Participant Dyads Research Articles

GRANDPARENT–GRANDCHILD ASIAN AMERICAN REMINISCENCE: INTERGENERATIONAL AND CULTURAL REFLECTION

Abstract Intergenerational solidarity between grandparents and grandchildren has been highlighted in Asian Families and it is beneficial for the health of grandparents. An intergenerational reminiscence program was developed to improve the well-being of Asian American older adults as well as generational bonding. This paper qualitatively reported the reflection of participant dyads based on the interviews at the end of program (n = 11). Older grandparents received 6 sessions of life-review with their grandchildren remotely or in person for approximately 1 hour each week for 6 weeks. At the end of the program, individual interviews were conducted with dyad participants. Braun and Clarke’s six-steps of thematic analysis were followed to examine the interview data. Thematic analysis of interview with grandparents revealed four themes: Family life (early childhood, intergenerational connection, family reunition through immigration); career and work (hard work, sacrifice personal life); major life turning points (immigration, baptism); stress and coping (grief/loss, resilience). Thematic analysis of qualitative data from grandchildren also yielded four themes: Unknown/unexpected family history; disagreement (life-work balance, being frugal); cultural respect, lasting legacy (always remembering the good part of life, take one thing at a time). Recommendations offered by the dyad participants included combining some topics to avoid overlapping, adding topics of spousal relationship or parenting, etc. The reflection from grandparent-grandchild dyad participants showed that intergenerational reminiscence program is promising in bonding the grandparent-grandchild connection with family history and cultural revisitation. Lessons learned and recommendations for future research on interventions for Asian American families are offered.

The empathy reading project: bibliotherapy between parents and their children with autism spectrum disorder

The Empathy Reading Project examined whether parent-led bibliotherapy supported children ages three to five living with autism spectrum disorder (ASD) to enhance their cognitive empathy and social-emotional development. Children with ASD benefit from interventions that are interactive and focus on developing social skills; and the parent-child relationship plays a vital part in the development of these skills. The study was a single case A-B-A-B research design with four, parent-child participant dyads. All parents met weekly with the researcher and provided bibliotherapy to their children for two 3-week interventions. Data were collected using an Individualized Daily Child Measure (IDCM) and the Social Development Subscale (SDS) of the Child Development Inventory. Results demonstrated significant improvement on at least one IDCM area for each child, with one child demonstrating improvements across all domains. SDS results remained consistent or varied only slightly pre-post. The Empathy Reading Project provided initial evidence that a parent-led, therapist-supported, intervention can help children living with ASD to improve their empathic, prosocial behaviors and decrease off-task behavior.

Communication Bridge-2 randomized controlled trial: Recruitment and baseline features.

Non-pharmacological interventions may offer significant benefits to the quality of life for persons with primary progressive aphasia (PPA) and their care partners but have lacked efficacy trials. To help fill the efficacy gap, we provide the feasibility of recruitment, enrollment, randomization, and baseline data for the Communication Bridge-2 (CB2) randomized controlled trial (RCT). CB2 is the first international, single enrollment site, Phase 2, Stage 2, parallel-group, active control, RCT delivered via video chat to individuals with PPA and their care partners. Participants were recruited, screened, and randomized into one of two speech-language intervention arms. Ninety-five participant dyads (PPA mean baseline age: 67.1; 48% female) from four countries were enrolled and randomized. Global recruitment, enrollment, and randomization of individuals with PPA into a video chat-delivered non-pharmacologic RCT is feasible. This trial provides a potential model for conducting rigorous non-pharmacologic efficacy trials for Alzheimer's disease and related dementias. Primary progressive aphasia (PPA) negatively impacts communication participation. Communication Bridge-2 (CB2) is a telemedicine-delivered randomized controlled trial. CB2 included global recruitment and randomization of 95 PPA participant dyads. CB2, the first international superiority trial for PPA using video chat shows feasibility. The study provides a model for rigorous non-pharmacologic trials for Alzheimer's disease and related dementias.

