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DuBose L, Fan Q, Fisher L, Hoang MN, Salha D, Lee S, Ory MG, Falohun T. Development and Evaluation of a Web-Based Platform for Personalized Educational and Professional Assistance for Dementia Caregivers: Proposal for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e64127. [PMID: 39110962 PMCID: PMC11339571 DOI: 10.2196/64127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Alzheimer disease (AD) and AD-related dementia are prevalent concerns for aging populations. With a growing older adult population living in the United States, the number of people living with dementia is expected to grow, posing significant challenges for informal caregivers. The mental and physical burdens associated with caregiving highlight the importance of developing novel and effective resources to support caregivers. However, technology solutions designed to address their needs often face low adoption rates due to usability issues and a lack of contextual relevance. This study focuses on developing a web-based platform providing financial and legal planning information and education for dementia caregivers and evaluating the platform's usability and adoptability. OBJECTIVE The goal of this project is to create a web-based platform that connects caregivers with personalized and easily accessible resources. This project involves industrial, academic, and community partners and focuses on two primary aims: (1) developing a digital platform using a Dementia Care Personalization Algorithm and assessing feasibility in a pilot group of caregivers, and (2) evaluating the acceptability and usability of the digital platform across different racial or ethnic populations. This work will aid in the development of technology-based interventions to reduce caregiver burden. METHODS The phase I study follows an iterative Design Thinking approach, involving at least 25 dementia caregivers as a user feedback panel to assess the platform's functionality, aesthetics, information, and overall quality using the adapted Mobile Application Rating Scale. Phase II is a usability study with 300 dementia caregivers in Texas (100 African American, 100 Hispanic or Latinx, and 100 non-Hispanic White). Participants will use the digital platform for about 4 weeks and evaluate its usefulness and ease of use through the Technology Acceptance Survey. RESULTS The study received funding from the National Institute on Aging on September 3, 2021. Ethical approval for phase I was obtained from the Texas A&M University Institutional Review Board on December 8, 2021, with data collection starting on January 1, 2022, and concluding on May 31, 2022. Phase I results were published on September 5, 2023, and April 17, 2024, respectively. On June 21, 2023, ethical approval for human subjects for phase II was granted, and participant recruitment began on July 1, 2023. CONCLUSIONS Upon completing these aims, we expect to deliver a widely accessible digital platform tailored to assist dementia caregivers with financial and legal challenges by connecting them to personalized, contextually relevant information and resources in Texas. If successful, we plan to work with caregiving organizations to scale and sustain the platform, addressing the needs of the growing population living with dementia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/64127.
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Affiliation(s)
- Logan DuBose
- School of Public Health, Texas A&M University, College Station, TX, United States
- Olera lnc, Houston, TX, United States
| | - Qiping Fan
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Louis Fisher
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Minh-Nguyet Hoang
- School of Medicine, Texas A&M University, College Station, TX, United States
| | - Diana Salha
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Tokunbo Falohun
- Olera lnc, Houston, TX, United States
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, United States
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Turnbull N, Sriruecha C, Kongmant R, Nghiep LK, Tudpor K. A Mobile Application for Enhancing Caregiver Support and Resource Management for Long-Term Dependent Individuals in Rural Areas. Healthcare (Basel) 2024; 12:1473. [PMID: 39120176 PMCID: PMC11311701 DOI: 10.3390/healthcare12151473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
The "SmartCaregivers" 1.0 mobile application is a beacon of hope for caregivers (CG) in rural areas, often facing limited access to facilities and support. This study, conducted from February to August 2021, aimed to comprehensively analyze the need for developing a database system and a mobile application tailored to enhance caregiver support and resource management for long-term dependent individuals in the rural areas of Maha Sarakham province, Thailand. The research followed a rigorous research and development (R & D) approach, specifically the ADDIE model (analysis, design, development, implementation, and evaluation). Data were collected from 402 caregivers and 10 key informants through surveys and interviews, as well as from 402 caregivers during the implementation and evaluation phases. The application's impact was assessed using a quasi-experimental design with a one-group pre-post-test, and its acceptance was evaluated through the technology acceptance model (TAM). The application significantly improved caregivers' knowledge scores, with a mean increase from 10.49 ± 2.53 to 12.18 ± 2.76 post-intervention. High scores for perceived usefulness (4.36 ± 0.62) and ease of use (4.31 ± 0.59) reassure the audience about the application's effectiveness in providing rapid access to health information, aiding decision-making, and improving care coordination. The system quality was also highly rated, with users appreciating the variety of functions and structural design. This potential for transformation and improvement instills hope and optimism for the future of caregiving in rural areas.
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Affiliation(s)
- Niruwan Turnbull
- Faculty of Public Health and Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham 44150, Thailand;
| | - Chanaphol Sriruecha
- Faculty of Science and Technology, College of Asian Scholars, Khon Kaen 40000, Thailand;
| | - Ruchakron Kongmant
- Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham 44150, Thailand;
| | - Le Ke Nghiep
- Vinh Long Department of Health, Vinh Long 85000, Vietnam;
| | - Kukiat Tudpor
- Faculty of Public Health and Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham 44150, Thailand;
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Albright L, Ko W, Buvanesh M, Haraldsson H, Polubriaginof F, Kuperman GJ, Levy M, Sterling MR, Dell N, Estrin D. Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study. JMIR Form Res 2024; 8:e56916. [PMID: 38814705 PMCID: PMC11176885 DOI: 10.2196/56916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
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Affiliation(s)
- Liam Albright
- Department of Information Science, Cornell University, New York, NY, United States
| | - Woojin Ko
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Meyhaa Buvanesh
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | | | - Fernanda Polubriaginof
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gilad J Kuperman
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michelle Levy
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicola Dell
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
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Giebel GD, Speckemeier C, Schrader NF, Abels C, Plescher F, Hillerich V, Wiedemann D, Börchers K, Wasem J, Blase N, Neusser S. Quality assessment of mHealth apps: a scoping review. FRONTIERS IN HEALTH SERVICES 2024; 4:1372871. [PMID: 38751854 PMCID: PMC11094264 DOI: 10.3389/frhs.2024.1372871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Introduction The number of mHealth apps has increased rapidly during recent years. Literature suggests a number of problems and barriers to the adoption of mHealth apps, including issues such as validity, usability, as well as data privacy and security. Continuous quality assessment and assurance systems might help to overcome these barriers. Aim of this scoping review was to collate literature on quality assessment tools and quality assurance systems for mHealth apps, compile the components of the tools, and derive overarching quality dimensions, which are potentially relevant for the continuous quality assessment of mHealth apps. Methods Literature searches were performed in Medline, EMBASE and PsycInfo. Articles in English or German language were included if they contained information on development, application, or validation of generic concepts of quality assessment or quality assurance of mHealth apps. Screening and extraction were carried out by two researchers independently. Identified quality criteria and aspects were extracted and clustered into quality dimensions. Results A total of 70 publications met inclusion criteria. Included publications contain information on five quality assurance systems and further 24 quality assessment tools for mHealth apps. Of these 29 systems/tools, 8 were developed for the assessment of mHealth apps for specific diseases, 16 for assessing mHealth apps for all fields of health and another five are not restricted to health apps. Identified quality criteria and aspects were extracted and grouped into a total of 14 quality dimensions, namely "information and transparency", "validity and (added) value", "(medical) safety", "interoperability and compatibility", "actuality", "engagement", "data privacy and data security", "usability and design", "technology", "organizational aspects", "social aspects", "legal aspects", "equity and equality", and "cost(-effectiveness)". Discussion This scoping review provides a broad overview of existing quality assessment and assurance systems. Many of the tools included cover only a few dimensions and aspects and therefore do not allow for a comprehensive quality assessment or quality assurance. Our findings can contribute to the development of continuous quality assessment and assurance systems for mHealth apps. Systematic Review Registration https://www.researchprotocols.org/2022/7/e36974/, International Registered Report Identifier, IRRID (DERR1-10.2196/36974).
