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This study is for adults 60 years and older who are grieving the recent loss of a spouse or partner. Bereavement is one of the most distressing transitions faced by older adults and triggers dramatic changes to older adults' daily routine which puts them at-risk for a mood disorder. The purpose of this study is to promote bereaved elders' mental health by focusing on healthy lifestyle practices. Study treatment involves using a tablet to record their daily physical activity, diet, and sleep behaviors, for 12 weeks. The investigators follow-up with people for up to one year.
Preventing mental health problems that develop following spousal bereavement is important because these conditions are highly prevalent and have lasting adverse consequences for the well-being of the bereaved survivor. The proposed research will evaluate the feasibility and acceptability of a healthy lifestyle intervention that uses a technology-based behavioral self-monitoring protocol to encourage engagement in physical activity, healthy eating, and good sleep practices following spousal bereavement. Data from 10 participants will be used for the development of a prevention intervention manual (Aim 1). A small pilot study will be conducted (Aim 2) in which 50 participants will be randomly assigned to 12 weeks of (1) behavioral self-monitoring using a smartphone (n=20), (2) behavioral self-monitoring using a smartphone + motivational interviewing-based lifestyle coaching (n=20), or (3) enhanced usual care (n=10). Blood samples will be collected to explore inflammatory cytokines as a potential mediator/moderator of mental health risk.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lifestyle | Experimental | Behavioral self-monitoring of daily physical activity, dietary, and sleep behaviors, for 12 weeks, into an electronic tablet. |
|
| Usual Care | No Intervention | Participants randomized to this condition will receive the written education provided to all participants. | |
| LIfestyle + coaching | Experimental | Behavioral self-monitoring of daily physical activity, dietary, and sleep behaviors, for 12 weeks, into an electronic tablet; and behavioral self-monitoring + motivational interviewing lifestyle coaching. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Behavioral self-monitoring | Behavioral | Behavioral self-monitoring will teach older adults to pay attention to their daily lifestyle practices and the conditions in which they occur. Behavioral self-monitoring is crucial for detecting change early, thereby preventing complications (mental illness symptom burden) that are associated with disruptions in healthy lifestyle practices. The steps of behavioral self-monitoring include: (1) selecting a goal, (2) paying attention to some aspect of behavior, and (3) recording some details of that behavior in a diary. |
| Measure | Description | Time Frame |
|---|---|---|
| Depressive symptoms (Hamilton Rating Scale of Depression [HRSD]) | Symptom levels of depression (Hamilton Rating Scale of Depression [HRSD]), | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Anxiety symptoms (7-item Generalized Anxiety Disorder Scale [GAD-7]) | Symptom levels of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) | 12 months |
| Grief symptoms (Inventory of Complicated Grief [ICG]) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sarah Stahl, PhD | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sarah Stahl | Pittsburgh | Pennsylvania | 15213 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38789080 | Derived | Stahl ST, Croswell E, Patel K, Neagoe I, Minhaj S, Lopaczynski A, Lyew T. Long-term follow-up of clinical trial participants: Predictors of post-trial response in older subjects. Contemp Clin Trials. 2024 Aug;143:107579. doi: 10.1016/j.cct.2024.107579. Epub 2024 May 22. |
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| ID | Term |
|---|---|
| D019964 | Mood Disorders |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D015438 | Health Behavior |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D062405 | Motivational Interviewing |
| ID | Term |
|---|---|
| D037001 | Directive Counseling |
| D003376 | Counseling |
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
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|
| Behavioral self-monitoring + Motivational interviewing | Behavioral | Participants will receive the same Behavioral self-monitoring intervention; participants in this condition will interact with a 'lifestyle coach' about their recorded behaviors, weekly. The lifestyle coach will use motivational interviewing to enhance older adults' confidence and intrinsic motivation to engage in healthy lifestyle practices. |
|
Symptom levels of complicated grief (Inventory of Complicated Grief [ICG])
| 12 months |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |