Design and rationale for a technology-based healthy lifestyle intervention in older adults grieving the loss of a spouse

Introduction: Experiencing the death of a spouse during late life is associated with an increased risk of developing debilitating mental health problems. Healthy lifestyle practices, such as regular exercise, healthy eating, and good sleep hygiene are promising strategies to influence the mental health and associated physical symptoms of late-life spousal bereavement. Objective: This paper describes the design and rationale of an intervention development study addressing selective and indicated prevention of depression, anxiety, and/or complicated grief disorder(s) among adults 60 years and older who are grieving the recent loss (within 8 months) of a spouse or partner. Methods: In Phase I, now complete, we developed and standardized behavioral self-monitoring of daily lifestyle choices via an electronic diary (BSM) and the combined BSM + motivational interviewing-based lifestyle coaching (BSM + MI) to be administered to participants grieving the loss of loved one. In Phase II, we have been implementing the interventions in a randomized controlled trial and addressing challenges related to recruitment. Randomization is to one of three cells: BSM, BSM + MI, or an enhanced usual care condition. Discussion: Several challenges in implementing our lifestyle interventions to older widow(er)s who are at risk for common mental disorders have been identified. Direct outreach to hospice organizations is an effective way to identify older adults in the early months following spousal death. Results from study may advance the field of grief support and promote a healthy adaptation to widowhood