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Affiliation(s)
- Godwin Denk Giebel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nils Frederik Schrader
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Felix Plescher
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Vivienne Hillerich
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Desiree Wiedemann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | | | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nikola Blase
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
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Roshid MM, Rahman MM, Alam MN, Banu B, Eity KF, Shahin RR, Shaba SSE, Rahman MJ, Sarker MHR, Okamura H. Combined Effects of the Mobile Health (mHealth) Psychoeducation and Benson Relaxation Technique in Reducing the Caregiving Burden of Cancer Patients in Bangladesh: A Protocol for a Randomized Controlled Trial. Cureus 2024; 16:e55520. [PMID: 38576646 PMCID: PMC10993085 DOI: 10.7759/cureus.55520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Chronic and noncommunicable diseases, including cancer, are a significant global public health concern. Family members or friends who serve as caregivers significantly contribute to supporting cancer patients without formal medical training. In most cases in Bangladesh, women perform caregiving activities with household responsibilities and lack adequate support from the family and healthcare systems; consequently, they face a significant burden as caregivers. This study aims to assess the effectiveness of combined mobile health (mHealth) psychoeducation and the Benson relaxation technique (BRT) on the caregiving burden among female informal caregivers of cancer patients in Bangladesh. METHODS We shall conduct a prospective, open-label, two-arm (1:1), randomized controlled trial in a hospital, focusing on the burden of informal female caregivers of cancer patients in Bangladesh. The combined intervention will be delivered to the intervention group through mHealth starting April 2024 and will span six months. Participants' data will be collected through face-to-face interviews using the Zarit Burden Interview (ZBI), the Hospital Anxiety Depression Scale, and the World Health Organization Quality of Life Bangla Short Instrument. Outcomes will be assessed at the baseline, midline, and endline. We shall employ descriptive statistics such as frequencies, percentages, means, and standard deviations. The t-test or Mann-Whitney U test will be used to compare continuous variables. Additionally, a two-way repeated-measures analysis of variance will be employed to evaluate the outcomes. RESULTS Participant enrollment began in January 2024, and recruitment is ongoing. The results of this study will be disseminated through publications and conferences. No external professional writers were involved in writing this manuscript. CONCLUSION This study addresses the gap in the assessment of combined interventions for caregiver burden in Bangladesh. These outcomes may provide valuable insights into caregivers' well-being, caregiving responsibilities, and the potential for integrated interventions to reduce the burden, especially among women. If effective, we recommend the national integration of psychoeducation and BRT using mHealth.
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Affiliation(s)
- Md Marufur Roshid
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Md Moshiur Rahman
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Md Nazmul Alam
- Department of Oncology, Khwaja Yunus Ali Medical College and Hospital, Sirajganj, BGD
| | - Bilkis Banu
- Department of Public Health, Northern University, Dhaka, BGD
| | - Kaniz Fateema Eity
- Department of Oncology, Khwaja Yunus Ali Medical College and Hospital, Sirajganj, BGD
| | - Rafiur Rahman Shahin
- Department of Oncology, Khwaja Yunus Ali Medical College and Hospital, Sirajganj, BGD
| | - Syeda Sabrina Easmin Shaba
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Md Jiaur Rahman
- Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | | | - Hitoshi Okamura
- Department of Psychosocial Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
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Mahmood A, Kim H, Chang CF, Kedia S, Arshad H, Dillon PJ. mHealth Apps Use and Their Associations With Healthcare Decision-Making and Health Communication Among Informal Caregivers: Evidence From the National Cancer Institute's Health Information National Trends Survey. Am J Health Promot 2024; 38:40-52. [PMID: 37708496 DOI: 10.1177/08901171231202861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE The current study investigates associations between mHealth apps and healthcare decision-making and health communication among informal caregivers in the US. DESIGN Cross-sectional study employing secondary data. SETTING The Health Information National Trends Survey (HINTS5, Cycles 2 through 4, 2018 - 2020). SAMPLE Self-identified informal caregivers (n = 1386; had mHealth apps = 61.3%, female = 63.2%, some college or more in education = 80.3%) who reported owning at least a smartphone or a tablet computer (i.e., ownership of a "smart device"). MEASURES Sociodemographic characteristics, reports of having mHealth apps, smart device utilization in healthcare decision-making and health communication. ANALYSIS Accounting for the complex design features of the HINTS data, we constructed multiple hierarchical logistic regressions to compute adjusted odds ratios (aOR) and their 95% confidence intervals (CI). RESULTS Compared to caregivers without mHealth apps, those with the apps had higher odds of utilizing their smart devices to make a health-related decision, such as how to treat a disease or a medical condition (aOR = 1.65; 95% CI: 1.13-2.39, P < .01), or engage in health-related discussions with a healthcare provider (aOR = 2.36; 95% CI: 1.54-3.61, P < .001). CONCLUSION Having mHealth apps was associated with a higher likelihood of using smart devices in healthcare decision-making and health communication by informal caregivers. Empowering caregivers to make informed health-related decisions and communicate effectively with healthcare providers are both crucial to health promotion and well-being. Future studies should investigate facilitators as well as barriers to using mHealth apps and smart devices in health-promoting strategies involving informal caregivers.
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Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Hyunmin Kim
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Cyril F Chang
- Fogelman College of Business and Economics, The University of Memphis, Memphis, TN, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Hassan Arshad
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
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Llaneza DH, Llaneza AJ, Kozlov E. Perceived Benefits and Barriers of mHealth Mindfulness Use for Caregivers of Older Adults with Cognitive Impairment: A Qualitative Exploration. Clin Gerontol 2024; 47:66-77. [PMID: 36502294 PMCID: PMC11338273 DOI: 10.1080/07317115.2022.2154728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Mobile (mHealth) mindfulness-based interventions have the potential to be feasible, acceptable, effective, and scalable interventions for caregivers of people living with cognitive impairment. This qualitative study of caregivers of older adults with cognitive impairment explored caregivers' experiences using a mindfulness therapy mobile application. METHODS Fifteen caregivers were interviewed using a semi-structured interview guide. Analysis was guided by the phenomenological approach and inductive-deductive analysis. RESULTS Six themes were generated from the data: convenience, barriers, perceived helpfulness, useful features, suggested app improvements, and skill transfer. Caregivers reported that the app was easy to use with many perceived benefits. Caregivers also noted some barriers to using the app. CONCLUSIONS This study revealed that self-directed mHealth delivered mindfulness therapy may be a promising intervention for the caregivers involved in the study. Having the ability to use the app anywhere and at any time was a prominent reason for continued regular use for the participants. This was especially important to some caregivers during the COVID-19 pandemic. The barriers discussed by the caregivers are important considerations for future app-based interventions for caregivers. CLINICAL IMPLICATIONS Clinicians can consider recommending mHealth mindfulness therapy to caregivers as a tool to provide caregivers with additional support.
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Affiliation(s)
- Danielle H. Llaneza
- Rutgers University, School of Public Health, Department of
Health, Behavior, Society, and Policy, Rutgers University, Piscataway, NJ, USA
| | - Amanda J. Llaneza
- Department of Biostatistics & Epidemiology, Hudson
College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma
City, OK, USA
| | - Elissa Kozlov
- Rutgers University, School of Public Health, Department of
Health, Behavior, Society, and Policy, Rutgers University, Piscataway, NJ, USA
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Sanprakhon P, Chaimongkol N, Lach HW. Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Randomized-Controlled Trial. West J Nurs Res 2023; 45:1017-1026. [PMID: 37752754 DOI: 10.1177/01939459231201251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND Older adults with advanced dementia require significant care, leading to high stress levels in caregivers. OBJECTIVES The current study aimed to evaluate the effects of an Integrative Stress Reduction Program on Thai caregiver's outcomes of stress, sleep quality, and caregiver-assessed neuropsychiatric symptoms of persons with dementia. METHODS A single-blind randomized-controlled trial was conducted. A sample of family caregivers of people with dementia was recruited from memory clinics at outpatient community health centers in Thailand and randomly assigned to the experimental and control groups. Participants in the experimental group were enrolled in 5 intervention sessions over 4 weeks, while the control group received usual care. Outcome variables were collected at baseline, 4 weeks postintervention, and 8 weeks of follow-up. RESULTS Compared with the control group, caregivers in the experimental group (n = 27) had significantly decreased stress (p < .01) and better sleep quality (p < .01), and caregivers reported that their family members with dementia (n = 27) had decreased neuropsychiatric symptoms (p < .01) after the intervention (week 4) and at the 8-week follow-up. CONCLUSIONS The Integrative Stress Reduction Program improved outcomes for caregivers and decreased neuropsychiatric symptoms in people with dementia.
