In It Together: Using Acceptance and Commitment Therapy to Treat Distress Among Older Adults With Sensory Loss and Their Spouses

Study Overview
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Brief Summary
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Impairments in hearing and/or vision are common in older age. Having lived one's life as a fully sighted and hearing individual, older adults with sensory loss must come to terms with their declining capacity to interact with others and waning independence. There is ample research evidence showing that sensory loss (i.e., loss of hearing, vision or both) can be a distressful experience for older adults and their spouses, yet little has been done to understand what works in alleviating this distress or develop scalable cost-effective interventions to counter this distress or associated outcomes like depression, anxiety, poor quality of life, and lower relationship quality. In this project, the investigators will design and test an easy-to-administer, online intervention aimed at reducing emotional and marital distress in older adults with sensory loss and their spouses. The goal of the intervention will be to develop acceptance of the sensory loss through a series of Acceptance and Commitment Therapy inspired educational, self-compassion, and therapeutic activities. In prior research, acceptance has been flagged as a promising factor on which to intervene to assist older couples' emotional and marital recovery in the context of sensory loss. Thus, the investigators expect that the intervention should show encouraging results regarding the alleviation of distress in this group and contribute significantly to the psychosocial rehabilitation of older adults with sensory loss and their spouses.

Official Title
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In It Together: Using Acceptance and Commitment Therapy to Treat Distress Among Older Adults With Sensory Loss and Their Spouses

Conditions
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Sensory Loss (Impairment of Sight and/or Hearing)

Intervention / Treatment
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* Behavioral: English: In It Together (IIT)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be 60 years of age or older Be able to read and write in Danish Be in a romantic relationship of at least 1 year Live together with the partner (share housing) Feel either one self or one's partner has a sensory loss (hearing and/or sight) that affects day-to-day life. This sensory loss does not need to be confirmed by a health care provider. Exclusion Criteria: Less than 60 years of age Cannot read or write in Danish Not in a romantic relationship Relationship length of less than 1 year Not living together with the partner (not share housing) Currently receiving psychological help (therapy/intervention)

Ages Eligible for Study
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Minimum Age: 60 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants will be randomized to one of two conditions: 1) Intervention group, which will receive access to the digital intervention program, and 2) Control group, who will not receive immediate acess to the digital intervention program. Intervention group: Participants will be asked to complete survey measures at baseline (prior to access to the 4-module digital intervention program), 6-weeks, 10 weeks, and 18 weeks. Control group: Participants will be asked to complete survey measures at baseline , 6-weeks, and 10 weeks (control group participants gain access to the digital intervention program after completion of the 10-week survey).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Gains access to the digital intervention program | Behavioral: English: In It Together (IIT)<br>* Digital intervention program that consists of 4 modules, to be completed 1 week apart. The modules consist of psychoeducation, as well as acceptance and commitment therapy-inspired activities.<br>* Other names: Danish: Sammen on Sansetab (SOS);|
| No Intervention: Wait-list- control group<br>Does not gain access to the intervention (until end of study) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| WHO-5 well-being | 5-item measure of general well-being (Bech, 1999, 2012) | Within the last 2 weeks | 
| Couple Satisfaction Index | 4-item measure of satisfaction with one's romantic relationship (Funk & Rogge, 2007) | Follow-up 1: During the last 6 weeks | 
| Depression | 9-item measure of depressive symptoms (PHQ-9; Kroenke, Spitzer, & Williams, 2001; Kroenke & Spitzer, 2002) | Within the last 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychological flexibility | 7-item measure of psychological flexibility (AAC-II; Bond, Hayes, Baer, Carpenter, Guenole, Orcutt, Waltz, & Zettle, 2011). | Follow-up 1: During the last 6 weeks | 
| Communication | 12-item measure of satisfaction with communication with partner (Jones, Jones, & Morris, .018) | Follow-up 1: During the last 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sensory loss, Hearing impairment, Sight impairment, Elderly couples, Age 60 or older, Online, Digital, Intervention, Acceptance and Commitment therapy