Implementing Arts on Prescription at Home for People Living With Dementia: A Hybrid-Effectiveness Feasibility Study.

Arts on prescription at home (AoP@Home) is a participatory art-based approach involving a professional artist engaging a person with dementia (and their family carer) in art-making in their own home. This study evaluated the implementation of AoP@Home within a real-world community aged care context. A hybrid effectiveness-implementation design was used to simultaneously test both the AoP@Home intervention and the implementation process. AoP@Home program outcomes included person with dementia and family carer (dyad) health and wellbeing, and personal goal attainment. Implementation outcomes were evaluated according to feasibility, fidelity, acceptability, uptake, and costs via routinely collected data, artist notes, and interviews with program managers, artists, and participant dyads. Four dyads completed an AoP@Home program during the study period. All participants with dementia reported improvements in their overall health and wellbeing, and wellbeing scores improved for all carers from baseline to post-program. Implementation was feasible using existing government funding mechanisms, and programs were acceptable to all stakeholders. It is possible to deliver participatory arts programs for community-dwelling people with dementia and their family, in their home, using sustainable and available funding models. Programs such as AoP@Home should be made more accessible alongside broader allied health and care services.

Enabled to Stand: A Single-subject Research Design Study Exploring Pediatric Power Wheelchair Standing Device Use.

To investigate the influence of powered wheelchair standing device (PWSD) use on changes in activity/participation in children with neurodevelopmental conditions. A mixed methods A-B-A single-subject research design was replicated with participants. The target behavior was parental perceptions of changes in children's performance of activity/participation goals measured via the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM with children, an interview, and a 3-measure implementation survey. COPM data related to the target behavior were analyzed using the split-middle celeration line method. Four child-parent dyads participated in the study. All participants achieved statistically and clinically significant increases in COPM performance ratings for the 5 parent-identified activity/participation goals. For the participant dyads in this study, use of the PWSD appeared to positively influence parental perceptions of improvements in their child's performance of activity/participation goals.

The acquired dyad inclination and decreased interpersonal brain communication in the pursuit of collective benefit

People perform better collectively than individually, a phenomenon known as the collective benefit. To pursue the benefit, they may learn from previous behaviors, come to know whose initial opinion should be valued, and develop the inclination to take it as the collective one. Such learning may affect interpersonal brain communication. To test these hypotheses, this study recruited participant dyads to conduct a perceptual task on which they made individual decisions first and then the collective one. The enhanced interpersonal brain synchronization (IBS) between participants was explored when individual decisions were in disagreement vs. agreement. Computational modeling revealed that participant dyads developed the dyad inclination of taking the higher-able participants', not the lower-able ones' decisions as their collective ones. Brain analyses unveiled the enhanced IBS at frontopolar areas, premotor areas, supramarginal gyri, and right temporal-parietal junctions. The premotor IBS correlated negatively with dyad inclination and collective benefit in the absence of correction. The Granger causality analyses further supported the negative relation of dyad inclination with inter-brain communication. This study highlights that dyads learn to weigh individuals' decisions, resulting in dyad inclinations, and explores associated inter-brain communication, offering insights into the dynamics of collective decision-making.

Remini-Sing RCT: Therapeutic Choir Participation for Community-Dwelling People with Dementia and Their Primary Caregivers.

Dementia negatively affects the wellbeing of both caregivers and care recipients. Community-based therapeutic choir singing offers opportunities for music participation and social engagement that are accessible and mutually enjoyable for people with dementia and their family caregivers and promotes shared and meaningful musical interactions, which may support relationship quality. This study aimed to investigate the impact of the Remini-Sing therapeutic choir intervention on relationship quality, quality of life, depression, and social connectedness for dyads, as well as caregiver burden and care recipient anxiety. A randomized-controlled trial design was used with a target sample of 180 dyads. Due to recruitment difficulties, 34 participant dyads were recruited and randomly assigned to a 20-week group singing condition (n = 16) or a waitlisted control group (n = 18). Participant dyads consisted of people with dementia and their family caregivers who resided at home in the community. The Remini-Sing therapeutic choirs were held in community settings. Assessments were conducted by masked assessors at baseline, 11 weeks, and 21 weeks. Twenty-one dyads completed assessments at the primary timepoint (Week 11). Issues with recruitment and retention resulted in an unpowered study with no statistically significant findings. Mean decreases in anxiety and depression for choir participants with dementia were supported by medium to large effect sizes, indicating a potential intervention effect to be explored in future powered studies. Key learnings related to study design are discussed regarding recruitment, retention, participant burden, and sustainability, with recommendations made for future dementia research.