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Affiliation(s)
| | | | - Helen W Lach
- Trudy Busch Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
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Atefi GL, de Vugt ME, van Knippenberg RJM, Levin ME, Verhey FRJ, Bartels SL. The use of Acceptance and Commitment Therapy (ACT) in informal caregivers of people with dementia and other long-term or chronic conditions: A systematic review and conceptual integration. Clin Psychol Rev 2023; 105:102341. [PMID: 37776577 DOI: 10.1016/j.cpr.2023.102341] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Informal caregivers are the primary source of support for adults with chronic conditions and disabilities. Empirical research highlights chronic stress and other risks of adverse outcomes of caregiving. Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based practice that shows promise in improving an array of outcomes, theoretically by increasing psychological flexibility as the primary process of change. Research has begun to evaluate ACT among informal caregivers of adult populations, and a systematic review is now needed to summarise this evidence base. Electronic searches from five databases, including PubMed, PsycInfo, Embase, CINAHL, and Cochrane Library, yielded an initial 7896 hits, which after screening for inclusion criteria, resulted in 21 clinical trials. Studies were coded to synthesise the feasibility, effectiveness, and quality of evidence. Findings show that ACT was reported to be largely feasible and acceptable. However, the efficacy of ACT was mixed, with a more consistent pattern for informal caregivers of people with dementia. Several methodological quality issues limited the findings. However, theoretical synthesis and preliminary evidence support the promising effect of ACT in subgroups of informal caregivers. Research on the process of change, as well as larger-scale, methodologically rigorous trials, are needed to consolidate these findings.
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Affiliation(s)
- Golnaz L Atefi
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Michael E Levin
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Clinical Neuroscience, Karolinska Institute, Sweden
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Sun L. Social media usage and students' social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work? BMC Psychol 2023; 11:362. [PMID: 37904182 PMCID: PMC10617103 DOI: 10.1186/s40359-023-01398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/16/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The increasing integration of digital technologies into daily life has spurred a growing body of research in the field of digital psychology. This research has shed light on the potential benefits and drawbacks of digital technologies for mental health and well-being. However, the intricate relationship between technology and psychology remains largely unexplored. PURPOSE This study aimed to investigate the impact of mindfulness-based mobile apps on university students' anxiety, loneliness, and well-being. Additionally, it sought to explore participants' perceptions of the addictiveness of these apps. METHOD The research utilized a multi-phase approach, encompassing a correlational research method, a pretest-posttest randomized controlled trial, and a qualitative case study. Participants were segmented into three subsets: correlations (n = 300), treatment (n = 60), and qualitative (n = 20). Data were gathered from various sources, including the social anxiety scale, well-being scale, social media use integration scale, and an interview checklist. Quantitative data was analyzed using Pearson correlation, multiple regression, and t-tests, while qualitative data underwent thematic analysis. RESULTS The study uncovered a significant correlation between social media use and the variables under investigation. Moreover, the treatment involving mindfulness-based mobile apps led to a reduction in students' anxiety and an enhancement of their well-being. Notably, participants held various positive perceptions regarding the use of these apps. IMPLICATIONS The findings of this research hold both theoretical and practical significance for the field of digital psychology. They provide insight into the potential of mindfulness-based mobile apps to positively impact university students' mental health and well-being. Additionally, the study underscores the need for further exploration of the intricate dynamics between technology and psychology in an increasingly digital world.
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Affiliation(s)
- Li Sun
- School of Marxism, Zhoukou Vocational and Technical College, Zhoukou, 466000, China.
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Woodworth EC, Briskin EA, Plys E, Macklin E, Tatar RG, Huberty J, Vranceanu AM. Mindfulness-Based App to Reduce Stress in Caregivers of Persons With Alzheimer Disease and Related Dementias: Protocol for a Single-Blind Feasibility Proof-of-Concept Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e50108. [PMID: 37831492 PMCID: PMC10612010 DOI: 10.2196/50108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Informal caregivers (ie, individuals who provide assistance to a known person with health or functional needs, often unpaid) experience high levels of stress. Caregiver stress is associated with negative outcomes for both caregivers and care recipients. Mindfulness-based interventions (MBIs) show promise for improving stress, emotional distress, and sleep disturbance in caregivers of persons with Alzheimer disease and related dementias (ADRD). Commercially available mobile mindfulness apps can deliver MBIs to caregivers of persons with ADRD in a feasible and cost-effective manner. OBJECTIVE We are conducting a single-blind feasibility proof-of-concept randomized controlled trial (RCT; National Institutes of Health [NIH] stage 1B) comparing 2 free mobile apps: the active intervention Healthy Minds Program (HMP) with within-app text tailored for addressing stress among caregivers of persons with ADRD, versus Wellness App (WA), a time- and dose-matched educational control also tailored for caregivers of persons with ADRD. METHODS We aim to recruit 80 geographically diverse and stressed caregivers of persons with ADRD. Interested caregivers use a link or QR code on a recruitment flyer to complete a web-based eligibility screener. Research assistants conduct enrollment phone calls, during which participants provide informed consent digitally. After participants complete baseline surveys, we randomize them to the mindfulness-based intervention (HMP) or educational control podcast app (WA) and instruct them to listen to prescribed content for 10 minutes per day (70 minutes per week) for 12 weeks. Caregivers are blinded to intervention versus control. The study team checks adherence weekly and contacts participants to promote adherence as needed. Participants complete web-based self-report measures at baseline, posttest, and follow-up; weekly process measures are also completed. Primary outcomes are a priori set feasibility benchmarks. Secondary outcomes are stress, emotional distress, sleep disturbance, caregiver burden, mindfulness, awareness, connection, insight, and purpose. We will calculate 1-sided 95% CI to assess feasibility benchmarks. Effect sizes of change in outcomes will be used to examine the proof of concept. RESULTS Recruitment started on February 20, 2023. We have enrolled 27 caregivers (HMP: n=14; WA: n=13) as of June 2023. Funding began in August 2022, and we plan to finish enrollment by December 2023. Data analysis is expected to begin in May 2024 when all follow-ups are complete; publication of findings will follow. CONCLUSIONS Through this trial, we aim to establish feasibility benchmarks for HMP and WA, as well as establish a proof of concept that HMP improves stress (primary quantitative outcome), emotional distress, sleep, and mindfulness more than WA. Results will inform a future efficacy trial (NIH stage II). HMP has the potential to be a cost-effective solution to reduce stress in caregivers of persons with ADRD, benefiting caregiver health and quality of care as well as patient care. TRIAL REGISTRATION ClinicalTrials.gov NCT05732038; https://clinicaltrials.gov/study/NCT05732038. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50108.
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Affiliation(s)
- Emily C Woodworth
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States
| | - Ellie A Briskin
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States
| | - Evan Plys
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Eric Macklin
- Harvard Medical School, Boston, MA, United States
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, United States
| | | | - Jennifer Huberty
- Department of Medicine, University of Texas Health, San Antonio, TX, United States
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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12
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Vázquez FL, Blanco V, Hita I, Torres ÁJ, Otero P, Páramo M, Salmerón M. Efficacy of a Cognitive Behavioral Intervention for the Prevention of Depression in Nonprofessional Caregivers Administered through a Smartphone App: A Randomized Controlled Trial. J Clin Med 2023; 12:5872. [PMID: 37762813 PMCID: PMC10531781 DOI: 10.3390/jcm12185872] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/02/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Due to the limited availability of in-person interventions for caregivers, the development of effective programs that use new technologies to prevent depression is needed. The goal of this research was to assess the efficacy of a cognitive behavioral intervention for the prevention of depression, administered to nonprofessional caregivers through a smartphone application (app). One hundred and seventy-five caregivers were randomly assigned to either an app-based cognitive behavioral intervention (CBIA), the CBIA intervention plus a telephone conference call (CBIA + CC), or an attention control group (ACG). At post-intervention, the incidence of depression was lower in the CBIA and CBIA + CC compared to the ACG (1.7% and 0.0% vs. 7.9%, respectively). The absolute risk, relative risk, and number needed to treat compared to the ACG were 6.2%, 21.6%, and 16 for the CBIA, whilst they were 8%, 0.0%, and 13 for the CBIA + CC. Depressive symptomatology was significantly lower in the CBIA and CBIA + CC compared to the ACG (d = 0.84, Cliff's δ = 0.49; d = 1.56, Cliff's δ = 0.72), as well as in the CBIA + CC compared to the CBIA (d = 0.72, Cliff's δ = 0.44). The prevention of depression was more likely in participants who received the CBIA, and adding the conference call in the CBIA + CC group improved the likelihood of this.
