{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:56:31Z","timestamp":1792799791269,"version":"4.5.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Alzheimer\u2019s Association","award":["Association Research Grant (AARG-20-685951)"],"award-info":[{"award-number":["Association Research Grant (AARG-20-685951)"]}],"id":[{"id":"https:\/\/ror.org\/0375f4d26","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      People with dementia often lose decisional capacity before death, underscoring the need for dementia-focused advance care planning (ACP) tools. In cooperation with our Community Advisory Board, we developed LEAD (\n                      <jats:underline>L<\/jats:underline>\n                      ife-Planning in\n                      <jats:underline>E<\/jats:underline>\n                      arly\n                      <jats:underline>A<\/jats:underline>\n                      lzheimer\u2019s and Other\n                      <jats:underline>D<\/jats:underline>\n                      ementias), a Web-based, self-guided, dementia-focused ACP intervention for care partners and persons with preclinical or mild dementia. This study evaluated the feasibility and initial efficacy of the LEAD intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Community-based dyads (N = 48) of one care recipient (person with or at risk for dementia) and one care partner completed the intervention and study surveys assessing decision-making self-efficacy, relationship quality, and medical advance directive completion. We utilized mixed-effects repeated measures models to explore changes in outcome variables over time in care recipients and care partners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-four percent of dyads completed the intervention. There was a significant increase in decision-making self-efficacy scores among care recipients and care partners (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and a decrease in relationship strain among care partners (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). There were no changes in positive relationship domains. Of the 23 dyads that did not have a completed medical advance directive prior to the study, 13 dyads (50.0%) completed this document during the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings suggest the LEAD intervention is feasible and demonstrates initial efficacy in promoting dementia-focused ACP. The LEAD intervention has the potential to reduce relationship strain and help care partners improve their confidence as proxy decision-makers for people with dementia who cannot make independent medical decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091251379840","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T13:49:53Z","timestamp":1758289793000},"page":"1281-1289","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the Feasibility of the LEAD Trial: Online Dyadic Dementia Care Planning for Early Alzheimer's and Other Dementias"],"prefix":"10.1177","volume":"43","author":[{"given":"Eli","family":"Iacob","sequence":"first","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Utz","sequence":"additional","affiliation":[{"name":"College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine P.","family":"Supiano","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordana L.","family":"Clayton","sequence":"additional","affiliation":[{"name":"College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Aruscavage","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-6593","authenticated-orcid":false,"given":"Sara G.","family":"Bybee","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-6697","authenticated-orcid":false,"given":"Sharon E.","family":"Bigger","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-9693","authenticated-orcid":false,"given":"Kara B.","family":"Dassel","sequence":"additional","affiliation":[{"name":"University of Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13526"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e318293b380"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12362"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.3543"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16801"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igz024"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074840717745669"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120929323"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-2015-2415"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2167702613497932"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.12357"},{"key":"e_1_3_4_13_2","doi-asserted-by":"crossref","unstructured":"Clayton JL Supiano KP Aruscavage N Bybee SG Utz RL Iacob E Dassel KB. 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