SBIR-STTR Award

Alzheimer’s Disease (AD) is a devastating illness for patients, families, and society. Most of the care of AD patients rests on shoulders of informal caregivers, largely untrained to undertake the caregiving role, bearing a high level of distress, and suffering deterioration in physical health and psychological well-being. There are over 15 million Americans providing care to dementia patients, experiencing high rates of stress (60%), depression (33%), associated risks for cardiovascular diseases, and many other adverse health effects. For example, in separate studies, hospitalization and emergency department visits were more likely for dementia caregivers than any other types of caregivers. Research suggests that non-pharmacological interventions are beneficial to dementia caregivers. However, many programs depend on facility-based approaches or small group interventions, which limit feasibility, cost- effectiveness, and deployment. The lack of dissemination is due to cost, location (i.e. outside settings, group meetings, etc.) or temporal factors (specific meeting times). In order to address these limitations, we propose the development of a new Mindfulness-based Cognitive Coping (MCC) Mobile App intervention, not only to enable access to caregivers with the mobile app (at any place, and any time), but also to provide an effective intervention to reduce stress and depression in a cost-effective manner to a large number of caregivers. The MCC intervention will be adapted from the Mindfulness-Based Cognitive Therapy (MBCT), which has been effective to treat individuals with major depressive disorder, with the integration of dementia caregiving coping strategies from our past studies, to help caregivers to overcome stressful situations in their caregiver role. Our goal is to enhance the very effective MBCT protocol with core dementia caregiving components and implement it in a mobile app, called Caring Mind App (CMA), with interactive and engaging features, in order to develop an intervention to decrease stress, reduce depression, and improve the psychological well-being of dementia caregivers, which could be disseminated to millions of families struggling with dementia. Innovation: this is the first implementation of the MBCT protocol combined with dementia caregiving coping strategies in a mobile app. As far as we know, there are no similar products in the market place. In partnership with the Alzheimer’s Association, Stanford University, and caregivers, we will determine the curriculum of the new intervention. Focus groups involving caregivers will inform the project and explore caregiver attitudes towards the MCC program, mobile app usage, and overall intervention protocol. A prototype will be developed and tested with dementia caregivers to establish the feasibility of the approach in Phase I. The results will guide the development of the full intervention in Phase II. Commercial Opportunity: MCC program will be available to dementia caregivers (15+ Million people in US) as a mobile app subscription. This model has been very successful with our current mobile apps in App Stores.

Public Health Relevance Statement:
Public Health Relevance Alzheimer’s disease affect over 15 million family dementia caregivers in US, the hidden patients of Alzheimer’s disease, resulting in deterioration of their physical health and psychological well-being, with high levels of stress and depression. This project aims to develop a new intervention for reducing caregiver distress and burden of care, enabling a more effective and less stressful caregiving process, which could be deployed to millions of dementia caregivers by the proposed mobile app throughout the app stores. After Phase II completion, the expected outcomes are the following: improve the overall quality of life of caregivers, enhance coping skills, decrease stress, and reduce depression; in addition, the following indirect benefits are expected (not measured by this study): delay patient institutionalization, decrease caregiver medication related to stress/depression, and thereby reduce societal costs.

Project Terms:
Access to Information; Address; Adopted; Adoption; Adult; Affect; Age; Alzheimer's Disease; American; Android; Attitude; Awareness; base; cardiovascular disorder risk; care burden; care giving burden; Caregiver Burden; caregiver depression; caregiver education; caregiver interventions; Caregivers; caregiving; Caring; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Clinical Trials; Cognitive; coping; Coping Skills; cost; cost effective; cost effectiveness; Data; Dementia; Dementia caregivers; dementia caregiving; Depressed mood; depressive symptoms; Deterioration; Development; Distress; Educational Curriculum; effective intervention; Effectiveness; Electronic Mail; Emergency department visit; Evaluation; Exercise; experience; Family; Feeling; Focus Groups; Fostering; Funding; Goals; Government; group intervention; Group Meetings; Health; Healthcare; Hospitalization; improved; Individual; informal caregiver; Informal Social Control; innovation; insight; Institutionalization; Internet; Intervention; Lead; Learning; Location; Major Depressive Disorder; Measures; meetings; Mental Depression; Mind; mindfulness; mindfulness based cognitive therapy; mobile application; Modeling; Motivation; Neurons; novel; novel therapeutics; Outcome; Ownership; Patients; Pattern; Pharmaceutical Preparations; Phase; physical conditioning; prevent; Process; programs; Prophylactic treatment; Protocols documentation; prototype; psychologic; public health relevance; Quality of life; Recruitment Activity; Recurrence; recurrent depression; Relapse; Reporting; Research; research and development; Rest; Role; rural underserved; Services; Shoulder; skills training; Societies; Stress; Techniques; Testing; Text; Thinking; Time; Training; Translating; United States National Institutes of Health; Universities; usability