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Affiliation(s)
- Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Rúa Xosé María Suárez Núñez, s/n, Campus Vida, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Evolutionary and Educational Psychology, Faculty of Psychology, Rúa Xosé María Suárez Núñez, s/n, Campus Vida, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Isabel Hita
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Rúa Xosé María Suárez Núñez, s/n, Campus Vida, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Ángela J. Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Medicine, Rúa de San Francisco, s/n, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, Faculty of Educational Studies, Campus de Elviña, s/n, University of A Coruña, 15071 A Coruña, Spain
| | - Mario Páramo
- Psychiatry Service, University Hospital Complex of Santiago de Compostela, R/ Ramón Baltar, s/n, Galician Health Service [SERGAS], 15706 Santiago de Compostela, Spain
| | - Mar Salmerón
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Rúa Xosé María Suárez Núñez, s/n, Campus Vida, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Paganini S, Meier E, Terhorst Y, Wurst R, Hohberg V, Schultchen D, Strahler J, Wursthorn M, Baumeister H, Messner EM. Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics. JMIR Mhealth Uhealth 2023; 11:e42415. [PMID: 37642999 PMCID: PMC10498318 DOI: 10.2196/42415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Chronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. OBJECTIVE This review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. METHODS SMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. RESULTS Of 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. CONCLUSIONS The moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.
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Affiliation(s)
- Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Evelyn Meier
- University of Education Freiburg, Freiburg, Germany
| | - Yannik Terhorst
- Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Ramona Wurst
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Vivien Hohberg
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dana Schultchen
- Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Jana Strahler
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Max Wursthorn
- Department of Public and Nonprofit Management, University of Freiburg, Freiburg, Germany
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Liu X, Zhao W, Qi Q, Luo X. A Survey on Autism Care, Diagnosis, and Intervention Based on Mobile Apps Focusing on Usability and Software Design. SENSORS (BASEL, SWITZERLAND) 2023; 23:6260. [PMID: 37514555 PMCID: PMC10384173 DOI: 10.3390/s23146260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
This article presents a systematic review on autism care, diagnosis, and intervention based on mobile apps running on smartphones and tablets. Here, the term "intervention" means a carefully planned set of activities with the objective of improving autism symptoms. We guide our review on related studies using five research questions. First, who benefits the most from these mobile apps? Second, what are the primary purposes of these mobile apps? Third, what mechanisms have been incorporated in these mobiles apps to improve usability? Fourth, what guidelines have been used in the design and implementation of these mobile apps? Fifth, what theories and frameworks have been used as the foundation for these mobile apps to ensure the intervention effectiveness? As can be seen from these research questions, we focus on the usability and software development of the mobile apps. Informed by the findings of these research questions, we propose a taxonomy for the mobile apps and their users. The mobile apps can be categorized into autism support apps, educational apps, teacher training apps, parental support apps, and data collection apps. The individuals with autism spectrum disorder (ASD) are the primary users of the first two categories of apps. Teachers of children with ASD are the primary users of the teacher training apps. Parents are the primary users of the parental support apps, while individuals with ASD are usually the primary users of the data collection apps and clinicians and autism researchers are the beneficiaries. Gamification, virtual reality, and autism-specific mechanisms have been used to improve the usability of the apps. User-centered design is the most popular approach for mobile app development. Augmentative and alternative communication, video modeling, and various behavior change practices have been used as the theoretical foundation for intervention efficacy.
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Affiliation(s)
- Xiongyi Liu
- Department of Curriculum and Foundations, Cleveland State University, Cleveland, OH 44115, USA
| | - Wenbing Zhao
- Department of Electrical and Computer Engineering, Cleveland State University, Cleveland, OH 44115, USA
| | - Quan Qi
- College of Information Science and Technology, Shihezi University, Shihezi 832003, China
| | - Xiong Luo
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China
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15
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Edge D, Watkins ER, Limond J, Mugadza J. The efficacy of self-guided internet and mobile-based interventions for preventing anxiety and depression - A systematic review and meta-analysis. Behav Res Ther 2023; 164:104292. [PMID: 37003138 DOI: 10.1016/j.brat.2023.104292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Anxiety and depression are highly prevalent mental disorders which are associated with a considerable personal and economic burden. As treatment alone has a minimal impact on prevalence, there is now a growing focus on interventions which may help prevent anxiety and depression. Internet and mobile based interventions have been identified as a useful avenue for the delivery of preventative programmes due to their scalability and accessibility. The efficacy of interventions that do not require additional support from a trained professional (self-guided) in this capacity is yet to be explored. METHOD A systematic search was conducted on the Cochrane Library, PubMed, PsycARTICLES, PsycINFO, OVID, MEDline, PsycEXTRA and SCOPUS databases. Studies were selected according to defined inclusion and exclusion criteria. The primary outcome was evaluating the effect of self-guided internet and mobile based interventions on incidence of anxiety and depression. The secondary outcome was effect on symptom severity. RESULTS After identifying and removing duplicates, 3211 studies were screened, 32 of which were eligible for inclusion in the final analysis. Nine studies also reported incidence data (depression = 7, anxiety = 2). The overall Risk Ratios for incidence of anxiety and depression were 0.86 (95% CI [0.28, 2.66], p = .79) and 0.67 (95% CI [0.48, 0.93], p = .02) respectively. Analysis for 27 studies reporting severity of depressive symptoms revealed a significant posttreatment standardised mean difference of -0.27 (95% CI [ -0.37, -0.17], p < .001) for self-guided intervention groups relative to controls. A similar result was observed for 29 studies reporting severity of anxiety symptoms with a standardised mean difference of -0.21 (95% CI [-0.31, -0.10], p < .001). CONCLUSIONS Self-guided internet and mobile based interventions appear to be effective at preventing incidence of depression, though further examination of the data suggests that generalisability of this finding may be limited. While self-guided interventions also appear effective in reducing symptoms of anxiety and depression, their ability to prevent incidence of anxiety is less clear. A heavy reliance on symptom measures in the data analysed suggests future research could benefit from prioritising the use of standardised diagnostic measuring tools to assess incidence. Future systematic reviews should aim to include more data from grey literature and reduce the impact of study heterogeneity.
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Affiliation(s)
- Daniel Edge
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom.
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
| | - Jenny Limond
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
| | - Jane Mugadza
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
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16
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Blanco V, Otero P, Vázquez FL. A pilot study for a smartphone app for the prevention of depression in non-professional caregivers. Aging Ment Health 2023; 27:166-175. [PMID: 35352600 DOI: 10.1080/13607863.2022.2056878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The main objective of the current study was to evaluate the feasibility and acceptability of a cognitive-behavioral prevention intervention administered through a smartphone app in non-professional caregivers with symptoms of depression. The secondary objective was to make a preliminary evaluation of its effectiveness either alone or supplemented with telephone conference calls. METHODS Eighty-seven participants (Mage = 51.8 years) were randomly assigned to an app-based cognitive-behavioral intervention (CBIA; n = 29), CBIA supplemented with telephone conference calls (CBIA + CC; n = 28), or an attention control group (ACG; n = 30). The participants for both interventions received five cognitive-behavioral modules through the app, and those in CBIA + CC an additional 30-minute phone call in each module. RESULTS 3.4% of caregivers dropped out. In all groups, the number of modules completed was high. Participants completed a high percentage of the homework and were highly satisfied with both CBIA and CBIA + CC. At post-intervention, there was a lower incidence of depression and depressive symptoms for CBIA + CC compared with CBIA, and for CBIA and CBIA + CC compared with ACG. CONCLUSION The results supported the feasibility and acceptability of the cognitive-behavioral intervention, and demonstrated that telephone contact improves its effectiveness.
