This is a K01 award application for Dr. Jacqueline Eaton, a gerontologist and young investigator pursuing transdisciplinary research on enhancing the quality of life of older adults and their caregivers through arts- based interventions. A K01 award will provide her with the means to acquire critical skills in four key career development areas: 1) behavioral intervention research using the NIH Stage Model; 2) Alzheimer’s Disease and related dementias (ADRD); 3) applied multilevel growth modeling; and 4) interdisciplinary team leadership and management skills for intervention research. By gaining these skills, Dr. Eaton will fulfill her career goal of becoming an independent academic investigator and national leader in arts-based intervention research focused on ADRD caregivers. Supporting this goal, Dr. Eaton has assembled the mentoring team of Drs. Lee Ellington (Primary Mentor), a research psychologist who leads complex, multi-site clinical caregiver studies, and Julene Johnson (Co-Mentor), a cognitive neuroscientist with expertise in developing arts-based interventions for older adults. She has also assembled a three person Advisory Committee with expertise in the NIH Stage Model, ADRD caregiving, and multilevel growth modeling. It is estimated that by 2050, 13.8 million Americans will be living with dementia and up to 90% will experience behavioral symptoms, such as agitation, combativeness, and depression. Behavioral symptoms are associated with greater stress for caregivers, which leads to poor health, decreased quality of life, and increased burden. There is a need to find effective interventions to address the negative effects of behavioral symptoms. This proposal focuses on developing and testing the Enhancing Active Caregiver Training (EnACT) to help caregivers better manage the common behavioral symptoms associated with ADRD. Using the NIH Stage Model, we will create (Stage 1a) and conduct preliminary testing (Stage 1b) of these techniques in a group intervention. By pursuing the following specific aims, Dr. Eaton will develop and test EnACT to prepare for a stage 3 clinical trial (to be proposed in an R01 application during the K01 award period). Specific Aim 1 will develop and iteratively refine the EnACT intervention for ADRD caregivers. Specific Aim 2 will evaluate the feasibility and acceptability of the EnACT intervention. Specific Aim 3 will examine potential mechanisms of change over time and their subsequent impact on proximal and distal outcomes. There is a rise in the number of caregivers required to give optimal support to an aging population that will have a greater need for, and impact on, local and national resources. Dr. Eaton’s proposed research is significant because effective evidence-based interventions require systematic approaches to enhance active caregiver training which has been shown to improve outcomes for ADRD caregivers. The proposed research is innovative because it combines techniques from a variety of disciplines to increase engagement and enhance our understanding of mechanisms of action within caregiver interventions.

PROJECT NARRATIVE Persons with Alzheimer’s disease and related dementias (ADRD) experience behavioral symptoms such as agitation, combativeness, depression, and apathy. These behaviors increase caregiver stress, which leads to negative outcomes, such as poor health, depression, and increased caregiver burden. This project seeks to develop and test an intervention to enhance active caregiver skill training to prepare caregivers to better manage behavioral symptoms in order to improve ADRD caregiver wellbeing.