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Kokorelias KM, Chiu M, Paul S, Zhu L, Choudhury N, Craven CG, Dubrowski A, Redublo T, Kapralos B, Smith MSD, Shnall A, Sadavoy J, Burhan A. Use of Virtual Reality and Augmented Reality Technologies to Support Resilience and Skill-Building in Caregivers of Persons With Dementia: A Scoping Review. Cureus 2024; 16:e64082. [PMID: 39114214 PMCID: PMC11305335 DOI: 10.7759/cureus.64082] [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: 05/11/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Dementia presents a growing public health challenge with most affected individuals living at home, placing significant responsibility on their caregivers. Various interventions, from traditional support groups and education programs to emerging technologies, and more specifically virtual reality (VR) and augmented reality (AR), aim to enhance caregiver skills. While VR/AR shows promise in educating and fostering empathy among caregivers and healthcare professionals, its overall effectiveness and practicality in older adults and dementia care warrant further exploration. This review aimed to summarize currently available VR and AR interventions tailored for family caregivers of persons living with dementia (PLWD) in home or clinical settings, including their level of effectiveness, and to compile a summary of features that contributed to technology acceptance in family caregivers of PLWD. We conducted a systematic search in OVID PsychInfo, CINAHL, Google Scholar, and ERIC, as well as CADTH's Grey Matters, OpenGrey, National Technical Information Service, OAIster, and Health Quality Ontario, to comprehensively summarize the existing evidence underscoring the role of VR and AR in supporting education, resilience-building, and skills training for family caregivers of PLWD. The search terms were built with the assistance of a research librarian and involved synonyms for VR, AR, and dementia. Two screeners conducted a rigorous screening and data extraction to analyze and summarize findings. Studies were included if they focused on family caregivers engaging in interventions utilizing a three-dimensional VR environment and/or Metaverse for group learning in psychotherapeutic modalities such as psychoeducation, therapy, communication, and skill-building. The primary outcome of the studies was assessing measures of well-being (e.g., quality of life, communication, interaction, personhood) and learning outcomes for caregivers, while the secondary outcomes focused on identifying barriers and facilitators influencing the acceptability of VR/AR among dementia caregivers. Content analysis and descriptive statistics were used to summarize key trends in technology and evidence effectiveness and acceptability. Of the 1,641 articles found, 112 were included, with six articles meeting inclusion for analysis. Studies differed in duration and frequency of data collection, with interventions varying from single events to months-long programs, often employing home-based approaches using VR or online platforms. No study used AR. Usability issues and unclear benefits of use were identified as factors that hinder technology acceptance for dementia caregivers. However, technologies demonstrated engaging user experiences, fostering skill-building, confidence, and competence among caregivers. Positive psychological effects were also observed, facilitated by immersive VR and AR interventions, resulting in improved caregiver empathy and reduced stress, depression, and loneliness. VR and AR interventions for family caregivers of PLWD show the potential to enhance empathy and skills and reduce stress. Challenges such as technological limitations and user inexperience issues persist. Home-based VR training aligns with caregiver comfort but lacks focus on financial aspects and cultural competencies. Co-design approaches offer solutions by addressing user concerns and promoting end-user engagement or empowerment.
