Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

Fuller-tyszkiewicz, Matthew, Richardson, Ben, Little, Keriann, Teague, Samantha, Hartley-Clark, Linda, Capic, Tanja, Khor, Sarah, Cummins, Robert A., Olsson, Craig A., and Hutchinson, Delyse (2020) Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial. JMIR Mental Health, 7 (7). e17541.

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Background: Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being.

Objective: This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability.

Methods: In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed.

Results: In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58).

Conclusions: This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design.

Item ID: 73657
Item Type: Article (Research - C1)
ISSN: 2368-7959
Copyright Information: © Matthew Fuller-Tyszkiewicz, Ben Richardson, Keriann Little, Samantha Teague, Linda Hartley-Clark, Tanja Capic, Sarah Khor, Robert A Cummins, Craig A Olsson, Delyse Hutchinson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC Fellowship, APP1175086
Date Deposited: 21 Jun 2022 02:13
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520302 Clinical psychology @ 100%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200208 Telehealth @ 100%
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