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Affiliation(s)
- Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Fernando L Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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17
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Jeon H, Choi YS, Lim Y. A web-based care assistant for caregivers of the elderly: Development and pilot study. Digit Health 2023; 9:20552076231200976. [PMID: 37706021 PMCID: PMC10496464 DOI: 10.1177/20552076231200976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023] Open
Abstract
Background The aging population in Korea has driven a surge in demand for elderly care services, leading to significant growth in elderly welfare facilities, particularly Adult Daycare Centers (ADCs). However, despite advancements in care facilities, caregivers continue to face challenges in providing suitable elderly care due to difficulties arising from gaps in the latest information on the elderly and their coping abilities. Objective The objective of this study is to develop and evaluate the effectiveness of the elderly care assistant system, which facilitates the sharing of information and knowledge necessary for elderly care among caregivers. Methods The ECA system was designed to support knowledge sharing through a knowledge management system based on an ontological knowledge model, with a web-based user interface for improved accessibility. A field trial was conducted at ADC in Seoul from August 17 to September 21, with eight caregivers participating. A mixed-methods approach, involving both surveys and interviews, was employed to gauge the ECA system's effectiveness. Results The study found that the use of the ECA was beneficial in promoting knowledge sharing among caregivers. Additionally, caregivers noted the potential benefits of using the ECA in conjunction with family caregivers, who can offer additional information and perspectives on elderly care. Conclusions This study presents preliminary evidence of the potential benefits of a care knowledge sharing system among various caregivers in elderly care. Although the elderly care assistant effectively promotes knowledge sharing, more research is needed to fully understand its impact on elderly care outcomes.
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Affiliation(s)
- Hwawoo Jeon
- Center for Intelligent & Interactive Robotics, Korea Institute of Science and Technology, Seoul, South Korea
- Division of Computer Science and Engineering, Hanyang University - Seoul Campus, Seoul, South Korea
| | - Yong Suk Choi
- Division of Computer Science and Engineering, Hanyang University - Seoul Campus, Seoul, South Korea
| | - Yoonseob Lim
- Center for Intelligent & Interactive Robotics, Korea Institute of Science and Technology, Seoul, South Korea
- Department of HY-KIST Bio-convergence, Hanyang University, Seoul, South Korea
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18
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Zhai S, Chu F, Tan M, Chi NC, Ward T, Yuwen W. Digital health interventions to support family caregivers: An updated systematic review. Digit Health 2023; 9:20552076231171967. [PMID: 37223775 PMCID: PMC10201006 DOI: 10.1177/20552076231171967] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
Objective Chronic diseases are the leading causes of death and disability in the U.S., and disease management largely falls onto patients' family caregivers. The long-term burden and stress of caregiving negatively impact caregivers' well-being and ability to provide care. Digital health interventions have the potential to support caregivers. This article aims to provide an updated review of interventions using digital health tools to support family caregivers and the scope of the Human-Centered Design (HCD) approaches. Methods We conducted a systematic search on July 2019 and January 2021 in PubMed, CINAHL, Embase, Cochrane Library, PsycINFO, ERIC, and ACM Digital Library, limiting to 2014-2021 to identify family caregiver interventions assisted by modern technologies. The Mixed Methods Appraisal Tool and the Grading of Recommendations Assessment, Development and Evaluation were used to evaluate the articles. Data were abstracted and evaluated using Rayyan and Research Electronic Data Capture. Results We identified and reviewed 40 studies from 34 journals, 10 fields, and 19 countries. Findings included patients' conditions and relationships with family caregivers, how the technology is used to deliver the intervention, HCD methods, theoretical frameworks, components of the interventions, and family caregiver health outcomes. Conclusion This updated and expanded review revealed that digitally enhanced health interventions were robust at providing high-quality assistance and support to caregivers by improving caregiver psychological health, self-efficacy, caregiving skills, quality of life, social support, and problem-coping abilities. Health professionals need to include informal caregivers as an essential component when providing care to patients. Future research should include more marginalized caregivers from diverse backgrounds, improve the accessibility and usability of the technology tools, and tailor the intervention to be more culturally and linguistically sensitive.
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Affiliation(s)
- Shumenghui Zhai
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Frances Chu
- School of Nursing, University of Washington, Seattle, WA, USA
- Providence Health System, Swedish First Hill, Seattle, WA, USA
| | - Minghui Tan
- School of Nursing, Peking Union Medical University, Beijing, China
| | - Nai-Ching Chi
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Teresa Ward
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
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19
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Mendez KJW, Labrique AB, Budhathoki C, Sadak T, Tanner EK, Cotter VT, Han HR. Use of mobile applications and health technologies among dementia caregivers with chronic conditions: A cross-sectional study. Digit Health 2023; 9:20552076231181213. [PMID: 37361436 PMCID: PMC10286551 DOI: 10.1177/20552076231181213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Almost 80% of people, who are caring for someone with dementia, have one or more chronic conditions and require self-management support. New technologies offer promising solutions; however, little is known about what technologies caregivers use for their health or in general. This study aimed to describe the prevalence of mobile application (app) and health-related technology use among caregivers who have chronic conditions and care for someone with dementia. Methods A cross-sectional study was conducted with 122 caregivers recruited online and from communities in the Baltimore-metropolitan area. Data were collected with online surveys and computer-assisted telephone interviews. Descriptive and inferential statistics were used to analyze survey data. Results Study participants were primarily female (95 of 122, 77.9%), middle-aged (average 53 years, standard deviation (SD) 17), well educated (average 16 years, SD 3.3), an adult child of the person with dementia (53 of 122, 43.4%), and had 4 chronic conditions on average (SD 2.6). Over 90% of caregivers used mobile apps (116 of 122), spending a range of 9 to 82 min on each app. Most caregivers reported using social media apps (96 of 116, 82.8%), weather apps (96 of 116, 82.8%), and/or music or entertainment apps (89 of 116, 76.7%). Among caregivers using each app type, more than half of caregivers used social media (66 of 96, 69%), games (49 of 74, 66%), weather (62 of 96, 65%), and/or music or entertainment apps (51 of 89, 57%) daily. Caregivers also used several technologies to support their own health-the most common being websites, mobile devices, and health-related mobile apps. Conclusion This study supports the feasibility of using technologies to promote health behavior change and support self-management among caregivers.
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Affiliation(s)
| | - Alain Bernard Labrique
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Tatiana Sadak
- University of Washington School of Nursing, Seattle, WA, USA
| | | | | | - Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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20
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Than TNH, Nguyen TTT, Nguyen TC, Vu LTD, Vo PT, TTruong K, Schofield P, Nguyen TA. Smartphone app-based intervention for reducing stress, depression, and anxiety in caregivers of people with dementia in Vietnam: Study protocol for a pilot randomized controlled trial. Digit Health 2023; 9:20552076231163786. [PMID: 36937692 PMCID: PMC10014987 DOI: 10.1177/20552076231163786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/24/2023] [Indexed: 03/14/2023] Open
Abstract
Objectives This study aims to: (1) identify the information required by family caregivers of people with dementia to be targeted within our dementia family caregiver intervention and (2) test the feasibility of the intervention and methodology to underpin a fully powered randomized controlled trial. Methods The study setting will be the Department of Geriatrics at Gia Dinh People's Hospital in Ho Chi Minh City. Inclusion criteria will be the family caregivers of people with dementia living in the community, who attend the Department and use smartphones. In phase 1, we will identify the intervention content with family caregivers of people with dementia through 20 in-depth interviews to determine what information and skills they need. In phase 2, a pilot randomized control trial design will be conducted, with 60 family caregivers of people with dementia being assigned to the intervention or control group by the block randomization method with a ratio of 1:1. The intervention will include weekly, online, psycho-educational, group sessions hosted on the Zalo app. The participants will complete questionnaires at baseline, immediately postintervention, and 3-month postintervention. The feasibility of the intervention and methodology will be assessed, including the rates of recruitment, retention, completion of assessments, and acceptability of the intervention. Results The required information and skills in phase 1 may include dealing with worrying behavior changes in people with dementia, emotional support, and seeking support sources. The rates of recruitment, retention, completion of assessments, and acceptability of the intervention will be obtained in phase 2. The scores of symptoms of stress, depression, and anxiety in the intervention group may be lower than those in the control group at postintervention and 3-month postintervention. Conclusion The study will provide a foundation for a fully powered clinical trial for the smartphone app-based intervention to reduce stress, depression, and anxiety among family caregivers of people with dementia in Vietnam.