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Affiliation(s)
- Kristina M Kokorelias
- Section of Geriatrics, Sinai Health and University Health Network, Toronto, CAN
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Mary Chiu
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
- Faculty of Health Sciences, Ontario Tech University, Oshawa, CAN
| | - Sayani Paul
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
| | - Lynn Zhu
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
| | - Nusrat Choudhury
- Medical Devices, National Research Council Canada, Boucherville, CAN
| | - Cole G Craven
- Computer Science, Ontario Tech University, Oshawa, CAN
| | - Adam Dubrowski
- Faculty of Health Sciences, Ontario Tech University, Oshawa, CAN
- maxSIMhealth Group, Ontario Tech University, Oshawa, CAN
| | - Tyler Redublo
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Bill Kapralos
- Software Informatics Research Centre, Ontario Tech University, Oshawa, CAN
- maxSIMhealth Group, Ontario Tech University, Oshawa, CAN
| | | | - Adriana Shnall
- The Koschitzky Centre for Innovations in Caregiving, Baycrest Centre, Toronto, CAN
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, CAN
| | - Joel Sadavoy
- Department of Geriatric Psychiatry, Mount Sinai Hospital, Toronto, CAN
- Department of Psychiatry, Temerty Faculty of Medicine, Unviersity of Toronto, Toronto, CAN
| | - Amer Burhan
- Applied Mental Health, Ontario Shores Centre for Mental Health Sciences, Toronto, CAN
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
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Islam M, Valiani AA, Datta R, Chowdhury M, Turin TC. Ethical and Equitable Digital Health Research: Ensuring Self-Determination in Data Governance for Racialized Communities. Camb Q Healthc Ethics 2024:1-11. [PMID: 38567458 DOI: 10.1017/s096318012400015x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Recent studies highlight the need for ethical and equitable digital health research that protects the rights and interests of racialized communities. We argue for practices in digital health that promote data self-determination for these communities, especially in data collection and management. We suggest that researchers partner with racialized communities to curate data that reflects their wellness understandings and health priorities, and respects their consent over data use for policy and other outcomes. These data governance approach honors and builds on Indigenous Data Sovereignty (IDS) decolonial scholarship by Indigenous and non-indigenous researchers and its adaptations to health research involving racialized communities from former European colonies in the global South. We discuss strategies to practice equity, diversity, inclusion, accessibility and decolonization (EDIAD) principles in digital health. We draw upon and adapt the concept of Precision Health Equity (PHE) to emphasize models of data sharing that are co-defined by racialized communities and researchers, and stress their shared governance and stewardship of data that is generated from digital health research. This paper contributes to an emerging research on equity issues in digital health and reducing health, institutional, and technological disparities. It also promotes the self-determination of racialized peoples through ethical data management.
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Affiliation(s)
- Mozharul Islam
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Sociology, Istanbul Sabahattin Zaim University, İstanbul, Türkiye
| | - Arafaat A Valiani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of History, Department of Indigenous, Race and Ethnic Studies, Global Health Program, University of Oregon, Eugene, OR, USA
| | - Ranjan Datta
- Canada Research Chair in Community Disaster Research at the Indigenous Studies, Department of Humanities, Mount Royal University, Calgary, Canada
| | - Mohammad Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Allemann H, Andréasson F, Hanson E, Magnusson L, Jaarsma T, Thylén I, Strömberg A. The co-design of an online support programme with and for informal carers of people with heart failure: A methodological paper. J Clin Nurs 2023; 32:7589-7604. [PMID: 37605222 DOI: 10.1111/jocn.16856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Abstract
AIM To describe the co-designing process of an online support programme with and for informal carers of people with heart failure. DESIGN A co-design process built on core concepts and ideas embedded in co-design methodology. DATA SOURCES Our co-design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. OUTCOMES The co-design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. CONCLUSION Co-design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. RELEVANCE TO CLINICAL PRACTICE Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person-centred care and provides a valuable learning opportunity for those involved. Furthermore, a co-designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self-care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. REPORTING METHODS Consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION Both informal carers and content creators were involved in developing the support programme.
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Affiliation(s)
- Hanna Allemann
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Elizabeth Hanson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Regional Association of Kalmar County, Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Lennart Magnusson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Regional Association of Kalmar County, Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ingela Thylén
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
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Messiha K, Chinapaw MJM, Ket HCFF, An Q, Anand-Kumar V, Longworth GR, Chastin S, Altenburg TM. Systematic Review of Contemporary Theories Used for Co-creation, Co-design and Co-production in Public Health. J Public Health (Oxf) 2023; 45:723-737. [PMID: 37147918 PMCID: PMC10470345 DOI: 10.1093/pubmed/fdad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/25/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND There is a need to systematically identify and summarize the contemporary theories and theoretical frameworks used for co-creation, co-design and co-production in public health research. METHODS The reporting of this systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Given substantial interest in and application of co-creation, co-design and co-production, we searched PubMed, CINAHL, Scopus and APA PsycINFO from 2012 to March-April 2022. A quality assessment and data extraction for theory content was performed. RESULTS Of the 3763 unique references identified through the comprehensive search strategy, 10 articles were included in the review: four articles named co-creation, two articles named co-creation and co-design, two articles named co-production and co-design, and two articles named co-design. Empowerment Theory was employed by two articles, whereas other theories (n = 5) or frameworks (n = 3) were employed by one article each. For the quality assessment, eight articles received a strong rating and two articles received a moderate rating. CONCLUSION There is little indication of theory applications for the approaches of co-creation, co-design and co-production in public health since 2012, given 10 articles were included in this review. Yet, the theories described in these 10 articles can be useful for developing such co-approaches in future public health research.