Clinical and cost-effectiveness of DREAMS START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) for people living with dementia and their carers: a study protocol for a parallel multicentre randomised controlled trial

IntroductionMany people living with dementia experience sleep disturbance and there are no known effective treatments. Non-pharmacological treatment options should be the first-line sleep management. For family carers, relatives’ sleep disturbance...

Physical Activity Patterns Within Dementia Care Dyads.

Previous research has explored the physical activity habits of people with dementia and their family carers separately, with little consideration of how physical habits are associated within dyads. In this observational study, we sought to explore the relationship between people with dementia and their carers' physical activity, at a group level and at a dyadic level. Twenty-six participant dyads (persons with dementia and their carer spouses) were asked to wear an accelerometer for 30days continuously. Comparisons were made at a group level and a dyadic level. People with dementia did not participate in significantly more moderate to vigorous physical activity (M = 15.44min/day; SD = 14.40) compared with carers (M = 17.95min/day; SD = 17.01). Within dyads, there were moderately strong associations between daily moderate to vigorous physical activity (r = .48-.54), but not with overall activity levels (r = .24). Despite physical activity habits remaining relatively low within people with dementia and carers, respectively, moderate to vigorous physical activity levels appear to be correlated within dyads. Understanding mutual influence on physical activity levels within dyads is an important pathway to promote an active lifestyle.

Augmented Reality in A Sustainable Engineering Design Context: Understanding Students’ Collaboration and Negotiation Practices

This study reports on the use of augmented reality (AR) within the context of sustainable engineering design education. The objective of this study is to understand students’ collaboration and negotiation practices in a sustainable engineering design context using AR. The technology used in this study includes MERGE Cube (a physical cube that acts as a digital canvas for AR) and CoSpaces Edu (an online platform for students to build 3D creations and animate them with code). There have been 48 instances of student participation from upper elementary to middle school in four iterations of this study since February 2022. The research was conducted based on a design-based research methodology, and the data was collected through qualitative methods and analyzed using the intra-action analysis method. This study’s outcome revealed that interactions among participant dyads and with the technology shed light on distinct dynamics within collaborative sustainability-oriented learning and design processes. These diverse interactions collectively emphasize the multifaceted nature of collaborative design, where individual experiences, communication styles, and technological proficiency all play integral roles in shaping the collaborative process. In addition, the results of our research showed that the complexities inherent in negotiating ownership and collaboration dynamics are influenced by individual attitudes, timing of involvement, and previous experiences. Given the importance of collaboration in achieving sustainability-oriented goals, these findings are relevant to the field of sustainable engineering education, especially when working with younger children.

Feasibility and acceptability of an online mental health intervention for pregnant women and their partners: a mixed method study with a pilot randomized control trial

