TY  - JOUR
AU  - Brodbeck, Jeannette
AU  - Jacinto, Sofia
AU  - Gouveia, Afonso
AU  - Mendonça, Nuno
AU  - Madörin, Sarah
AU  - Brandl, Lena
AU  - Schokking, Lotte
AU  - Rodrigues, Ana Maria
AU  - Gonçalves, Judite
AU  - Mooser, Bettina
AU  - Marques, Marta M.
AU  - Isaac, Joana
AU  - Nogueira, Vasco
AU  - Matos Pires, Ana
AU  - van Velsen, Lex
PY  - 2022
DA  - 2022/11/30
TI  - A Web-Based Self-help Intervention for Coping With the Loss of a Partner: Protocol for Randomized Controlled Trials in 3 Countries
JO  - JMIR Res Protoc
SP  - e37827
VL  - 11
IS  - 11
KW  - bereavement
KW  - cognitive behavioral therapy
KW  - CBT
KW  - cost-effectiveness
KW  - electronic mental health
KW  - grief
KW  - technology acceptance
AB  - Background: The death of a partner is a critical life event in later life, which requires grief work as well as the development of a new perspective for the future. Cognitive behavioral web-based self-help interventions for coping with prolonged grief have established their efficacy in decreasing symptoms of grief, depression, and loneliness. However, no study has tested the efficacy for reducing grief after losses occurring less than 6 months ago and the role of self-tailoring of the content. Objective: This study aims to evaluate the clinical efficacy and acceptance of a web-based self-help intervention to support the grief process of older adults who have lost their partner. It will compare the outcomes, adherence, and working alliance in a standardized format with those in a self-tailored delivery format and investigate the effects of age, time since loss, and severity of grief at baseline as predictors. Focus groups to understand user experience and a cost-effectiveness analysis will complement the study. Methods: The study includes 3 different randomized control trials. The trial in Switzerland comprises a waitlist control group and 2 active arms consisting of 2 delivery formats, standardized and self-tailored. In the Netherlands and in Portugal, the trials follow a 2-arm design that will be, respectively, complemented with focus groups on technology acceptance and cost-effectiveness analysis. The main target group will consist of adults aged >60 years from the general population in Switzerland (n≥85), the Netherlands (n≥40), and Portugal (n≥80) who lost their partner and seek help for coping with grief symptoms, psychological distress, and adaptation problems in daily life. The trials will test the intervention’s clinical efficacy for reducing grief (primary outcome) and depression symptoms and loneliness (secondary outcomes) after the intervention. Measurements will take place at baseline (week 0), after the intervention (week 10), and at follow-up (week 20). Results: The trials started in March 2022 and are expected to end in December 2022 or when the needed sample size is achieved. The first results are expected by January 2023. Conclusions: The trials will provide insights into the efficacy and acceptance of a web-based self-help intervention among older adults who have recently lost a partner. Results will extend the knowledge on the role of self-tailoring, working alliance, and satisfaction in the effects of the intervention. Finally, the study will suggest adaptations to improve the acceptance of web-based self-help interventions for older mourners and explore the cost-effectiveness of this intervention. Limitations include a self-selective sample and the lack of cross-cultural comparisons. Trial Registration: Switzerland: ClinicalTrials.gov NCT05280041; https://clinicaltrials.gov/ct2/show/NCT05280041; Portugal: ClinicalTrials.gov NCT05156346; https://clinicaltrials.gov/ct2/show/NCT05156346 International Registered Report Identifier (IRRID): PRR1-10.2196/37827 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2022/11/e37827
UR  - https://doi.org/10.2196/37827
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36449341
DO  - 10.2196/37827
ID  - info:doi/10.2196/37827
ER  -