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Affiliation(s)
- Katrina Messiha
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans C F F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Vinayak Anand-Kumar
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Giuliana R Longworth
- Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Science, Ghent University, Ghent, Belgium
| | - Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Liverpool S, Eisenstadt M, Mulligan Smith A, Kozhevnikova S. An App to Support Fathers' Mental Health and Well-Being: User-Centered Development Study. JMIR Form Res 2023; 7:e47968. [PMID: 37578834 PMCID: PMC10463090 DOI: 10.2196/47968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/30/2023] [Accepted: 06/22/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Numerous studies describe the popularity and usefulness of parenting programs. In particular, parenting programs are generally viewed as effective for supporting parents' mental well-being during key transition periods. However, the evidence base for fathers is limited owing to their lack of involvement in parenting programs and scarcity of tailored support. OBJECTIVE This paper aimed to describe the co-design process for a universal digital intervention for fathers (fatherli) and the outline of a logic model with its expected outcomes. METHODS Following established guidelines for co-designing and developing complex interventions, we conducted a nonsystematic review of the available literature to gather key information, developed market surveys to assess fathers' needs and interests, consulted with key stakeholders to obtain expert opinions, and engaged in a rapid iterative prototyping process with app developers. Each step was summarized, and the information was collated and integrated to inform a logic model and the features of the resulting intervention. RESULTS The steps in the co-design process confirmed a need for and interest in a digital intervention for fathers. In response to this finding, fatherli was developed, consisting of 5 key features: a discussion forum for anyone to post information about various topics (the forum), a socializing platform for fathers to create and engage with others in small groups about topics or points of shared interest (dad hub), a tool for fathers to find other fathers with shared interests or within the same geographic location (dad finder), a resource for fathers to access up-to-date information about topics that interest them (dad wiki), and a portal to book sessions with coaches who specialize in different topics (dad coaching space). The evidence-based logic model proposes that if fatherli is successfully implemented, important outcomes such as increased parental efficacy and mental health help-seeking behaviors may be observed. CONCLUSIONS We documented the co-design and development process of fatherli, which confirmed that it is possible to use input from end users and experts, integrated with theory and research evidence, to create suitable digital well-being interventions for fathers. In general, the key findings suggest that an app that facilitates connection, communication, and psychoeducation may appeal to fathers. Further studies will now focus on acceptability, feasibility, and effectiveness. Feedback gathered during pilot-testing will inform any further developments in the app to increase its applicability to fathers and its usability.
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Affiliation(s)
- Shaun Liverpool
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Mia Eisenstadt
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, United Kingdom
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
| | - Aoife Mulligan Smith
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Sofia Kozhevnikova
- fatherli Ltd, 103c Camley St, Kings Cross, N1C 4PF, London, United Kingdom
- School of Biosciences, University of Nottingham, Nottingham, United Kingdom
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Jaworski BK, Webb Hooper M, Aklin WM, Jean-Francois B, Elwood WN, Belis D, Riley WT, Hunter CM. Advancing digital health Equity: Directions for behavioral and social science research. Transl Behav Med 2022; 13:132-139. [PMID: 36318232 DOI: 10.1093/tbm/ibac088] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
The field of digital health is evolving rapidly and encompasses a wide range of complex and changing technologies used to support individual and population health. The COVID-19 pandemic has augmented digital health expansion and significantly changed how digital health technologies are used. To ensure that these technologies do not create or exacerbate existing health disparities, a multi-pronged and comprehensive research approach is needed. In this commentary, we outline five recommendations for behavioral and social science researchers that are critical to promoting digital health equity. These recommendations include: (i) centering equity in research teams and theoretical approaches, (ii) focusing on issues of digital health literacy and engagement, (iii) using methods that elevate perspectives and needs of underserved populations, (iv) ensuring ethical approaches for collecting and using digital health data, and (v) developing strategies for integrating digital health tools within and across systems and settings. Taken together, these recommendations can help advance the science of digital health equity and justice.