BackgroundUntreated perinatal mood and anxiety disorders (PMAD) have short- and long-term health and social consequences; online cognitive behavioral therapy (CBT) interventions can reduce symptoms. Despite partner support being protective online interventions rarely target couples. This study builds on research on an existing CBT-based intervention, the Mothers and Babies Online Course (eMB), by testing its feasibility with prenatal couples.MethodsWe conducted a pilot, randomized, controlled feasibility trial using a 1:1 parallel design. To be eligible, participant dyads were pregnant people (between 13–30 weeks gestation and with a score of 10 or greater on either the GAD-7 or PHQ-9 scale indicating elevated symptoms of anxiety or depression) and their cohabitating partners, living in Missouri, with access to the internet; both in the dyad consented to participate. Recruitment occurred via Facebook ads, flyers, and a snowball approach. The intervention group received eMB, and the control group received a list of community resources. We examined retention and adherence data extracted from eMB analytics and study databases. All participants were given depression and anxiety scales at baseline, 4 and 8 weeks to test preliminary efficacy; satisfaction and acceptability were measured at trial end (i.e., eight weeks) and via interview.ResultsThere were 441 people who responded to recruitment materials, 74 pregnant people were screened; 19 partners did not complete enrolment, and 25 dyads were ineligible. There were 15 dyads per group (N = 30) who enrolled; all completed the study. The survey response rate was 90% but partners required nearly twice the number of reminders. No participant completed all lessons. Mean depression and anxiety scores dropped over time for dyads in control (M = -1.99, -1.53) and intervention (M = -4.80, -1.99). Intervention pregnant people’s anxiety significantly decreased (M = -4.05; 95% CI [0.82, 7.27]) at time two compared to control. Twelve pregnant people and four partners participated in post-intervention interviews and suggested improvements for eMB.ConclusionOnline dyadic interventions can potentially reduce PMAD symptoms. However, to feasibly study eMB with couples, strategies to increase program adherence are necessary. Tailoring interventions to overtly include partners may be advantageous.Trial registrationClinicalTrials.gov NCT05867680, 19/05/2023.

A mobile application-based post-stroke care strategy for survivors and their caregivers for prevention and management of post-stroke complications - "Stroke Home Care:" Development and feasibility.

In developing nations such as India, a disparity exists between the available resources for stroke rehabilitation and the substantial burden of stroke cases. Consequently, the provision of cost-effective and multidisciplinary post-stroke rehabilitation care to stroke survivors becomes of paramount importance. The utilization of mobile applications (apps) for stroke care has been on the rise, offering a personalized and pragmatic solution with the potential for wider reach in settings constrained by limited resources. To address the unmet needs in the prevention and management of post-stroke complications, we conceptualized a strategy known as a mobile application-based post-stroke care strategy for both survivors and their caregivers. The scope of the app's focus was determined based on the incidence of post-stroke complications within a prospective cohort of stroke patients, in conjunction with existing literature. An initial "web-based mobile app" prototype was crafted to align with the identified focus area. Before the development of the final app version, a feasibility study was conducted involving 30 participant dyads (comprising a patient and a caregiver). Content validity was evaluated by a panel of 20 stroke experts encompassing neurologists, nurses, physiotherapists, and psychologists. The "Stroke Home Care" (SHC) mobile app was conceived as a web-based educational tool aimed at preventing and managing post-stroke complications. It seeks to train caregivers of immobile stroke patients in the administration of preventive and therapeutic care procedures, thereby potentially enhancing survivors' quality of life and alleviating caregivers' burden. The feasibility and validity studies indicated "high satisfaction" levels among most caregivers and experts (>75%), with the remainder expressing "satisfaction" and no "dissatisfaction" regarding app utilities. Stroke experts unanimously deemed the app "appropriate", with consensus on contents, video quality, video length, and voice clarity. Caregivers reported "satisfactory" user experiences, encountering no issues during app installation or operation. Suggestions from both caregivers and experts were integrated into the final app version. The "SHC" app represents a feasible and well-received innovation tailored for the use by caregivers of stroke survivors. Consequently, the initial feasibility of the developed app serves as a precursor to a randomized controlled clinical trial aimed at substantiating its effectiveness within the post-stroke survivor and caregiver population. Notably, within resource-constrained contexts, this app has the potential to be a pivotal tool for post-stroke care.

Making "Fast Friends" Online in Middle Childhood and Early Adolescence.

Close peer relationships are critical to children's and adolescents' healthy development and well-being, yet youth sometimes struggle to make friends. The present work tested whether an online version of the Fast Friends procedure could engender closeness among 9- to 13-year-old youth. Participant dyads (N = 131), matched in age and gender, were randomly assigned to answer personal questions that encourage self-disclosure and play a collaborative game (Fast Friends condition) or to engage in similar activities without self-disclosure or collaboration (control condition). Fast Friends dyads reported feeling closer and expressed more interest in future contact than control dyads. The discussion addresses potential future uses and implications of an online Fast Friends procedure.

