Stress Management and Resiliency Training Program for Parkinson's Disease (SMART-PD)

Stress Management and Resiliency Training Program for Parkinson's Disease Patients and Their Caregivers (SMART-PD)

SMART-PD is an 8-session program designed to decrease the physiological, emotional, cognitive and behavioral effects of stress in participants with Parkinson's disease and their caregivers by teaching cognitive-behavioral techniques and relaxation skills to help participants learn to elicit the relaxation response, alter cognitive appraisals, improve healthy lifestyle behaviors and access social support. The SMART program has been shown to be effective for reducing mental health symptoms such as depression and anxiety as well as physical symptoms such as pain and in promoting positive health behaviors.

Study Overview

• Status: Recruiting
• Conditions: Parkinson Disease
• Intervention / Treatment: Behavioral: Stress Management and Resiliency Training Program for Parkinson's Disease (SMART-PD)

Detailed Description

This is an interventional study sponsored by the Parkinson's Foundation designed to measure the feasibility, acceptability, and initial impact of the SMART-PD program on participants with a recent (less than five years) diagnosis of Parkinson's disease and their caregivers. This program provides information and tools to help patients and their caregivers cope with the new PD diagnosis and manage the stress and negative mental health symptoms (such as anxiety and depression) associated with the diagnosis.

SMART-PD is a manualized 8-week intervention that teaches cognitive-behavioral techniques and relaxation skills to help participants learn to elicit the relaxation response, alter cognitive appraisals, improve healthy lifestyle behaviors (i.e., sleep, nutrition, physical activity) and access social support.

Participants will take baseline and follow-up questionnaires to ascertain the impact of the program on outcomes such as quality of life, emotional health, coping skills, and healthy lifestyle behaviors.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sandra Skinner, PhD; Phone Number: 631-444-7513; Email: sandra.skinner@stonybrookmedicine.edu
• Study Contact Backup: Name: Lucero Molina; Phone Number: 631-632-3797; Email: lucero.molina@stonybrookmedicine.edu

Study Locations

• United States
  • New York
    • Stony Brook, New York, United States, 11794
      • Recruiting
      • Stony Brook Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Diagnosis of Parkinson's Disease within the past three years or caregiver of someone with a recent diagnosis of Parkinson's disease
• Ability to participate in 8 weekly program sessions via Microsoft Teams or in-person (as available)
• Ability to provide informed consent

Exclusion Criteria:

• Previous participation in the SMART program

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Parkinson's Patients and Caregivers; Will participate in the 8-session SMART-PD program as a participant with Parkinson's disease or as a caregiver of a participant with Parkinson's disease	Behavioral: Stress Management and Resiliency Training Program for Parkinson's Disease (SMART-PD); SMART-PD is a manualized intervention that teaches cognitive-behavioral techniques and relaxation skills to help participants learn to elicit the relaxation response, alter cognitive appraisals, improve healthy lifestyle behaviors (i.e., sleep, nutrition, physical activity) and access social support.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Enrollment and participation	The number of participants who enroll and fully participate in the program will be used to measure the feasibility of using SMART-PD for patients with Parkinson's disease and their caregivers.	One year
SMART Group Feedback Form	Designed to assess the accessibility of the SMART-PD program, The SMART Group Feedback form contains six Likert-scale questions such as, "On a 10-point scale, how would you rate the following items: helpfulness/effectiveness of SMART group" and four open-ended questions such as, "What has been the most helpful part of the group for you?"	Eight weeks
Change from Baseline General Quality of Life at 1-week post-intervention	The Short Form Health Survey (SF-36) is a quality of life measure that assesses eight aspects of health through the use of 36 multiple choice, yes/no, and Likert-scale items. An example question is, "Compared to one year ago, how would you rate your health in general now?" The SF-36 consists of eight scales (vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health). Scores are converted into z-scores with a scale of 0-100 with 0 indicating the greatest level of disability and 100 the least.	1-week post-intervention
Change from Baseline Parkinson's disease Quality of Life at 1-week post-intervention	The Parkinson's Disease Quality of Life Questionnaire (PDQ-39) consists of 39 Likert-scale questions asking how often in the last month the participant experienced something due to having Parkinson's disease. An example question is, "Had difficulty doing leisure activities which you would like to do?" with response options for all questions being "never", "occasionally", "sometimes", "Often", and "always or cannot do at all". The overall score from the PDQ-39 can be used for a global assessment, and scores can also be broken down into the following individual scales: mobility, activities of daily living, emotional well-being, stigma, social support, cognitions, communications and bodily discomfort.	1-week post-intervention
Change from Baseline Healthy Lifestyle Behaviors at 1-week post-intervention	The Lifestyle Profile II contains 52 Likert-scale items pertaining to healthy lifestyle behaviors in the areas of healthy eating, physical activity, spirituality, stress management, health responsibility, and interpersonal relations. Respondents are asked to indicate the frequency with which they engage in behaviors with the response options of "Never", "Sometimes", "Often", and "Routinely". An example question is, "Take some time for relaxation each day." Scores range from 52-208 and fall into the categories of poor (52-90), moderate (91-129), good (130-168), an excellent (169-208).	1-week post-intervention
Change from Baseline Caregiver Burden at 1-week post-intervention	The Zarit Burden Interview Short Form (ZBI-12) is designed to measure caregiver burden and consists of 12 Likert-scale items that ask respondents to if they feel a certain way "Never", "Rarely", "Sometimes", "Quite Frequently" or "Nearly Always". An example question is, "That because of the time you spend with your relative that you don't have enough time for yourself?" Scores range from 0-48 and are grouped into the categories of mild burden (0-10), mild to moderate burden (10-20), and high burden (>20).	1-week post-intervention
Change from Baseline cognitive functioning at 1-week post-intervention	The Montreal Cognitive Assessment (MoCA) is a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Examples of questions include drawing a clock at ten past eleven and serial subtraction starting at 100. Scores on the MoCA range form 0-30 with a score of 26 or higher generally considered normal.	1-week post-intervention
Change from Baseline Coping at 1-week post-intervention	Ways of Coping is a 66 Likert-scale item instrument that assesses behaviors used to cope with everyday stressful encounters. Response options are "Not Used", "Used Somewhat", "Used Quite A Bit", and "Used A Great Deal". Respondents are asked to describe a stressful situation they experienced in the past week and to respond to each item asking to what extent they used that way of coping in that situation. Examples of items are, "Turned to work or substitute activity to take my mind off things" and "Found new faith". The items comprise eight scales: confrontive coping, distancing, self-controlling, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive reappraisal.	1-week post-intervention
Change from Baseline Depression Symptoms at 1-week post-intervention	The Patient Health Questionnaire (PHQ-9) is used to measure depressive symptoms. The nine Likert-scale items have response options of, "Not at all", "Several days", "More than half the days", and "Nearly every day" and include questions such as, "Little interest or pleasure in doing things" and "Poor appetite or overeating." Scores range from 0-27 with 0 indicating no depression and five bands of scores ranges indicating minimal (1-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe depression (20-27).	1-week post-intervention
Change from Baseline Anxiety Symptoms at 1-week post-intervention	The Generalized Anxiety Disorder (GAD-7) consists of seven Likert-scale items designed to measure anxiety. Response options are, "Not at all", "Several Days", "More than half the days", and "Nearly every day" and item examples are, "Trouble relaxing" and "Becoming easily annoyed or irritated". Scores range form 0-21 with scores of 8 or higher indicating a probable anxiety disorder.	1-week post-intervention

Collaborators and Investigators

• Sponsor: Stony Brook University
• Collaborators: Parkinson's Disease Foundation
• Investigators: Principal Investigator: Adam Gonzalez, PhD, Stony Brook Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): August 3, 2020
• Primary Completion (Anticipated): December 31, 2021
• Study Completion (Anticipated): January 31, 2022

Study Registration Dates

• First Submitted: May 24, 2021
• First Submitted That Met QC Criteria: May 24, 2021
• First Posted (Actual): May 27, 2021

Study Record Updates

• Last Update Posted (Actual): September 21, 2021
• Last Update Submitted That Met QC Criteria: September 20, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease
• Other Study ID Numbers: 663519

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No