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Affiliation(s)
- Beth K Jaworski
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health , Bethesda, MD , USA
| | - Will M Aklin
- National Institute on Drug Abuse, National Institutes of Health , Bethesda, MD , USA
| | - Beda Jean-Francois
- National Center for Complementary and Integrative Health, National Institutes of Health , Bethesda, MD , USA
| | - William N Elwood
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Deshirée Belis
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - William T Riley
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
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An international qualitative feasibility study to explore the process of using social innovation (co-production) strategies with older people: the SAIL project. QUALITY IN AGEING AND OLDER ADULTS 2022. [DOI: 10.1108/qaoa-02-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to present the feasibility study findings from a four-year project funded by the European Union Commission (the SAIL project, Staying Active and Independent for Longer). The funding stream was Interreg 2Seas which offers opportunities for coastal areas on both sides of the English Channel to work together on complex practical issues. The project focused on enabling older people to stay active and independent for longer using social innovation (co-production) approaches.
Design/methodology/approach
Ten pilot projects were developed, and each of the pilots worked with an academic partner to undertake a feasibility study that included 10 pilots across the four countries involved, France, Belgium, Holland and England.
Findings
This paper presents barriers and facilitators (using logic models) to the social innovation process with older people, which has wider relevance in terms of social innovation and its application.
Research limitations/implications
The findings which inform this paper are extensive, and this is a longitudinal qualitative study with much of the data collection being done using an online wiki (complemented by interviews and documentary analysis) which is a relatively new method for data collection. However, the consistency of the findings when analysed by three researchers was clear and pragmatically this complex method was required to examine complexity in the process of implementing social innovation in practice.
Practical implications
This project has enabled greater understanding of how social innovation can be applied and has highlighted contextual issues that can undermine or enable attempts to adopt the approach.
Social implications
For the 10 pilot projects generated, there were obviously important cultural and geographical differences in terms of engagement and practical implementation of social innovation. Some of which, as mentioned in this paper, are very important for the successful implementation of social innovation in a particular setting and indeed may be a strength or a barrier in terms of engaging with local people and agencies.
Originality/value
The development of logic models is a useful approach when the topic under study is complex and likely to produce a diverse set of process outcomes. The logic model focuses upon the relationships between the resources that are used to create the intervention and what is produced in terms of outcomes. Ultimately, this enables the identification of the factors that contribute to a successful intervention. Thus, in relation to this study, logic models have helped to provide an evidence-based framework that can support decision-making regarding the most effective use of limited resources to support successful social innovation processes in the future. The logic model for each area of the findings presented here can in the future be used to help implement social innovation; also, to consider how it can be improved in future research.
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Malloy JA, Partridge SR, Kemper JA, Braakhuis A, Roy R. Co-Design of Digital Health Interventions for Young Adults: A Scoping Review Protocol (Preprint). JMIR Res Protoc 2022; 11:e38635. [DOI: 10.2196/38635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
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Jaworski BK, Taylor K, Ramsey KM, Heinz AJ, Steinmetz S, Owen JE, Tsai J, Pietrzak RH. Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel. JMIR Ment Health 2022; 9:e36217. [PMID: 35245204 PMCID: PMC8985691 DOI: 10.2196/36217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. OBJECTIVE The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. RESULTS We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. CONCLUSIONS The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.