Joint music sessions, parents, and their lesbian and gay young adult children: Effectiveness on the ‘coming out’ process, relationships, and wellbeing

‘Coming out’ can be a psychologically challenging event and parental acceptance is often a prime concern. This article reports a study on the impact of music sessions delivered online and jointly for dyads of parents and their young adult children with lesbian and gay sexual identities in improving parental acceptance of sexual orientation, parent adult relationships, and wellbeing, compared to a waitlist control group. The music sessions were effective (Hedges’ g= −0.91 to 0.67; p < 0.05) and participants with higher formal education (postgraduate or professional degree), and whose intervention compliance was higher (>50% music sessions attended and homework sessions completed), were reported higher post-test scores on perceived parental support on sexual orientation, positive dimensions of parent adult relationships (warmth or affection, thoughtfulness, doing favors, and support of decisions made), and wellbeing, and lower post-test scores on negative dimensions of parent adult relationships (anger/hostility, insensitivity, demanding favors, and doubts on decisions made). Actor-partner interdependence models suggested that post-test outcome scores of parents and young adults were mutually interdependent and associated. With adequate emphasis on program compliance and some refinements for participant dyads with less formal education, music sessions enhance relationality and can be an effective family-based intervention for persons with diverse sexual identities.

Comparative effectiveness of verbal instruction versus video-based education (VIVid) among family caregivers for improving the quality of life in advanced head and neck cancer patients receiving palliative care in Eastern India: a randomized controlled trial.

To determine if video-based educational intervention compared to the standard verbal guidelines, provided to caregivers on home-based palliative care could enhance the quality of life (QoL) in advanced head and neck cancer (HNC) patients. The study employed a prospective, two-arm parallel-group, randomized controlled trial design. Investigators prepared a real-world demonstrational video of ten minutes duration regarding home-based care for family caregivers, with voice-over in Odia language (Eastern India). The contents of the video addressed the management of common problems in palliative care among HNC patients. This study included 180 participants, 90 patient & caregiver dyads randomized to interventional (video-based education) or control (verbal instruction) groups. Patients' QoL was measured at baseline and 3weeks follow-up using EORTC QLQ C30. Data were analyzed descriptively, and the Chi-square, Mann-Whitney U, T-test, spearman correlation, and multiple hierarchical regression analyses were employed for statistical analysis, with a significance level of p < 0.05. Seventy participant dyads completed the planned two assessments: baseline and at the end of 3rd week (Intervention = 37; Control = 33). The intervention group showed a significant improvement in the patient's health-related QoL, physical, emotional, and social functioning. Symptom burden reduction was observed for pain, nausea, and fatigue. A significant increase in the change in QoL with the video-based education group (VBE) compared to the verbal instruction (VI) group after adjusting for age, gender, physical functioning, and pain symptomology (adjusted R2 = 0.402) was noted. VBE intervention using smart-phone may offer caregivers a viable means of enhancing self-management while improving patients' QoL within the socio-cultural challenges for home-based palliative care in India. Further research on training caregivers using digital interventions and home-based visits is recommended. CTRI/2021/06/034473 [Registered on: 30/06/2021].