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Affiliation(s)
- The NH Than
- Department of Geriatrics, University of Medicine and Pharmacy at Ho
Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Geriatrics and Palliative Care, University of Medicine
and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tran TT Nguyen
- Department of Geriatrics, University of Medicine and Pharmacy at Ho
Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Geriatrics, Gia Dinh People's Hospital, Ho Chi Minh City, Vietnam
| | - Tuan C Nguyen
- Department of Rheumatology, Ho Chi Minh City University Medical
Center, Ho Chi Minh City, Vietnam
| | - Lan TD Vu
- Department of Geriatrics, University of Medicine and Pharmacy at Ho
Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phong T Vo
- Department of Geriatrics, University of Medicine and Pharmacy at Ho
Chi Minh City, Ho Chi Minh City, Vietnam
| | - Khoa TTruong
- Department of Geriatrics, University of Medicine and Pharmacy at Ho
Chi Minh City, Ho Chi Minh City, Vietnam
| | - Penelope Schofield
- Department of Health Services Research, Peter MacCallum Cancer
Centre, Melbourne, Australia
- Sir Peter MacCallum Department on Oncology, Faculty of Medicine,
Dentistry and Health Sciences, The University of Melbourne, Melbourne,
Australia
- Department of Psychology and Iverson Health Innovation Research
Institute, Swinburne University, Melbourne, Australia
| | - Tuan A Nguyen
- Department of Psychology and Iverson Health Innovation Research
Institute, Swinburne University, Melbourne, Australia
- Social Gerontology Division, National Ageing Research
Institute, Melbourne, Australia
- UniSA Clinical and Health Sciences, University of South Australia,
Adelaide, Australia
- Health Strategy and Policy Institute, Ministry of Health, Hanoi,
Vietnam
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21
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Tinoco-Camarena JM, Puig-Llobet M, Lluch-Canut MT, Roldan-Merino J, Moreno-Arroyo MC, Moreno-Poyato A, Balaguer-Sancho J, Agüera Z, Sánchez-Ortega MA, Hidalgo-Blanco MÁ. Effectiveness of the Online "Dialogue Circles" Nursing Intervention to Increase Positive Mental Health and Reduce the Burden of Caregivers of Patients with Complex Chronic Conditions. Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:644. [PMID: 36612964 PMCID: PMC9819240 DOI: 10.3390/ijerph20010644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The personal demands involved in caring for a chronically ill person can lead to emotional and physical exhaustion in caregivers. The aim of this study was to evaluate the effectiveness of an online nursing intervention called "dialogue circles" designed to reduce caregiver overload and enhance positive mental health (PMH) in family caregivers. We used a pre-post design. The sample consisted of 86 family caregivers of patients with complex chronic conditions, randomly assigned to the intervention group (n = 43) or the control group (n = 43). All participants completed the Zarit scale and the Positive Mental Health Questionnaire 15 days before starting the intervention and 30 days after its completion. Comparison of the post-test changes revealed statistically significant differences between the two groups in PMH and overload, with the intervention group showing greater positive changes in all dimensions of PMH after the intervention and lower scores on overload. In conclusion, the results suggest that incorporating dialogue circles as an online nursing intervention in the caregivers of patients with complex chronic conditions can enhance PMH and decrease caregiver overload, especially in settings where face-to-face encounters are not possible.
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Affiliation(s)
- Jose Manuel Tinoco-Camarena
- Center of Cornellà Specialists, Consorci Sanitari Integral, 08940 Barcelona, Spain
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - María Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Juan Roldan-Merino
- Department of Mental Health, Campus Docent Sant Joan de Déu School of Nursing, University of Barcelona, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Mari Carmen Moreno-Arroyo
- Department of Nursing, Fundamental and Medical-Surgical, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Department of Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Antonio Moreno-Poyato
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Judith Balaguer-Sancho
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Hospital de la Santa Creu I Sant Pau, 08041 Barcelona, Spain
| | - Zaida Agüera
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Health Sciences Campus Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28015 Madrid, Spain
| | - Maria Aurelia Sánchez-Ortega
- University School of Nursing and Occupational Therapy of Terrassa (EUIT), Universitat Autònoma de Barcelona, 08221 Terrassa, Spain
| | - Miguel Ángel Hidalgo-Blanco
- Department of Nursing, Fundamental and Medical-Surgical, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Department of Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
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22
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Fernández-Felipe I, Guillén V, Castilla D, Navarro-Haro MV, García-Palacios A. A smartphone application of "Family Connections" to increase the use of skills and improve psychological symptoms in relatives of people with borderline personality disorder: A study protocol for a randomized controlled trial. Internet Interv 2022; 29:100546. [PMID: 35607385 PMCID: PMC9123206 DOI: 10.1016/j.invent.2022.100546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - Verónica Guillén
- University of Valencia and Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, Spain
| | | | | | - Azucena García-Palacios
- Universitat Jaume I and Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, Spain
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23
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The Impact of Mobile Phone Reminders on Perceived Self-Care Levels of Informal Caregivers. INFORMATICS 2022. [DOI: 10.3390/informatics9030059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Informal caregivers play a fundamental role in caring for people that need assistance and provide an effective service in managing their loved ones’ health. Because of this, they have little time to attend to themselves and perform self-care practices. Some of these practices can improve mental health. By snowball sampling, we recruited 15 informal caregivers, 12 females and three males. Using the Wilcoxon signed-rank test, we analyzed the impact of the reminders on a self-care scale. We used the Mindful Self-Care Scale, comparing the same population without reminders and with reminders. Results indicated that total self-care scores with reminders increased statistically significantly, T = 13, Z = −2.481, p ≤ 0.013, with a large effect size (r = 0.64). This study shows a significant self-care increase in informal caregivers after using reminders. Future development of a reminders-based approach could focus on increasing self-care and the time caregivers take for themselves, empowering them to take a more active role in meeting their own needs.
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24
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Muuraiskangas ST, Honka AM, Junno UM, Nieminen HO, Kaartinen JK. A Technology-Assisted Telephone Intervention for Work-Related Stress Management: Pilot Randomized Controlled Trial. J Med Internet Res 2022; 24:e26569. [PMID: 35830233 PMCID: PMC9330204 DOI: 10.2196/26569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/24/2021] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background Stress management interventions combining technology with human involvement have the potential to improve the cost-effectiveness of solely human-delivered interventions, but few randomized controlled trials exist for assessing the cost-effectiveness of technology-assisted human interventions. Objective The aim of this study was to investigate whether a technology-assisted telephone intervention for stress management is feasible for increasing mental well-being or decreasing the time use of coaches (as an approximation of intervention cost) while maintaining participants’ adherence and satisfaction compared with traditional telephone coaching. Methods A 2-arm, pilot randomized controlled trial of 9 months for stress management (4-month intensive and 5-month maintenance phases) was conducted. Participants were recruited on the web through a regional occupational health care provider and randomized equally to a research (technology-assisted telephone intervention) and a control (traditional telephone intervention) group. The coaching methodology was based on habit formation, motivational interviewing, and the transtheoretical model. For the research group, technology supported both coaches and participants in identifying behavior change targets, setting the initial coaching plan, monitoring progress, and communication. The pilot outcome was intervention feasibility, measured primarily by self-assessed mental well-being (WorkOptimum index) and self-reported time use of coaches and secondarily by participants’ adherence and satisfaction. Results A total of 49 eligible participants were randomized to the research (n=24) and control (n=25) groups. Most participants were middle-aged (mean 46.26, SD 9.74 years) and female (47/49, 96%). Mental well-being improved significantly in both groups (WorkOptimum from “at risk” to “good” Â>0.85; P<.001), and no between-group differences were observed in the end (Â=0.56, 95% CI 0.37-0.74; P=.56). The total time use of coaches did not differ significantly between the groups (366.0 vs 343.0 minutes, Â=0.60, 95% CI 0.33-0.85; P=.48). Regarding adherence, the dropout rate was 13% (3/24) and 24% (6/25), and the mean adherence rate to coaching calls was 92% and 86% for the research and control groups, respectively; the frequency of performing coaching tasks was similar for both groups after both phases; and the diligence in performing the tasks during the intensive phase was better for the research group (5.0 vs 4.0, Â=0.58, 95% CI 0.51-0.65; P=.03), but no difference was observed during the maintenance phase. Satisfaction was higher in the research group during the intensive phase (5.0 vs 4.0, Â=0.66, 95% CI 0.58-0.73; P<.001) but not during the maintenance phase. Conclusions The technology-assisted telephone intervention is feasible with some modifications, as it had similar preliminary effectiveness as the traditional telephone intervention, and the participants had better satisfaction with and similar or better adherence to the intervention, but it did not reduce the time use of coaches. The technology should be improved to provide more digested information for action planning and templates for messaging. Trial Registration ClinicalTrials.gov NCT02445950; https://www.clinicaltrials.gov/ct2/show/study/NCT02445950
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Affiliation(s)
| | | | | | - Hannu Olavi Nieminen
- Movendos Ltd, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere university, Tampere, Finland
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25
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Catuara-Solarz S, Skorulski B, Estella-Aguerri I, Avella-Garcia CB, Shepherd S, Stott E, Hemmings NR, Ruiz de Villa A, Schulze L, Dix S. The Efficacy of "Foundations," a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e30976. [PMID: 34978535 PMCID: PMC9255362 DOI: 10.2196/30976] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/19/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomized control trial that took place during the first wave of the COVID-19 pandemic in the United Kingdom. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomized to either the intervention or control arm. Participants in the intervention arm were given access to the Foundations app for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10], 7-item Generalized Anxiety Disorder scale [GAD-7], Office of National Statistics Four Subjective Well-being Questions [ONS-4], World Health Organization-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and at weeks 2 and 4. The self-reported measures of perceived stress (10-item Perceived Stress Score [PSS-10]) were obtained weekly. RESULTS A total of 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety, with a mean GAD-7 score change from baseline of -1.35 (SD 4.43) and -0.23 (SD 3.24), respectively (t134=1.71, P=.04); resilience, with a mean change in CD-RISC score of 1.79 (SD 4.08) and -0.31 (SD 3.16), respectively (t134=-3.37, P<.001); sleep, with a mean MISS score change of -1.16 (SD 2.67) and -0.26 (SD 2.29), respectively (t134=2.13, P=.01); and mental well-being, with a mean WHO-5 score change of 1.53 (SD 5.30) and -0.23 (SD 4.20), respectively (t134=-2.16, P=.02), within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the difference did not reach statistical significance relative to the control group, with a PSS score change from baseline to week 2 of -2.94 (SD 6.84) and -2.05 (SD 5.34), respectively (t134= 0.84, P=.20). CONCLUSIONS This study provides a proof of principle that the digital mental health app Foundations can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. Foundations therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic. TRIAL REGISTRATION OSF Registries osf.io/f6djb; https://osf.io/vm3xq.
