EMBRACE Awardee: Year 1
Manka Nkimbeng, PhD, MPH, BSN
Assistant Professor, Division of Health Policy & Management
University of Minnesota School of Public Health
Dr. Manka Nkimbeng’s research interests center around understanding the causes of health issues for those at higher risk and improving health outcomes for older adults. Encompassing her research and policy expertise, she works to develop and test interventions that can be translated into health policies and clinical practice to improve health for those high-risk older adults.
Exploring an Adapted Active Caregiving: Empowering Skills (ACES) Intervention for High Risk Care Partners
This randomized controlled trial (RCT) aims to evaluate an adapted Active Caregiving: Empowering Skills (ACES) intervention among at-risk dementia care partners to determine its effects on the mechanisms underlying caregiver self-efficacy, dysfunctional thoughts, and engagement in leisure activities.
Participants (n = 100) will be randomly assigned to the ACES for Caregivers treatment group or a waitlist control group:
- ACES: ACES is a psychoeducational program based on Cognitive Behavioral Therapy. ACES focuses on teaching caregivers how to manage problematic behaviors with the person living with dementia. This program teaches the following skills: (a) how to monitor daily mood and rate of engagement in pleasant activities or events; (b) how to identify potentially powerful pleasant events by graphing the relationship between events and mood; (c) how to develop a self-change plan targeting at least one specific pleasant event to increase; (d) identification of potential obstacles to doing this; (e) setting reasonable weekly goals; and (f) learning to reward oneself. ACES is a 4-week program that a lay leader offers through a 2-hour group class in person or over the phone.
NIH Stage: IA
EMBRACE Awardee: Year 2
Elizabeth Fauth, PhD
Professor, Human Development and Family Studies
Utah State University
Dr. Elizabeth Fauth has over 20 years of research expertise in caregiving for persons with Alzheimer’s disease and related dementias (ADRD), program evaluation of caregiver interventions, and ACT and mental health literacy trainings. She serves as the Director of Utah’s state-funded Alzheimer’s Disease and Dementia Research Center.
Online Self-Guided ACT for Dementia Caregivers: Evaluating Psychological Flexibility as the Mechanism to Improve Psychological Distress
This randomized controlled trial (RCT) will evaluate the efficacy of an online, self-guided Acceptance and Commitment Therapy (ACT) for Caregivers program for improving dementia caregiver psychological distress. This RCT will also investigate whether and how treatment effects explain changes in the mechanism of psychological flexibility, and how changes in psychological flexibility account for changes in distress.
Participants (n = 120) will be randomly assigned to the ACT for Caregivers treatment group or a waitlist control group:
- ACT: The ACT for Caregivers is an online, self-guided intervention intended to improve psychological flexibility (via learning to be more open, aware, and engaged) and psychological distress. Participants access six sessions (each corresponding to one or more tenets of psychological flexibility) and work through them in order, asynchronously and at their own pace, at home. Participants are encouraged (but not required) to complete one session per week over six weeks, with each session lasting 20-40 minutes. Participants in the treatment group will remain in the study for 12 weeks.
NIH Stage: II
EMBRACE Awardees: Year 3
Darina Petrovsky, PhD, RN
Assistant Professor, School of Nursing
Duke University
Dr. Darina Petrovsky is an Assistant Professor and Elizabeth C. Clipp Term Chair of Nursing at Duke University School of Nursing. Dr. Petrovsky’s research centers on facilitating the implementation of evidence-based, music-based interventions to improve the well-being of persons living with dementia (PLWD) and their care partners.
Katherine Ramos, PhD
Assistant Professor, Psychiatry and Behavioral Sciences, Population Health Sciences, and Medicine
Duke University
Dr. Kathy Ramos is an Associate Professor and Senior Fellow in the Center for the Study of Aging and Human Development at Duke University. Dr. Ramos is a geropsychologist whose clinical research expertise intersects the fields of aging, palliative care, and behavioral medicine. She develops and evaluates behavioral interventions aimed at assisting older adult patients, along with their partners and families, in managing the challenges posed by chronic and life-threatening illnesses, particularly addressing the physical and psychological aspects of these conditions.
Examining a Mechanism of a Dyadic Music-Based Intervention in Persons Living With Dementia and Their Care Partners
The overall objective of this randomized controlled trial (RCT) is to test a music-based intervention (MBI) for dyads of persons living with dementia and their care partners, such that by fostering safe emotional expression and shared discussion surrounding music listening, music will create a unique opportunity to target emotion regulation as a mechanism to improve relationship quality for both dyad members.
Participants (n = 74 dyads) will be randomized using a 1:1 ratio to either the dyadic MBI group or the education control group:
- MBI: A six-session intervention delivered over 6 weeks by an interventionist. Sessions last 45 minutes. An interventionist will tailor each session to the individual musical preferences and relationship type (marital vs adult child). Each dyad member will then select 2-3 tracks from their personalized playlist, with support from the interventionist as needed. The interventionist will then introduce each track (alternating PLWD and care partner) and ask each person about their thoughts, feelings, and the significance of that music to them.
- Education Control: Participants randomized to the control group will receive education focused on preventative lifestyle measures such as diet, nutrition, and exercise.
NIH Stage: I
Eunjin Tracy, PhD
Assistant Professor, Human Development and Family Science
University of Missouri
Dr. Eunjin Tracy’s research adopts a life-course perspective to examine how sleep and circadian rhythms within couples and family contexts shape trajectories of healthy aging and disease. Her long-term career goal is to apply a family systems perspective to public health research by focusing on the role of sleep and circadian rhythms, thereby improving health as well as the functioning of couples and family relationships.
Mechanisms of Action, Efficacy, and Feasibility of a Web-Based Cognitive Behavioral Therapy for Insomnia Intervention in Spousal Alzheimer’s Disease and Related Dementias Caregivers
This study will evaluate Sleep Healthy Using the Internet for Dementia Caregivers (SHUTi-DC), a web-based cognitive behavioral therapy intervention (CBT-I) program adapted for spousal ADRD caregivers, to determine whether the adapted intervention can improve insomnia symptoms by engaging key behavioral (sleep efficiency and regularity) and cognitive (presleep arousal and dysfunctional sleep beliefs) mechanisms of change.
This study uses a two-arm, parallel-group randomized controlled trial design. Participants (n = 80) will be randomized in a 1:1 ratio to either:
- SHUTi-DC: An eight-week fully web-based cognitive behavioral therapy for insomnia (CBT-I) program adapted for spousal caregivers of individuals with ADRD. Participants receive the full interactive SHUTi program, along with two dementia-specific psychoeducational modules adapted for spousal caregiving. Interactive modules will be released weekly and take 20-40 minutes to complete.
- Active control: A web-based sleep education program that includes general sleep health information and the same two dementia-specific psychoeducational modules, but does not include interactive CBT-I components.
NIH Stage: I