LEADing Advance care conversations: Development of an intervention platform

AbstractBackgroundThe LEAD Guide ( Life‐Planning in Early Alzheimer’s Disease; Dassel et al., 2019) addresses changes in cognition and goals of care along the Alzheimer’s disease and related dementias (ADRD) continuum and anticipates the need for surrogate decision‐makers upon loss of the care recipient’s decisional abilities.MethodWe developed a preliminary interactive version of the LEAD Guide, which serves as the foundation of a self‐administered intervention designed to promote and guide community‐based ADRD dyads through a dementia‐focused ACP process. The intervention model includes the LEAD Guide, along with education/information about ACP in the context of ADRD, and interactive instructions. We developed the LEAD Intervention using an iterative design process, which relied on feedback from a 11‐member community advisory board comprised of a clinical dementia specialist, the Director and Program Manager from the State Chapter of the Alzheimer’s Association, and community‐based ADRD dyads. We used Qualtrics, a web‐based survey platform, to simulate the basic functionality and flow of the interactive web‐delivered intervention we envisioned. We then conducted extensive beta‐testing with our community advisory board through written surveys and focus groups.ResultIn general, users were enthusiastic about the LEAD Intervention and appreciated the opportunity to engage in meaningful guided ACP with their family member. Recommended revisions fell into two categories: technological (adding a progress bar, reducing the number of items per page, adding back arrows, reducing text and using more graphics/figures, closed‐captioning, video‐facilitated instructions) and personalization (using piped text that integrates participants’ names into survey items to increase a personal feel, and creating downloadable copies of participants’ LEAD Guide responses).ConclusionThe process of creating a feasible, acceptable, and efficacious intervention requires input from ADRD experts as well as community‐based caregivers and persons with mild ADRD. The iterative process that our research team engaged in with our community advisory board members provided invaluable information on how to create and revise a web‐based ACP intervention platform for community‐based ADRD dyads. We are currently enrolling 60 ADRD dyads in the revised web‐based intervention, with the goal of exploring the impact on relationship quality, decision‐making self‐efficacy, and ACP congruence within participant dyads.

Postural and Gestural Synchronization, Sequential Imitation, and Mirroring Predict Perceived Coupling of Dancing Dyads

Body movement is a primary nonverbal communication channel in humans. Coordinated social behaviors, such as dancing together, encourage multifarious rhythmic and interpersonally coupled movements from which observers can extract socially and contextually relevant information. The investigation of relations between visual social perception and kinematic motor coupling is important for social cognition. Perceived coupling of dyads spontaneously dancing to pop music has been shown to be highly driven by the degree of frontal orientation between dancers. The perceptual salience of other aspects, including postural congruence, movement frequencies, time-delayed relations, and horizontal mirroring remains, however, uncertain. In a motion capture study, 90 participant dyads moved freely to 16 musical excerpts from eight musical genres, while their movements were recorded using optical motion capture. A total from 128 recordings from 8 dyads maximally facing each other were selected to generate silent 8-s animations. Three kinematic features describing simultaneous and sequential full body coupling were extracted from the dyads. In an online experiment, the animations were presented to 432 observers, who were asked to rate perceived similarity and interaction between dancers. We found dyadic kinematic coupling estimates to be higher than those obtained from surrogate estimates, providing evidence for a social dimension of entrainment in dance. Further, we observed links between perceived similarity and coupling of both slower simultaneous horizontal gestures and posture bounding volumes. Perceived interaction, on the other hand, was more related to coupling of faster simultaneous gestures and to sequential coupling. Also, dyads who were perceived as more coupled tended to mirror their pair's movements.

Factors Affecting Mealtime Difficulties in Older Adults with Dementia Living in Long-Term Care Facilities: A Multilevel Model Analysis

Aim(s). This study conducted a multilevel analysis of mealtime difficulties in older adults with dementia based on the social-ecological model. Background. Mealtime difficulty in this population should be examined from an extensive perspective, rather than approaching it as an individual problem. Method(s). This was a cross-sectional study involving 342 participant dyads from 57 long-term care facilities; 114 direct care workers; and 342 older adults with dementia. A multilevel regression analysis was conducted using the MPlus 8.0 program. Results. Among intrapersonal factors, age, cognitive function, activities of daily living, and number of beds in the facility were identified as affecting mealtime difficulty. Environmental factors included meal assistant education experience and whether an environment suitable for eating had been established. Conclusion(s). The results show that intrapersonal factors exert a large influence on the mealtime difficulties of older adults with dementia in long-term care facilities and support the need to improve environmental factors, which are modifiable. Implications for Nursing Management. This study provided useful information about the influence of leaders on mealtime difficulties in older adults with dementia. Leaders should establish an environment in the facility for reduced mealtime difficulties.

