Intelligent Personal Assistant for Managing Depression in Homebound Older Adults

Study Overview
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Brief Summary
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The purpose of this study is to design a companion booklet and pilot test it with a voice-controlled intelligent personal assistants (VIPA), like Google Home or Amazon Alexa, to provide homebound older adult patients with skills and tools to help manage social isolation.

Detailed Description
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The objective of this pilot study is to design a companion booklet and pilot test it with a voice-controlled intelligent personal assistant (VIPA), Google Home or Amazon Alexa, to provide patients with skills and tools to help manage their social isolation. The companion booklet is a document that will be created using feedback obtained from a panel of geriatric experts, highlighting features of the VIPA that may be most beneficial to socially-isolated older adults. It will be submitted to the IRB for approval once finalized. The specific aims of this project are to: Aim 1: Design a companion booklet to be used in conjunction with a VIPA (Google Home/Amazon Alexa) for improving social isolation and communication among homebound older adults, defined as someone who is unable to leave the home without assistance of a device or another person, due to a physical or cognitive condition. Aim 2: Assess the feasibility and implementation of the VIPA (Google Home/Amazon Alexa) and the companion booklet and its impact on clinical and functional outcomes for older adults with social isolation.

Official Title
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Intelligent Personal Assistant for Managing Depression in Homebound Older Adults

Conditions
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Aging, Physical Dependence

Intervention / Treatment
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* Behavioral: VIPA and companion booklet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults aged 65 years or older; Homebound patients of the Northwestern Medicine Geriatrics Program; English-speaking; and Able to verbally consent Exclusion Criteria: Condition that limits ability to consent, such as severe cognitive impairment or lack of English proficiency Less than 65 years of age

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VIPA device and companion booklet<br>For Aim 2, we will recruit a total of 20-40 older adult homebound patients who are likely to be socially isolated, through the Geriatric and General Internal Medicine clinics at Northwestern (over 2,300 homebound older adults) to use the VIPA and accompanying instructional booklet focused on social-isolation. Either the study PI or Research Study Coordinator (RSC) will visit the participant's home, or assist the patient virtually, once consented, to set up the Google Home or Amazon Alexa device for them and review the companion VIPA booklet with them. | Behavioral: VIPA and companion booklet<br>* Participants will be asked to use the VIPA and accompanying second iteration of the instructional booklet focused on social-isolation. These participants will be surveyed over the phone for 16 weeks (baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks) with outcomes measured at each time point.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Acceptability | usability assessment that we adapted from this original source: Questionnaire for User Interface Satisfaction. Based on: Lund, A.M. (2001) Measuring Usability with the USE Questionnaire. STC Usability SIG Newsletter, 8:2; constructs assessed: usefulness, ease of use, ease of learning, satisfaction. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Social Isolation | PROMIS Social Isolation -Short Form 8a: The PROMIS Social Isolation item bank assesses perceptions of being avoided, excluded, detached, disconnected from, or unknown by, others; scores range from 8 to 40, with a higher score representing higher levels of social isolation | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Anxiety | General Anxiety Disorder Scale (GAD-7): Total score (adding all the numbers) provides a possible score from 0-21, higher scores reflect more anxiety. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Self Efficacy for Managing Social Interactions | PROMIS Self Efficacy for Managing Social Interactions -Short Form 4a: : Confidence in participating in social activities and getting help when necessary. Managing communication with others about their medical condition, including communication with health professionals. Scores range from 4 to 20, with 20 representing higher self-efficacy | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Companionship | PROMIS Companionship -Short Form 4a: The PROMIS adult Companionship item bank assesses perceived availability of someone with whom to share enjoyable social activities such as visiting, talking, celebrations, etc. Scores range from 4 to 20, with higher scores representing higher levels of companionship. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Ability to Participate in Social Roles and Activities | PROMIS Ability to Participate in Social Roles and Activities -Short Form 4a: scores range from 4 to 20, with higher scores representing a higher perceived ability to participate | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Depression | Geriatric Depression Scale (GDS) - Short Form: scores range from 1 to 15, with higher scores reflecting more depressive symptoms. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Functional Status | PROMIS-Physical function 8b: PROMIS Physical Function instruments measure self-reported capability rather than actual performance of physical activities. Scores range from 8 to 40. A higher score represents higher levels of physical function. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Cognitive Function | Brief Montreal Cognitive Assessment (MoCA): The Montreal Cognitive Assessment (MoCA) was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Scores range from 0 to 22, with higher scores representing higher cognitive function. A score of 18 or higher is considered normal cognition. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 
| Change in Well-being | Neuro-QOL Positive Affect & Well-Being: Scores range from 9 to 26, and higher scores indicate better self-reported well-being. | baseline, 2 weeks, 4 weeks, 8 weeks, and 16 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Social Isolation, Loneliness, Older Adults, Homebound