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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.

作者信息

Woodworth Emily C, Briskin Ellie A, Plys Evan, Macklin Eric, Tatar Raquel G, Huberty Jennifer, Vranceanu Ana-Maria

机构信息

Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Boston, MA, United States.

Harvard Medical School, Boston, MA, United States.

出版信息

JMIR Res Protoc. 2023 Oct 13;12:e50108. doi: 10.2196/50108.


DOI:10.2196/50108
PMID:37831492
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10612010/
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.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9725/10612010/307538809986/resprot_v12i1e50108_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9725/10612010/65d31ba6aa7b/resprot_v12i1e50108_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9725/10612010/307538809986/resprot_v12i1e50108_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9725/10612010/65d31ba6aa7b/resprot_v12i1e50108_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9725/10612010/307538809986/resprot_v12i1e50108_fig2.jpg

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引用本文的文献

[1]
Podcasts in Mental, Physical, or Combined Health Interventions for Adults: Scoping Review.

J Med Internet Res. 2025-5-7

[2]
Family Caregiver Perspectives on Digital Methods to Measure Stress: Qualitative Descriptive Study.

J Med Internet Res. 2025-4-24

[3]
Pilot Randomized Controlled Trial of the Feasibility of a Mobile App-Delivered Mindfulness-Based Intervention for Caregiver Stress.

Gerontologist. 2025-5-10

[4]
A Mindfulness-Based Lifestyle Intervention for Dementia Risk Reduction: Protocol for the My Healthy Brain Feasibility Randomized Controlled Trial.

JMIR Res Protoc. 2024-11-21

[5]
Exploring the social and cultural aspects of Chinese family caregivers' experience as they support loved ones with dementia transitioning into nursing homes: a qualitative study protocol.

BMJ Open. 2024-8-12

本文引用的文献

[1]
Feasibility, Acceptability, and Preliminary Efficacy of an App-Based Meditation Intervention to Decrease Firefighter Psychological Distress and Burnout: A One-Group Pilot Study.

JMIR Form Res. 2022-6-8

[2]
Are Your Participants Real? Dealing with Fraud in Recruiting Older Adults Online.

West J Nurs Res. 2023-1

[3]
A Mobile App for Stress Management in Middle-Aged Men and Women (Calm): Feasibility Randomized Controlled Trial.

JMIR Form Res. 2022-5-24

[4]
The Benefits of Using the Healthy Minds Application in Medical Students.

Acad Med. 2021-11-1

[5]
The plasticity of well-being: A training-based framework for the cultivation of human flourishing.

Proc Natl Acad Sci U S A. 2020-12-22

[6]
Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial.

JMIR Ment Health. 2020-11-27

[7]
A Novel Educational Control Group Mobile App for Meditation Interventions: Single-Group Feasibility Trial.

JMIR Form Res. 2020-7-21

[8]
Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial.

JMIR Ment Health. 2020-7-24

[9]
Co-design of an mHealth application for family caregivers of people with dementia to address functional disability care needs.

Inform Health Soc Care. 2021-3-2

[10]
Mentalizing Imagery Therapy Mobile App to Enhance the Mood of Family Dementia Caregivers: Feasibility and Limited Efficacy Testing.

JMIR Aging. 2019-3-21

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