Intergenerational Associations of Adverse Childhood Experiences and Adolescent Engagement in High-Risk Behaviors

Purpose: While the association between Adverse Childhood Experiences (ACEs) and negative health outcomes in adulthood is well established, very few studies have examined the cumulative impact of ACEs across generations (intergenerational ACEs – caregiver and youth) on health outcomes in adolescence. The purpose of this study is to examine whether intergenerational ACEs are associated with an increased likelihood of participation by youth in high-risk behaviors including tobacco use, vaping, alcohol use, engagement in sexual activity, or result in higher rates of affective disorders such as depression. Methods: 234 caregiver-youth dyads were recruited via a convenience sample from pediatric clinics at East Tennessee State University and Western Michigan University Homer Stryker M.D. School of Medicine. Participant dyads completed a survey assessing both caregiver and youth ACEs, youth depression, and youth participation in high-risk behaviors. Caregiver-youth dyads were sorted into an ACEs matrix with the following groups: Low Caregiver-Low Youth ACEs (LC-LY), Low Caregiver-High Youth ACEs (LC-HY), High Caregiver-Low Youth ACEs (HC-LY), and High Caregiver-High Youth ACEs (HC-HY). Results: HC-HY dyads were 11.4 times more likely to report moderate to severe depression compared to LC-LY dyads (p&lt;0.01). HC-HY dyads were 4.5, 3.3, and 7.5 times more likely to have youth participate in alcohol use (p&lt;0.05), vaping (p&lt;0.05), and sexual activity (p&lt;0.01), respectively, compared to LC-LY dyads. Conclusions: Intergenerational ACEs exposure was related to greater youth engagement in high-risk behaviors and risk of depression. Assessing both caregiver and youth ACEs would better identify youth at risk for alcohol use, vaping, sexual debut, and depression.

Retention of Participant and Study Partner Dyads in Alzheimer’s Disease Clinical Trials

AbstractBackgroundStudy retention is crucial to clinical trial success. Greater than expected dropout rates can lead to reduced power and biased results. Alzheimer’s disease (AD) trial success depends not only on participants but also on their study partners. We investigated whether study partner type was associated with the risk of dropout in large Phase 3 registration trials.MethodWe used data from two trials of bapineuzumab for patients with mild‐to‐moderate AD. Data were provided by the sponsor of the trials, Janssen Research &amp; Development, LLC for use in these analyses. The co‐primary endpoints were the change from baseline to week 78 in the Disability Assessment for Dementia (DAD) and the 11‐item AD Assessment Scale (ADAS Cog‐11). We defined completers as participants with baseline and week 78 scores on ADAS Cog‐11 or DAD. Participants were excluded from our analyses if they did not declare a study partner type in the Resource Utilization in Dementia‐Lite (RUD‐Lite) or if they were missing ADAS Cog‐11 and DAD at baseline. Time‐to‐dropout was defined as the time from study enrollment to the time of the last visit during which ADAS Cog‐11 or DAD were conducted.ResultData were available for 1,234 participants in the non‐carrier study and 1,221 participants in the carrier study. Table 1 presents baseline characteristics for participants included in our analysis (n = 1,229 non‐carriers and n = 1,097 carriers). In both trials, we observed a higher proportion of participants enrolled with a spouse (non‐carriers: 817, 66.3%; carriers: 837, 76.3%). Approximately 75% of spousal dyads completed the non‐carrier trial, while 60% of adult‐child dyads and 54% of dyads with other study partners completed the trial. Differences in the proportion of completers were lower in the carrier study, with approximately 75%, 73%, and 70% of completers among spousal, adult child, and “other” dyads. The same trend for time‐to‐dropout can be seen in Figure 1.ConclusionWe found that a higher proportion of spousal dyads completed the trials compared to other dyad types. Understanding the factors driving these associations may help understand reasons for dropout and could lead to the development of retention strategies.