Resilient Together for Dementia: A live video resiliency dyadic intervention for persons with dementia and their care-partners early afterdiagnosis

PROJECT SUMMARY In this K23 proposal, I outline a comprehensive 5-year training program that will support my transition towards an

independent investigator focused on the development and rigorous testing of interventions for dyads (i.e., pairs) of persons

living with dementia (PWDs) and their informal care-partners, with an emphasis on early intervention. In this application, I propose a significant and innovative proposal that is directly tied with my proposed training and career development goals. Background: Alzheimer's disease and related dementias (ADRD) produce a host of stressors for PWDs and their

spousal care-partners (SPs), who both experience substantial emotional distress after diagnosis. Emotional distress is interdependent within dyads and – without treatment—becomes chronic and negatively impacts both partners' health, quality of life, and their ability to navigate the short and long-term challenges associated with ADRDs. Addressing

emotional distress early, when PWDs can still meaningfully participate, is an unexplored opportunity to prevent chronic

emotional distress and preserve quality of life for both partners. Specific aims and research design: I aim to develop the

first version of the live video Resilient Together for Dementia (RT-D) intervention and methodology via 1) interviews and quantitative surveys (N=20) of PWD-SP dyads, with additional feedback from 2) focus groups with ADRD medical stakeholders (N=4) (Aim 1). Next, I will explore, via an open pilot (N=5 dyads) with exit interviews and pre-post self-

report assessments, the initial feasibility, acceptability, and credibility of the live video RT-D and procedures, and to

further refine RT-D as needed (Aim 2). Finally, I will establish, via a pilot feasibility RCT of the RT-D versus control (N= up to 50 dyads), the feasibility, acceptability and credibility of RT-D following predetermined benchmarks (Aim 3). Findings will inform a hybrid efficacy-effectiveness trial through the R01 mechanisms and future studies extending this

work to include additional family members and other care-partners. Training and mentoring: My aims are supported by

3 training goals to develop expertise in: 1) qualitative and mixed methods assessment to inform intervention adaptation; 2)

specialty training in geriatrics and ADRD clinical care; 3) clinical trial methodology to facilitate dyadic intervention development and refinement. I will obtain mentorship from an exemplary team led by my primary mentor Dr. Ana-Maria Vranceanu, a clinical health psychologist with expertise in mixed-methods research and live video dyadic intervention

development, and my co-mentor Dr. Christine Ritchie, a geriatrician and palliative care physician with decades of work

improving the treatment of ADRD. My training goals are supported by 1) a team of expert mentors, 2) a rich institutional environment at Massachusetts General Hospital and Harvard Medical School, and 3) targeted coursework, scientific meetings, seminars and planned publications. Relevance to the NIA mission. This K23 is in line with NIAs priorities to

develop interventions to the maintain health and wellbeing and reduce the burden of ADRDs. Impact: I am a clinical psychologist with expertise in couple and family interventions for neurological populations. The experience gained will

serve as the foundation for an independent career in dyadic interventions for ADRDs, with a focus on early intervention.