Patricia Sagaspe, Maria Montserrat Sanchez-Ortuno, Lucile Dupuy, Florian Pecune, Julien Coelho, Jean Arthur Micoulaud-Franchi, Yannick Levavasseur, Etienne de Sevin, Alex Chanteclair, Pierre Philip, Nathalie Salles
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Insomnia was evaluated with the Insomnia Severity Index.</p><p><strong>Results: </strong>Logistic regression analyses showed that higher credibility and trust in the app's VC were associated with higher odds of treatment completion, but only in older adults (trust scores × age group: odds ratio [OR] = 1.12; 95% confidence interval [CI] = 1.01-1.25; <i>p</i> < .05, and credibility scores × age group: OR = 1.25 [95% CI = 1.06-1.47], <i>p</i> < .01). Within the subset of users who completed the intervention (<i>n</i> = 289), insomnia remission (χ<sup>2</sup> = 2.72, NS) and insomnia response rates (χ<sup>2</sup> = 2.34, NS) were comparable across both groups.</p><p><strong>Discussion and implications: </strong>This brief behavioral intervention appears to be efficacious for the self-management of insomnia symptoms in older adults. 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引用次数: 0
摘要
背景与目的：失眠是老年人最常见的睡眠障碍之一。认知行为疗法是老年人这种情况的一线治疗方法，但亲自治疗费用昂贵，而且往往无法获得。在这项研究中，在一组老年人和年轻人中，我们旨在比较：(a)他们对全自动移动健康干预来管理失眠的最初看法，(b)这些看法与治疗完成程度的关系，以及(c)干预对失眠严重程度和相关结果的影响。研究设计和方法：对自选的老年人（≥65岁）和年轻人（18-35岁）（n = 5,660）进行了病例系列研究，他们下载了一款免费的应用程序，该应用程序在法国提供虚拟伴侣（VC）的帮助下提供简短的失眠症行为干预。为期17天的干预包括睡眠卫生和刺激控制建议。主要结局是治疗完成（是/否）。在干预开始时，通过2份简短的问卷（完成率：1597名使用者）评估VC的治疗可接受性和信任度。采用失眠症严重程度指数评价失眠症。结果：Logistic回归分析显示，对应用程序VC的较高可信度和信任度与较高的治疗完成几率相关，但仅适用于老年人(信任评分×年龄组：比值比[OR] = 1.12；95%置信区间[CI] = 1.01-1.25；p p n = 289)、失眠缓解（χ2 = 2.72， NS）和失眠缓解率（χ2 = 2.34， NS）在两组间具有可比性。讨论和启示：这种简短的行为干预似乎对老年人失眠症状的自我管理有效。在全自动干预中整合有说服力的互动元素，如化身和虚拟教练，对于刺激老年人的参与特别有用。临床试验注册号：NCT05074901。
Perceptions and Effectiveness of a Fully Automated Brief Behavioral Insomnia Therapy, Delivered by a Virtual Companion, in Older and Young Adults.
Background and objectives: One of the most common sleep disturbances in older people is insomnia. Cognitive-behavioral therapy is the first-line treatment for this condition in older adults, but in-person treatment is costly and often unavailable. In this study, in a group of older and young subjects, we aimed to compare: (a) their initial perceptions of a fully automated mobile health intervention to manage insomnia, (b) how these perceptions related to treatment completion, and (c) the effects of the intervention on insomnia severity and related outcomes.
Research design and methods: A case-series study was conducted with a self-selected sample of older (≥65 years) and young (18-35 years) adults (n = 5,660) who downloaded a free app, available in France, that delivers a brief behavioral intervention for insomnia aided by a virtual companion (VC). The 17-day intervention included sleep hygiene and stimulus control recommendations. Primary outcome was treatment completion (yes/no). At the beginning of the intervention, treatment acceptability and trust in the VC were assessed with 2 short questionnaires (completion rate: 1,597 users). Insomnia was evaluated with the Insomnia Severity Index.
Results: Logistic regression analyses showed that higher credibility and trust in the app's VC were associated with higher odds of treatment completion, but only in older adults (trust scores × age group: odds ratio [OR] = 1.12; 95% confidence interval [CI] = 1.01-1.25; p < .05, and credibility scores × age group: OR = 1.25 [95% CI = 1.06-1.47], p < .01). Within the subset of users who completed the intervention (n = 289), insomnia remission (χ2 = 2.72, NS) and insomnia response rates (χ2 = 2.34, NS) were comparable across both groups.
Discussion and implications: This brief behavioral intervention appears to be efficacious for the self-management of insomnia symptoms in older adults. The integration of persuasive interaction elements, such as avatars and virtual coaches, in fully automated interventions could be particularly useful to stimulate older adults' engagement.
期刊介绍：
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.
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