by my primary mentor Dr. Ana-Maria Vranceanu, a clinical health psychologist with expertise in mixed-methods research and live video dyadic intervention development, and my co-mentor Dr. Christine Ritchie, a geriatrician and palliative care physician with decades of work improving the treatment of ADRD. My training goals are supported by 1) a team of expert mentors, 2) a rich institutional environment at Massachusetts General Hospital and Harvard Medical School, and 3) targeted coursework, scientific meetings, seminars and planned publications. Relevance to the NIA mission. This K23 is in line with NIAs priorities to develop interventions to the maintain health and wellbeing and reduce the burden of ADRDs. Impact: I am a clinical psychologist with expertise in couple and family interventions for neurological populations. The experience gained will serve as the foundation for an independent career in dyadic interventions for ADRDs, with a focus on early intervention.

项目概要 在这份 K23 提案中，我概述了一个为期 5 年的综合培训计划，该计划将支持我向 独立调查员专注于针对两人（即成对）的干预措施的开发和严格测试 痴呆症患者 (PWD) 及其非正式护理伙伴，重点是早期干预。 我提出了一项重要且创新的提案，该提案与我提出的培训和职业发展直接相关 背景：阿尔茨海默病和相关痴呆症 (ADRD) 给残疾人及其患者带来许多压力源。 配偶照顾伙伴（SP）在诊断后都经历了严重的情绪困扰。 夫妻间相互依存，如果不进行治疗，就会成为慢性病，并对双方的健康产生负面影响， 生活质量，以及他们应对与 ADRD 相关的短期和长期挑战的能力。 当残疾人士仍然可以有意义地参与时，尽早消除情绪困扰是预防慢性情绪困扰的一个尚未探索的机会 具体目标和研究设计：我的目标是开发 实时视频 Resilient Together for Dementia (RT-D) 干预和方法的第一版通过 1) 访谈和 对 PWD-SP 双人组的调查 (N=20)，以及来自 2) 个 ADRD 定量医学焦点小组的额外反馈 接下来，我将通过公开试点（N=5 组）进行探索，包括离职面谈和事前自我评估。 报告实时视频 RT-D 和程序的评估、初步可行性、可接受性和可信度，并 根据需要进一步完善 RT-D（目标 2），我将通过 RT-D 与控制的试点可行性 RCT 建立（N=）。 最多 50 对），RT-D 遵循预定基准（目标 3）的可行性、可接受性和可信度。 研究结果将为通过 R01 机制进行的混合疗效-效果试验以及扩展此研究的未来研究提供信息 努力让更多的家庭成员和其他护理伙伴参与其中 培训和指导：我的目标得到了支持。 3 个培训目标，旨在培养以下方面的专业知识：1) 定性和混合方法评估，以指导干预措施的调整；2) 老年病学和 ADRD 临床护理方面的专业培训；3) 促进二元干预的临床试验方法 我将获得由我的主要导师 Ana-Maria 博士领导的模范团队的指导。 Vranceanu，临床健康心理学家，擅长混合方法研究和实时视频二元干预 我的共同导师 Christine Ritchie 博士是一名老年病学家和姑息治疗医生，拥有数十年的工作经验 改善 ADRD 的治疗我的培训目标得到了 1) 专家导师团队的支持，2) 丰富的机构。 马萨诸塞州总医院和哈佛医学院的环境，以及 3) 有针对性的课程作业、科学 会议、研讨会和计划出版物 与 NIA 使命的相关性符合 NIA 的优先事项。 制定干预措施以维持健康和福祉并减轻 ADRD 的负担 影响：我是一名临床医生。 具有神经人群夫妻和家庭干预专业知识的心理学家。 作为 ADRD 双重干预的独立职业的基础，重点是早期干预。