{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:36:02Z","timestamp":1788867362755,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG0599882"],"award-info":[{"award-number":["P30AG0599882"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG058777"],"award-info":[{"award-number":["R01AG058777"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG068421"],"award-info":[{"award-number":["R01AG068421"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG0830344"],"award-info":[{"award-number":["R01AG0830344"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Family caregivers experience conflicts in caring for people with Alzheimer's dementia (PWD; e.g., siblings disagreeing, advocating with providers, PWD refusing assistance). Subsequently, family caregivers experience frustration, burden, and stress. Furthermore, these caregivers rarely receive formal conflict resolution training to ameliorate these concerns. We developed NegotiAge\u2014an artificial intelligence (AI)\u2010based negotiation training intervention that teaches caregivers how to resolve conflicts and provides the opportunity to practice negotiating with online avatars in real\u2010world conflicts. We sought to optimize the potency and test the early effect of NegotiAge on family caregivers following the multiphase optimization strategy (MOST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants, Design, Setting<\/jats:title>\n                    <jats:p>\n                      National randomized factorial trial of NegotiAge with family caregivers of PWD (&gt;\u200965\u2009years). Caregivers were randomized to one of eight conditions and variables\/outcomes assessed at baseline and 1\u2009month following NegotiAge. The mixed methods project used dependent sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests (quantitative) and constant comparative analysis (qualitative).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 23 states, 125 family caregivers (mean\u2010age 54\u2009years, 77% female) completed the study. Participants experienced significantly less caregiver burden (\u22123.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.002) and negative affect (\u22122.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) between baseline and 1\u2009month following. Those receiving two or more exercises experienced further significant burden reduction (\u22125.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.04). Qualitative analyses supported these findings: \u201cThere was a time when my mother was crying. Because of the training I was able to calm her.\u201d; \u201cWhen we have a conflict, I focus on the interest of both of us\u2013helped tremendously.\u201d In the month following, 54% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200967) of participants experienced conflicts and 74% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200993) applied skills learned. Among utilizers, there was a significant decrease in forcing behaviors (\u22121.24,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NegotiAge, an AI\u2010based negotiation training intervention, significantly reduced burden and improved negative affect among family caregivers. Engaging in more negotiation exercises further reduced burden. NegotiAge has the potential to improve the lives of caregivers and PWD. Further testing is needed to determine the direct impact on older adults and long\u2010term effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT04837937\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70546","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:10:24Z","timestamp":1781712624000},"page":"2032-2040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>NegotiAge<\/scp>\n                    \u2014An\n                    <scp>AI<\/scp>\n                    \u2010Based Caregiver Negotiation Training: Results From the Multiphase Optimization Strategy (\n                    <scp>MOST<\/scp>\n                    ) Trial"],"prefix":"10.1111","volume":"74","author":[{"given":"Vanessa","family":"Ramirez\u2010Zohfeld","sequence":"first","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaine","family":"Murawski","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celie","family":"Jobin","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Olvera","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan","family":"Mell","sequence":"additional","affiliation":[{"name":"University of Central Florida  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Brett","sequence":"additional","affiliation":[{"name":"Center on Dispute Resolutions, Northwestern University, Kellogg School of Business  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Gratch","sequence":"additional","affiliation":[{"name":"Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Tschoe","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela F.","family":"Pfammatter","sequence":"additional","affiliation":[{"name":"University of Tennessee Knoxville  Knoxville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4290-5081","authenticated-orcid":false,"given":"Lee A.","family":"Lindquist","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","first-page":"327","article-title":"Alzheimer's Disease Facts and Figures","volume":"17","year":"2024","journal-title":"Alzheimer's and Dementia: The Journal of the Alzheimer's Association"},{"key":"e_1_2_10_3_1","unstructured":"U.S. Bureau of Labor Statistics \u201cCelebrating National Family Caregivers Month With BLS Data \u201d2025 https:\/\/www.bls.gov\/blog\/2023\/celebrating\u2010national\u2010family\u2010caregivers\u2010month\u2010with\u2010bls\u2010data.html."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.7664"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2016.01.004"},{"key":"e_1_2_10_6_1","volume-title":"Caregiving: A National Profile and Assessment of Caregiver Services and Needs","author":"McKune S. 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