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Affiliation(s)
- Beth K Jaworski
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Katherine Taylor
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Kelly M Ramsey
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Adrienne J Heinz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Sarah Steinmetz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jason E Owen
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jack Tsai
- National Center on Homelessness Among Veterans, US Department of Veterans Affairs, Tampa, FL, United States.,School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, San Antonio, TX, United States
| | - Robert H Pietrzak
- National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, US Department of Veterans Affairs, New Haven, CT, United States.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
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Goodridge D, Reis N, Neiser J, Haubrich T, Westberg B, Erickson-Lumb L, Storozinski J, Gonzales C, Michael J, Cammer A, Osgood N. An App-Based Mindfulness-Based Self-compassion Program to Support Caregivers of People With Dementia: Participatory Feasibility Study. JMIR Aging 2021; 4:e28652. [PMID: 34842530 PMCID: PMC8665388 DOI: 10.2196/28652] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/13/2021] [Accepted: 07/31/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The number of persons with dementia is steadily growing, as is the number of individuals supporting persons with dementia. Primary caregivers of persons with dementia are most often family members or spouses of the persons with dementia, and they are more likely to experience increased stress and other negative effects than individuals who are not primary caregivers. Although in-person support groups have been shown to help buffer the negative impacts of caregiving, some caregivers live in isolated or rural communities and are unable to make the burdensome commitment of traveling to cities. Using an interdisciplinary approach, we developed a mobile smartphone support app designed for primary caregivers of persons with dementia, with the goal of reducing caregiver burden and easing stress. The app features a 12-week intervention, largely rooted in mindfulness-based self-compassion (MBSC), because MBSC has been linked to minimizing stress, depression, and anxiety. OBJECTIVE The primary objectives of our program are twofold: to explore the feasibility of a 12-week mobile support program and to conduct an initial efficacy evaluation of changes in perceived caregiver burden, coping styles, and emotional well-being of caregivers before and after the program. METHODS Our feasibility study used a 2-phase participatory pretest and posttest design, focusing on acceptability, demand, practicality, implementation, and efficacy. At phase I, we recruited 57 primary caregivers of persons with dementia (mean age 76.3, SD 12.9 years), comprising spouses (21/57, 37%), children (21/57, 37%), and friends or relatives (15/57, 26%) of persons with dementia, of whom 29 (51%) completed all measures at both pre- and postprogram. The content of the program featured a series of MBSC podcasts. Our primary outcome measure was caregiver burden, with secondary outcome measures including coping styles and emotional well-being. Daily ecological momentary assessments enabled us to ask participants, "How are you feeling today?" Phase II of our study involved semistructured follow-up interviews with most participants (n=21) who completed phase I. RESULTS Our findings suggest that our app or program meets the feasibility criteria examined. Notably, participants generally accepted the program and believed it could be a useful resource. Emotional well-being increased significantly (P=.04), and emotion-based coping significantly decreased (P=.01). Participants generally considered the app or program to be a helpful resource. CONCLUSIONS Although there were no significant changes in caregiver burden, we were encouraged by the increased emotional well-being of our participants following the completion of our program. We also conclude that our app or program demonstrated feasibility (ie, acceptability, practicality, implementation, and efficacy) and can provide a much-needed resource for primary caregivers of persons with dementia. In the subsequent version of the program, we will respond to participant feedback by incorporating web-based weekly sessions and incorporating an outcome measure of self-compassion.
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Affiliation(s)
- Donna Goodridge
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nathan Reis
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jenna Neiser
- Department of Computer Science, College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Tim Haubrich
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, SK, Canada
| | - Bev Westberg
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, SK, Canada
| | | | | | | | | | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nathaniel Osgood
- Department of Computer Science, Faculty of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
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Abstract
Background: Design workshops offer effective methods in eliciting end-user participation from design inception to completion. Workshops unite stakeholders in the utilization of participatory methods, coalescing in the best possible creative solutions. Objective: This systematic review aimed to identify design approaches whilst providing guidance to health information technology designers/researchers in devising and organizing workshops. Methods: A systematic literature search was conducted in five medical/library databases identifying 568 articles. The initial duplication removal resulted in 562 articles. A criteria-based screening of the title field, abstracts, and pre-full-texts reviews resulted in 72 records for full-text review. The final review resulted in 10 article exclusions. Results: 62 publications were included in the review. These studies focused on consumer facing and clinical health information technologies. The studied technologies involved both clinician and patients and encompassed an array of health conditions. Diverse workshop activities and deliverables were reported. Only seven publications reported workshop evaluation data. Discussion: This systematic review focused on workshops as a design and research activity in the health informatics domain. Our review revealed three themes: (1) There are a variety of ways of conducting design workshops; (2) Workshops are effective design and research approaches; (3) Various levels of workshop details were reported.
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