Alzheimer's Disease (AD) is a devastating illness for patients, families, and society. Most of the care of ADpatients rests on shoulders of informal caregivers, largely untrained to undertake the caregiving role, bearing ahigh level of distress, and suffering deterioration in physical health and psychological well-being.There are over 16 million Americans providing care to AD patients, experiencing high rates of depressivesymptoms (30%), stress (59%), associated risks for cardiovascular diseases, and many other adverse healtheffects. For example, in separate studies, hospitalization and emergency department visits were more likely fordementia caregivers than any other types of caregivers.The severity of AD caregiving is influenced by several factors, such as intensity of dementia symptoms in ADpatients, how challenging distressful situations are perceived by caregivers, and available resources. Althoughinformation and programs about Alzheimer's Disease are available to the public, an essential missing tool ishow to deal with depressive symptoms in an effective manner, as they are very common and demanding.Therefore, in this Phase II project, we propose to complete the new Mindfulness-based Cognitive Coping(MCC) intervention, and enable easy access with our mobile app, called Caring Mind App (CMA), providing aneffective cost-effective intervention for caregivers to reduce their stress and depressive symptoms.The MCC intervention is built upon the Mindfulness-Based Cognitive Therapy (MBCT), which has beeneffective to treat individuals with major depressive disorder, with the integration of caregiving coping strategiesfrom our past studies to help caregivers to overcome stressful situations in their caregiver role.Innovation: (1) integration of MBCT with caregiving coping in a mobile app; (2) anonymous sharing of realresponses and techniques used by caregivers; and (3) automated content update through an advanced"crowdsourcing" of caregiving knowledge (after "curation" by project personnel) to promote best practices.Phase I demonstrated the feasibility, met all milestones, and provided evidence to support the concept (MCCin app format). AD caregivers were able to use the Caring Mind mobile App and accepted it very well. In fact,besides demonstrating usability, acceptance and perceived benefits, Phase I study showed significant positiveoutcomes for caregivers on reducing their depressive symptoms and psychological stress.In Phase II, we will finalize the MCC curriculum, develop the complete app, and evaluate its effectiveness in arandomized clinical trial; resulting in a novel intervention that integrates MCC content, aggregation ofcommunity shared experience, effective training to reduce depressive symptoms and psychological stress, anda mobile app to be deployed to millions of families struggling with Alzheimer's Disease.Commercial Opportunity: MCC program will be available to AD caregivers (16+ Million people in US) as amobile app subscription. This model has been very successful with our current mobile apps in App Stores.

Public Health Relevance Statement:
Public Health Relevance Alzheimer's disease affects over 16 million family caregivers in US, "the hidden patients," resulting in deterioration of their physical health and psychological well-being, with high levels of stress and depressive symptoms. This project aims to develop a new intervention for reducing depressive symptoms and caregiver distress, enabling a more effective and less stressful caregiving process, which could be deployed to millions of AD caregivers by the proposed mobile app throughout the app stores. After Phase II completion, the expected outcomes are the following: reduce depressive symptoms, decrease stress, enhance coping skills, and improve the quality of life of caregivers; in addition, the following indirect benefits are expected (not measured by this study): delay patient institutionalization, decrease caregiver medication related to stress/depressive symptoms, and thereby reduce societal costs.

Project Terms:
<21+ years old>