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26
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Leung AYM, Cheung T, Fong TKH, Zhao IY, Kabir ZN. The Use of an Electronic Painting Platform by Family Caregivers of Persons with Dementia: A Feasibility and Acceptability Study. Healthcare (Basel) 2022; 10:healthcare10050870. [PMID: 35628007 PMCID: PMC9141057 DOI: 10.3390/healthcare10050870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 02/01/2023] Open
Abstract
Painting is a well-known method for alleviating stress, but it is uncertain whether family caregivers can use an electronic painting platform at home for this purpose. Aim. The aim in this study was to assess the feasibility and acceptability of having family caregivers of persons with dementia (FCPWD) draw electronic paintings using a mobile app, and to assess the preliminary effect of the intervention on their well-being. Methods. This was a two-phase feasibility and acceptability study, with qualitative interviews conducted in Phase 1 and qualitative interviews and a quantitative survey conducted in Phase 2. Caregiving burden, depressive symptoms, self-rated health, and social support were measured before and after the intervention. Participants were asked to draw electronic paintings at any time they liked, and to share the paintings with friends or relatives if they wished. Result. The recruitment rate in Phase 2 was 87.5% (28 out of 32), with 78.6% participants (22 out 28) completing all activities in 8 weeks. The FCPWD regarded the e-painting app as an appropriate channel for expressing their emotions. They found the layout of the app to be easy to use and were satisfied with it. A total of 116 pictures were produced. Log-in frequency was significantly correlated with the sharing of paintings with friends or relatives (r = 0.72, p < 0.001). Conclusion. FCPWD considered the e-painting mobile app to be a feasible and acceptable technology-based psychosocial platform. A further investigation with a larger sample in a full-scale randomized controlled trial is warranted.
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Affiliation(s)
- Angela Y. M. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.C.); (I.Y.Z.)
- WHO Collaborating Centre for Community Health Services (WHOCC), The Hong Kong Polytechnic University, Hong Kong 999077, China
- Centre for Gerontological Nursing (CGN), The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Correspondence: ; Tel.: +852-2766-5587
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.C.); (I.Y.Z.)
| | - Tommy K. H. Fong
- Centre for Gerontological Nursing (CGN), The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Department of Psychiatry, The University of Hong Kong, Hong Kong 999077, China
| | - Ivy Y. Zhao
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.C.); (I.Y.Z.)
- WHO Collaborating Centre for Community Health Services (WHOCC), The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Zarina N. Kabir
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 14183 Stockholm, Sweden;
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27
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Guillén V, Fonseca-Baeza S, Fernández-Felipe I, Botella C, Baños R, García-Palacios A, Marco J. Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face. Internet Interv 2022; 28:100532. [PMID: 35646607 PMCID: PMC9136357 DOI: 10.1016/j.invent.2022.100532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). AIM The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. METHOD This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. RESULTS There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). CONCLUSIONS This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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Affiliation(s)
- V. Guillén
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain,Corresponding author at: Dep. of Personality, Evaluation and Psychological Treatments, University of Valencia, Av. Blasco Ibañez 21, 46010, Spain.
| | | | - I. Fernández-Felipe
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - C. Botella
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - R. Baños
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - A. García-Palacios
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - J.H. Marco
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
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28
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Bining M, Wasserman S, Brahim LO, Belzile E, Magalhaes M, Lambert SD. An Evaluation of Publicly Available Smartphone Apps to Support Unpaid Cancer Caregivers. J Pain Symptom Manage 2022; 63:430-439. [PMID: 34606930 DOI: 10.1016/j.jpainsymman.2021.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT With advancements in mobile technology and increased access to smartphones, the use of Mobile Health applications (apps) has surged. These apps provide an innovative avenue for supporting cancer caregivers who face increasing burden and lack formal support; however, the quality of these apps has not been formally evaluated. OBJECTIVES Evaluate the quality, usefulness, therapeutic potential, and security of publicly available apps to support unpaid cancer caregivers in managing their roles and responsibilities. METHODS Cancer caregiving apps were identified through a search of the Apple and Google Play stores in October 2020. Two authors evaluated the apps using 1) the Mobile App Rating Scale (MARS) tool for quality, 2) complementary sections of Enlight for therapeutic persuasiveness and alliance, security and privacy, and 3) an unmet needs checklist to assess usefulness. Analyses were undertaken to identify high-scoring apps. RESULTS Overall, 24 apps were evaluated by two authors (MB, SW). Across the sample, the mean quality score (MARS) was adequate at 65.7% (3.3/5.0, SD = .5, range: 2.3-4.2). The combined score for therapeutic persuasiveness and alliance (Enlight) was fair at 60.7% (3.0/5.0, SD = .8, range: 1.1-4.5), and the privacy and security checklists yielded means of 79.3% (6.3/8.0, SD = 1.4, range: 50.0%-100.0%) and 41.3% (1.7/4.0, SD = 1.4, range: 0.0-100.0%), respectively. The unmet needs checklist was 43.2% (SD = 5.3, range: 9.4%-69.7%). A hierarchical cluster analysis identified 12 high scoring apps. CONCLUSION Superior cluster apps scored acceptably for quality and privacy and low for security and usefulness. Findings will assist clinicians, caregivers, and families identify apps to support cancer caregivers.
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Affiliation(s)
- Mira Bining
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada.
| | - Sydney Wasserman
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada
| | - Lydia Ould Brahim
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada
| | - Eric Belzile
- St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
| | - Mona Magalhaes
- St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada; St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
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Alhasani M, Mulchandani D, Oyebode O, Baghaei N, Orji R. A Systematic and Comparative Review of Behavior Change Strategies in Stress Management Apps: Opportunities for Improvement. Front Public Health 2022; 10:777567. [PMID: 35284368 PMCID: PMC8907579 DOI: 10.3389/fpubh.2022.777567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 12/03/2022] Open
Abstract
Stress is one of the significant triggers of several physiological and psychological illnesses. Mobile health apps have been used to deliver various stress management interventions and coping strategies over the years. However, little work exists on persuasive strategies employed in stress management apps to promote behavior change. To address this gap, we review 150 stress management apps on both Google Play and Apple's App Store in three stages. First, we deconstruct and compare the persuasive/behavior change strategies operationalized in the apps using the Persuasive Systems Design (PSD) framework and Cialdini's Principles of Persuasion. Our results show that the most frequently employed strategies are personalization, followed by self-monitoring, and trustworthiness, while social support strategies such as competition, cooperation and social comparison are the least employed. Second, we compare our findings within the stress management domain with those from other mental health domains to uncover further insights. Finally, we reflect on our findings and offer eight design recommendations to improve the effectiveness of stress management apps and foster future research.
