Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA.
School of Medicine, University of Virginia, Charlottesville, VA, USA.
Ann Behav Med. 2024 Oct 16;58(10):658-669. doi: 10.1093/abm/kaae041.
BACKGROUND: Digital health interventions show potential to increase caregivers' access to psychosocial care; however, it is unclear to what extent existing interventions may need to be tailored to meet caregivers' unique needs. PURPOSE: This study aimed to determine whether-and if so, how-an efficacious Internet-delivered insomnia program should be modified for caregivers. The generalizability of these findings beyond the tested program was also examined. METHODS: Higher-intensity family caregivers (N = 100; age M = 52.82 [SD = 13.10], 75% non-Hispanic White, 66% ≥college degree) received access to an Internet-based cognitive-behavioral therapy for insomnia (CBT-I) program. Participants who completed one or more intervention "Cores" provided open-ended feedback on their experience; nonusers (completed no Cores) shared their barriers. RESULTS: Most caregivers who used the program (n = 82, 82%) found it feasible, citing its user-friendly, fully automated online format. Many reported that CBT-I strategies were helpful, although some faced challenges in implementing these strategies due to the unpredictability of their caregiving responsibilities. Opinions were divided on the utility of tailoring the program for caregivers. Nonusers (n = 18, 18%) primarily cited concerns about time burden and lifestyle compatibility as usage barriers. CONCLUSIONS: Delivering fully automated behavioral interventions through the Internet appears suitable for many caregivers. Extensive tailoring may not be required for most caregivers to benefit from an existing online CBT-I program, although additional guidance on integrating CBT-I strategies in the context of challenging sleep schedules and environments may help a subset of caregivers. Future research should explore how such tailoring may enhance digital health intervention uptake and effectiveness for caregivers.
背景:数字健康干预措施显示出增加护理人员获得心理社会保健的潜力;然而,尚不清楚现有的干预措施在多大程度上需要进行调整,以满足护理人员的独特需求。
目的:本研究旨在确定一种有效的互联网失眠症干预措施是否需要进行调整,以及如果需要,应该如何调整,以适应护理人员的需求。此外,还研究了这些发现除了经过测试的方案之外是否具有普遍适用性。
方法:高强度家庭护理人员(N=100;年龄 M=52.82[SD=13.10],75%为非西班牙裔白人,66%至少拥有大学学历)可以获得基于互联网的认知行为疗法治疗失眠症(CBT-I)方案。完成一个或多个干预“核心”的参与者提供了对其体验的开放性反馈;未使用者(未完成任何核心)则分享了他们的障碍。
结果:大多数使用该方案的护理人员(n=82,82%)认为该方案可行,因为其用户友好且完全自动化的在线格式。许多人报告说 CBT-I 策略很有帮助,尽管由于他们的护理责任不可预测,有些人在实施这些策略时面临挑战。对于为护理人员调整方案的实用性,意见存在分歧。未使用者(n=18,18%)主要表示担心时间负担和生活方式兼容性,这是使用的障碍。
结论:通过互联网提供完全自动化的行为干预措施似乎适合许多护理人员。大多数护理人员可能不需要进行大量调整即可从现有的在线 CBT-I 方案中受益,但在具有挑战性的睡眠时间表和环境背景下整合 CBT-I 策略的额外指导可能会帮助一部分护理人员。未来的研究应探讨如何进行这种调整,以提高护理人员对数字健康干预措施的接受度和效果。
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