Efficacy of a Healthy Lifestyle Intervention to Prevent Depression in Older Spousally-bereaved Adults-Supplement

PROJECT SUMMARY/ABSTRACTOlder spousally-bereaved adults are at very high risk for major depressive disorder (MDD). In the age ofCOVID-19, the inability to engage in rituals that support the grieving process will make it much more difficult tocope with the death of a spouse. This proposed Administrative Supplement leverages our funded R01 "Efficacyof a Healthy Lifestyle Intervention to Prevent Depression in Older Spousally-bereaved Adults" (WELL) toincrease the reach, uptake, and sustainability of our existing behavioral-health intervention to accommodateolder spouses bereaved by COVID-19 who are seeking prevention and self-management strategies to managepsychiatric symptoms both during and following the pandemic. We will use digital advertising to optimize reachand access in geographic locations heavily impacted by the COVID-19 pandemic. To promote adherence toand sustained use of WELL, we will use existing data (K01 MH103467) to identify individual and intervention-level characteristics that are associated with discontinuation vs sustained use of digital interventions for mentalhealth support. Additional measurements of death, dying, and bereavement (preparedness for death, lack ofclosure, social isolation, and loss of mourning rituals) will be obtained for the 100 participants recruited over theSupplement's two-year time frame. The data will be used to examine both the impact of COVID-19 death ondepression symptoms (collected through this supplement) and trajectories of depression symptoms over oneyear (collected through this supplement during the WELL follow-up time period). The aims of the proposedresearch will examine in older spousally-bereaved adults at high risk for MDD (due to subthreshold symptomsof depression) (1) whether depression symptom burden is higher in older spouses bereaved by COVID-19 thanthose bereaved by other causes of death; and (2) whether COVID-19 bereavement is associated with otherpsychopathological conditions including anxiety, post-traumatic stress, suicidal ideation, and prolonged griefdisorder(s). In sum, WELL provides a unique opportunity to examine the relationship between COVID-19 deathand surviving spouses' psychiatric symptoms in a large longitudinal study of community-dwelling older spousesparticularly vulnerable to MDD due to spousal bereavement.