Design and rationale for a technology-based healthy lifestyle intervention in older adults grieving the loss of a spouse

Abstract

Introduction Experiencing the death of a spouse during late life is associated with an increased risk of developing debilitating mental health problems. Healthy lifestyle practices, such as regular exercise, healthy eating, and good sleep hygiene are promising strategies to influence the mental health and associated physical symptoms of late-life spousal bereavement. Objective This paper describes the design and rationale of an intervention development study addressing selective and indicated prevention of depression, anxiety, and/or complicated grief disorder(s) among adults 60 years and older who are grieving the recent loss (within 8 months) of a spouse or partner. Methods In Phase I, now complete, we developed and standardized behavioral self-monitoring of daily lifestyle choices via an electronic diary (BSM) and the combined BSM + motivational interviewing-based lifestyle coaching (BSM+MI) to be administered to participants grieving the loss of loved one. In Phase II, we have been implementing the interventions in a randomized controlled trial and addressing challenges related to recruitment. Randomization is to one of three cells: BSM, BSM+MI, or an enhanced usual care condition. Discussion Several challenges in implementing our lifestyle interventions to older widow(er)s who are at risk for common mental disorders have been identified. Direct outreach to hospice organizations is an effective way to identify older adults in the early months following spousal death. Results from study may advance the field of grief support and promote a healthy adaptation to widowhood.

User Preferences Related to Multimedia Elements of a Mobile Application to Prevent Diabetes

“…With regard to the motivations and advantages of using a mobile application, the results agree with the findings of Lau et al [22], who reported that the majority of women participating in their study expressed the practicality and ease of access anytime and anywhere, according to their status and their roles, the recommendation of friendly activities adapted to their needs and expectations as the main advantages of using mobile applications [23]. Stahl et al [24] showed that mobile applications are an option for the achievement of healthy lifestyles at all ages.…”

Development of a family caregiver needs-assessment scale for end-of-life care for senility at home (FADE)

“…We assume that adapting to the process of senility may enable the caregiver to be calm at the time of death and provide appropriate end-of-life care sufficiently. Although aging and senility are laws of nature and death is unavoidable, caregivers often find it difficult to put aside their expectations and frequently experience significant emotional upheaval [30]. The six items that comprised this first factor, such as “acceptance of death,” “acceptance of senility,” and “development of a system for the moment of death,” highlighted the importance of slowly and gradually accepting and adapting to senility and death, even when experiencing anxiety at the passing of a loved one disturbs one’s emotional stability.…”

Digital Monitoring of Sleep, Meals, and Physical Activity for Reducing Depression in Older Spousally-Bereaved Adults: A Pilot Randomized Controlled Trial

“…The app also provided feedback in real time about participants' sleep, meals, and physical activity (see Stahl et al, 2017 for design and pilot testing of app). 9 Participants randomized to DM + coach received weekly calls from a health coach who used motivational interviewing (MI) techniques to strengthen participants' intrinsic motivation to engage in a regular behavioral routine. Using the MI Treatment Integrity Coding Manual -four components of MI were met during each session: open-ended questions, affirmations, reflective listening, and summarizing statements.…”