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Affiliation(s)
- Mona Alhasani
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
- *Correspondence: Mona Alhasani
| | | | - Oladapo Oyebode
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Nilufar Baghaei
- Games and Extended Reality Lab, Massey University, Auckland, New Zealand
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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30
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The effect of caregiver educational program on caregiver reactions and lifestyle behaviors for caregivers of colorectal cancer patients: a quasi-experimental study. Support Care Cancer 2022; 30:4389-4397. [DOI: 10.1007/s00520-022-06862-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/24/2022] [Indexed: 12/22/2022]
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31
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Firmawati E, Setyopanoto I, Pangastuti HS. Mobile Health Application to Support Family Caregivers in Recurrent Stroke Prevention: Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2021.7859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND OF THE STUDY: Caregivers play a vital role in continuum care for stroke patients. Involvement of caregivers in stroke care was important. With the advancement of information technology and the rapid growth worldwide in cell-phone use and internet connectivity, additional evidence may be needed in the use of mobile applications to support caregivers in stroke care.
AIM OF THE STUDY: The aims of this review was to identify existing mobile application designed to support family caregivers of people with stroke disease.
METHODOLOGY: A scoping review study framework was carried out in this study, using the EBSCO, Cochrane, PubMed, ProQuest, and Science Direct databases using search keywords: ‘family caregiver’, ‘mobile health application’, and ‘recurrent stroke or secondary stroke prevention’. This review examined studies published between January 2011 and December 2020. Of a total of 728 papers found, 9 journals were selected. RESULTS: The results founded three categories and their attendant sub-categories. The categories was caregivers support, involvement caregivers in stroke care, and barriers. The majority of mobile application was used to provide video education for caregivers. Caregivers involved in stroke care including emotional care, nutrition, exercise, and recurrent stroke prevention. Poor connection was the most barrier in using mobile application.
CONCLUSION: Mobile application can support caregivers in stroke care. Healthcare providers are expected to utilize mobile applications in helping caregivers in post-stroke care.
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Boyt N, Ho AK, Morris-Bankole H, Sin J. Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis. Digit Health 2022; 8:20552076221129069. [PMID: 36276187 PMCID: PMC9585576 DOI: 10.1177/20552076221129069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients. Methods We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions' features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness. Results Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g = 1.17 [95% CI; 0.1 to 2.24], p = 0.03) and reducing anxiety (g = -1.29 [95% CI; -1.56 to -1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers' quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes' follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies' evidence quality as 'very-low'. Conclusions This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.
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Affiliation(s)
- Neil Boyt
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Aileen K Ho
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Hannah Morris-Bankole
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Jacqueline Sin
- School of Health Sciences, University of London, Myddelton Street Building, Myddelton Street, London, EC1R 1UW, England
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Six SG, Byrne KA, Tibbett TP, Pericot-Valverde I. Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis. JMIR Ment Health 2021; 8:e32199. [PMID: 34847058 PMCID: PMC8669581 DOI: 10.2196/32199] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Previous research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification. OBJECTIVE The aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements. METHODS A meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis. RESULTS A random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=-0.27, 95% CI -0.36 to -0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (β=-0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (β=-1.93, SE=2.28; P=.40). CONCLUSIONS The results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms.
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Affiliation(s)
- Stephanie G Six
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Kaileigh A Byrne
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Thomas P Tibbett
- SAP National Security Services, Inc, Newtown Square, PA, United States
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Gordon JS, Sbarra D, Armin J, Pace TWW, Gniady C, Barraza Y. Use of a Guided Imagery Mobile App (See Me Serene) to Reduce COVID-19-Related Stress: Pilot Feasibility Study. JMIR Form Res 2021; 5:e32353. [PMID: 34546941 PMCID: PMC8491644 DOI: 10.2196/32353] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 12/13/2022] Open
Abstract
Background The SARS-CoV-2 pandemic has led to concerns about mental health resulting from regional and national lockdowns, social isolation, job loss, and concern about disease exposure. Objective We describe results of the pilot feasibility study of the See Me Serene mHealth app. The app provides users with immersive, vivid, nature experiences to reduce stress and anxiety related to COVID-19 and other isolation. The goals of the study were to develop the See Me Serene app and test the feasibility and acceptability of study procedures, and explore the potential impact of the app on stress and anxiety. Methods We developed and tested the See Me Serene app and our study procedures for feasibility, and gathered preliminary data with a goal of 100 participants. The research was conducted in 2 phases: (1) development and internal testing of the app; and (2) feasibility and pilot testing with participants recruited online through earned media (eg, news stories), presentations at a university campus, and social media (eg, online sharing of earned media and presentations). The feasibility study employed a mixed methods, within-subjects, pre-/posttest design. At baseline and 30-day follow-up, we assessed stress-related variables via validated self-report measures and saliva samples for determination of cortisol concentrations. Results We met or surpassed all our feasibility benchmarks for recruitment (101 participants recruited), retention (91% [90/99] of 30-day assessment completed), and data collection (99 participants completed all baseline data; 85% [84/99] of salivary cortisol samples returned). Participants adhered to the intervention. On average, participants listened to 48.2 audio files over 30 days or approximately 1.6 audio files per day. Participants were satisfied with the app, with 87% (78/90) rating the app as helpful in dealing with stress and anxiety. The app showed the potential to reduce stress, anxiety, loneliness, and worry. We did not find significant differences (P=.41) in cortisol levels over time. Our findings suggest that future research is warranted to test the efficacy of the See Me Serene app with a representative, diverse sample. Conclusions There is a need for evidence-based and easily disseminable stress-reduction interventions. See Me Serene is a feasible intervention and has the potential to reduce stress related to COVID-19 and other forms of social isolation. More research on See Me Serene is warranted.
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Affiliation(s)
- Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - David Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Department of Family and Community of Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Thaddeus W W Pace
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Chris Gniady
- Department of Computer Science, University of Arizona, Tucson, AZ, United States
| | - Yessenya Barraza
- College of Nursing, University of Arizona, Tucson, AZ, United States
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Jukic T, Ihan A, Strojnik V, Stubljar D, Starc A. The effect of active occupational stress management on psychosocial and physiological wellbeing: a pilot study. BMC Med Inform Decis Mak 2020; 20:321. [PMID: 33272279 PMCID: PMC7712526 DOI: 10.1186/s12911-020-01347-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 11/23/2020] [Indexed: 01/07/2023] Open
Abstract
Background The aim of the study was to address the working population with an occupational stress prevention program using mHealth solution and encourage them for healthy lifestyle choices.
Methods Seventeen participants were randomized from the corporate setting. A 24alife app with a good compliance program was selected. Test battery has been designed to test the physical readiness, psychological evaluation and biological blood markers for stress. Participants were followed up after 30, 60 and 90 days, respectively, within the intervention period. Weight of participants was tracked three times per month. Univariate analysis compared the continuous variables by One-Way Repeated-Measures ANOVA test when the data were normally distributed, or Wilcoxon rank sum test for abnormal distribution of variables.
Results Participants used the app with a compliance rate of 94.1%. The psychological evaluation revealed higher motivation for work, lower burnout scores and participants gave subjective responses of better general wellbeing. Some of the participants lost up to four kg of body mass. Physical readiness has also improved. Conclusions Results of mHealth projects on corporate could include primary health care institutions and health ministry to extend the existing system to patients’ pockets where they can monitor their disease and increase the ability of self-care.
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Affiliation(s)
- Tomislav Jukic
- Department of Internal medicine, Family medicine and History of Medicine, Faculty of Medicine Josip Juraj Strossmayer, Osijek, Croatia
| | - Alojz Ihan
- Institute of Microbiology and Immunology, Medical Faculty of Ljubljana, Ljubljana, Slovenia
| | - Vojko Strojnik
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - David Stubljar
- Department of Research & Development, In-Medico, Mestni trg 11, 8330, Metlika, Slovenia.
| | - Andrej Starc
- Chair of Public Health, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
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