SAGE-LEAF: Reducing Burden in Alzheimer's Disease Caregivers Through Positive Emotion Regulation and Virtual Support
Condition: Alzheimer Disease
MeSH terms: Alzheimer Disease
Study type: Interventional

Summary: 
      The goal of the proposed study, is to adapt a positive emotion intervention for Alzheimer's
      Disease (AD) caregivers into a self-guided online format that incorporates social connection
      components and adaptive system feedback mechanisms to promote intervention adherence.
      Previous tests of the facilitated version of the program, called SAGE-LEAF (Social
      Augmentation to self-Guided Electronic delivery of the Life Enhancing Activities for Family
      caregivers), have shown efficacy for improving well-being in dementia caregivers. If
      effective, the SAGE-LEAF program can be disseminated to Alzheimer's caregivers nationwide
      through AD treatment and research centers.
    

Detailed description: 
      The prevalence of Alzheimer's Disease (AD) and other dementias is steadily climbing and
      predicted to affect as many as 16 million Americans by 2050. In 2016, 59% of dementia
      caregivers reported experiencing high levels of emotional and physical stress, and the risk
      that the chronic stress of dementia caregiving places on caregivers for developing a range of
      physical and mental health issues is extensively documented. Caregiving-related stress
      contributes to social isolation, loneliness, and physical illness and increases the risk of
      caregiver death. Interventions for dementia caregivers have primarily focused on reducing
      negative emotions and burden. However, over the past few decades, it has become clear that
      positive emotions are uniquely related to better psychological and physical well-being,
      independent of the effects of negative emotion suggesting that an intervention that
      specifically targets positive emotion holds promise for improving caregiver well-being and,
      ultimately, quality of care for the individual living with AD. The investigators' recent
      randomized trial of the positive emotion skills intervention, delivered by trained
      facilitators via the web in N = 170 family caregivers of people with dementia resulted in
      significant improvements in caregiver psychological well being. However,
      facilitator-delivered interventions are costly and difficult to implement with fidelity on a
      large scale. Furthermore, a major challenge to advancing behavioral interventions delivered
      by trained facilitators is assuring fidelity. The investigators have developed a self-guided
      online version of the intervention that has shown feasibility and acceptability in several
      samples, but this version does not capture the critical social connection aspects of the
      facilitator-delivered intervention. The investigators propose to take the next step toward
      closing the science-to-practice gap for the positive emotion regulation intervention by
      tailoring the self-guided online version specifically for dementia caregivers that
      incorporates the social connection components to combat the loneliness and isolation
      experienced by many Alzheimer's caregivers. The intervention, called SAGE-LEAF (Social
      Augmentation of self-Guided Electronic delivery of the Life Enhancing Activities for Family
      caregivers), leverages the lessons learned from the original LEAF project and adapts its
      positive emotion intervention to AD caregivers in a self-guided format while incorporating
      social connection components and adaptive system feedback mechanisms to promote intervention
      adherence.
    

Intervention name(s): SAGE LEAF
Intervention type(s): Behavioral
Intervention description(s): SAGE LEAF covers 8 skills and each skill has related home-practice activities that "unlock" every week. Each week will consist of 1-2 days of didactic material and 5-6 days of real-life home practice. Participants can access the skills at their own leisure and as often as they'd like within that week. Participants cannot skip modules with didactic material and can only progress to the next lesson if they have completed the current one. However, participants can return to old lessons or exercises if they choose to do so at a later time.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Alzheimer's Disease and Related Dementias; Caregiver