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Randomized Controlled Trial
. 2022 Mar 3;77(3):513-524.
doi: 10.1093/geronb/gbab115.

A Controlled Pilot Study of the Wish Outcome Obstacle Plan Strategy for Spouses of Persons With Early-Stage Dementia

Joan K Monin  1 , Gabriele Oettingen  2 , Holly Laws  3 , Daniel David  4 , Lyndsay DeMatteo  1 , Richard Marottoli  5
Affiliations
Randomized Controlled Trial

A Controlled Pilot Study of the Wish Outcome Obstacle Plan Strategy for Spouses of Persons With Early-Stage Dementia

Joan K Monin et al. J Gerontol B Psychol Sci Soc Sci. .

Abstract

Objectives: Behavioral interventions can reduce distress for couples coping with early-stage dementia. However, most interventions are limited in accessibility and fail to address individualized goals. This pilot study examined the dyadic effects on multiple indicators of well-being of the Wish Outcome Obstacle Plan (WOOP) intervention, which guides participants to use Mental Contrasting with Implementation Intentions to achieve attainable goals in their daily lives.

Methods: This randomized controlled trial included 45 older persons with early-stage dementia (PWD) and their spousal care partners (CPs: n = 90 individuals). CPs were assigned randomly to WOOP training immediately after baseline (WOOP) or after a 3-month follow-up interview (Control; CON). Both groups received a dementia care education booklet. WOOP CPs were instructed to practice WOOP at least once a day for 2 weeks. All CPs and PWDs completed home surveys (baseline, 2 weeks, and 3 months), measuring perceived stress, depressive symptoms, quality of life, and affect.

Results: Mixed-effects models showed significant intervention × time interaction effects with large effect sizes for CPs on three of the five outcomes over 3 months. Compared with CON, WOOP CPs had decreased perceived stress (δ = 1.71) and increased quality of life (δ = 1.55) and positive affect (δ = 2.30). WOOP PWD showed decreased perceived stress (δ = 0.87) and increased quality of life (δ = 1.26), but these effects were not statistically significant.

Discussion: WOOP is a promising, brief intervention to improve dementia CPs' well-being that may also positively affect their partners with dementia.

Trial registration: ClinicalTrials.gov NCT03691428.

Keywords: Affect; Behavioral interventions; Caregiving; Dementia; Mental contrasting with implementation intentions.

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Figures

Figure 1.
Figure 1.
Study flow chart. WOOP = Wish Outcome Obstacle Plan group; CON = wait list control group; PWD = person with dementia. Due to the coronavirus disease 2019 restrictions, one couple in the intervention group and one couple in the waitlist group completed their questionnaires through the mail with support from video-chat.
Figure 2.
Figure 2.
Wish Outcome Obstacle Plan card.
Figure 3.
Figure 3.
Perceived stress changes from baseline to 3 months for care partners and persons with dementia in WOOP and CON conditions. WOOP = Wish Outcome Obstacle Plan group; CON = control group; PWD = person with dementia; CP = care partner; Time 3 = 3-month visit.
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